Science.gov

Sample records for temporomandibular joint disease

  1. 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 ...

  2. [Dissertations 25 years after date 28. Degenerative diseases of the temporomandibular joint].

    PubMed

    de Bont, L G M

    2011-09-01

    In 1985, the dissertation 'Temporomandibular joint. Articular cartilage structure and function' was published. Much was known at the time concerning the (clinical) pathogenesis of osteoarthrosis of the temporomandibuIar joint, the associated radiographical characteristics and the results of non-surgical treatment. Little was known, however, concerning the processes that lead to the loss of bone tissue and other degenerative changes. The current idea that osteoarthrosis was histopathologically characterized by defects in the joint surfaces did not seem to apply to temporomandibular joints. In temporomandibular joints, the phenomenon was recognized of degenerative changes in the deeper layers of the articular cartilage and the subchondral bone, while the articular surface could be microscopically intact. A dislocated articular disc was seen as part of the disease osteoarthrosis. Clear insight into the origins of osteoarthrosis was not achieved. PMID:21957640

  3. A review of temporomandibular joint disease (TMJD). Part II: Clinical and radiological semiology. Morbidity processes.

    PubMed

    Poveda Roda, Rafael; Díaz Fernández, José María; Hernández Bazán, Sergio; Jiménez Soriano, Yolanda; Margaix, María; Sarrión, Gracia

    2008-02-01

    The clinical signs and symptoms of greatest semiologic value in temporomandibular joint disease (TMJD) are muscle pain, joint pain, limitations in mandibular movement, and joint sounds. Imaging studies of the joint are very useful for establishing the diagnosis and for discarding other disease processes, though in many cases diagnostic error results from the detection of a large proportion of patients with alterations in the imaging studies but with no associated clinical manifestations. Panoramic X-rays and magnetic resonance imaging are the most commonly used complementary techniques for diagnosing TMJD. MRI may be regarded as the imaging technique of choice, particularly when studying the soft tissues. Biochemical evaluation of the joint synovial fluid has improved our understanding of TMJD pathogenesis, though to date such parameters have not been extended to clinical practice. Myofascial pain with positive painful palpation of the masticatory muscles; joint disc displacements with reduction characterized by the presence of opening or opening and closing clicks; disc displacements without reduction characterized by limitations in oral aperture; and osteoarthritis / osteoarthrosis characterized by the auscultation of friction sounds during mandibular movement, are the morbidity processes most often seen in the context of TMJD. The present study offers a review of the semiology and morbidity processes of the temporomandibular joint. PMID:18223525

  4. Temporomandibular joint dislocation

    PubMed Central

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

    2015-01-01

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

  5. [Biomechanics of temporomandibular joint].

    PubMed

    Kang, H; Yi, X

    2000-09-01

    Temporomandibular joint (TMJ) is one of the most intricate and complicate loading joints in the human body. Articular cartilage is characteristic of low infiltrative, porous viscoelastic material. In physiological condition, there is a stress-absorbing architecture system in the TMJ cartilage, which consists of collagen-proteoglycan-water gel network. TMJ disc is a specific connective tissue as stress concentration absorber between condyle and articular fossa, but it does not belong to fibrocartilage. Retrodiscal tissue has high compliance of which the role is to play volume-compensating mechanism in joint movement. Lateral wall is a complexed structure out of ligament and capsule with weak tensile strength and tensile rigidity. Therefore, prolonged oral parafunction will result in joint fatigue and failure. PMID:11285848

  6. Rheumatoid arthritis affecting temporomandibular joint

    PubMed Central

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

    2015-01-01

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

  7. [Relation between temporomandibular joint disorder and subjective symptoms of fatigue].

    PubMed

    Oda, M; Sawamura, Y; Yatagai, T; Kojima, T; Moriue, Y; Miyagi, M; Hayashi, K; Ishii, M

    1999-10-01

    An investigation was performed for the purpose of guaging the relation between temporomandibular joint disorder on the one hand and occupational category and subjective symptoms of fatigue on the other. Subjects were 2,414 workers (1,598 male, 816 female) in small and medium size enterprises at 67 workplaces in Hiroshima Prefecture. A comparison of cases with and without temporomandibular joint disorder showed that there were more complaints of fatigue among those with the disorder. Given these indications that temporomandibular joint disorder was related to occupation, it is possible that temporomandibular joint disease may be a work-related disease. PMID:10565184

  8. Engineering Alloplastic Temporomandibular Joint Replacements

    PubMed Central

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

    2011-01-01

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

  9. Temporomandibular joint diagnostics using CBCT

    PubMed Central

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

    2015-01-01

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

  10. Temporomandibular joint multidisciplinary team clinic.

    PubMed

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

    2014-11-01

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

  11. Temporomandibular Joint, Closed

    MedlinePLUS

    ... Search Text size: Website Contents NIDCR Home Oral Health Diseases and Conditions Gum Disease TMJ Disorders Oral Cancer Dry Mouth Burning Mouth Tooth Decay See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease ...

  12. Temporomandibular Joint, Open

    MedlinePLUS

    ... Search Text size: Website Contents NIDCR Home Oral Health Diseases and Conditions Gum Disease TMJ Disorders Oral Cancer Dry Mouth Burning Mouth Tooth Decay See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease ...

  13. Temporomandibular Joint Disorders and Orofacial Pain.

    PubMed

    Ahmad, Mansur; Schiffman, Eric L

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  15. Temporomandibular joint involvement in ankylosing spondylitis

    PubMed Central

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

    2013-01-01

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

  16. The Temporomandibular Joint Pain Dysfunction Syndrome

    PubMed Central

    Speck, John E.

    1988-01-01

    When a patient complains of headache, neckache, or earache and these are associated with noisy temporomandibular joint function, restricted opening or increased pain when chewing, a temporomandibular joint or masticatory muscle disorder should be considered in the differential diagnosis, because signs and symptoms of these disorders are common in all age groups. This article indicates the more common etiological contributions, that is, microtrauma, repeated microtrauma, muscle hyperactivity, and arthritis, which may contribute singly or in combination to produce the so-called temporomandibular joint pain dysfunction syndrome, and how treatment can often be improved by a team approach. ImagesFigure 1 PMID:21253196

  17. Clinical view of the temporomandibular joint disorder.

    PubMed

    Badel, Tomislav; ?imi?, Samir; Muniti?, Mirna; Zadravec, Dijana; Kes, Vanja Baši?; Šimunkovi?, Sonja Kraljevi?

    2014-12-01

    Temporomandibular pain has a musculoskeletal origin because it occurs as a consequence of masticatory muscle function disorder and temporomandibular joint disorder. Most common diagnoses of disorders are disc displacement and osteoarthritis, but their comorbidity can also occur. Pain is the most common symptom, where chronic temporomandibular pain may con- tribute to the occurrence of psychological disorders in the patient population. Splint is the most widespread dental method of treatment but other, noninvasive methods of musculoskeletal pain treatment are also recommended. Electronic axiography is used for visualization of mandibular movements, in particular pathologic sounds in the joints. Mental health, although not so obvious in dental practice, can influence the need of a multidisciplinary approach to the patient with disorder of the temporomandibular joint. PMID:25868315

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

    PubMed Central

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

    2015-01-01

    Objective To determine if temporomandibular joint chondrocyte apoptosis is induced in rats with dental biomechanical stimulation and what a role TNF takes. Methods Thirty-two rats were divided into 4 groups (n = 8/group) and exposed to incisor mal-occlusion induced by unilateral anterior crossbite biomechanical stimulation. Two groups were sampled at 2 or 4 weeks. The other two groups were treated with local injections of a TNF inhibitor or PBS into the temporomandibular joints area at 2 weeks and then sampled at 4 weeks. Twenty-four rats either served as unilateral anterior crossbite mock operation controls (n = 8/group) with sampling at 2 or 4 weeks or received a local injection of the TNF inhibitor at 2 weeks with sampling at 4 weeks. Chondrocytes were isolated from the temporomandibular joints of 6 additional rats and treated with TNF in vitro. Joint samples were assessed using Hematoxylin&eosin, Safranin O, TUNEL and immunohistochemistry staining, real-time PCR, fluorogenic activity assays and Western blot analyses. The isolated chondrocytes were also analyzed by flow cytometry. Results Unilateral anterior crossbite stimulation led to temporomandibular joint cartilage degradation, associated with an increase in TUNEL-positive chondrocytes number, caspase-9 expression levels, and the release of cytochrome c from mitochondria at 2 weeks without changes in TNF and caspase-8 levels until after 4 weeks. TNF stimulated apoptosis of the isolated chondrocytes and up-regulated caspase-8 expression, but did not change caspase-9 expression levels. Local injection of TNF inhibitor down-regulated caspase-8 expression and reduced TUNEL-positive cell number, but did not reverse cartilage thickness reduction, caspase-9 up-regulation or cytochrome c release. Conclusions Unilateral anterior crossbite stimulation induces mitochondrion-mediated apoptosis of articular chondrocytes. TNF accelerated the unilateral anterior crossbite induced chondrocytes apoptosis via death-receptor pathway. However, anti-TNF therapy does not prevent cartilage loss in this model of temporomandibular joint. PMID:26529096

  19. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  20. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  1. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

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

    PubMed

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

    2013-03-01

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

  3. Imaging of the temporomandibular joint: An update

    PubMed Central

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

    2014-01-01

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

  4. [A particular temporomandibular disorder: the temporomandibular joint ankylosis. Basic and clinical concepts].

    PubMed

    Bocquet, Emmanuelle; Mercier, Marie; Moreau, Alexis; Ferri, Joël; Danguy, Michel

    2014-12-01

    Ankylosis of the temporomandibular joint mostly affects children and young adults. Although it is rare, it is an extremely debilitating disease whose effects on growth, morphological development and personal development are significant. To manage this disorder, it is essential to be informed about the causes, about the anatomical shapes it presents and about its symptoms. This knowledge will also help us choose the most appropriate therapy, that may nevertheless result in failures and in relapses requiring prosthetic rehabilitation. PMID:25443409

  5. Gnathological splint therapy in temporomandibular joint disorder

    PubMed Central

    Gnanashanmugham, K.; Saravanan, B.; Sukumar, M. R.; Tajir, T. Faisal

    2015-01-01

    Temporomandibular joint (TMJ) forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD) is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic reasons to systemic disorders. The option of Gnathological splint is a conservative, safe and an effective mode of therapy for TMDs caused by occlusal discrepancies (fulcrum/interferences). This article presents a case report of a patient with TMD caused by occlusal discrepancy PMID:26015741

  6. Gnathological splint therapy in temporomandibular joint disorder.

    PubMed

    Gnanashanmugham, K; Saravanan, B; Sukumar, M R; Tajir, T Faisal

    2015-04-01

    Temporomandibular joint (TMJ) forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD) is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic reasons to systemic disorders. The option of Gnathological splint is a conservative, safe and an effective mode of therapy for TMDs caused by occlusal discrepancies (fulcrum/interferences). This article presents a case report of a patient with TMD caused by occlusal discrepancy. PMID:26015741

  7. Radiation dose in temporomandibular joint zonography

    SciTech Connect

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

    1991-06-01

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

  8. Quantitative Radiological Diagnosis Of The Temporomandibular Joint

    NASA Astrophysics Data System (ADS)

    Jordan, Steven L.; Heffez, Leslie B.

    1989-05-01

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

  9. Dynamic stereometry of the temporomandibular joint.

    PubMed

    Palla, S; Gallo, L M; Gössi, D

    2003-01-01

    Studies on jaw kinematics have provided a good understanding of the motion of the mandible in space, but are of little biomechanical relevance because they could not relate the movements to anatomic structures. This is possible by the combination of three-dimensional reconstructions of the temporomandibular joint (TMJ) anatomy with jaw motion recordings. This technique allows us to analyze the variation of the relationship between the articular surfaces, providing indirect insight into disk deformation during function and parafunction as well as TMJ loading. As far as the variation of the condyle-fossa distance is concerned, data indicated that during chewing the distance was smaller 1) on closing than on opening; 2) on the balancing than on the working side; and 3) during chewing of hard than soft food. Moreover, during a forceful static biting, the condyle-fossa distance decreased more on the contralateral, i.e. on the balancing side than on the working side. The decrease was related to the degree of clenching force. These results support the content that both condyles are loaded during chewing and the balancing side joint more than the working one. Biomechanically, the development of osteoarthrosis is more likely related to the magnitude and frequency of stresses applied on the cartilage. Joint movements produce tractional forces that may cause shear stresses contributing to cartilage wear and fatigue. Tractional forces are the result of frictional forces caused by the cartilage surface rubbing and of plowing forces caused by the translation of a stress-field through the cartilage matrix, as the intra-articular space changes during motion. Translation of the stress-field in mediolateral direction seems to be particularly important for the integrity of the TMJ disk because of its anisotropic properties. Dynamic stereometry showed that stress-fields translate in mediolateral direction during opening/closing, protrusion and laterotrusion, and that their translatory velocity varies intraindividually and with the rate of the condylar movement. Furthermore, the results seem to indicate that the lateral area of the TMJ disk is more often exposed to shear stresses caused by stress-field translation than the medial one. In conclusion, dynamic stereometry provides a good visualization of the movement of the condyles in the respective fossae. This helps improving our understanding for the complexity of condylar movements. The technique may also contribute to ameliorate our knowledge of TMJ biomechanics and therefore of the etiology of degenerative joint diseases and possibly also of internal derangement. PMID:14606533

  10. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total temporomandibular joint prosthesis. 872.3940 Section 872.3940 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  11. Bilateral temporomandibular joint dislocation with locked mandibular impaction.

    PubMed

    Hynes, Sally L; Jansen, Leigh A; Brown, D Ross; Courtemanche, Douglas J; Boyle, James C

    2012-02-01

    Bilateral anterior temporomandibular joint dislocation is very rare, with only 2 reported cases published. In the present report, we describe a healthy 25-year-old man from Haida Gwaii, in British Columbia, Canada, who was transferred to our tertiary trauma center with life-threatening complications of a bilateral anterior temporomandibular joint dislocation with locked mandibular impaction. PMID:22260912

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

    SciTech Connect

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

    1984-01-01

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

  13. Septic Arthritis in the Temporomandibular Joint

    PubMed Central

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

    2015-01-01

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

  14. Videofluoroscopic analysis of temporomandibular joint ankylosis.

    PubMed

    Montalva, Fernando Molina; Sosa, Fernando Flores; Aguilar, Lesvia Olivia; Taylor, Jesse Adam

    2008-05-01

    The causes of temporomandibular joint (TMJ) ankylosis, or hypomobility, are many, and it is important to understand the underlying etiology before treatment. Classically, TMJ ankylosis has been diagnosed by clinical evaluation and static imaging techniques such as plain radiographs, computed tomography, and magnetic resonance imaging. Static imaging demonstrates the size and location of the bones and soft tissues of the TMJ at a given moment; however, it fails to show the dynamic relationship of structures as the condylar head goes through its range of motion. The purpose of this study is to evaluate the use of videofluoroscopy as a dynamic means of assessing TMJ ankylosis. To do so, videofluoroscopy must be able to distinguish between bony fusion, fibrosis of the surrounding soft tissues, degeneration of the joint space, and mechanical causes of joint limitation. Six patients--2 healthy controls and 4 patients with known TMJ ankylosis--were submitted to standardized videofluoroscopic evaluation and thorough physical examination that included measurement of mandibular excursion. Videofluoroscopic data were compared with physical data. Condylar displacement was recorded in all patients, and values ranged from 0% to 100%. Videofluoroscopy allowed for the measurement of the TMJ joint space and for a detailed observation of bony and soft tissue components as they ranged in motion. In all cases, the exact cause limiting mandibular excursion was noted. Videofluoroscopy has become our preferred method of imaging the TMJ because it provides a detailed and dynamic evaluation at a reasonable cost. PMID:18520390

  15. Family Therapy in Complex Temporomandibular Joint Dysfunction

    PubMed Central

    Boll, Pamela G.; Mercuri, Louis G.

    1988-01-01

    The purpose of this paper is to offer the oral and maxillofacial surgeon a collaborative approach to the treatment of complex temporomandibular joint (TMJ) dysfunction. Through a positive relationship with a family therapist, the oral and maxillofacial surgeon in this case reports family therapy intervention as an additive solution to resolving apparent recurrent surgical failures. After three surgical procedures, the oral and maxillofacial surgeon noted continued muscle hyperactivity brought on by family environmental stress and arranged for family therapy treatment before a fourth surgical procedure. This paper presents a complicated TMJ case history, documentation for including the family in treatment of pain problems, collaborative efforts necessary for acceptance of referral for psychological intervention, and a family therapy approach to treatment in complex TMJ dysfunction. PMID:3166348

  16. Disk repositioning surgery of the temporomandibular joint with bioabsorbable anchor.

    PubMed

    Spallaccia, Fabrizio; Rivaroli, Andrea; Basile, Emanuela; Cascone, Piero

    2013-01-01

    The most common temporomandibular joint (TMJ) pathologic disease is anterior-medial displacement of the articular disk, which can lead to TMJ-related symptoms.The indication for disk repositioning surgery is irreversible TMJ damage associated with temporomandibular pain. We describe a surgical technique using a preauricular approach with a high condylectomy to reshape the condylar head. The disk is anchored with a bioabsorbable microanchor (Mitek Microfix QuickAnchor Plus 1.3) to the lateral aspect of the condylar head. The anchor is linked with a 3.0 Ethibond absorbable suture to fix the posterolateral side of the disk above the condyle.The aims of this surgery were to alleviate temporomandibular pain, headaches, and neck pain and to restore good jaw mobility. In the long term, we achieved these objectives through restoration of the physiological position and function of the disk and the lower articular compartment.In our opinion, the bioabsorbable anchor is the best choice for this type of surgery because it ensures the stability of the restored disk position and leaves no artifacts in the long term that might impede follow-up with magnetic resonance imaging. PMID:24036782

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

    PubMed Central

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

    2015-01-01

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

  18. Soft tissue mechanics of the temporomandibular joint.

    PubMed

    Sindelar, Betty J; Herring, Susan W

    2005-01-01

    Direct measurement of temporomandibular joint (TMJ) tissue deformation requires animal experimentation. Most of the available data pertain to the mechanical strain on the bone surfaces around the joint. However, bone is rarely the first joint tissue to show injury, being affected after damage to collagenous tissues such as the disc or capsule. Capsular ligaments guide or limit movement, while the intra-articular disc may also distribute joint loads. However, these tissues are difficult to visualize dynamically and not suitable for strain gage attachment, so in vivo deformations are poorly understood. Using pigs as the best nonprimate model for human TMJ function, we implanted differential variable reluctance transducers to measure antero-posterior strain in the lateral aspect of the intra-articular disc. The results were compared to previously published data on the TMJ capsule. Passive manipulation in anesthetized animals indicated that opening, protrusion, and contralateral movements caused the disc to elongate. On the contrary, closing, retrusion and ipsilateral movements caused disc shortening. These strains are opposite to those observed in the capsule and are expected on anatomical grounds. Surprisingly, disc strain during mastication differed from that during manipulation. The disc elongated during jaw closure, more on the retruding balancing side (16% +/- 1) than on the working side (8% +/- 2). This anomalous behavior may reflect compressive loading, such that the disc elongates as a result of the Poisson effect rather than condylar movement. Because the capsule also elongates during the power stroke, especially on the balancing side, both disc and capsule are maximally loaded on the same side at the same moment. PMID:16088132

  19. Tractional forces on porcine temporomandibular joint discs.

    PubMed

    Nickel, J C; Iwasaki, L R; Beatty, M W; Marx, D B

    2009-08-01

    Tractional forces on the temporomandibular joint (TMJ) disc predispose tissue fatigue. This study tested the hypotheses that tractional forces: (1) increased with stress-field velocity (V) and aspect ratio (AR, contact area diameter/cartilage thickness), and compressive strain (epsilon); and (2) varied depending on cartilage thickness. Porcine TMJ discs (n = 187) received a 10-N vertical static load via an acrylic indenter for 1, 5, 10, 30, or 60 sec, followed by movement. Physical data were recorded and analyzed by quadratic regression relations and a likelihood ratio test. Results showed non-linear increases in tractional forces that were positively correlated with increased V, AR, and epsilon when the stress-field moved onto relatively thicker (R(2) = 0.83) and thinner cartilage (R(2) = 0.86). When V was > 27 mm/sec and AR.epsilon(3), was > 0.09, tractional forces were significantly higher (< or = 12% of peak) when the stress-field moved onto thicker cartilage. Stress-field dynamic mechanics and cartilage thickness significantly affected TMJ disc tractional forces. PMID:19734461

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

    PubMed

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

    2012-01-01

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

  1. Mouse genetic models for temporomandibular joint development and disorders.

    PubMed

    Suzuki, A; Iwata, J

    2016-01-01

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

  2. Radiographic changes in the temporomandibular joint of patients with rheumatoid arthritis, psoriatic, arthritis, and ankylosing spondylitis.

    PubMed

    Wenneberg, B; Könönen, M; Kallenberg, A

    1990-01-01

    Sixty-one subjects with rheumatoid arthritis, 61 with psoriatic arthritis, 61 with ankylosing spondylitis, and 77 healthy controls were examined using orthopantomography to determine the frequency of radiographic changes in the condyle of the temporomandibular joint. Radiographic changes were found significantly more often in subjects with rheumatoid arthritis (66%), psoriatic arthritis (38%), and ankylosing spondylitis (30%) than in controls (12%). Subjects with rheumatoid arthritis also had significantly more radiographic changes, especially cortical erosions and subcortical cysts, than subjects with psoriatic arthritis or ankylosing spondylitis. It may be concluded that rheumatoid arthritis is a more severe disease than psoriatic arthritis or ankylosing arthritis regarding temporomandibular joint involvement. PMID:2098385

  3. Septic Arthritis of the Temporomandibular Joint in an Infant

    PubMed Central

    Chuk, Raymond; Arvier, John; Laing, Barbara; Coman, David

    2015-01-01

    Infantile temporomandibular joint septic arthritis is an uncommon paediatric infection, but one which carries the potential for severe morbidity and mortality. Early diagnosis and aggressive medical and possibly surgical management is indicated for the best outcomes. The presenting clinical features are non-specific in a neonate and an infant; as such a high degree of clinical suspicion is required. We present the case of an eleven-month-old boy who has made a full recovery from an acute temporomandibular joint septic arthritis and review the relevant literature. PMID:26236452

  4. An interesting case of gunshot injury to the temporomandibular joint.

    PubMed

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

    2015-03-01

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

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

    SciTech Connect

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

    1990-12-01

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

  6. MRI in a case of osteosarcoma in the temporomandibular joint.

    PubMed

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

    2014-01-01

    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

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

    PubMed

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

    2003-10-22

    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

  8. Nasal obstruction may alleviate bruxism related temporomandibular joint disorders.

    PubMed

    Bektas, Devrim; Cankaya, Mustafa; Livaoglu, Murat

    2011-02-01

    Temporomandibular disorder (TMD) is a collective term used to identify a group of musculoskeletal conditions of the temporomandibular region. Bruxism is a non-functional activity characterized by repeated tooth clenching or grinding in an unconscious manner. Over the time bruxism may lead to TMD by the uploading it causes. Nasal obstruction is a common complaint that necessitates mouth breathing when severe. The treatment of bruxism is frequently performed by oral appliances, which induce occlusal disengagement and relax jaw musculature and therefore reduce the force on the temporomandibular joint (TMJ). We believe that nasal obstruction may indirectly have a preemptive and therapeutic effect on sleep bruxism related TMD by causing mouth breathing. PMID:21041035

  9. Diagnostic Accuracy on Magnetic Resonance Imaging for the Diagnosis of Osteoarthritis of the Temporomandibular Joint

    PubMed Central

    Harada, Saori; Kobayashi, Kazuhiko

    2015-01-01

    Objectives Osteoarthritis, which is also called degenerative arthritis or degenerative joint disease, is primarily a disease that results from the breakdown and loss of cartilage in joints. The purpose of this study was to investigate the diagnostic accuracy of magnetic resonance images for the diagnosis of osteoarthritis of the temporomandibular joint. Materials and Methods Fifty patients (50 joints) with closed locking of the temporomandibular joint were examined with magnetic resonance imaging and then underwent arthroscopic surgery. The agreement of osteoarthritis between magnetic resonance images and arthroscopic findings was studied using the ? coefficient. Results The incidence of osteoarthritis on magnetic resonance images (38%) was significantly lower than that in arthroscopic findings (78%). There was no significant agreement between these two findings (p=.108). The ? coefficient was 0.154. Conclusion The diagnostic accuracy of magnetic resonance images for osteoarthritis of the temporomandibular joint was low; early osteoarthritis could not be diagnosed from magnetic resonance images. Clinicians should understand that the diagnostic accuracy of osteoarthritis without arthroscopy is not always high. PMID:26393215

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

    PubMed

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

    2007-07-01

    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

  11. A clinical study on temporomandibular joint ankylosis in children.

    PubMed

    Güven, Orhan

    2008-09-01

    Temporomandibular joint (TMJ) ankylosis is a disabling condition of the masticatory system and is most commonly due to trauma, infections, and some systemic diseases. Hypomobility affects the surrounding structures as well as the joint itself. Ankylosis arising in early childhood usually leads to facial asymmetry. Ankylosis in children usually occurs from an intracapsular compression fracture or rarely from a suppurative arthritis of middle ear infection.Treatment of the ankylosis is probably one of the greatest challenges in TMJ surgery, and the treatment of TMJ ankylosis in children is much more challenging than in adults because of high recurrence and the probable change in the unpredictable growth of the mandible. In treatment of TMJ ankylosis in children, to maintain a normal growth and the development of the face is as important as to provide a satisfactory mouth opening with free movement of the mandible.A variety of techniques and various success rates in the treatment of TMJ ankylosis both in adults and in children have been reported. However, no single method has produced uniformly successful results. In this study, gap arthroplasty was applied in 6 patients, and 2 different types of fossa implants were used as interpositional material in the other 8 patients, and the results of the treatments have been evaluated retrospectively. PMID:18812849

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  17. Early magnetic resonance imaging control after temporomandibular joint arthrocentesis

    PubMed Central

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

    2015-01-01

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

  18. Three-dimensional temporomandibular joint modeling and animation.

    PubMed

    Cascone, Piero; Rinaldi, Fabrizio; Pagnoni, Mario; Marianetti, Tito Matteo; Tedaldi, Massimiliano

    2008-11-01

    The three-dimensional (3D) temporomandibular joint (TMJ) model derives from a study of the cranium by 3D virtual reality and mandibular function animation. The starting point of the project is high-fidelity digital acquisition of a human dry skull. The cooperation between the maxillofacial surgeon and the cartoonist enables the reconstruction of the fibroconnective components of the TMJ that are the keystone for comprehension of the anatomic and functional features of the mandible. The skeletal model is customized with the apposition of the temporomandibular ligament, the articular disk, the retrodiskal tissue, and the medial and the lateral ligament of the disk. The simulation of TMJ movement is the result of the integration of up-to-date data on the biomechanical restrictions. The 3D TMJ model is an easy-to-use application that may be run on a personal computer for the study of the TMJ and its biomechanics. PMID:19098544

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

    PubMed Central

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

    2014-01-01

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

  20. Temporomandibular Joint Hypermobility Manifestation Based on Clinical Observations

    PubMed Central

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

    2015-01-01

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

  1. [Postoperative evaluation of surgically treated cases with temporary silicone implant in temporomandibular joint].

    PubMed

    Shigeru, Aoyama; Koji, Kino; Toshihisa, Shibuya; Fumiaki, Sato; Akiko, Kobayashi; Hiroyuki, Yoshitake; Tadasu, Haketa; Yoko, Amamori; Takayuki, Ishikawa; Nahoko, Yoshida; Teruo, Amagasa

    2003-09-01

    We have carried out temporary silicone implants after diskectomies or arthroplasties in temporomandibular joint surgeries to avoid postoperative adhesion and to maintain articular space. We evaluated 19 joints in 15 patients who had received dacron-reinforced silicone implant after silicone sheet removal through follow-up for at least 6 months. The cases included temporomandibular joint disorder (10 joints in 9 patients), psoriatic arthritis (2 joints in 1 patient), ankylosis (4 joints in 3 patients) and synovial chondromatosis (2 joints in 2 patients). On the basis of the criteria of temporomandibular dysfunction for the results, they were classified as bad (4 patients). It is thought that factors other than the implant are related to the bad results in the postoperative evaluation. In this study, lymphadenopathy induced by exfoliated silicone debris could not be confirmed. The temporary silicone implant in the temporomandibular joint was thought to be useful. PMID:14577342

  2. Bilateral Traumatic Temporomandibular Joint Luxation in a Rat

    PubMed Central

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

    2011-01-01

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

  3. Consequences of viscoelastic behavior in the human temporomandibular joint disc.

    PubMed

    Koolstra, J H; van Eijden, T M G J

    2007-12-01

    The consequences of the viscoelastic behavior of the temporomandibular joint disc were analyzed in simulated jaw open-close cycles. It was hypothesized that viscoelasticity helps protect the underlying bone, while augmenting the smoothness of articular movements. Simulations were performed with a dynamic model of the masticatory system, incorporating the joints' cartilaginous structures as Finite Element Models. A non-linear viscoelastic material model was applied for the disc. The apparent stiffness of the disc to principal stress was largest when the jaw was closed, whereas, with the Von Mises' stress, it appeared largest when the jaw was open. The apparent stiffnesses appeared to be dependent on both the speed of the movements and the presence of a resistance between the teeth. It was concluded that the disc becomes stiffer when load concentrations can be expected. During continued cyclic motion, it softens, which favors smoothness of joint movement at the cost of damage prevention. PMID:18037655

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

    PubMed Central

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

    2015-01-01

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

  5. [Radiographic scanning of the temporomandibular joint. Technic and results].

    PubMed

    Bertrand, J L; Rives, J M; Cantaloube, D

    1989-01-01

    The authors report a prospective study involving investigation of the temporo-mandibular joints for algo-dysfunctional syndromes by gaseous arthroscanning. They propose a double articular compartment injection technique using CT scan localization. The CT scan study is performed using fine sagittal sections with the mouth both closed and open, and also Hirtz coronal sections. Early results directly demonstrate menisco-ligamentary structures, the position of the meniscus in the closed position and its displacement on mouth opening, these being of fundamental importance to the practitioner. The authors present normal results and the principal pathological results encountered in the investigation of algodysfunctional syndromes involving this joint (T.M.A.D.S.). CT scan allows more precise localization for joint injection than radioscopy, and while the images obtained are markedly better than those obtained on opaque arthrograms, they offer less dynamic information in view of the lack of radioscopy. PMID:2814320

  6. [Botulinum toxin treatment of neurogenic dislocation of the temporomandibular joint].

    PubMed

    Daelen, B; Koch, A; Thorwirth, V

    1998-05-01

    Botulinum toxin leads to paresis of the skeletal muscle lasting 2-4 months via an inhibition of acetylcholine release at the neuromuscular junction. Since 1995, botulinum toxin injections have been used in the treatment of recurrent dislocation of the temporomandibular joint (TMJ). The chemical denervation of the external pterygoid muscle restricts the angle of mouth opening, thus helping to prevent dislocation. TMJ dislocations that occur as a result of increased tone in the protracted masticatory muscles were recently defined as neurogenic dislocations of the TMJ. We conducted a clinical study to investigate the efficacy of botulinum toxin injections into the external pterygoid muscle in five patients with recurrent neurogenic dislocations of the TMJ. In the 3 months prior to the first treatment, the patients had suffered a total of 19 dislocations. In the 3-month period following the initial treatment, only one woman experienced a dislocation. We performed the treatment a total of 25 times. Five dislocations occurred during the 6- to 36-month observation period. In the meantime, two patients remain recurrence-free 1 year after receiving treatment. All the patients had a restricted ability to open their mouths as a side effect of the weakening of the external pterygoid muscle that was completely reversible over the course of 3-4 months. All other side effects were equally well-tolerated by the patients and fully reversible after 3 weeks at the most. In the two patients who remain recurrence-free without any further treatment, the increased tone of the muscles serving the jaw normalised spontaneously over the course of the underlying neurological disease. Our results show that, in the treatment of recurrent neurogenic dislocations of the TMJ, botulinum toxin injections represent a therapeutic alternative that has few side effects. PMID:9658838

  7. Dynamic shear properties of the temporomandibular joint disc.

    PubMed

    Tanaka, E; Hanaoka, K; van Eijden, T; Tanaka, M; Watanabe, M; Nishi, M; Kawai, N; Murata, H; Hamada, T; Tanne, K

    2003-03-01

    Shear stress might be an important factor associated with fatigue failure and damage of the temporomandibular joint disc. Little information, however, is available on the dynamic behavior of the disc in shear. Since the disc is an anisotropic and viscoelastic structure, in the present study the dependency of the dynamic shear behavior on the direction and frequency of loading was examined. Ten porcine discs were used for dynamic shear tests. Shear stress was applied in both anteroposterior (A-P test) and mediolateral (M-L test) directions. The dynamic moduli increased as the loading frequency increased. The dynamic elasticity was significantly larger in the A-P test than in the M-L test, although the dynamic viscosity was similar in both tests. The present results suggest that non-linearities, compression/shear coupling, and intrinsic viscoelasticity affect the shear material behavior of the disc, which might have important implications for the transmission of load in the temporomandibular joint. PMID:12598554

  8. First Bite Syndrome After Bilateral Temporomandibular Joint Replacement: Case Report.

    PubMed

    Alwanni, Nada; Altay, Mehmet Ali; Baur, Dale A; Quereshy, Faisal A

    2016-03-01

    First bite syndrome (FBS) refers to intense pain in the parotid region, which coincides with the first bite of every meal, gradually subsides over the next several bites, but returns with the first bite of the next meal. The definitive diagnosis can be readily established by the characteristic onset of pain after the first bite of every meal. Pain is typically most intense at the first meal of the day, although some patients experience symptoms when thinking of food or salivating. FBS is a recognized complication of surgery within the parapharyngeal space; however, other surgical procedures involving the upper neck have been associated with this syndrome. The extreme rarity of FBS complicates a thorough understanding of its pathophysiology. Various medical agents have been used, with variable success, for the management of patients with FBS. Although proved effective, more radical treatment modalities are commonly reserved for persistent or refractory cases, because there is potential of spontaneous decrease in the severity of symptoms with time. This report describes the case of a patient presenting with symptoms of FBS after bilateral temporomandibular joint replacement. To the authors' knowledge, this is the first case of FBS in the literature occurring after temporomandibular joint replacement. PMID:26518528

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

    PubMed

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

    2015-01-01

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

  10. Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis.

    PubMed

    Dias, I M; Cordeiro, P C deF; Devito, K L; Tavares, M L F; Leite, I C G; Tesch, R deS

    2016-03-01

    Temporomandibular joint (TMJ) disc displacement is a clinical sign often found in patients with temporomandibular disorders (TMDs) and associated with TMJ osteoarthrosis. Osteoarthrosis is a degenerative joint disease that may be associated with pain and functional disability. The aim of this study was to evaluate the odds ratio (OR) of joints with disc displacement presenting osteoarthrosis via magnetic resonance imaging (MRI) analysis. In total, 224 TMJ images from patients with signs and symptoms of a TMD were evaluated. The OR, a measure of association, was used to calculate the likelihood of TMJ disc displacement (with or without reduction) with osteoarthrosis. Joints with anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) were 2.73- and 8.25-times, respectively, more likely to have osteoarthrosis. A nine-times greater likelihood of osteophyte occurrence was observed in cases of ADDwoR, whereas a lower OR for their occurrence (OR 2.96) was observed in cases of ADDwR. The significant OR of joints with disc displacement presenting osteoarthrosis, particularly in cases of ADDwoR, emphasizes the importance of accurate assessment of changes in disc position, which may be associated with other painful and functional disorders of the TMJ. PMID:26474932

  11. Dietary correlates of temporomandibular joint morphology in the great apes.

    PubMed

    Terhune, Claire E

    2013-02-01

    Behavioral observations of great apes have consistently identified differences in feeding behavior among species, and these differences have been linked to variation in masticatory form. As the point at which the mandible and cranium articulate, the temporomandibular joint (TMJ) is an important component of the masticatory apparatus. Forces are transmitted between the mandible and cranium via the TMJ, and this joint helps govern mandibular range of motion. This study examined the extent to which TMJ form covaries with feeding behavior in the great apes by testing a series of biomechanical hypotheses relating to specific components of joint shape using linear measurements extracted from three-dimensional coordinate data. Results of these analyses found that taxa differ significantly in TMJ shape, particularly in the mandibular fossa. Chimpanzees have relatively more anteroposteriorly elongated joint surfaces, whereas gorillas tend to have relatively anteroposteriorly compressed joints. Orangutans were most commonly intermediate in form between Pan and Gorilla, perhaps reflecting a trade-off between jaw gape and load resistance capabilities. Importantly, much of the observed variation among taxa reflects differences in morphologies that facilitate gape over force production. These data therefore continue to emphasize the unclear relationship between mandibular loading and bony morphology, but highlight the need for further data regarding food material properties, jaw gape, and ingestive/food processing behaviors. PMID:23225317

  12. Pseudotumors and tumors of the temporomandibular joint. A review

    PubMed Central

    Bagán, José V.; Sanchis, José M.; Margaix, María

    2013-01-01

    Objective: To review the pseudotumors and tumors of the temporomandibular joint (TMJ) published in journals included in Journal Citation Reports (JCR), and to evaluate whether there are clinical and radiological signs capable of differentiating between pseudotumors and tumors and between malignant and benign tumors. Material and Methods: A systematic Medline search was made of clinical cases of tumors and pseudotumors of the TMJ covering a 20-year period and published in journals included in JCR. Only cases with histological confirmation were included. A description is provided of the general characteristics of TMJ tumors, with comparison of the clinical, diagnostic, therapeutic and evolutive variables referred to pseudotumors, benign tumors and malignant tumors. Results: We identified 285 TMJ tumors published in 181 articles of 15 journals. The most frequent lesions were pseudotumors (synovial chondromatosis, pigmented villonodular synovitis, eosinophilic granuloma and osteochondroma). The mean age was 42 years and one month ± 16 years and two months. Tumors were more common in females. The mean time from symptoms onset to consultation was 30 months and 8 days ± 41 months and 9 days, and almost 19.6% of the cases initially had been diagnosed and treated as TMJ dysfunction. The most frequent clinical manifestations were pain, swelling and the limitation of joint movements. The most common radiological findings in the case of benign and malignant lesions were radiopacities and radiotransparencies, respectively. No panoramic X-ray alterations were observed in 14.6% of the benign tumors and in 7.7% of the malignant lesions. Surgery was the usual form of treatment. Sequelae were recorded in 18.2% of the cases, with tumor relapse in 9.1%. The four-year survival rate in the case of malignant tumors was 72.2%. Key words:Tumor, temporomandibular joint, metaplasia, pseudotumor, condyle. PMID:23385515

  13. Can pterygoid plate asymmetry be linked to temporomandibular joint disorders?

    PubMed Central

    Guerrero, Maria Eugenia; Beltran, Jorge; de Laat, Antoon

    2015-01-01

    Purpose This study was performed to evaluate the relationship between pterygoid plate asymmetry and temporomandibular joint disorders. Materials and Methods Cone-beam computed tomography (CBCT) images of 60 patients with temporomandibular disorders (TMD) involving pain were analyzed and compared with images of 60 age- and gender-matched controls. Three observers performed linear measurements of the lateral pterygoid plates. Results Statistically significant differences were found between measurements of the lateral pterygoid plates on the site that had pain and the contralateral site (p<0.05). The average length of the lateral pterygoid plates (LPPs) in patients with TMD was 17.01±3.64 mm on the right side and 16.21±3.51 mm on the left side, and in patients without TMD, it was 11.86±1.97 mm on the right side and 11.98±1.85 mm on the left side. Statistically significant differences in the LPP length, measured on CBCT, were found between patients with and without TMD (p<0.05). The inter-examiner reliability obtained in this study was very high for all the examiners (0.99, 95% confidence interval: 0.98-0.99). Conclusion Within the limits of the present study, CBCT lateral pterygoid plate measurements at the side with TMD were found to be significantly different from those on the side without TMD. More research is needed to explore potential etiological correlations and implications for treatment. PMID:26125003

  14. The incidence of osteo-arthritis of the temporomandibular joint in various cultures.

    PubMed

    Griffin, C J; Powers, R; Kruszynski, R

    1979-04-01

    Three hundred and forty-eight cranial remains from Bronze and Iron Age British, Romano-British, Anglo-Saxon, Eastern Coast Australian aborigines, Medieval Christian Norse, Medieval Scarborough, 17--20th century British and German cultures, were examined for the presence of osteoarthritis in the temporomandibular joints. Cultures exposed to more stringent living conditions and with well-worn teeth had about twice the incidence of osteo-arthritis as the more sophisticated cultures. In general, loss of either molar support or occlusal imbalance were potent aetiological factors in this disease. PMID:380538

  15. Three-dimensional animation of the temporomandibular joint.

    PubMed

    Krebs, M; Gallo, L M; Airoldi, R L; Meier, D; Boesiger, P; Palla, S

    1994-01-01

    The aim of this investigation was to develop a method to reconstruct three-dimensionally the temporomandibular joint (TMJ) by means of magnetic resonance (MR) tomograms and to combine this reconstruction with jaw motion data, recorded with six degrees of freedom by means of the opto-electronic system Jaws-3D, in order to analyse the movement of the whole condyle within the fossa during opening and closing, protrusive and laterotrusive movements. The three-dimensional reconstruction of the TMJ was calculated and animated on a graphics workstation. The condyle - fossa distance during jaw movements was computed for every condylar point and visualized by shading the surface of the condyle with pseudo colors. Furthermore, the location of the minimum condyle-fossa distance was calculated and displayed in a plane graph representing the condylar surface. For five subjects without any past or present history of myoarthropathies of the masticatory system the resulting patterns were analyzed and compared. PMID:25274083

  16. Temporomandibular joint dysfunction: from Costen to the present.

    PubMed

    Perry, H T

    1995-01-01

    Sixty years ago, James Costen, an otolaryngologist, described a group of signs and symptoms of jaw and ear disturbances that he related to loss of mandibular posterior teeth and lower jaw overclosure. His recommended therapy was to "build up the bite". This review of the literature since that time presents evolving concepts that have primarily refuted Costen's original concepts and have stressed the aetiologic role of muscle function, psychosocial factors, and individual parafunctional habits related to the stress of daily life. Present treatment protocol for temporomandibular joint dysfunction emphasizes the need for an accurate diagnosis by the dentist or physician--as to whether the problem is arthrogenous, neurogenous, myogenous, or a combination of these--prior to the initiation of any therapy. PMID:7605085

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

    PubMed Central

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

    2015-01-01

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

  18. Temporomandibular joint dysfunction and selected health parameters in the elderly.

    PubMed

    Harriman, L P; Snowdon, D A; Messer, L B; Rysavy, D M; Ostwald, S K; Lai, C H; Soberay, A H

    1990-10-01

    Little research has focused on temporomandibular joint dysfunction (TMJD) in the elderly. The present study describes relationships between TMJD and selected health parameters in a population of 75- to 94-year-old Roman Catholic sisters (nuns). Mental, physical, and oral assessments made on 117 sisters identified 26 with TMJD. Among all sisters, TMJD was not associated with age, education, mental impairments, hand coordination, handgrip strength, mobility, or use of walking aids. In 75- to 84-year-old sisters, TMJD was positively associated with self-reported arthritis (p = 0.12), edentulism (p = 0.09), and the presence of complete dentures (p = 0.05), and negatively associated with the number of teeth present (p = 0.05), especially the posterior teeth. These associations were weaker in 85- to 94-year-old sisters. This study suggests that TMJD is associated with the presence of complete dentures and a low number of teeth, especially the posterior teeth. PMID:2216377

  19. Malformations of the temporo-mandibular joint in laboratory animals and in man.

    PubMed

    Gundlach, K K

    1999-01-01

    In 108 fetal mice and 67 rat fetuses the normal development of the temporomandibular joint was initially explored. Then malformations of the splanchnocranium were induced and studied histologically in 287 newborn rats and 67 mice. These animals had been delivered by caesarean section after treating the pregnant dams with one of 6 different teratogens. Finally, anomalous temporomandibular joints in 53 patients were analyzed radiographically and compared to the findings made in the above mentioned laboratory animals. Most malformations of the temporomandibular region detected were found to be embryopathies. They all fit into a new teratogenic order that was established by comparing the abnormal to the normal development of the structures involved. PMID:10081564

  20. Incidence of systemic joint hypermobility and temporomandibular joint hypermobility in pregnancy.

    PubMed

    Silveira, Erika B; Rocabado, Mariano; Russo, Adriana K; Cogo, Jose C; Osorio, Rodrigo A L

    2005-04-01

    The purpose of this study was to establish a possible correlation between systemic hypermobility and temporomandibular hypermobility during pregnancy. One hundred (100) healthy pregnant women were evaluated: 7% in the first trimester (1T), 38% in the second trimester (2T), and 55% in the third trimester (3T) of gestation. In the series, the authors analyzed systemic joint hypermobility (SJH), range of mandibular movement (MMR), head and shoulder posture, head lateralization, and the presence of noise, pain, and parafunction in the temporomandibular joint. They observed that pain is present to a mild degree mostly in the head and ears of all pregnant women who presented with pain. Most of the subjects had some type of parafunction, but only 42.8% had noises. Mild SJH was seen in 50% of the 2T and 3T subjects, and in 28.5% of 1T subjects. Mild mandibular hypermobility was found for jaw opening (46%) and lateralization to the right (44%) or to the left (46%). Most of the subjects had hypomobility for jaw protrusion and retraction. The subjects had head protrusion and anterior posture as a result of the change in their center of gravity brought about by pregnancy. The authors found no association between systemic joint hypermobility (SJH) and temporomandibular hypermobility, although hormonal changes and complex factors during pregnancy may represent a risk factor for both types of mobility change. PMID:15898570

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

    PubMed

    Park, Yongnam; Bae, Youngsook

    2014-08-01

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

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

    PubMed

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

    2013-12-01

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

  3. Change of Range of Motion of the Temporomandibular Joint after Correction of Mild Scoliosis

    PubMed Central

    Park, Yongnam; Bae, Youngsook

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

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

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

    PubMed

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

    2015-02-01

    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

  7. Stress-field translation in the healthy human temporomandibular joint.

    PubMed

    Gallo, L M; Nickel, J C; Iwasaki, L R; Palla, S

    2000-10-01

    Movement over the surface of the temporomandibular joint (TMJ) disc produces tractional forces. These forces potentially increase the magnitude of shear stresses and contribute to wear and fatigue of the disc. Theoretically, tractional forces in all synovial joints are the result of frictional forces, due to rubbing of the cartilage surfaces, and plowing forces, due to translation of the stress-field through the cartilage matrix as the joint surface congruency changes during motion. For plowing forces to occur in the TMJ, there must be mediolateral translation of the stress-field as the condyle moves dorsoventrally during jaw function. To test whether mediolateral stress-field translation occurs in the intact TMJ, we measured stress-field position and translation velocities in ten normal individuals during rhythmic jaw opening and closing. Magnetic resonance imaging and jaw tracking were combined to animate the three-dimensional position of the stress-field between the articulating surfaces. This allowed for mediolateral translation velocity measurements of the centroid of the stress-field. The results showed that during jaw opening and closing at 0.5 Hz, the average peak mediolateral translation velocity was 35 +/- 17 mm/sec. When opening and closing increased to 1.0 Hz, the average peak velocity was 40 +/- 19 mm/sec. Theoretical model estimates of the work done during such translation ranged from 6 to 709 mJ between the individual joints studied. The potential clinical importance of this measure is that long-term exposure of the TMJ disc to high work may result in fatigue failure of the TMJ disc. PMID:11077988

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

    SciTech Connect

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

    1986-04-01

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

  9. Effects of Enzymatic Degradation after Loading in Temporomandibular Joint

    PubMed Central

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

    2015-01-01

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

  10. Effects of enzymatic degradation after loading in temporomandibular joint.

    PubMed

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

    2015-02-01

    Synovial fluid of the joint decreases friction between the cartilage surfaces and reduces cartilage wear during articulation. Characteristic changes of synovial fluid have been shown in patients with osteoarthritis (OA) in the temporomandibular joint (TMJ). OA is generally considered to be induced by excessive mechanical stress. However, whether the changes in synovial fluid precede the mechanical overloading or vice versa remains unclear. In the present study, our purpose was to examine if the breakdown of joint lubrication affects the frictional properties of mandibular condylar cartilage and leads to subsequent degenerative changes in TMJ. We measured the frictional coefficient in porcine TMJ by a pendulum device after digestion with hyaluronidase (HAase) or trypsin. Gene expressions of interleukin-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

  11. Incidental findings on MRI of the temporomandibular joint

    PubMed Central

    Makdissi, J; Pawar, R R; Radon, M; Holmes, S B

    2013-01-01

    Objectives: The aim of this study was to determine the prevalence of incidental findings in MRI of the temporomandibular joint (TMJ). Methods: MRI reports of 730 patients were assessed. The reports were analysed by one consultant and one clinical lecturer in dental and maxillofacial radiology. The prevalence of intracranial and extracranial incidental findings was recorded and categorized. Results: There were 53 (7.3%) incidental findings, of which 11 (1.5%) were intracranial and 42 (5.7%) were extracranial (divided into paranasal sinuses, mastoid air cells, muscle hypertrophy, lymphadenopathy and salivary glands). A total number of eight intracranial findings needed further dedicated imaging and/or specialist clinical opinion. Only one tumour (a meningioma) was found and required surgical intervention. Conclusions: Incidental findings on TMJ MRI are rare but not unheard of. The clinical relevance of incidental findings can be significant, and it is therefore important to ensure that the full data set of images is inspected, including any scout slices. A close working relationship between the areas of dental and maxillofacial radiology and neuroradiology is essential in expediting a second opinion relating to intracranial findings. All incidental findings should be communicated to referring clinicians in a timely manner, based on their urgency and clinical significance. PMID:24005059

  12. Subtypes of nociceptive units in the rat temporomandibular joint.

    PubMed

    Takeuchi, Yoshinari; Toda, Kazuo

    2003-10-15

    Response properties of nociceptors in the rat's temporomandibular joint (TMJ) were investigated using an in vitro TMJ-nerve preparation. Recordings were obtained from 33 nociceptive units that responded to mechanical, chemical, and/or thermal stimuli. According to both characteristics of nociceptors and afferent fibers, nociceptive units in the TMJ area were classified into the following four subtypes: Adelta-high-threshold mechanonociceptor (HTM) (12.1%), Adelta-polymodal nociceptor (POLY) (36.4%), C-HTM (12.1%), and C-POLY (39.4%). The mean mechanical threshold of the Adelta units was significantly lower than that of the C units. Bradykinin increased the discharge of Adelta- and C-POLY units. No significant differences of thermal thresholds between Adelta and C units were found. The percentage of Adelta units was 47.2% and of C units was 52.8%, respectively. In the TMJ area, POLY units were predominant (75.8%), suggesting that inflammatory reactions can easily evoke pain sensation. PMID:14519457

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

    SciTech Connect

    Masui, Takayuki; Isoda, Haruo; Mochizuki, Takao

    1996-05-01

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

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

    PubMed

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

    2014-05-01

    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

  15. Fitting a temporomandibular joint prosthesis to the skull.

    PubMed

    van Loon, J P; de Bont, L G; Stegenga, B; Verkerke, G J

    2000-10-01

    Fitting a temporomandibular joint (TMJ) prosthesis to the skull by using stock prostheses seems to be an appropriate method. However, fitting the skull with one stock part requires many differently shaped parts. Therefore, we fitted the skull with two connected stock parts. The aim of the study was to test whether it is possible to achieve a close fit to the skull with this design, with a maximum of 10 different parts. The articular eminence was fitted with a gully-shaped fitting member, which was rotationally connected to a basic part that fitted to the lateral side of the TMJ. The relevant dimensions of 20 dry skulls were measured and the results were used to derive the optimal dimensions of the prosthesis parts. Prototypes were subsequently fabricated. The fit of the prototypes was tested by measuring the maximum gap between fitting member and skull. All skulls could be fit with a set of four different basic parts and three different fitting members. The average maximum gap between fitting member and skull was 0.20 mm (range 0.11-0.43 mm). It was concluded that a close fit to the skull can be achieved with two connected stock parts and with a total number of seven parts. PMID:11065020

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-04-01

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

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

    PubMed

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

    2015-02-01

    Integration of engineered musculoskeletal tissues with adjacent native tissues presents a significant challenge to the field. Specifically, the avascularity and low cellularity of cartilage elicit the need for additional efforts in improving integration of neocartilage within native cartilage. Self-assembled neocartilage holds significant potential in replacing degenerated cartilage, though its stabilization and integration in native cartilage require further efforts. Physical and enzymatic stabilization methods were investigated in an in vitro model for temporomandibular joint (TMJ) disc degeneration. First, in phase 1, suture, glue and press-fit constructs were compared in TMJ disc intermediate zone defects. In phase 1, suturing enhanced interfacial shear stiffness and strength immediately; after four weeks, a 15-fold increase in stiffness and a ninefold increase in strength persisted over press-fit. Neither suture nor glue significantly altered neocartilage properties. In phase 2, the effects of the enzymatic stabilization regimen composed of lysyl oxidase, CuSO4 and hydroxylysine were investigated. A full factorial design was employed, carrying forward the best physical method from phase 1, suturing. Enzymatic stabilization significantly increased interfacial shear stiffness after eight weeks. Combined enzymatic stabilization and suturing led to a fourfold increase in shear stiffness and threefold increase in strength over press-fit. Histological analysis confirmed the presence of a collagen-rich interface. Enzymatic treatment additionally enhanced neocartilage mechanical properties, yielding a tensile modulus over 6 MPa and compressive instantaneous modulus over 1200 kPa at eight weeks. Suturing enhances stabilization of neocartilage, and enzymatic treatment enhances functional properties and integration of neocartilage in the TMJ disc. Methods developed here are applicable to other orthopaedic soft tissues, including knee meniscus and hyaline articular cartilage. PMID:25519993

  19. Design and wear testing of a temporomandibular joint prosthesis articulation.

    PubMed

    van Loon, J P; Verkerke, G J; de Vries, M P; de Bont, L G

    2000-02-01

    As part of the development of a total temporomandibular joint prosthesis, a prosthesis articulation was designed. The articulation consists of a spherical head (ball) of the mandibular part, rotating against an enveloping ultra-high-molecular-weight polyethylene (UHMWPE) disc with a flat cranial side, which slides along the opposing skull part. The aim of this study was to determine the in vitro wear rate of the articulation, and to predict the in vivo wear rate from the results. Based on a disc thickness of 5 mm and a ball diameter of 8 mm, the stresses within the disc were calculated by means of a finite element computer model. The wear rate of the ball-disc articulation was determined by in vitro wear tests, with a stainless-steel ball rotating against a UHMWPE disc in a serum-based lubricant. Eight discs were tested for seven million cycles each. The in vitro wear rate of the disc-skull part articulation was calculated from the test results of the ball-disc articulation. The maximum Von Mises' stress was less than the yield strength of UHMWPE and, therefore, was sufficiently low. The in vitro wear rate of the ball-disc articulation was 0.47 mm3 per million cycles. The in vivo expected total wear rate is 0.65 mm3 per year, corresponding with a yearly decrease of disc thickness of 0.0094 mm. Although it is difficult to judge whether this wear rate is sufficiently low, because the influence of UHMWPE wear particles in the TMJ region is unknown, both the expected wear rate and the decrease of thickness appear to be acceptable. PMID:10728972

  20. Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report.

    PubMed

    Song, Ji-Young; Kim, Seong-Gon; Choi, Hang-Moon; Kim, Hyun Jung

    2015-06-01

    Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence. PMID:26125005

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

    SciTech Connect

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

    1985-01-01

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

  2. Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

    PubMed Central

    Kim, Seong-Gon; Choi, Hang-Moon; Kim, Hyun Jung

    2015-01-01

    Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence. PMID:26125005

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

    PubMed Central

    2014-01-01

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

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

    PubMed

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

    2014-03-01

    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

  5. Management of Temporomandibular Joint Reankylosis in Syndromic Patients Corrected with Joint Prostheses: Surgical and Rehabilitation Protocols

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

    Lohiya, Sapna; Dillon, Jasjit

    2016-01-01

    This report describes 2 patients whose septic arthritis of the temporomandibular joint (SATMJ) presented atypically, resulting in treatment delay and complications. A 49-year-old man developed left-side facial allodynia, which was first treated unsuccessfully as trigeminal neuralgia. On day 21, the patient sustained facial trauma from a fall and presented to the emergency department (ED). Maxillofacial contrast-enhanced computed tomographic (CT) scan was suggestive of parotiditis, SATMJ, or hemarthrosis. His condition did not improve with empiric antibiotic treatment. On day 30, contrast-enhanced magnetic resonance imaging (MRI) confirmed SATMJ. Incision and drainage yielded 6 mL of pus and produced clinical improvement. Cultures grew methicillin-resistant Staphylococcus aureus, which was treated with amoxicillin plus clavulanate and sulfamethoxazole plus trimethoprim for 30 days. On day 59, the patient still had slight preauricular pain and CT-proved TMJ osteoarthritic changes. A 56-year-old woman developed right-side facial pain after a crown procedure on her right mandibular second molar. Oral prednisone (and clindamycin) produced partial relief. Her primary physician suspected temporal arteritis, but its biopsy result on day 11 was normal. Gradually, the patient developed trismus and malocclusion refractory to various medicines. On day 49, she presented to the ED. A contrast-enhanced maxillofacial CT scan suggested SATMJ. Incision and drainage yielded 30 mL of pus and produced clinical improvement. During days 50 to 57, the patient received intravenous ampicillin plus sulbactam and metronidazole. However, preauricular tenderness and drainage from the surgical incision persisted. On day 55, CT scan showed a residual abscess. Secondary debridement yielded 5 mL of pus. Culture grew coagulase-negative S aureus. On day 141, the patient still had slight preauricular pain and TMJ osteoarthritic changes on MRI. In these cases, the SATMJ diagnosis was delayed owing to the mildness of local and systemic manifestations, the possibility of confounding conditions, and the rarity of SATMJ. Contrast-enhanced CT and MRI facilitated the diagnosis. Abscess drainage alleviated the symptoms. Postinfectious osteoarthritis developed possibly from treatment delay. SATMJ should be considered in all patients with enigmatic preauricular pain, trismus, or malocclusion. PMID:26183013

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

    ERIC Educational Resources Information Center

    Funch, Donna P.; Gale, Elliot N.

    1984-01-01

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

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

    PubMed

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

    1991-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-01-01

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

  10. Effects of experimentally induced inflammation on temporomandibular joint nociceptors in rats.

    PubMed

    Takeuchi, Yoshinari; Zeredo, Jorge L; Fujiyama, Rie; Amagasa, Teruo; Toda, Kazuo

    2004-01-01

    Response properties of nociceptors in the temporomandibular joint (TMJ) and surrounding area under experimental inflammation were investigated using an in vitro TMJ-nerve preparation in the rat. Nociceptive units (receptor and innervating nerve fiber) were classified into the following subtypes: Adelta-high-threshold mechanonociceptor (HTM), Adelta-polymodal nociceptor (POLY), C-HTM and C-POLY. In the inflamed joint, mechanical thresholds tended to be lower; however, the reaction to bradykinin was not identified as clearly as in control. Experimentally induced inflammation increased the proportion of heat-sensitive units and lowered heat threshold significantly. These results suggest that inflammation may sensitize nociceptors in the temporomandibular joint, and cause hyperalgesia and allodynia. PMID:14698466

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2008-05-01

    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

  13. Evaluation of Korean teenagers with temporomandibular joint disorders

    PubMed Central

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

    2013-01-01

    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

  14. Two-year prospective study of outcomes following total temporomandibular joint replacement.

    PubMed

    Gonzalez-Perez, L M; Fakih-Gomez, N; Gonzalez-Perez-Somarriba, B; Centeno, G; Montes-Carmona, J F

    2016-01-01

    The purpose of this 2-year prospective study was to investigate outcomes achieved with a stock temporomandibular joint (TMJ) replacement system in the management of end-stage TMJ disorders. Fifty-two patients requiring reconstruction (36 unilateral/16 bilateral) were operated on during the period 2006-2012; 68 total prostheses were implanted (Biomet Microfixation TMJ Replacement System). The mean age at surgery was 52.6±11.5 years. Changes in the values of inclusion diagnostic criteria at entry were assessed. These included persistent and significant TMJ pain, functional impairment after failure of other surgical therapies, and imaging evidence consistent with advanced TMJ disease of more than 1-year duration. Subjects were excluded if they presented insufficient quantity/quality of bone to support the TMJ replacement, severe hyperfunctional habits, active infectious disease, or an inability to follow postoperative instructions. Over the 2 years of postoperative follow-up, mean pain intensity was reduced from 6.4±1.4 to 1.6±1.2 (P<0.001), and jaw opening was improved from 2.7±0.9cm to 4.2±0.7cm (P<0.001). During the study period, three of 68 implants (4%) were explanted and new TMJ replacements fitted. The results of this study support the view that the surgical placement of stock TMJ prostheses provides significant long-term improvements in pain and function, with few complications. PMID:26377771

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

    NASA Astrophysics Data System (ADS)

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

    1995-05-01

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

  16. Use of Ultrasonography for Assessing Treatment Efficacy in a Case With Ankylosis of the Temporomandibular Joint.

    PubMed

    Ho, Kai-Yu; Ho, Sally; Colletti, Patrick M

    2016-03-01

    The patient was a 32-year-old university lecturer with limited mouth opening for 15 years. The patient was diagnosed with right temporomandibular joint ankylosis 10 years prior. Ultrasonography was employed to assess capsule-condyle distance before and after physical therapy. A treatment plan aiming at mobilizations and exercises was implemented, and the patient reported improvements in eating and speaking. J Orthop Sports Phys Ther 2016;46(3):225. doi:10.2519/jospt.2016.0404. PMID:26928737

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

    PubMed

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

    2015-12-01

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

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

    PubMed

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

    2014-04-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    Ahmad, Imran; Bariar, Lalit Mohan

    2015-01-01

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

  1. Periodontal Ligament Mesenchymal Stromal Cells Increase Proliferation and Glycosaminoglycans Formation of Temporomandibular Joint Derived Fibrochondrocytes

    PubMed Central

    Guo, Fujun; Mi, Jianqiang; Zhang, Zhiye

    2014-01-01

    Objectives. Temporomandibular joint (TMJ) disorders are common disease in maxillofacial surgery. The aim of this study is to regenerate fibrocartilage with a mixture of TMJ fibrochondrocytes and periodontal ligament derived mesenchymal stem cells (PD-MSCs). Materials and Methods. Fibrochondrocytes and PD-MSC were cocultured (ratio 1 : 1) for 3 weeks. Histology and glycosaminoglycans (GAGs) assay were performed to examine the deposition of GAG. Green florescent protein (GFP) was used to track PD-MSC. Conditioned medium of PD-MSCs was collected to study the soluble factors. Gene expression of fibrochondrocytes cultured in conditioned medium was tested by quantitative PCR (qPCR). Results. Increased proliferation of TMJ-CH was observed in coculture pellets when compared to monoculture. Enhanced GAG production in cocultures was shown by histology and GAG quantification. Tracing of GFP revealed the fact that PD-MSC disappears after coculture with TMJ-CH for 3 weeks. In addition, conditioned medium of PD-MSC was also shown to increase the proliferation and GAG deposition of TMJ-CH. Meanwhile, results of qPCR demonstrated that conditioned medium enhanced the expression levels of matrix-related genes in TMJ-CH. Conclusions. Results from this study support the mechanism of MSC-chondrocyte interaction, in which MSCs act as secretor of soluble factors that stimulate proliferation and extracellular matrix deposition of chondrocytes. PMID:25436212

  2. 'Friction and adhesive forces'--possible underlying causes for temporomandibular joint internal derangement.

    PubMed

    Nitzan, D W

    2003-01-01

    Since normal temporomandibular joint (TMJ) movements depend primarily on the disc freely sliding down the slope of the eminence, understanding how aberrations in the lubrication system contribute to TMJ dysfunction is clearly critically important. It provides a possible explanation for the genesis of disc displacement and helps make us familiar with the clinical appearance and ways of treating limited mouth opening caused by the anchored disc phenomenon (ADP) versus disc displacement without reduction, TMJ open lock versus dislocation and osteoarthritis. This understanding clarifies the efficiency of procedures such as joint hydraulic pump, arthrocentesis and arthroscopic lavage and lysis particularly in ADP, open lock and osteoarthritis. PMID:12784037

  3. Development of synovial membrane in the temporomandibular joint of the human fetus.

    PubMed

    Carvalho de Moraes, L O; Tedesco, R C; Arraez-Aybar, L A; Klein, O; Mérida-Velasco, J R; Alonso, L G

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. A biphasic finite element model of in vitro plowing tests of the temporomandibular joint disc.

    PubMed

    Spilker, R L; Nickel, J C; Iwasaki, L R

    2009-06-01

    Disorders of the temporomandibular joint (TMJ) afflict 3-29% of people aged 19-40 years. Degenerative joint disease (DJD) of the TMJ generally occurs 15 years earlier than in other human joints and 1.5-2 times more often in women than men. The TMJ disc is the primary stress distribution mechanism within the joint. Mechanical failure of the TMJ disc precedes clinical signs of DJD. Unlike postcranial synovial joints, biomimetic replacements of the disc have not been successful, probably due to the paucity of knowledge about TMJ biomechanics. Translation of stress-fields mediolaterally across the TMJ disc may lead to fatigue failure because of the effect of traction forces on the tissue surface and because the disc is relatively weak in this aspect. Traction forces are composed of friction forces, which are known to be low in the TMJ, and plowing forces which are relatively much higher and result from movement and pressurization of fluids within the tissues due to translating surface loads. In the in vitro plowing experiment, a rigid curve-ended indenter is lowered into a TMJ disc that has been mounted on a stage with pressure gauges, and the indenter is then translated in a prescribed mediolateral motion that is intended to simulate the motion of the mandibular condyle on the TMJ disc in vivo. As a first step, these plowing experiments have quantified the variables thought to be important in tissue failure. A next step is to define the full role of these variables in the pathomechanics of TMJ disc tissue through a validated model. Therefore, the aim of this study was to develop and test a finite element model of the plowing experiments based on an orthotropic biphasic description of the soft tissue behavior of the TMJ disc. For this plowing model, the arbitrary Lagrange Eulerian method was used to approximate the moving load problem, where in vitro the indenter slid along the tissue's superior surface. Approximate validation of the plowing model was based on comparisons of model-predicted temporal and spatial distribution of indenter displacement and total normal stresses (+/-15%) and laboratory measurements during one complete cycle of plowing motion. Other useful predictions from the plowing model include spatial and temporal distributions of biomechanical variables of interest that cannot be measured experimentally, such as total stress, pressure, strain, and the relative significance of the orthotropic solid phase properties. PMID:19350392

  6. Internal derangements of the temporomandibular joint: A review of the anatomy, diagnosis, and management

    PubMed Central

    Young, Andrew L.

    2015-01-01

    Internal derangements of the temporomandibular joint are conditions in which the articular disc has become displaced from its original position the condylar head. Relevant anatomic structures and their functional relationships are briefly discussed. The displacement of the disc can result in numerous presentations, with the most common being disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening). These are described in this article according to the standardized Diagnostic Criteria for Temporomandibular Disorders, as well as the less common posterior disc displacement. Appropriate management usually ranges from patient education and monitoring to splints, physical therapy, and medications. In rare and select cases, surgery may be necessary. However, in for the majority of internal derangements, the prognosis is good, particularly with conservative care.

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

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    1980-02-01

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

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

    PubMed Central

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

    2009-01-01

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

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

    SciTech Connect

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

    1984-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Fries, Marc D.; Vohra, Yogesh K.

    2002-10-01

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

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

    PubMed

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

    2012-01-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    PubMed Central

    An, S-Y

    2015-01-01

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

  16. [Myoarthropathy of the temporomandibular joint and masticatory muscles. Pain therapy management and relaxation instead of aggressive surgery].

    PubMed

    Türp, J C

    2003-05-01

    Temporomandibular pain is often characterized by a mismatch between symptoms and findings. The dentist's well-established therapeutic strategies for the management of acute pain are therefore frequently not effective in patients with painful temporomandibular disorders (TMD). Instead, dentists should apply the tried and tested principles that are applied in general medicine to the diagnosis and treatment of musculoskeletal pain (e.g. arthritic pain or fibromyalgia). When consulted by patients with rheumatic diseases, physicians should routinely enquire whether they also experience temporomandibular pain. PMID:12813975

  17. [Botulinum toxin type A in the treatment of neurogenic dislocation of the temporomandibular joint].

    PubMed

    Daelen, B; Koch, A; Thorwirth, V

    1998-05-01

    Botulinum toxin leads to paresis of the skeletal muscle lasting 2-4 months via an inhibition of acetylcholine release at the neuromuscular junction. Since 1995, botulinum toxin injections have been used in the treatment of recurrent dislocation of the temporomandibular joint (TMJ). The chemical denervation of the external pterygoid muscle restricts the angle of mouth opening, thus helping to prevent dislocation. TMJ dislocations that occur as a result of increased tone in the protracted masticatory muscles were recently defined as neurogenic dislocations of the TMJ. We conducted a clinical study to investigate the efficacy of botulinum toxin injections into the external pterygoid muscle in five patients with recurrent neurogenic dislocations of the TMJ. In the 3 months prior to the first treatment, the patients had suffered a total of 19 dislocations. In the 3-month period following the initial treatment, only one woman experienced a dislocation. We performed the treatment a total of 25 times. Five dislocations occurred during the 6- to 36-month observation period. In the meantime, two patients remain recurrence-free 1 year after receiving treatment. All the patients had a restricted ability to open their mouths as a side effect of the weakening of the external pterygoid muscle that was completely reversible over the course of 3-4 months. All other side effects were equally well-tolerated by the patients and fully reversible after 3 weeks at the most. In the two patients who remain recurrence-free without any further treatment, the increased tone of the muscles serving the jaw normalised spontaneously over the course of the underlying neurological disease. Our results show that, in the treatment of recurrent neurogenic dislocations of the TMJ, botulinum toxin injections represent a therapeutic alternative that has few side effects. PMID:23525991

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

    PubMed Central

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

    2014-01-01

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

  19. Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders.

    PubMed

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

    2014-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    1996-04-01

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

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

    PubMed Central

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

    2012-01-01

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

  2. ADAM10 localization in temporomandibular joint disk with internal derangement: an ex vivo immunohistochemical study.

    PubMed

    Loreto, Carla; Chiarenza, Giovanni Paolo Salvatore; Musumeci, Giuseppe; Castrogiovanni, Paola; Imbesi, Rosa; Ruggeri, Alessandra; Almeida, Luis Edoardo; Leonardi, Rosalia

    2016-04-01

    The purpose of this study was to determine the presence of ADAM10 in temporomandibular joint disk with internal derangement. Twenty-five paraffin blocks of displaced temporomandibular joint (TMJ) disk specimens from earlier investigations were retrieved from the archives of the University of Catania. Of these 16 had been removed from females and 9 from males; 11 with anterior disk displacement with reduction (ADDwR) and 14 with anterior disk displacement without reduction (ADDwoR). The sections were dehydrated, embedded in paraffin and cut. Then they were incubated in 0.3% H2O2/methanol and half of sections from each sample were incubated in diluted rabbit polyclonal anti-ADAM10 antibody. Then biotinylated anti-mouse/anti-rabbit IgG was applied to the sections, followed by avidin-biotin-perioxidase complex. The results were analyzed and the results were that ADAM10 was overexpressed in the posterior band of sections from patients with ADDwR compared to the other bands of both ADDwR and ADDwoR sections. Overexpression correlated with severe histopathological degeneration. We believe these results have the potential to provide insights into the pathogenesis of TMJ disk degeneration and to help design new therapeutic approaches targeting the proteolytic events that lead to tissue degeneration. Early therapeutic block of ADAM10 activity could succeed in limiting aggrecan-rich matrix breakdown without affecting normal physiology. PMID:26947053

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

    PubMed

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

    2016-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2005-04-01

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

  5. Therapeutic effect of hyaluronic acid on experimental osteoarthrosis of ovine temporomandibular joint.

    PubMed

    Kim, C H; Lee, B J; Yoon, J; Seo, K M; Park, J H; Lee, J W; Cho, E S; Hong, J J; Lee, Y S; Park, J H

    2001-10-01

    A symptomatic relief by hyaluronic acid (HA, MW: 3.5 x 10(6)), which is synthesized by Streptococcus spp, was investigated in experimental ovine osteoarthrosis. Bilateral osteoarthrosis (OA) of the temporo-mandibular joints (TMJs) was induced by perforating discs and by scrapping subchondral condylar surface. HA was intra-articularly injected into the left joints of 6 sheep on 7, 10, 14, 17 and 21 days after the operation and physiological saline as the control was injected into the contralateral (right) joints on the same day. Three sheep were killed at I month post-operation (MPO) and the remaining three sheep were killed at 3 MPO. Various responses such as proliferation of fibrous tissue, denudation, erosion, osteophyte formation, subcortical cyst formation and ankylosis were observed radiographically and histopathologically. The treatment of HA ameliorated the degenerative changes and lowered the osteoarthrotic score in the left joints at I MPO (9.96 vs 5.81) and 3 MPO (10.86 vs 5.29) compared to the right joints. These results indicate that a repeated intra-articular injection of HA inhibits the progression of OA in ovine TMJs by inducing the development of articular cartilage and by reducing the proliferation of fibrotic tissue. PMID:11714023

  6. Finite element analysis of the temporomandibular joint during lateral excursions of the mandible.

    PubMed

    Pérez Del Palomar, A; Doblaré, M

    2006-01-01

    One of the most significant characteristics of the temporomandibular joint (TMJ) is that it is in fact composed of two joints. Several finite element simulations of the TMJ have been developed but none of them analysed the different responses of its two sides during nonsymmetrical movement. In this paper, a lateral excursion of the mandible was introduced and the biomechanical behaviour of both sides was studied. A three-dimensional finite element model of the joint comprising the bone components, both articular discs, and the temporomandibular ligaments was used. A fibre-reinforced porohyperelastic model was introduced to simulate the behaviour of the articular discs, taking into account the orientation of the fibres in each zone of these cartilage components. The mandible movement during its lateral excursion was introduced as the loading condition in the analysis. As a consequence of the movement asymmetry, the discs were subjected to different load distributions. It was observed that the maximal shear stresses were located in the lateral zone of both discs and that the lateral attachment of the ipsilateral condyle-disc complex suffered a large distortion, due to the compression of this disc against the inferior surface of the temporal bone. These results may be related with possible consequences of a common disorder called bruxism. Although it would be necessary to perform an exhaustive analysis of this disorder, including the contact forces between the teeth during grinding, it could be suggested that a continuous lateral movement of the jaw may lead to perforations of both discs in their lateral part and may damage the lateral attachments of the disc to the condyle. PMID:16125714

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

    PubMed

    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

    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

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

    PubMed

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

    2016-03-01

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

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

    PubMed Central

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

    2014-01-01

    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

  10. Combined surgical therapy of temporomandibular joint ankylosis and secondary deformity using intraoral distraction.

    PubMed

    Cascone, Piero; Piero, Cascone; Agrillo, Alessandro; Alessandro, Agrillo; Spuntarelli, Giorgio; Giorgio, Spuntarelli; Arangio, Paolo; Paolo, Arangio; Iannetti, Giorgio; Giorgio, Iannetti

    2002-05-01

    Temporomandibular joint (TMJ) ankylosis is a pathological process caused by damage of the mandibular condyle. When this event takes place in subjects during the developmental age, it results in an alteration of the entire maxillofacial complex. Therefore, surgical methods able to remove the temporomandibular ankylosis also include necessary operations to correct the secondary maxillofacial deformity. The distraction osteogenesis has induced our center to modify the surgical protocol for the therapy of patients who have developed TMJ ankylosis and secondary maxillomandibular deformity. We have treated four patients with monolateral ankylosis of the TMJ and serious deformities of the maxillomandibular complex secondary to functional limitation. During the same operation, arthroplasty was performed with the removal of the ankylotic block and the interposition of a temporal muscle flap in the new articular space; an intraoral osteodistractor was also positioned to lengthen the mandible. All patients showed recovery of the eurhythmy of the face and good re-establishment of the symmetry. An average 12-month follow-up showed the average opening of the mouth to be at least 35 mm. The combination of TMJ arthroplasty and intraoral osteodistraction provides good functional and aesthetic results in patients affected by ankylosis who have developed secondary maxillofacial deformities. PMID:12040209

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

    PubMed Central

    Juran, Cassandra M.; Dolwick, M. Franklin

    2015-01-01

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

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

    PubMed

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

    2015-02-01

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

  13. Cone-Beam Computed Tomographic Assessment of Mandibular Condylar Position in Patients with Temporomandibular Joint Dysfunction and in Healthy Subjects

    PubMed Central

    Paknahad, Maryam; Shahidi, Shoaleh; Iranpour, Shiva; Mirhadi, Sabah; Paknahad, Majid

    2015-01-01

    Statement of the Problem. The clinical significance of condyle-fossa relationships in the temporomandibular joint is a matter of controversy. Different studies have evaluated whether the position of the condyle is a predictor of the presence of temporomandibular disorder. Purpose. The purpose of the present study was to investigate the condylar position according to gender in patients with temporomandibular disorder (TMD) and healthy controls using cone-beam computed tomography. Materials and Methods. CBCT of sixty temporomandibular joints in thirty patients with TMD and sixty joints of thirty subjects without TMJ disorder was evaluated in this study. The condylar position was assessed on the CBCT images. The data were analyzed using Pearson chi-square test. Results. No statistically significant differences were found regarding the condylar position between symptomatic and asymptomatic groups. Posterior condylar position was more frequently observed in women and anterior condylar position was more prevalent in men in the symptomatic group. However, no significant differences in condylar position were found in asymptomatic subjects according to gender. Conclusion. This study showed no apparent association between condylar positioning and clinical findings in TMD patients. PMID:26681944

  14. Three-dimensional finite-element model of the human temporomandibular joint disc during prolonged clenching.

    PubMed

    Hirose, Miho; Tanaka, Eiji; Tanaka, Masao; Fujita, Reiji; Kuroda, Yukiko; Yamano, Eizo; van Eijden, Theo M G J; Tanne, Kazuo

    2006-10-01

    In the temporomandibular joint (TMJ), overloading induced by prolonged clenching appears to be important in the cascade of events leading to disc displacement. In this study, the effect of disc displacement on joint stresses during prolonged clenching was studied. For this purpose, finite-element models of the TMJ, with and without disc displacement, were used. Muscle forces were used as a loading condition for stress analysis during a time-period of 10 min. The TMJ disc and connective tissue were characterized as a linear viscoelastic material. In the asymptomatic model, large stresses were found in the central and lateral part of the disc through clenching. In the retrodiscal tissue, stress relaxation occurred during the first 2 min of clenching. In the symptomatic model, large stresses were observed in the posterior part of the disc and in the retrodiscal tissue, and the stress level was kept constant through clenching. This indicates that during prolonged clenching the disc functions well in the asymptomatic joint, meanwhile the retrodiscal tissue in the symptomatic joint is subject to excessive stress. As this structure is less suitable for bearing large stresses, tissue damage may occur. In addition, storage of excessive strain energy might lead to breakage of the tissue. PMID:17026512

  15. Shear properties of the temporomandibular joint disc in relation to compressive and shear strain.

    PubMed

    Tanaka, E; Kawai, N; Hanaoka, K; Van Eijden, T; Sasaki, A; Aoyama, J; Tanaka, M; Tanne, K

    2004-06-01

    Shear stress can result in fatigue, damage, and irreversible deformation of the temporomandibular joint disc. Insight into the dynamic shear properties of the disc may give insight into the mechanism inducing tissue failure due to shear. We tested the hypothesis that the dynamic shear properties of the disc depend on the amount of shear and compressive strain. Twenty-four porcine discs were used for dynamic shear tests. The specimens were clamped between the plates of a loading apparatus under compressive strains of 5%, 10%, and 15%. Dynamic shear was applied to the specimen by a sinusoidal strain of, respectively, 0.5%, 1.0%, and 1.5%. Both the dynamic elasticity and viscosity were proportional to compressive strain and inversely proportional to shear strain. These shear characteristics suggest a significant role of compressive and shear strain on the internal friction of the disc. PMID:15153455

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

    PubMed Central

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

    2013-01-01

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

  17. Transcriptomic study on the impact of temporomandibular joint internal derangement in the condylar cartilage of rabbits.

    PubMed

    Wang, Shuhua; Xu, Gaoli; Deng, Liquan; Gu, Zhiyuan

    2015-09-01

    Internal derangement (ID) in the temporomandibular joint (TMJ) compromises a group of clinical problems, and holds a relative high prevalence in populations. However, the temporal genomic change in gene expression of condylar cartilage during continuous ID remains unclear. Here we reported the differentially expressed gene pattern in condylar cartilage of rabbits with ID from 1 to 8 weeks by microarray analysis. The whole genome project was deposited at GenBank under the accession PRJNA278127. The microarray analysis showed that 6478 genes have more than two-fold changes among all the tested transcripts. Many inflammation gene increased rapidly in the early stage while decrease later. On the contrary, the bone construction related genes showed a low level at first and increased at later period in the ID progression. Besides, the current study found some genes such as HLA2G, which had never been reported, might be relevant with ID. PMID:26484287

  18. Prospective short term comparison of outcomes after single or double puncture arthrocentesis of the temporomandibular joint.

    PubMed

    ?entürk, Mehmet Fatih; Tüzüner-Öncül, Ay?egül Mine; Cambazo?lu, Mine

    2016-01-01

    Our aim was to compare the single puncture technique for arthrocentesis of the temporomandibular joint (TMJ) with the double puncture technique and to evaluate the short-term effects of a single puncture. Forty patients were randomly divided into two groups: the first was treated by single puncture, and the second with double puncture, arthrocentesis. During the one-month follow-up period the visual analogue and verbal scales for pain, maximal mouth opening, and satisfaction were evaluated within each group and between the two groups. Both groups recorded significant improvements compared with the baseline values in almost all outcome variables. There were no significant differences between the groups. Arthrocentesis of the TMJ was successful with both techniques. PMID:26782027

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

    PubMed

    Yilmaz, E; Kansu, O; Ozgen, B; Akçiçek, G; Kansu, H

    2013-01-01

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

  20. Reconstruction of the temporomandibular joint after surgical ablation of a multiply recurrent ameloblastoma: a case report.

    PubMed

    Morrison, Matthew D; Psutka, David J

    2014-01-01

    Reconstruction of large mandibular defects, whether involving the temporomandibular joint (TMJ) or not, has historically been achieved with autogenous grafts, such as free costochondral grafts and vascularized bone grafts. Ensuring intact, functioning microcirculation is critical for graft survival in the face of postoperative radiation therapy secondary to malignant tumour ablation. However, in the case of benign tumours, such as ameloblastomas, postoperative radiation therapy is not required, thus increasing the options for reconstruction. Alloplastic components coupled with nonvascularized bone grafts have been used successfully to restore mandibular form, function and esthetics after extensive mandibular resection. In this article, we describe a case of a multiply recurrent ameloblastoma treated by left hemimandibulectomy and immediate reconstruction with a custom-fabricated alloplastic system in combination with an anterior iliac crest bone graft. The result was a high degree of mandibular function and facial cosmesis, minimal donor-site morbidity, and nearly immediate return to function. PMID:25055228

  1. Tissue interaction is required for glenoid fossa development during temporomandibular joint formation

    PubMed Central

    Wang, Ying; Liu, Chao; Rohr, Joseph; Liu, Hongbing; He, Fenglei; Yu, Jian; Sun, Cheng; Li, Lu; Gu, Shuping; Chen, YiPing

    2011-01-01

    The mammalian temporomandibular joint (TMJ) develops from two distinct mesenchymal condensations that grow towards each other and ossify through different mechanisms, with the glenoid fossa undergoing intramembranous ossification while the condyle being endochondral in origin. In this study, we used various genetically modified mouse models to investigate tissue interaction between the condyle and glenoid fossa during TMJ formation in mice. We report that either absence or dislocation of the condyle results in an arrested glenoid fossa development. In both cases, glenoid fossa development was initiated, but failed to sustain, and became regressed subsequently. However, condyle development appears to be independent upon the presence of the forming glenoid fossa. In addition, we show that substitution of condyle by Meckel’s cartilage is able to sustain glenoid fossa development. These observations suggest that proper signals from the developing condyle or Meckel’s cartilage are required to sustain the glenoid fossa development. PMID:21953591

  2. Autologous blood injection to the temporomandibular joint: magnetic resonance imaging findings

    PubMed Central

    Yüce, Serdar; Cavus, Umut Yücel; Akin, Kayihan; Cakir, Banu

    2012-01-01

    Purpose The aim of this study was to investigate the effect of the autologous blood injection (ABI) for chronic recurrent temporomandibular joint (TMJ) dislocation using magnetic resonance imaging (MRI). Materials and Methods ABI was applied to 14 patients who had chronic recurrent TMJ dislocation. MRIs of the patients were taken and compared before and one month after the injection. Results All of the patients had no dislocations of their TMJs on clinical examination one month after the injection. In the pre-injection, unilateral or bilateral TMJ dislocations were observed on MRIs in all patients. One month after the injection, TMJ dislocations were not observed in MRI evaluation of any patients. A significant structural change that caused by ABI was not observed. Conclusion The procedure was easy to perform and it caused no foreign body reaction. However, it was unclear how the procedure prevented the dislocation. PMID:22474643

  3. Management of severe sleep apnea secondary to juvenile arthritis with temporomandibular joint replacement and mandibular advancement

    PubMed Central

    Paul, S. Arun; Simon, S. Sibu; Issac, Barney; Kumar, Saurav

    2015-01-01

    Variations affecting the growth centers can severely affect the normal formation and subsequent function of vital musculoskeletal structures. We report a case of bilateral condylar atrophy with a history of juvenile arthritis (JA) resulting in progressive obstructive sleep apnea (OSA) in adulthood. In addition to this, the case report emphasizes the role of temporomandibular joint replacement and advancement of the mandible to correct progressive OSA secondary to idiopathic JA. Computed tomography revealed micrognathia, condylar hypoplasia, and decreased pharyngeal airway space. The resultant increase in the retrolingual-pharyngeal airway space following the surgery, helped to completely resolve the presenting symptoms. It is hoped that the described technique could be used in similar cases with a predictable outcome. PMID:26538944

  4. Association Between Stress, Sleep Quality and Temporomandibular Joint Dysfunction: Simulated Mars Mission

    PubMed Central

    Rai, Balwant; Kaur, Jasdeep

    2013-01-01

    Objectives The aim of this study was to test the association between quality of sleep and stress in individuals with TMD (temporomandibular joint dysfunction) in simulated Mars mission. Methods The 24 healthy crew members were recruited. The physiological measures of systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded. The Symptom Checklist-90-revised was used which was based on nine dimensions of psychological functioning. The Multidimensional Pain Inventory was pain severity, social and physical activities, affective distress, social support, and feelings of life control. The Pittsburgh Sleep Quality Index was used to measure the number of hours spent in bed and during asleep, frequency and reasons for awakening, and difficulty returning to sleep after awakening. The orofacial pain questionnaire was applied to measure pain experience using descriptors from the McGill Pain Questionnaire. Salivary cortisol and melatonin were measured. Results The 15 crew members reported temporomandibular joint pain after 6 days of mission. On dental examination, 5 crew members reported simple muscle pain (SM) and other 10 crew members with TMD. The TMD group endorsed more affective descriptors of their pain experience. Compared to the TMD group, the SM group also reported significantly poorer sleep duration. The TMD group reported nonsignificantly more daytime dysfunction than the control. Higher levels of salivary cortisol and salivary melatonin were reported in the TMD group as compared to other group. Conclusion This study concludes that both quality of sleep and stress levels due to extreme condition (simulated Mars mission) were associated with TMD in simulated Mars mission. PMID:23772292

  5. Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review.

    PubMed

    Kellesarian, Sergio Varela; Al-Kheraif, Abdulaziz A; Vohra, Fahim; Ghanem, Alexis; Malmstrom, Hans; Romanos, Georgios E; Javed, Fawad

    2016-01-01

    The aim of this study was to review the cytokine profiles in the synovial fluid (SF) of patients with temporomandibular joint disorders (TMJD). Databases were searched from 1965 till September 2015 using different combinations of the following key words: "Temporomandibular joint"; "Cytokine"; "disorder"; and "synovial fluid" and "inflammation". Titles and abstracts of studies identified using the above-described protocol were screened and checked for agreement. Full-texts of articles judged by title and abstract to be relevant were read and independently evaluated. Hand-searching of the reference lists of potentially relevant original and review articles was also performed. The pattern of the present systematic review was customized to mainly summarize the relevant data. Fifteen studies were included. In 12 studies, cytokine profile of patients with TMJD was assessed using enzyme linked immunosorbent assay; and in 2 studies, histological analysis was performed to assess the cytokine profile of patients with TMJD. Patients with TMJD presented raised levels of interleukin (IL)-6 in 8 studies, IL-1beta (1?) in 5 studies and tumor necrosis factor-alpha (TNF-?) in 5 studies. Two studies showed no significant difference in TNF-? levels in patients with and without TMJD; and IL-1? levels were comparable in patients with and without TMJD in 2 studies. Raised levels of IL-6, TNF-?, IL-1?, IL-8, and IFN-? in the SF have been associated with inflammation in patients with TMJD. Cytokines IL-10, osteoclastogenesis inhibitory factor/osteoprotegerin (OCIF/OPG), and VEGF found in the SF of TMJs could have an anti-inflammatory effect. PMID:26556103

  6. A Meta-analysis of Clinical Effects of Low-level Laser Therapy on Temporomandibular Joint Pain

    PubMed Central

    Chang, Wen-Dien; Lee, Chia-Lun; Lin, Hung-Yu; Hsu, Yung-Chun; Wang, Chung-Jieh; Lai, Ping-Tung

    2014-01-01

    [Purpose] Temporomandibular joint (TMJ) pain is a symptom of TMJ disease. Low-level laser therapy (LLLT) is often used in the clinical treatment of TMJ pain. The aim of this study was to review the effective parameters of LLLT for TMJ pain. [Methods] This study was a systematic review in which electronic databases were searched for the period of January 2005 to January 2010. We selected reports of randomized controlled trials and calculated the effect size (ES) of the pain relief to evaluate the effect of LLLT. [Results] Seven reports are found to meet the inclusion criteria and discussed. Based on the calculation results, the pooled ES was –0.6, indicating a moderate effect of pain relief. In addition, the dosages and treatments with wavelengths of 780 and 830?nm can cause moderate and large pain relief effects. [Conclusion] Use of LLLT on the masticatory muscle or joint capsule for TMJ pain had a moderate analgesic effect. The optimal parameters for LLLT to treat TMJ pain have not been confirmed. However, our results can be a vital clinical reference for clinical physicians in treatment of patients with TMJ pain. PMID:25202201

  7. Use of autologous conditioned serum (Orthokine®) for the treatment of the dege-nerative osteoarthritis of the temporomandibular joint. Review of the literature

    PubMed Central

    Álvarez-Camino, Juan C.; Vázquez-Delgado, Eduardo

    2013-01-01

    Objectives: Treatment of osteoarthritis (OA) using autologous conditioned serum (ACS) has become in recent years an alternative to consider in the approach of the degenerative joint disease of the knee. There is no support in the literature for the use of ACS for the treatment of OA of the temporomandibular joint (TMJ), although the promising results obtained in human patients with knee joint disease as well as in animal studies are opening the way for its use at the TMJ. The aim of this paper is to conduct a review of the published literature regarding the use of the ACS for the treatment of OA in humans, considering the level of scientific evidence, and following the principles of the evidence-based medicine and dentistry. Material and Methods: A PubMed-MEDLINE search was carried out of articles published between 1980 and 2011. After an initial search, a total of 102 articles were obtained, followed by a selection of the most relevant articles according to the topic; a total of 8 articles were selected, which were stratified according to their level of scientific evidence using SORT criteria (Strength of Recommendation Taxonomy). Results: At the time of this review, there is no available literature referring the use of ACS at the TMJ. However, the use of the ACS in other joints is well documented, both experimentally and clinically, in humans and animals. The reviewed articles, with a level of evidence 1 and 2 according to the SORT criteria, have generally promising results. Discussion and Conclusions: The use of ACS in the treatment of OA in joints other than the TMJ, is endorsed by the level of evidence found in the literature, which opens the door to future studies to determine the feasibility of the use of the ACS in the treatment of degenerative OA that affects TMJ. Key words:Osteoarthritis, temporomandibular joint, autologous conditioned serum. PMID:23524415

  8. Historical development of alloplastic temporomandibular joint replacement after 1945 and state of the art.

    PubMed

    Driemel, O; Braun, S; Müller-Richter, U D A; Behr, M; Reichert, T E; Kunkel, M; Reich, R

    2009-09-01

    The variety of temporomandibular joint (TMJ) prostheses and condylar reconstruction plates available is in contradiction to their rare application. This emphasizes that alloplastic TMJ reconstruction is still evolving. This article reviews the history of TMJ reconstruction. Medline as well as public and private libraries have been searched. Current systems are reviewed. Prosthetic devices can be differentiated into fossa-eminence prostheses, ramus prostheses and condylar reconstruction plates, and total joint prostheses. Fossa and total joint prostheses are recommended when the glenoid fossa is exposed due to excessive stress (degenerative disorders, arthritis, ankylosis, multiply operated pain patients). Singular replacement of the condyle is preferred as a temporary solution in ablative surgery. The use of prosthetic devices for long-term replacement should be restricted to selected cases, taking care to retain the disk, in order to prevent penetration into the middle cranial fossa. The term 'condylar reconstruction plate' reflects this more clearly than 'ramus prosthesis' which suggests permanent reconstruction. Long-term studies comparing the functional and aesthetic results of the various prostheses and condylar reconstruction plates are not available, which leaves the choice to personal experience. PMID:19464145

  9. Investigating activity of masticatory muscles in patients with hypermobile temporomandibular joints by using EMG

    PubMed Central

    Davoudi, Amin; Rybalov, Oleg; Shadmehr, Elham; Hatami, Amin

    2015-01-01

    Background Temporomandibular joint hypermobility (TMJH) can manifest higher range of motions in mandible. The aim of this study was to investigate and compare the activity of masticatory muscle of TMJs in healthy individuals and patients with mild, moderate and severe TMJH. Material and Methods In this clinical study, 69 patients (between the ages of 22 to 42) with manifestation of TMJH were included. The patients were divided into three groups based on their maximum mouth opening (MMO): (light) with MMO of 50-55 mm; (moderate) with MMO between 55 to 65 mm; and (severe) with MMO >65 mm. Also, 20 healthy people with profiled tomography in the last 6 months were invited as control group (healthy) with normal MMO (<50 mm). All the groups subjected to electromyogram (EMG) in 2 steps: maximal voluntary clenching (MVC) of the jaws; and during chewing of bread by using one side of the jaws voluntary. The collected data were analyzed by Student T-test and Chi-Square tests using SPSS software version 15 at significant level of 0.05. Results Both TMJs of light, moderate and severe groups showed significant differences in frequency, time of activity and rest in comparison with healthy group during chewing and MVC (all p values < 0.01). Conclusions Masticatory muscles activity reduced in relation with the severity of TMJH and higher excessive mouth opening. Key words:Electromyography, joint hypermobility, mouth opening, tempormandibular joint. PMID:26155352

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2010-01-01

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

  12. Intra-articular injection of tenoxicam following temporomandibular joint arthrocentesis: a pilot study.

    PubMed

    Aktas, I; Yalcin, S; Sencer, S

    2010-05-01

    This study examined the clinical and radiological effects of intra-articular tenoxicam injection following arthrocentesis and compared them with arthrocentesis alone in patients with disc displacement without reduction (DDwoR). 24 temporomandibular joints (TMJs) in 21 patients with DDwoR were studied. Patients were divided randomly into Group A in which only arthrocentesis was performed (14 TMJs in 14 patients) and Group AT which received arthrocentesis plus intra-articular injection of tenoxicam (10 TMJs in 7 patients). Patients were evaluated before the procedure, on postoperative day 7, then 2, 3, 4 weeks, and 2, 3, 4, 5, 6 months postoperatively. Intensity of joint pain was assessed using a visual analog scale. Maximum mouth opening was recorded at each follow-up. TMJ sounds and palpation scores were noted as positive or negative. Magnetic resonance imaging (MRI) was performed before and 6 months after treatment in both groups. Disc form, disc location during neutral position, reduction with movement, joint effusion, structures of the articular surfaces, and bone marrow anomalies were evaluated all in MRIs. Both treatments succesfully increased maximum mouth opening and reduced TMJ pain; there were no complications. Difference between the groups was not statistically significant and a larger controlled study is necessary to clarify this use of tenoxicam. PMID:20211542

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

    PubMed

    El Adli, Joseph J; Deméré, Thomas A

    2015-04-01

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

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

    SciTech Connect

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

    1989-11-01

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

  15. Temporomandibular joint disorder in a patient with multiple sclerosis--review of literature with a clinical report.

    PubMed

    Badel, Tomislav; Carek, Andreja; Podoreski, Dijana; Pavicin, Ivana Savić; Lovko, Sandra Kocijan

    2010-09-01

    Temporomandibular disorders are a form of musculoskeletal disorders, which reduce the function of stomatognathic system and they are related to some other diseases causing painful conditions and disorders of oral function. The aim of this paper is to describe a one year follow up clinical case of a female patient with comorbid multiple sclerosis and a relatively rare form of articular disc disorder. Primary clinical diagnostics encompassed manual methods of TMJ examination. Definite diagnosis included radiologic examination. Clinical hyperextensive condyle position was palpated bilaterally and subsequently confirmed by a functional panoramic radiograph of TMJ. The anterior displacement of disc with reduction was diagnosed by magnetic resonance and in the right joint there was a disc displacement upon excursive movement. From relevant literature, the relationship of a number of diseases that can be related to functional disorder of the orofacial system, such as multiple sclerosis, has been described from many aspects. Also, apart from the standard classification of one form of anterior displacement of the disc, made primarily by magnetic resonance, cases of disc displacement upon excursive mandibular movement can rarely be found in literature. PMID:20977121

  16. Bite-force endurance in patients with temporomandibular joint osteoarthrosis and internal derangement.

    PubMed

    Stegenga, B; Broekhuijsen, M L; De Bont, L G; Van Willigen, J D

    1992-11-01

    The aim of this study was to investigate the potential clinical relevance of testing bite force endurance in patients with articular temporomandibular disorders. The endurance of a 50 N bite force was measured in 51 patients with painful temporomandibular joint disorders. The results were compared to those of a control group of 20 subjects. The force exerted was sustained until this task could not be continued because of intolerable pain or fatigue. The endurance test was repeated following therapy. Testing bite force endurance could be reliably carried out (paired t-test not significant, product-moment correlation coefficient 0.87). The mean endurance time in the patient group was significantly different from that of the control group (t = 7.43, df = 69, P < 0.01). The 95% confidence intervals for patients and controls did not show any overlap. No difference in endurance time between diagnostic subgroups could be detected (F = 1.30, df = 4,46, P < 0.28). Following treatment, all patients showed a significant increase of endurance time (t = 8.09, df = 50, P < 0.01) and reported a decrease in post-test pain. The mean difference between pre- and post-treatment endurance was 60s. Subjects of the control group stopped the biting effort predominantly because of muscle fatigue. By contrast, the main reason of the patients to cease the effort was TMJ pain. The results of this study indicate that the discriminatory power of the test is sufficient to justify its utility as a complementary tool in assessing the functional capacity of the masticatory system. PMID:1469499

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

    PubMed Central

    Lawaf, Shirin; Tabarestani, Tohid

    2015-01-01

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

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

    PubMed Central

    Peimani, Ali; Sardary, Farimah

    2014-01-01

    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. PMID:25628667

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2015-01-01

    Modern health care in the field of Medicine, Dentistry and Nursing is grounded in fundamental philosophy and epistemology of translational science. Recently in the U.S major national initiatives have been implemented in the hope of closing the gaps that sometimes exist between the two fundamental components of translational science, the translational research and translational effectiveness. Subsequent to these initiatives, many improvements have been made; however, important bioethical issues and limitations do still exist that need to be addressed. One such issue is the stakeholder engagement and its assessment and validation. Federal, state and local organizations such as PCORI and AHRQ concur that the key to a better understanding of the relationship between translational research and translational effectiveness is the assessment of the extent to which stakeholders are actively engaged in the translational process of healthcare. The stakeholder engagement analysis identifies who the stakeholders are, maps their contribution and involvement, evaluates their priorities and opinions, and accesses their current knowledge base. This analysis however requires conceptualization and validation from the bioethics standpoint. Here, we examine the bioethical dilemma of stakeholder engagement analysis in the context of the person-environment fit (PE-fit) theoretical model. This model is an approach to quantifying stakeholder engagement analysis for the design of patient-targeted interventions. In our previous studies of Alzheimer patients, we have developed, validated and used a simple instrument based on the PE-fit model that can be adapted and utilized in a much less studied pathology as a clinical model that has a wide range of symptoms and manifestations, the temporomandibular joint disorders (TMD). The temporomandibular joint (TMJ) is the jaw joint endowed with sensory and motor innervations that project from within the central nervous system and its dysfunction can be manifested systemically in forms of movement disorders, and related pathological symptomatologies.Currently, there is limited reliable evidence available to fully understand the complexity of the various domains of translational effectiveness, particularly in the context of stakeholder engagement and its assessment, validation as well as the bioethical implications as they pertain to evidence-based, effectivness-focused and patient-centered care. PMID:25600231

  1. Dental and Temporomandibular Joint Pathology of the Northern Fur Seal (Callorhinus ursinus).

    PubMed

    Aalderink, M T; Nguyen, H P; Kass, P H; Arzi, B; Verstraete, F J M

    2015-05-01

    Skulls from 145 northern fur seals (Callorhinus ursinus) were examined macroscopically according to predefined criteria. The museum specimens were acquired from strandings along the west coast of the USA between 1896 and 2008. Seventy-one skulls (49.0%) were from male animals, 56 (38.6%) from female animals and 18 (12.4%) from animals of unknown sex. Their age varied from juvenile to adult, with 58 adult animals (40.0%) and 87 juvenile animals (60.0%). The majority of teeth were available for examination (95.1%); 3.4% of teeth were artefactually absent, 0.8% were deemed absent due to acquired tooth loss and 0.6% were deemed congenitally absent. Males were no more likely than females to have either acquired tooth loss (P = 0.054) or congenitally absent teeth (P = 0.919). Adults had significantly more acquired tooth loss than juveniles (P = 0.0099). Malformations were seen in 11 teeth (0.2% of all 4,699 teeth available for examination). Two roots, instead of the typical one root, were found on 14 teeth (0.3%). Supernumerary teeth were associated with 14 normal teeth (0.3%) in eight specimens (5.5% of the total number of specimens). A total of 22 persistent deciduous teeth were found, 19 of which were associated with the maxillary canine teeth. Attrition/abrasion was seen on 194 teeth (3.9%); the canine teeth were most often affected, accounting for 39.7% of all abraded teeth. Adults were found to have a greater prevalence of abraded teeth than juveniles (P <0.0001). No significant difference was found in the appearance of attrition/abrasion between males and females (P = 0.072). Tooth fractures were found in 24 specimens (16.6%), affecting a total of 54 teeth (1.1%). Periapical lesions were found in two skulls (1.4%). None of the specimens showed signs of enamel hypoplasia. About a fifth (18.6%) of alveoli, either with or without teeth, showed signs of alveolar bony changes consistent with periodontitis. A total of 108 specimens (74.5%) had at least one tooth associated with mild periodontitis. Lesions consistent with temporomandibular joint osteoarthritis (TMJ-OA) were found in 29 specimens (20.0%). Both periodontal disease and TMJ-OA were significantly more common in adults than in juveniles (P <0.0001). Periodontitis was found to be more common in males than in females (P <0.012). Although the significance of the high incidence of periodontitis and TMJ-OA in the northern fur seal remains unknown, the occurrence and severity of these diseases found in this study may play an important role in this species morbidity and mortality. PMID:25824117

  2. Dental and Temporomandibular Joint Pathology of the Eastern Pacific Harbour Seal (Phoca vitulina richardii).

    PubMed

    Aalderink, M T; Nguyen, H P; Kass, P H; Arzi, B; Verstraete, F J M

    2015-05-01

    Skulls from 214 Eastern Pacific harbour seals (Phoca vitulina richardii) were examined macroscopically according to predefined criteria. The museum specimens were acquired from strandings along the west coast of the USA between 1909 and 2014. Ninety-eight skulls (45.8%) were from male animals, 108 (50.5%) from female animals and eight (3.7%) from animals of unknown sex. Their age varied from neonate to adult, with 101 adult animals (47.2%), 93 juvenile animals (43.5%) and 20 neonatal animals (9.3%). The majority of teeth were available for examination (90.0%); 7.5% of teeth were absent artefactually, 2.3% were deemed absent due to acquired tooth loss and 0.2% were absent congenitally. Males were no more likely than females to have either acquired tooth loss (P = 0.492) or congenitally absent teeth (P = 0.494). Adults had significantly more acquired tooth loss than juveniles (P <0.0001). All teeth were normal in morphology, except for four teeth from one skull that exhibited macrodontia. An unusual number of roots were found in most maxillary molar teeth; three roots were counted on six maxillary molar teeth and almost all other maxillary molar teeth available for examination had a fused root. Only 26 maxillary molar teeth exhibited two roots. Supernumerary teeth were associated with 13 normal teeth in nine specimens. The most common sites associated with supernumerary teeth were the left and right mandibular first premolar teeth (53.9% of all supernumerary teeth). No persistent deciduous teeth were found in any of the juvenile or adult specimens. Of the total number of teeth available for examination, 22.1% were abraded; six adult specimens showed attrition/abrasion on all of their teeth present. Adults were found to have a greater prevalence of abraded teeth than juveniles (P <0.0001). No significant difference was found in the appearance of attrition/abrasion between males and females (P = 0.518). Tooth fractures were uncommon, affecting 11 teeth (0.2%) in seven animals. Periapical lesions were found in four skulls (2.1% of the total number of specimens). None of the specimens showed signs of enamel hypoplasia. More than half (55.6%) of alveoli, either with or without teeth, showed signs of alveolar bony changes consistent with periodontitis. A total of 178 specimens (91.8%) had at least one tooth associated with mild periodontitis. Lesions consistent with temporomandibular joint osteoarthritis (TMJ-OA) were found in 67 specimens (34.5%). The most common articular surface to be affected was the left mandibular fossa of the temporal bone, with lesions in 44 cases (32.8% of all lesions). In 13 specimens (6.7%) all articular surfaces were affected. Both periodontal disease and TMJ-OA were significantly more common in adults than in juveniles (P <0.0001). Although the significance of the high incidence of periodontitis and TMJ-OA in the Eastern Pacific harbor seal remains unknown, the occurrence and severity of these diseases as found in this study may play an important role in the morbidity and mortality of this species. PMID:25824118

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

    PubMed Central

    Mottaghi, Ahmad; Zamani, Elham

    2014-01-01

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

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

    PubMed

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

    2015-04-01

    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

  5. Correlation between clinical symptoms and magnetic resonance imaging findings in patients with temporomandibular joint internal derangement

    PubMed Central

    Jung, Young-Wook; Park, Sung-Hoon; On, Sung-Woon

    2015-01-01

    Objectives The purpose of this study was to clarify which findings in magnetic resonance imaging (MRI) are good predicators of pain and mouth opening limitation in patients with temporomandibular joint (TMJ) internal derangement (ID). Materials and Methods Clinical examinations for pain and mouth opening limitation were conducted for suspected TMJ ID. MRI scans were taken within a week of clinical examinations. On the oblique-sagittal plane image, readings were obtained in terms of the functional aspect of disc position, degree of displacement, disc deformity, joint effusion, and osteoarthrosis. Multiple logistic regression analyses were conducted to identify the predictors of pain and mouth opening limitation. Results A total of 48 patients (96 TMJs) were studied, including 39 female patients and 9 male patients whose ages ranged from 10 to 65 years. The resultant data showed significant correlations between pain and the MR imaging of the degree of disc displacement (P<0.05). The probability of there being pain in moderate to significant cases was 9.69 times higher than in normal cases. No significant correlation was found between mouth opening limitation and MRI findings. Conclusion We identified a significant correlation between clinical symptoms and MRI findings of ID. The degree of anterior disc displacement may be useful for predicting pain in patients with TMJ ID. PMID:26131429

  6. Antinociceptive and anti-inflammatory effects of electroacupuncture on experimental arthritis of the rat temporomandibular joint.

    PubMed

    Gondim, Delane Viana; Costa, Jéssyca Lima; Rocha, Suellen Sousa; Brito, Gerly Anne de Castro; Ribeiro, Ronaldo de Albuquerque; Vale, Mariana Lima

    2012-04-01

    This study investigated the antinociceptive and anti-inflammatory effects of electroacupuncture (EA) on zymosan-induced acute arthritis of the rat temporomandibular joint (TMJ). Male Wistar rats were injected with saline or zymosan (control group; 2 mg) into the left TMJ. Low frequency EA (10 Hz, 30 min) was performed at acupoints (LI4, LI11, ST36, ST44) or sham points 2 h after or 1 h before zymosan administration. Mechanical hypernociception was accessed by the electronic Von Frey method after zymosan administration. Rats were sacrificed 6 h after zymosan administration and the joint was removed for histopathological analysis, myeloperoxidase activity assessment, vascular permeability observations, and immunohistochemical verification of inflammatory mediators. The results showed that EA inhibited zymosan-induced hypernociception, compared with the control group and with the sham group (p < 0.05). The results showed that EA inhibited inflammatory parameters such as neutrophil migration, vascular permeability, and tumour necrosis factor ? (TNF-?), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS) expression in the TMJ compared with the sham group (p < 0.05). Histopathological analysis showed that EA significantly inhibited edema and periarticular infiltration (p < 0.05) compared with the control and sham groups. EA at acupoints produced antinociceptive and anti-inflammatory effects on zymosan-induced arthritis in the rat TMJ. PMID:22443108

  7. Arthrocentesis and Temporomandibular Joint Disorders: Clinical and Radiological Results of a Prospective Study

    PubMed Central

    De Riu, Giacomo; Soma, Damiano; Pisano, Milena; Sembronio, Salvatore; Tullio, Antonio

    2013-01-01

    Purpose. We evaluated the efficacy of arthrocentesis in the treatment of temporomandibular joint (TMJ) disorders. Material and Methods. In this prospective clinical case series, 30 consecutive patients with TMJ disorders underwent arthrocentesis using saline and sodium hyaluronate injections. Outcome measures were TMJ pain, maximum mouth opening (MMO), joint noises, and anatomical changes in the TMJ architecture. Patients were evaluated using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) at the beginning of treatment and 60 days after the last arthrocentesis. Pretreatment and posttreatment clinical parameters were compared using paired and unpaired t-tests, and McNemar's test was used to evaluate CBCT and MRI changes (P < 0.05). Results. At 1-year follow-up examinations, visual analogue scale scores indicated that pain was reduced significantly and mean postoperative MMO was increased significantly. CBCT findings showed no significant change, and MRI showed only slight reductions in inflammatory signs. Conclusions. Within the limitations of this study, we can conclude that arthrocentesis is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders. This trial is registered with NCT01903512. PMID:24319462

  8. Examination of the heads of the lateral pterygoid muscle on the temporomandibular joint.

    PubMed

    Coskun Akar, Gulcan; Govsa, Figen; Ozgur, Zuhal

    2009-01-01

    The lateral pterygoid muscles (LPMs) function as a unit during precise mandibular positioning movements that occur during such activities as speech, singing, or playing musical instruments. The LPM has been the focus of an attempt to explain problems associated with the temporomandibular joint and anterior displacement of the meniscus of the joint. The aim of the study was to define the general morphology, describing the position and shape of the heads of the LPMs. In the course of dissection, the heads of the LPMs were noted, as well as the pattern, position of the origin and insertion, and course under 2.5x loupe magnification in 25 adult male human cadavers. The LPM has the general form of an irregular pyramid that narrows progressively toward the front. As a result of the macroscopic examination, the LPM was found to originate, with 3 heads as the superior LPM (SLPM), the inferior LPM (ILPM), and inner LPM. It was realized that the ILPM width was 3 times more than that of the SLPM. The SLPM ending fibers of LPM had a more tendinous structure compared with the ILPM ending fibers. The SLPM and ILPM were observed as being adhered mostly to the pterygoid fovea. The study has shown that the muscle has atypical penniform structure made up of 8 tendinous layers that were particularly well developed. It is an indisputable fact that the success in surgical strategy and planning mainly relies on the surgeon's knowledge of the variable origins and insertions of the LPM. PMID:19165031

  9. XROMM analysis of tooth occlusion and temporomandibular joint kinematics during feeding in juvenile miniature pigs.

    PubMed

    Menegaz, Rachel A; Baier, David B; Metzger, Keith A; Herring, Susan W; Brainerd, Elizabeth L

    2015-08-01

    Like humans, domestic pigs are omnivorous and thus are a common model for human masticatory function. Prior attempts to characterize food-tooth interactions and jaw movements associated with mastication have been limited to aspects of the oral apparatus that are visible externally (with videography) and/or to 2D movements of oral structures (with monoplanar videofluoroscopy). We used XROMM, a 3D technique that combines CT-based morphology with biplanar videofluoroscopy, to quantify mandibular kinematics, tooth occlusion and mandibular condylar displacements within the temporomandibular joint (TMJ) during feeding. We observed that the pig TMJ moved detectably in only three of six possible degrees of freedom during mastication: two rotations, pitch and yaw; and one translation, protraction-retraction. Asymmetrical yaw around a dorsoventral axis produced the observed alternating left-right chewing cycles responsible for food reduction. Furthermore, the relative motions of the upper and lower premolars contained a substantial mesiodistal component in addition to the buccolingual component, resulting in an oblique (rather than a strictly transverse) power stroke. This research demonstrates the capacity of XROMM to explore the kinematic underpinnings of key masticatory movements, such as the occlusal power stroke, by integrating tooth, joint and rigid body jaw movements. XROMM also allowed us to test kinematic hypotheses based on skeletal anatomy with actual kinematics observed during naturalistic feeding behaviors. We observed that the soft tissue structures of the TMJ appear to play a significant role in limiting the range of motion of a joint, and thus analyses based solely on osseous morphology may over-estimate joint mobility. PMID:26089531

  10. Relationship between activity of gluthatione peroxidase and nitric oxide in synovial fluid and the progression of temporomandibular joint internal derangement.

    PubMed

    Güven, Orhan; Tozo?lu, Sinan; Tekin, Umut; Salmano?lu, Berrin; Güne?, Onur

    2015-05-01

    The purposes of this study were to measure the activity of glutathione peroxidase (GPX) and nitric oxide (NO) in the synovial fluid of patients with temporomandibular joint (TMJ) internal derangement (ID) and to indicate the relationship between the activity of GPX and NO and the progress of the ID. Twenty-six patients with TMJ ID were identified and classified according to Wilkes staging through clinical and radiologic examinations. Levels of GPX were determined indirectly by a coupled reaction with glutathione reductase. Levels of NO were measured colorimetrically. The activity of GPX and NO was observed to be progressively increasing as the stage of the TMJ ID progressed. There were significant correlations between the 2 substances and the Wilkes stages. Oxidative stress may have a role in the pathogenesis of TMJ ID. In synovial fluid, GPX and NO activities are increased as the stage of the disease increased. Increase in the activities of GPX might not be enough to prevent progression of the TMJ ID. PMID:25974819

  11. Juvenile idiopathic arthritis and rheumatoid arthritis: bacterial diversity in temporomandibular joint synovial fluid in comparison with immunological and clinical findings.

    PubMed

    Olsen-Bergem, H; Kristoffersen, A K; Bjørnland, T; Reseland, J E; Aas, J A

    2016-03-01

    Temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) occurs in up to 80% of affected children. The purpose of this study was to investigate the presence of bacterial DNA in synovial fluid, and to compare this with clinical and immunological findings in children with JIA, adults with persistent JIA, and adults with rheumatoid arthritis, in order to detect whether bacteria contribute to inflammation in TMJ arthritis. Synovial fluid and skin swab samples were collected from 30 patients (54 TMJs). Bacterial detection was performed using 16S rRNA pyrosequencing. Bacterial DNA was detected in 31 TMJs (57%) in 19 patients (63%). A positive statistically significant correlation was registered between bacterial DNA detected in TMJ synovial fluid and the following factors: total protein concentration in synovial fluid, interleukin 1?, tumour necrosis factor alpha, adrenocorticotropic hormone, and adiponectin, as well as the duration of the general medical disease. Fourteen different bacterial species were detected in synovial fluid. Bacterial DNA in TMJ synovial fluid without contamination was detected in more than 50% of the patients. Studies are needed to evaluate the consequences of this bacterial DNA in synovial fluid with regard to TMJ arthritis. PMID:26554824

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

    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

  14. Strain rate dependent orthotropic properties of pristine and impulsively loaded porcine temporomandibular joint disk.

    PubMed

    Beatty, M W; Bruno, M J; Iwasaki, L R; Nickel, J C

    2001-10-01

    The purpose of this study was to characterize the tensile stress-strain behavior of the porcine temporomandibular joint (TMJ) disk with respect to collagen orientation and strain rate dependency. The apparent elastic modulus, ultimate tensile strength, and strain at maximum stress were measured at three elongation rates (0.5, 50, and 500 mm/min) for dumbbell-shaped samples oriented along either anteroposterior or mediolateral axes of the disks. In order to study the effects of impact-induced fissuring on the mechanical behavior, the same properties were measured along each orientation at an elongation rate of 500 mm/min for disks subjected to impulsive loads of 0.5 N. s. The results suggested a strongly orthotropic nature to the healthy pristine disk. The values for the apparent modulus and ultimate strength were 10-fold higher along the anteroposterior axis (p < or = 0.01), which represented the primary orientation of the collagen fibers. Strain rate dependency was evident for loading along the anteroposterior axis but not along the mediolateral axis. No significant differences in any property were noted between pristine and impulsively loaded disks for either orientation (p > 0.05). The results demonstrated the importance of choosing an orthotropic model for the TMJ disk to conduct finite element modeling, to develop failure criteria, and to construct tissue-engineered replacements. Impact-induced fissuring requires further study to determine if the TMJ disk is orthotropic with respect to fatigue. PMID:11416845

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

    PubMed

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

    2012-09-01

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

  16. A new method for three-dimensional reconstruction and animation of the temporomandibular joint.

    PubMed

    Krebs, M; Gallo, L M; Airoldi, R L; Palla, S

    1995-01-01

    The aim of this project was to develop a new method for the three-dimensional reconstruction and animation of the temporomandibular joint (TMJ). Magnetic resonance (MR) tomograms of the TMJ were combined, using an extraorally placed reference system, with jaw motion data, recorded with six degrees of freedom, by means of the opto-electronic tracking system Jaws-3D. The three-dimensional reconstruction of the TMJ was calculated and animated on a graphics workstation by means of kinematic transformations. A subject without any past or present history of myoarthropathies of the masticatory system, performed jaw opening and closing and chewed chewing gum. The animation provided a three-dimensional visualisation of the movements of the entire condyle within the fossa. The condyle-fossa distance was computed for every condylar point and represented by shading the surface of the condyle with pseudo-colours. The position of the minimum distance between condyle and fossa was calculated and displayed in a plane graph representing the condylar surface. PMID:7605078

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

    PubMed Central

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

    2010-01-01

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

  18. Incremental increase in percentage mouth opening after coronoidectomy in temporomandibular joint ankylosis.

    PubMed

    Kumar, P; Singh, V; Agrawal, A; Bhagol, A; Bali, R

    2015-07-01

    The aim of this study was to evaluate the incremental improvement in mouth opening following coronoidectomy. Twenty-three patients with unilateral temporomandibular joint (TMJ) ankylosis (Sawhney types I-III) were assessed preoperatively; physical and radiological examinations were done (panoramic radiography and computed tomography). Data including demographic and clinical parameters were recorded. Patients with bilateral ankylosis, recurrent cases, and those with Sawhney type IV TMJ ankylosis were not included. The improvement in mouth opening was measured after ostectomy, after ipsilateral coronoidectomy, and after contralateral coronoidectomy. The improvements in mouth opening at each stage were analysed using the Student's t-test and Pearson's correlation coefficient. There was a marked improvement in maximal incisal opening (MIO) from 5.7 ± 4.2mm to 23.7 ± 5.9 mm after removal of the ankylotic bony mass. MIO was significantly increased after ipsilateral coronoidectomy (31.6 ± 7.4mm), and after contralateral coronoidectomy, a mean MIO of 39.4 ± 11.2mm was achieved. At more than 1 year of follow-up, all patients showed improved mouth opening. In conclusion, coronoidectomy plays an important role in improving mouth opening in the treatment of TMJ ankylosis. PMID:25801011

  19. Long-term Outcomes of Shamanic Treatment for Temporomandibular Joint Disorders

    PubMed Central

    Vuckovic, Nancy H; Williams, Louise A; Schneider, Jennifer; Ramirez, Michelle; Gullion, Christina M

    2012-01-01

    Background: Temporomandibular joint disorders (TMDs) are chronic, often refractory, pain conditions affecting the jaw and face. Patients least likely to respond to allopathic treatment have the most marked biologic responsiveness to external stressors and concomitant psychosocial and emotional difficulties. From a shamanic healing perspective, this describes individuals who are thought to be “dispirited” and may benefit from this ancient form of spiritual healing. Objective: To report on the long-term quantitative and qualitative outcomes relative to end-of-treatment status of a phase I study that evaluated the feasibility and efficacy of shamanic healing for people with TMDs. Methods/Design: Participants were contacted by telephone at one, three, six, and nine months after treatment and asked to report pain and disability outcomes and qualitative feedback. Setting: Portland, OR. Participants: Twenty-three women aged 25 to 55 years diagnosed with TMD. Primary Outcome Measures: Participants rated their TMD-related pain and disability (on the TMD Research Diagnostic Criteria Axis II Pain Related Disability and Psychological Status Scale) at each follow-up call and were asked to describe their condition qualitatively. Results: Improvements in usual pain, worst pain, and functional impairment reported at end of treatment did not change during the 9 months after treatment ended (p > 0.18). Conclusion: Shamanic healing had lasting effects on TMDs in this small cohort of women. PMID:22745613

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

    PubMed Central

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

    2014-01-01

    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

  1. Stability of treatments for recurrent temporomandibular joint luxation: a systematic review.

    PubMed

    de Almeida, V L; de S Vitorino, N; de O Nascimento, A L; da Silva Júnior, D C; de Freitas, P H L

    2016-03-01

    Temporomandibular joint luxation (TMJ) is the excessive anterior translation of the mandibular condyle out of its normal range of movement and away from the glenoid fossa. Once dislocation occurs, the abnormal condylar position generates reflex contractions of the masticatory muscles, which in turn hinder movement of the condyle back to its resting position. Frequent luxation episodes characterize a condition referred to as recurrent TMJ luxation. While there are several surgical and conservative therapeutic options available for recurrent TMJ luxation, a robust, evidence-based rationale for choosing one technique over another is missing. Thus, a systematic review based on the PRISMA statement was proposed in an attempt to determine which therapeutic option results in the longest time to relapse. There is no good quality evidence on which treatment options guarantee the long-term elimination of recurrent TMJ luxation. In cases of post-surgical relapse, eminectomy has often been used as a 'rescue procedure', which may mean that surgeons empirically consider this treatment to be the 'gold standard' for addressing recurrent TMJ luxation. PMID:26616027

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

    PubMed

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

    2015-07-01

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

  3. Botulinum toxin therapy for temporomandibular joint disorders: a systematic review of randomized controlled trials.

    PubMed

    Chen, Y-W; Chiu, Y-W; Chen, C-Y; Chuang, S-K

    2015-08-01

    The objective of this study was to undertake a systematic review to assess the efficacy of botulinum toxin therapy (BTX) for temporomandibular joint disorders (TMDs). A comprehensive search of major databases through PubMed, EMBASE, and Cochrane CENTRAL was conducted to locate all relevant articles published from inception to October 2014. Eligible studies were selected based on inclusion criteria and included English language, peer-reviewed publications of randomized controlled trials comparing BTX versus any alternative intervention or placebo. Quality assessment and data extraction were done according to the Cochrane risk of bias tool and recommendations. The entire systematic search and selection process was done independently by two reviewers. Five relevant study trials were identified, involving 117 participants. Two trials revealed a significant between-group difference in myofascial pain reduction, another trial that compared BTX with fascial manipulation showed equal efficacy of pain relief on TMDs, while the remaining two trials showed no significant difference between the BTX and placebo groups. Because of considerable variations in study methods and evaluation of results, a meta-analysis could not be performed. Based on this review, no consensus could be reached on the therapeutic benefits of BTX on TMDs. A more rigorous design of trials should be carried out in future studies. PMID:25920597

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

    PubMed

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

    2015-01-01

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

  5. Biomechanical analysis of a temporomandibular joint condylar prosthesis during various clenching tasks.

    PubMed

    Huang, Heng-Li; Su, Kuo-Chih; Fuh, Lih-Jyh; Chen, Michael Y C; Wu, Jay; Tsai, Ming-Tzu; Hsu, Jui-Ting

    2015-09-01

    The objective of this study was to evaluate the effect of clenching tasks on the stress and stability of a temporomandibular joint (TMJ) condylar prosthesis, as well as on the stress and strain in the whole mandible and bone surrounding three screws. Three-dimensional finite element models of the mandible and a TMJ condylar prosthesis using three screws were established. Six static clenching tasks were simulated in this study: incisal clench (INC), intercuspal position (ICP), right unilateral molar clench (RMOL), left unilateral molar clench (LMOL), right group function (RGF), and left group function (LGF). Based on the simulation of the six clenching tasks, none of the inserted screws or the TMJ condylar prosthesis were broken. In addition, the stability of the TMJ condylar prosthesis was sufficiently high for bone ongrowth. For the whole mandibular bone, the maximum von Mises stress and von Mises strain observed in the cortical bone and cancellous bone were yielded by the ICP and RMOL, respectively. For the bone surrounding the inserted screws, the maximum von Mises stress and von Mises strain in both the cortical bone and cancellous bone were yielded by the LMOL. Clenching tasks had significant effects on the stress distribution of the TMJ condylar prosthesis, as well as on the stress and strain distribution of the whole mandible and the bone surrounding the inserted screws. PMID:26027864

  6. Treatment of temporomandibular joint structures by 308-nm excimer laser--an in vitro investigation.

    PubMed

    Liesenhoff, T; Funk, A

    1994-12-01

    Arthroscopy of the temporomandibular joint (TMJ) has become a clinically important and increasingly accepted method for diagnosis and treatment of TMJ alteration. This minimally invasive method is clearly limited by the anatomic dimensions of the TMJ. The 308-nm excimer laser has already found clinical applications in angioplasty, ophthalmology, and dentistry. This study aimed to find out whether it is possible to ablate TMJ-related structures under arthroscopic conditions. It also aimed to determine the energy threshold for ablation and the maximum rate of ablation. By histologic investigation of the irradiated tissues, the amount of tissue alteration was determined. TMJ structures of freshly slaughtered pigs served as tissue samples. The 308-nm excimer laser light was guided through optical fibers. The tissue was irradiated under continuous flow of saline solution. The energy threshold for ablation of TMJ structures was found at about 1 J/cm2. The maximum rate of ablation was found at 3-5 micron/pulse, depending on the type of tissue. The amount of tissue alteration varied between 1 and 150 microns. The types of tissue alteration were vacuolization and hyalinization. The results of the investigations described indicate that the 308-nm excimer laser is an ideal tool for TMJ arthroscopic surgery. Unlike other laser systems, it offers a unique combination of minimal tissue alteration, precise tissue ablation, guidability through optical fibers, and good transmission through water. This makes possible endoscopic removal of free bodies, adhesions, exostoses, and appositions in a minimally invasive surgical procedure. PMID:7890990

  7. Stress analysis in human temporomandibular joint affected by anterior disc displacement during prolonged clenching.

    PubMed

    Abe, S; Kawano, F; Kohge, K; Kawaoka, T; Ueda, K; Hattori-Hara, E; Mori, H; Kuroda, S; Tanaka, E

    2013-04-01

    Parafunctional habits, such as prolonged clenching and bruxism, have been associated with dysfunctional overloading in the temporomandibular joint (TMJ). In this study, stress distributions in the TMJ were analysed during prolonged clenching, using three-dimensional finite element (FE) models of the TMJ with and without disc displacement. The aim of this study was to investigate stress distribution of the cartilaginous tissues in the TMJ with and without disc displacement. Finite element models were developed on the basis of magnetic resonance images from two subjects with and without anterior disc displacement. Condylar movements recorded during a 5-min clenching were used as the loading condition for stress analysis. In the asymptomatic model, the highest von Mises stresses were located in the lateral area (4·91 MPa) of the disc surfaces, and after 5-min clenching, the higher stresses were still located at the lateral area (3·65 MPa). In all the cartilaginous tissues, 30-50% of stress reduction occurred during 5-min clenching. In contrast, the von Mises stress in the cartilaginous tissues of the symptomatic model with disc displacement was markedly lower, compared with the asymptomatic model. However, in the condylar cartilage, stress relaxation during clenching was not recognised. Furthermore, relatively high stresses were observed in the retrodiscal tissues throughout clenching. The present results indicate that disc position could be involved in the stress distribution of the TMJ components during prolonged clenching. PMID:23398635

  8. Tensile stress patterns predicted in the articular disc of the human temporomandibular joint

    PubMed Central

    Koolstra, J H; Tanaka, E

    2009-01-01

    The direction of the first principal stress in the articular disc of the temporomandibular joint was predicted with a biomechanical model of the human masticatory system. The results were compared with the orientation of its collagen fibers. Furthermore, the effect of an active pull of the superior lateral pterygoid muscle, which is directly attached to the articular disc, was studied. It was hypothesized that the markedly antero-posterior direction of the collagen fibers would be reflected in the direction of the tensile stresses in the disc and that active pull of the superior lateral pterygoid muscle would augment these tensions. It was found that the tensile patterns were extremely dependent on the stage of movement and on the mandibular position. They differed between the superior and inferior layers of the disc. The hypothesis could only be confirmed for the anterior and middle portions of the disc. The predicted tensile principal stresses in the posterior part of the disc alternated between antero-posterior and medio-lateral directions. PMID:19627392

  9. Effect of mandibular distraction osteogenesis on temporomandibular joint after previous irradiation and hyperbaric oxygenation.

    PubMed

    Muhonen, A; Peltomäki, T; Hinkka, S; Happonen, R P

    2002-08-01

    The purpose was to evaluate the effect of mandibular distraction osteogenesis (DO) on condylar cartilage after radiotherapy and hyperbaric oxygenation (HBO). Unilateral DO was performed on low- and high-dose irradiated rabbits with or without accompanying HBO, and non-irradiated animals. High-dose irradiated animals were given irradiation in the temporomandibular joint (TMJ) equivalent to 50 Gy in 25 fractions. Low-dose irradiated rabbits received scattered irradiation of 10% of that of high-dose irradiated animals. After radiotherapy, some of the animals were given HBO 18 times at 2.5 ATA for 90 min/day. One month after completion of radiotherapy, distraction osteotomy with distractor placement was performed. After a latency period, distraction was started at the rate of 1 mm/day, continued for 2 weeks, and the regenerate was allowed to consolidate for 1 month. Condyles of non-operated rabbits served as controls. Histological changes were more evident on the distracted than on the non-distracted side. In distracted, non-irradiated animals, condylar cartilage changes were minor and probably clinically insignificant. In irradiated rabbits, condylar cartilage changes on the lengthened side were severe, and often cartilage was either totally or partially sealed off by bone. Condylar heads were morphologically deformed. Even low doses of irradiation resulted in notable changes on the operated side, and HBO did not prevent disadvantageous effects. PMID:12361073

  10. Pre-arthroplastic and simultaneous mandibular distraction for correction of facial deformity in temporomandibular joint ankylosis

    PubMed Central

    Chellappa, A.L.; Mehrotra, D.; Vishwakarma, K.; Mahajan, N.; Bhutia, D.P.

    2015-01-01

    Introduction In cases of temporomandibular joint (TMJ) ankylosis, interposition arthroplasty allows return of functional jaw movements. In order to improve the facial appearance, distraction osteogenesis is the treatment of choice, and may be timed either as a pre-arthroplastic, simultaneous or post-arthroplastic procedure. This study was planned to compare the treatment outcomes of pre-arthroplastic distraction (PAD) and simultaneous arthroplastic distraction (SAD) to establish the better treatment modality in terms of improvement in function and aesthetics. Materials and methods This prospective randomized experimental study included 20 children and adolescents suffering from facial deformity due to long standing unilateral TMJ ankylosis. They were randomly allocated to the two surgical groups with ten in each group. Result Both groups resulted in good facial symmetry and aesthetics. Initially, during the distraction period, mouth opening of SAD group scored less than that of PAD group but became comparable in 30 days. More pain at the distraction site and over the normal TMJ was observed in PAD group. The excursive movements were almost comparable in both the groups. Conclusion We conclude that both procedures are effective in correcting the post-ankylotic deformity and improving function. Although PAD has better control over movement of the distracting segment, the contralateral TMJ may experience pain. SAD requires a shorter management period but is associated with a temporary decrease in function. Also, control of distraction may be difficult and chances of reankylosis are always there. PMID:26587380

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

    PubMed Central

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

    2015-01-01

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

  12. Effect of Lengthy Root Canal Therapy Sessions on Temporomandibular Joint and Masticatory Muscles

    PubMed Central

    Sahebi, Safoora; Moazami, Fariborz; Afsa, Masoomeh; Nabavi Zade, Mohammad Reza

    2010-01-01

    Background and aims Trauma is one of the major factors associated with temporomandibular joint disorders (TMD). These disorders result from macro-trauma or micro-trauma. Macro-trauma might be iatrogenic; for example, from intuba-tion procedures, third molar extraction procedures, and lengthy dental appointments. The aim of this study was to evaluate the effect of lengthy root canal therapy (more than 2 hours) on TMJ and its supporting structures. Materials and methods Eighty patients whose root canal therapy session lasted more than 2 hours were examined for the status of TMJ and masticatory muscles. After one week the second part of the examination was carried out for TMJ problems and pain and tenderness levels of masticatory muscles. Data was analyzed using Wilcoxon statistical test. Results Women showed more pain compared to men. There was a significant increase in pain in the external acoustic meatus examination one week after root canal therapy. Patients who were treated for their posterior teeth suffered more pain than those who were treated for the anteriors and premolars. Other aspects of the examination were not affected significantly by lengthy root canal therapy. Conclusion Lengthy dental treatments can harm TMJ and masticatory muscles and wide opening of the mouth during such appointments can worsen the situation. Therefore, it is wise to break the appointment into shorter intervals and let the patients rest during treatment to close their mouth to prevent iatrogenic damage to TMJ. PMID:22991607

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

    PubMed Central

    Pierson, Melissa Joan

    2011-01-01

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

  14. Somatosensory function following painful repetitive electrical stimulation of the human temporomandibular joint and skin.

    PubMed

    Ayesh, E E; Jensen, T S; Svensson, P

    2007-05-01

    Temporomandibular disorders (TMD) are common pain problems in the population with uncertain pathophysiology and mechanisms. The aim of this experimental study was to: (1) Establish an experimental pain model using electrical stimuli to describe characteristics of nociception from the human temporomandibular joint (TMJ) and overlying skin. (2) Test the hypothesis that there would be sex-related differences in TMJ sensitivity. Forty-three healthy subjects (24 men and 19 women) participated. Using two unipolar needle electrodes into the skin (above the TMJ) in one session or into the TMJ in the other session, sensory detection threshold (SDT), pain detection threshold (PDT), and summation threshold (SumT) were measured, before and after repetitive electrical stimulation. Painful repetitive electrical stimulation was applied for 20 min with individually adjustment of the intensity of the stimuli to keep the pain rating around five on a 0-10 cm visual analogue scale (VAS). Sensitivity to tactile and pin-prick stimuli were assessed at 11 sites around the TMJ using two von Frey nylon filaments (5.16 and 84.96 g), as well as pressure pain threshold (PPT) and pressure pain tolerance (PPTOL) before the stimulation, after 20 min of stimulation and finally 15 min after the end of stimulation. Numerical rating scale (NRS) from 0 to 100 was used to rate the intensity of applied von Frey filaments. SDT, PDT, and SumT were higher in the TMJ than in the skin. These three measures increased after painful repetitive stimulation for 20 min (de-sensitization). In contrast to this effect, a hypersensitivity to pin-prick stimuli was detected around the TMJ area on the stimulated side after 20 min of electrical stimulation in the TMJ, but not in the skin. A bilateral hyposensitivity to tactile stimuli was detected after skin and TMJ stimulation. PPT and PPTOL did not show a significant change over time. Except for lower TMJ PPTOLs in women than men there were no significant sex-related differences in mechanical or electrical measures. The present findings indicate differences in the elicitation of hypersensitivity following repetitive electrical stimulation of skin and deep tissues. The mechanisms underlying these findings are not clear but differences in the induction of long-term potentiation and depression is a possibility. From a clinical point of view, the lack of sex differences in most of the used measures indicates that the higher prevalence of women than men amongst patients with persistent TMJ pain problems not entirely can be ascribed to a higher sensitivity of the TMJ. Further studies will examine the somatosensory sensitivity of patients with TMJ pain problems. PMID:17146645

  15. 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

    Bae, Youngsook

    2014-01-01

    [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

  16. 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

    Bae, Youngsook

    2014-09-01

    [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

  17. Effectiveness of different surgical modalities in the management of temporomandibular joint ankylosis: a meta-analysis

    PubMed Central

    Liu, Xiaohan; Shen, Pei; Zhang, Shanyong; Yang, Chi; Wang, Yong

    2015-01-01

    Background: A meta-analysis was conducted to evaluate the effectiveness of three surgical modalities-gap arthroplasty (GA), interpositional gap arthroplasty (IPG) and joint reconstruction (AR)-in treating temporomandibular joint (TMJ) ankylosis. Methods: A systematic review was performed using the PUBMED, EMBASE and OVID search engines in February 2015 to identify cohort studies with no restrictions, with the aim of evaluating the three surgical modalities. The outcome was the change between the pre- and postoperative maximal incisal opening (MIO). Analyses of category, heterogeneity, sensitivity and publication bias were performed. A fixed-effects model was used to compute the pooled weighted mean difference in the MIO among the different groups. Result: Seventeen studies with 740 participants were included in the final analysis. The IPG therapy showed a significantly greater MIO when compared to GA (WMD=1.16 mm; 95% CI, 0.15-2.16) and AR (WMD=0.99 mm; 95% CI, 0.05-1.92) therapies. The weighted mean difference between the AR and GA modalities was 2.94 mm (95% CI, 0.12-5.75). The pooled odds ratios (ORs) of the recurrence rate for IPG, GA and AR were 0.01 (95% CI, 0.00-0.03), 0.03 (95% CI, 0.00-0.07) and 0.06 (95% CI, 0.04-0.09), respectively. Conclusion: The analysis showed that IPG was more effective and displayed a lower recurrence rate, followed by AR and GA, in treating TMJ ankylosis. Thus, this analysis provides strong evidence supporting IPG as a first-line therapy for TMJ ankylosis. PMID:26884893

  18. Characterization of the Temporomandibular Joint of Southern Sea Otters (Enhydra lutris nereis)

    PubMed Central

    Lieske, Danielle; Vapniarsky, Natalia; Verstraete, Frank J. M.; Leale, Dustin M.; Young, Colleen; Arzi, Boaz

    2015-01-01

    The structure–function relationship of the temporomandibular joint (TMJ) of southern sea otter has largely not been described. This study aims to describe the histological, biochemical, and biomechanical features of the TMJ disk in the southern sea otter. The TMJ disks from fresh cadaver heads of southern sea otter adult males (n = 8) and females (n = 8) acquired from strandings were examined. Following macroscopical evaluation, the TMJs were investigated for their histological, mechanical, and biochemical properties. We found that the sea otter TMJ disks are, in general, similar to other carnivores. Macroscopically, the TMJ disk was highly congruent, and the mandibular head was encased tightly by the mandibular fossa with a thin disk separating the joint into two compartments. Histologically, the articular surfaces were lined with dense fibrous connective tissue that gradually transitioned into one to two cell thick layer of hyaline-like cartilage. The disk fibers were aligned primarily in the rostrocaudal direction and had occasional lacuna with chondrocyte-like cells. The disk was composed primarily of collagen type 1. Biochemical analysis indicates sulfated glycosaminoglycan content lower than other mammals, but significantly higher in male sea otters than female sea otters. Finally, mechanical analysis demonstrated a disk that was not only stronger and stiffer in the rostrocaudal direction than the mediolateral direction but also significantly stronger and stiffer in females than males. We conclude that the congruent design of the TMJ, thin disk, biochemical content, and mechanical properties all reflect a structure–function relationship within the TMJ disk that is likely designed for the sea otter’s hard diet and continuous food intake. PMID:26664997

  19. Characterization of the Temporomandibular Joint of Southern Sea Otters (Enhydra lutris nereis).

    PubMed

    Lieske, Danielle; Vapniarsky, Natalia; Verstraete, Frank J M; Leale, Dustin M; Young, Colleen; Arzi, Boaz

    2015-01-01

    The structure-function relationship of the temporomandibular joint (TMJ) of southern sea otter has largely not been described. This study aims to describe the histological, biochemical, and biomechanical features of the TMJ disk in the southern sea otter. The TMJ disks from fresh cadaver heads of southern sea otter adult males (n?=?8) and females (n?=?8) acquired from strandings were examined. Following macroscopical evaluation, the TMJs were investigated for their histological, mechanical, and biochemical properties. We found that the sea otter TMJ disks are, in general, similar to other carnivores. Macroscopically, the TMJ disk was highly congruent, and the mandibular head was encased tightly by the mandibular fossa with a thin disk separating the joint into two compartments. Histologically, the articular surfaces were lined with dense fibrous connective tissue that gradually transitioned into one to two cell thick layer of hyaline-like cartilage. The disk fibers were aligned primarily in the rostrocaudal direction and had occasional lacuna with chondrocyte-like cells. The disk was composed primarily of collagen type 1. Biochemical analysis indicates sulfated glycosaminoglycan content lower than other mammals, but significantly higher in male sea otters than female sea otters. Finally, mechanical analysis demonstrated a disk that was not only stronger and stiffer in the rostrocaudal direction than the mediolateral direction but also significantly stronger and stiffer in females than males. We conclude that the congruent design of the TMJ, thin disk, biochemical content, and mechanical properties all reflect a structure-function relationship within the TMJ disk that is likely designed for the sea otter's hard diet and continuous food intake. PMID:26664997

  20. Arthroscopic lysis and lavage for internal derangement of the temporomandibular joint

    PubMed Central

    Abboud, Waseem A.; Givol, Navot; Yahalom, Ran

    2015-01-01

    Introduction: Arthroscopy of the temporomandibular joint (TMJ) is a valuable diagnostic and therapeutic tool for various intra-articular disorders, especially internal derangement (ID) of the TMJ. Objectives: To evaluate the efficacy and safety of a standardized arthroscopic procedure for the treatment of two stages of ID; early/intermediate stage and intermediate/late stage. Materials and Methods: Retrospective analysis of medical records of 78 patients (99 joints) treated by arthroscopic lysis and lavage in the authors’ department during a 5-year period. Patients were diagnosed preoperatively as suffering from ID of the TMJ. The results were stratified according to the stage of ID. Three outcome variables were used to assess efficacy of treatment: Maximal interincisal opening (MIO), level of pain on a visual analog scale (VAS), and frequency of intermittent locking episodes. In addition, complications were reported. Results: Mean MIO of the group of patients with intermediate/late stage ID increased from 27 ± 4.7 mm preoperatively to 38 ± 5.4 mm postoperatively (P < 0.0001). For the group of patients with early/intermediate stage ID, mean MIO did not change significantly after arthroscopy (39.1 ± 6.2 mm compared to 41.4 ± 5 mm, P = 0.06), however, subjective evaluation of pain on a VAS decreased from 7.2 ± 1.2 preoperatively to 3.4 ± 2.2 postoperatively (P < 0.0001), and 80% of the patients (25 of 31) denied experiencing intermittent locking episodes after treatment (P < 0.0001). Conclusion: Arthroscopic lysis and lavage is a safe and effective therapeutic modality for the treatment of both mild and advanced stages of ID.

  1. Association of Temporomandibular Joint Signs & Symptoms with Dental Fluorosis & Skeletal Manifestations in Endemic Fluoride Areas of Dungarpur District, Rajasthan, India

    PubMed Central

    Asawa, Kailash; Bhat, Nagesh; Tak, Mridula; Shinde, Kushal; Jain, Sandeep

    2015-01-01

    Introduction Endemic fluorosis resulting from high fluoride concentration in groundwater is a major public health problem. India is among the numerous nations, where fluoride sullied groundwater is creating wellbeing issues. Safe drinking water in rural areas of India is predominantly rely on groundwater sources, which are exceptionally contaminated with fluoride. Aim To investigate the association of temporomandibular joint Signs & Symptoms with Dental Fluorosis & Skeletal Manifestations among people living in Dad, Bokersal & Deotalab villages of Dungarpur District, Rajasthan, India. Materials and Methods The study group consisted of 750 subjects who were born & brought up in Dad, Bokersal & Deotalab villages of Dungarpur District, Rajasthan. Temporomandibular joint & Dental fluorosis was assessed by performing type III clinical examination according to WHO guidelines (1997). For the assessment of skeletal manifestations, participants were asked to perform three diagnostic tests: (1)Touching the toes without bending the knees; (2) Touching the chest with the chin; (3) Stretching the arms sideways & folding the arms to touch the back of the head. Chi Square test & Multiple Logistic Regression were applied for statistical analysis. Results Among the 750 (462 males & 288 females) who participated in the study, 53% had moderate grade of dental fluorosis. The most prominent symptom suggesting Temporomandibular Joint Disorder was the clicking sound affecting 21.4% population.(p>0.001). TMJ Signs & Symptoms were prominent in the age group of 45-54 years & males were highly affected than females. Conclusion Clinical examination of TMJ in Dental Fluorosis & Skeletal Fluorosis subjects showed a significant association with Dental Fluorosis & Skeletal Fluorosis. PMID:26816986

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

    PubMed Central

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

    2014-01-01

    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

  3. Realization of masticatory movement by 3-dimensional simulation of the temporomandibular joint and the masticatory muscles.

    PubMed

    Park, Jong-Tae; Lee, Jae-Gi; Won, Sung-Yoon; Lee, Sang-Hee; Cha, Jung-Yul; Kim, Hee-Jin

    2013-07-01

    Masticatory muscles are closely involved in mastication, pronunciation, and swallowing, and it is therefore important to study the specific functions and dynamics of the mandibular and masticatory muscles. However, the shortness of muscle fibers and the diversity of movement directions make it difficult to study and simplify the dynamics of mastication. The purpose of this study was to use 3-dimensional (3D) simulation to observe the functions and movements of each of the masticatory muscles and the mandible while chewing. To simulate the masticatory movement, computed tomographic images were taken from a single Korean volunteer (30-year-old man), and skull image data were reconstructed in 3D (Mimics; Materialise, Leuven, Belgium). The 3D-reconstructed masticatory muscles were then attached to the 3D skull model. The masticatory movements were animated using Maya (Autodesk, San Rafael, CA) based on the mandibular motion path. During unilateral chewing, the mandible was found to move laterally toward the functional side by contracting the contralateral lateral pterygoid and ipsilateral temporalis muscles. During the initial mouth opening, only hinge movement was observed at the temporomandibular joint. During this period, the entire mandible rotated approximately 13 degrees toward the bicondylar horizontal plane. Continued movement of the mandible to full mouth opening occurred simultaneously with sliding and hinge movements, and the mandible rotated approximately 17 degrees toward the center of the mandibular ramus. The described approach can yield data for use in face animation and other simulation systems and for elucidating the functional components related to contraction and relaxation of muscles during mastication. PMID:23851865

  4. Modulation of paratrigeminal nociceptive neurons following temporomandibular joint inflammation in rats

    PubMed Central

    Yamazaki, Yoko; Ren, Ke; Shimada, Masahiko; Iwata, Koichi

    2009-01-01

    To evaluate the involvement of paratrigeminal nucleus (Pa5) nociceptive neurons in temporomandibular joint (TMJ) inflammation-induced pain and its autonomic correlates, we conducted behavioral, single unit recording and Fos immunohistochemical studies in anesthetized rats. Nocifensive behaviors to mechanical, heat or cold stimulation of the lateral face over the TMJ region were significantly enhanced in the TMJ-inflamed rats for 10–14 days after injection of complete Freund’s adjuvant (CFA) into the TMJ and gradually decreased at the end of the 14-day observation period. Lowering of the nocifensive threshold in TMJ-inflamed rats lasted longer in vagus nerve-transected rats than vagus nerve-intact rats. A large number of Fos-like immunoreactive (LI) cells were observed in the Pa5, and half of them were retrogradely labeled with Fluorogold (FG) injected into the parabrachial nucleus. Background activity of Pa5 wide dynamic range and nociceptive specific neurons was significantly higher in the TMJ-inflamed rats when compared with controls. Responses to mechanical stimuli were significantly higher in NS neurons in the TMJ-inflamed rats. All thermal responsive Pa5 neurons were exclusively sensitive to cold and the response to cold was significantly higher in the TMJ-inflamed rats compared with control rats. Vagus nerve stimulation significantly decreased responses to mechanical and cold stimuli as well as the background activity in TMJ-treated rats but not in TMJ-untreated rats. The present findings suggest that populations of Pa5 neurons are nociceptive and involved in TMJ inflammation-induced pain as well as in autonomic processes related to TMJ pain. PMID:18778706

  5. Reactive arthritis in relation to internal derangements of the temporomandibular joint: a case control study.

    PubMed

    Lund, Bodil; Holmlund, Anders; Wretlind, Bengt; Jalal, Shah; Rosén, Annika

    2015-09-01

    The aim of this study was to find out if reactive arthritis was involved in the aetiology of chronic closed lock of the temporomandibular joint (TMJ) by looking for bacterial antigens in the synovial membrane of the TMJ, and by studying the antibody serology and carriage of human leucocyte antigen (HLA) B27 in patients with chronic closed lock. Patients with reciprocal clicking and healthy subjects acted as controls. We studied a total of 43 consecutive patients, 15 with chronic closed lock, 13 with reciprocal clicking, and 15 healthy controls with no internal derangements of the TMJ. Venous blood samples were collected from all subjects for measurement of concentrations of HLA tissue antigen and serology against Chlamydia trachomatis, Yersinia enterocolitica, Salmonella spp., Campylobacter jejuni, and Mycoplasma pneumoniae. Samples of synovial tissue from patients with closed lock and reciprocal clicking were obtained during discectomy and divided into two pieces, the first of which was tested by strand displacement amplification for the presence of C trachomatis, and the second of which was analysed for the presence of species-specific bacterial DNA using 16s rRNA pan-polymerase chain reaction (PCR). There were no significant differences between the groups in the incidence of antibodies against M pneumoniae, Salmonella spp. or Y enterocolitica. No patient had antibodies towards C trachomatis or C jejuni. We found no bacterial DNA in the synovial fluid from any patient. The HLA B27 antigen was present in 2/15 subjects in both the closed lock and control groups, and none in the reciprocal clicking group. In conclusion, reactive arthritis does not seem to be the mechanism of internal derangement of the TMJ. PMID:25957137

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

    NASA Astrophysics Data System (ADS)

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

    2014-04-01

    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.

  7. Differential gene expression in the perichondrium and cartilage of the neonatal mouse temporomandibular joint

    PubMed Central

    Hinton, RJ; Serrano, M; So, S

    2009-01-01

    Objective To discover genes differentially expressed in the perichondrium of the mandibular condylar cartilage (MCC) that might enhance regenerative medicine or orthopedic therapies directed at the tissues of the temporomandibular joint Design We used targeted gene arrays (osteogenesis, stem cell) to identify genes preferentially expressed in the perichondrium (PC) and the cartilaginous (C) portions of the MCC in 2 day-old mice Results Genes with higher expression in the PC sample related to growth factor ligand-receptor interactions (FGF-13 (6.4X), FGF-18 (4X), NCAM (2X); PGDF receptors, TGF-?, and IGF-1), the Notch isoforms (especially Notch 3 and 4) and their ligands, or structural proteins/ proteoglycans (collagen XIV (21X), collagen XVIII (4X), decorin (2.5X)). Genes with higher expression in the C sample consisted mostly of known cartilage-specific genes (aggrecan (11X), procollagens X (33X), XI (14X), IX (4.5X), Sox 9 (4.4X), and Indian hedgehog (6.7X)). However, the functional or structural roles of several genes that were expressed at higher levels in the PC sample are unclear (myogenic factor 9 (9X), tooth-related genes such as tuftelin (2.5X) and dentin sialophosphoprotein (1.6X), VEGF–B (2X) and its receptors (3–4X), and sclerostin (1.7X)). Conclusions FGF, Notch, and TGF-? signaling may be important regulators of MCC proliferation and differentiation; the relatively high expression of genes such as myogenic factor 6 and VEGF–B and its receptors suggests a degree of unsuspected plasticity in PC cells. PMID:19627518

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

    PubMed Central

    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

    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

  9. Motivation, characterization, and strategy for tissue engineering the temporomandibular joint disc.

    PubMed

    Detamore, Michael S; Athanasiou, Kyriacos A

    2003-12-01

    The purpose of this review is to serve as the standard point of reference in guiding researchers investigating the tissue engineering of the temporomandibular joint (TMJ) disc. Tissue engineering of the TMJ disc is in its infancy, and currently there exists a gap between the tissue engineering community and the TMJ characterization community. The primary goal is to help bridge that gap by consolidating the characterization studies here as a reference to researchers attempting to tissue engineer the TMJ disc. A brief review of TMJ anatomy is provided, along with a description of relevant pathology, current treatment, and a rationale for engineering the TMJ disc. The biochemical composition and organization of the disc are reviewed, including glycosaminoglycan (GAG) and collagen content. The collagen of the disc is almost exclusively type I and primarily runs anteroposteriorly through the center and in a ringlike fashion around the periphery. The GAG content is approximately an order of magnitude less than that of hyaline cartilage, and although the distribution is not entirely clear, it seems as though chondroitin and dermatan sulfate are by far the primary GAGs. Cellular characterization and mechanical properties under compression, tension, and shear are reviewed as well. The cells of the disc are not chondrocytes, but rather resemble fibrocytes and fibrochondrocytes and may be of the same lineage. Mechanically, the disc is certainly anisotropic and nonhomogeneous. Finally, a review of efforts in tissue engineering and cell culture studies of the disc is provided and we close with a description of the direction we envision/propose for successful tissue engineering of the TMJ disc. PMID:14670096

  10. [Algodystrophic syndrome of the temporo-mandibular joint: a clinical experience].

    PubMed

    de Filippis, C; Osti, L; Osti, R; Marioni, G; Pedace, E

    1998-04-01

    Algo-dysfunctional syndrome (ADS) of the temporo-mandibular joint (TMJ) is frequently encountered and, since its clinical expression is extremely polymorphic, it is often misdiagnosed. As there are many causes for ADS, even in a single patient, in line with the most recent interpretations found in the literature, an attempt was made to determine how important the lack of muscular coordination is in the onset of clinical symptoms. The study was conducted on 48 patients (32 females, 16 males, age range 17-68 years, average age 41.7 years) with ADS, clinically diagnosed according to the criteria defined by Rendell et al. The patients belonged to three distinct groups: -Group 1: patients with ADS of articular origin (9 cases); -Group 2: patients with ADS of dental and/or periodontal origin (18 cases); -Group 3: patients with ADS for which there was no apparent cause (21 cases). All patients were treated with a rehabilitation protocol aimed at eliminating the muscle spasm and restoring correct coordination. The results obtained showed that conservative treatment to resolve the muscle spasm gave positive results in 69% of the cases. The patients with concomitant articular pathology proved the least responsive to treatment. It was, therefore, considered likely that the main cause for clinical expression of this pathology is the muscle spasm itself. On this basis it can be concluded that muscular rehabilitation of the TMJ is valid in the treatment of ADS as it has proved able to break the vicious cycle of symptoms at the base of this pathology. PMID:9844222

  11. Temporomandibular joint pain: A critical role for Trpv4 in the trigeminal ganglion

    PubMed Central

    Chen, Yong; Williams, Susan H.; McNulty, Amy L.; Hong, Ji Hee; Lee, Suk Hee; Rothfusz, Nicole E.; Parekh, Puja K.; Moore, Carlene; Gereau, Robert; Taylor, Andrea B.; Wang, Fan; Guilak, Farshid; Liedtke, Wolfgang

    2013-01-01

    Temporomandibular joint disorder (TMJD) is known for its mastication-associated pain. TMJD is medically relevant because of its prevalence, severity, chronicity, and “therapy-refractoriness” of its pain, and its largely elusive pathogenesis. Against this background we sought to investigate pathogenetic contributions of the calcium-permeable TRPV4 ion channel, robustly expressed in the trigeminal ganglion sensory neurons, to TMJ inflammation and pain behavior. We demonstrate here that TRPV4 is critical for TMJ-inflammation evoked pain behavior in mice, and that trigeminal ganglion pro-nociceptive changes are Trpv4-dependent. As a quantitative metric, bite force was recorded as evidence of masticatory sensitization, in keeping with human translational studies. In Trpv4?/? mice with TMJ-inflammation, attenuation of bite force was significantly less than in WT mice. Similar effects were seen with systemic application of a specific TRPV4 inhibitor. TMJ-inflammation and mandibular bony changes were apparent after CFA injections, but remarkably independent of Trpv4 genotype. Intriguingly, as a result of TMJ-inflammation, WT mice exhibited significant up-regulation of TRPV4 and phosphorylated ERK in TMJ-innervating trigeminal sensory neurons, absent in Trpv4?/? mice. Mice with genetically-impaired MEK/ERK phosphorylation in neurons showed a similar resistance to reduction of bite-force as Trpv4?/? mice. Thus, TRPV4 is necessary for masticatory sensitization in TMJ-inflammation, and likely functions up-stream of MEK/ERK phosphorylation in trigeminal ganglion sensory neurons in-vivo. TRPV4 therefore represents a novel pro-nociceptive target in TMJ inflammation, and should be considered a target-of-interest in human TMJD. PMID:23726674

  12. Gap Arthroplasty versus Interpositional Arthroplasty for Temporomandibular Joint Ankylosis: A Meta-Analysis

    PubMed Central

    Ma, Junli; Liang, Limin; Jiang, Hua; Gu, Bin

    2015-01-01

    Gap arthroplasty (GA) and interpositional arthroplasty (IA) are widely used for the treatment of temporomandibular joint ankylosis (TMJA). However, controversy remains as to whether IA is superior to GA. PubMed, EMBASE, the Cochrane Library, the Web of science and the China National Knowledge Infrastructure were searched for literature regarding these procedures (published from 1946 to July 28, 2014). A study was included in this analysis if it was: (1) a randomized controlled trial or non-randomized observational cohort study; (2) comparing the clinical outcomes between GA and IA with respect to the maximal incisal opening (MIO) and reankylosis; (3) with a follow-up period of at least 12 months. The methodological quality of the included studies was evaluated according to the Newcastle-Ottawa Scale Eight non-randomized observational cohort studies with 272 patients were included. All the statistical analyses were performed using the RevMan 5.3 and Stat 12. The pooled analysis showed no significant difference in the incidence of reankylosis between the IA group (13/120) and the GA group (29/163) (RR= 0.67, 95% CI=0.38 to 1.16; Z=1.43, p=0.15). The IA group showed a significantly larger MIO than the GA group (MD=1.96, 95% CI=0.21 to 3.72, Z=2.19, p=0.03, I2=0%). In conclusion, patients with TMJA could benefit more from IA than GA, with a larger MIO and a similar incidence of reankylosis. IA shows to be an adequate option in the treatment of TMJA based on the results of maximal incisal opening. PMID:26010224

  13. A short-term study in sheep with the Groningen temporomandibular joint prosthesis.

    PubMed

    van Loon, J P; de Bont, L G; Spijkervet, F K; Verkerke, G J; Liem, R S

    2000-10-01

    As part of the pre-clinical testing process of a newly developed temporomandibular joint (TMJ) prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ prosthesis. The prosthesis consisted of a skull part, a mandibular part and an intervening polyethylene disc. In the first series (6 sheep), three designs were tested, differing in the applied metal (stainless steel or titanium) and in the fitting method of the skull part (a fitting member or bone cement). The sheep were sacrificed after 8-16 weeks. In the second series (8 sheep), the preferred titanium fitting member design was applied, and the sheep were sacrificed after 2-10 weeks. One sheep was excluded because no correct position of the prosthesis parts could be achieved. At sacrifice, the removal torque of the screws was measured, and the surrounding tissues were harvested for histologic examination. The sheep recovered well and functioned until the end of the scheduled sacrifice date. Encountered problems were two disc dislocations, one fistula formation, and one screw failure. All mandibular parts were clinically stable, as were most skull parts with a fitting member, and one of both skull parts fitted with bone cement. The clinically observed stability was confirmed by the removal torque values, which indicated well-integrated screws. It is concluded that the TMJ prosthesis could remain stable and functional over the initial healing period. The main restriction of the sheep model is the much larger translatory capacity compared with patients, which adversely influences tissue healing. PMID:11071231

  14. Effect of asymmetric force on the condylar cartilage, subchondral bone and collagens in the temporomandibular joints.

    PubMed

    Zhang, Caixia; Xu, Yue; Cheng, Yangxi; Wu, Tuojiang; Li, Huang

    2015-04-01

    This study aimed to define the effects of asymmetric force on rat temporomandibular joints (TMJs). A total of 232 10-week-old rats were used in the experiment. Their left TMJs were kept forward and upward with 40g or 120g. The histological and osteogenic changes, as well as the expression of type I, II and III collagens were observed. Our results showed that the curve of the cartilage thickness changes in the anterior part of the treated side in the heavy force group (HS) decreased first and increased later during the strength and the recovery periods, while the reverse changes were shown in the middle and posterior parts. The cartilage thickness change on the other side in the heavy force group (HO) was the opposite. Additionally, the cartilage thickness change on the treated side and the other side of the light force group (LS and LO) were similar to but not as significantly changed as HS and HO. There were significant differences among the experimental groups. The subchondral bone trabecula also decreased after the pressure loading and removing, then recovered, without significant differences among these groups. Furthermore, more pathological changes such as fractures, bone cysts, the degradation of type II collagen and the increased expression of type III collagen were observed on the treated sides following the application of heavy force. In contrast, more osteogenesis and more active changes were found in the light force group. In conclusion, our study demonstrated that asymmetric force exerted different effects on the cartilage, subchondral bone and collagens of TMJs. Greater changes occurred in the heavy force group, and light force provided more benefits for TMJs remodelling. PMID:25703817

  15. Unilateral Ankylosis of Temporomandibular Joint (TMJ) with Contralateral Condylar Aplasia and Related Orthopedic Deformity – Syndromic or Nonsyndromic?

    PubMed Central

    Vijay, Pradkhshana; Sunil, VSB; Bajpai, Manas; Chhibber, Neha

    2015-01-01

    Condylar aplasia which means “failure of development” is a rare condition and can be unilateral or bilateral. Mandibular condylar Aplasia without any association with syndrome is extremely rare. Temporomandibular joint (TMJ) ankylosis results from trauma, infection and inadequate surgical treatment of the condylar area. Congenital cases are very rare. We report case of congenital unilateral aplasia of left mandibular condyle with ankylosis of right condyle, with an associated orthopedic deformity in a nine-year-old male patient, which may be a part of some unreported syndrome that has not been mentioned so far in literature. As per our best knowledge, no other case including such clinical features has been reported. PMID:25738097

  16. Congenital infiltrating lipomatosis of the face with exophytic temporomandibular joint ankylosis: a case report and review of the literature

    PubMed Central

    Sahai, S; Rajan, S; Singh, N; Arora, H

    2013-01-01

    Congenital infiltrating lipomatosis of the face (CIL-F) is a rare lipomatous lesion with diffuse fatty infiltration of tissues and hyperplasia of underlying bone. We report clinical and CT findings in an unusual case of CIL-F presenting with progressive hemifacial asymmetry, manifesting as severely restricted mouth opening owing to exophytic temporomandibular joint ankylosis. The role of imaging in diagnosis is presented with a review of the literature. Differential diagnosis of CIL-F and its exclusion as a cause of hemifacial hyperplasia are also discussed. PMID:22241871

  17. Use of a new instrument for lateral release in arthroscopic surgery of the temporomandibular joint: a preliminary study.

    PubMed

    Shibuya, Tomoaki; Kino, Koji; Yoshitake, Hiroyuki; Yonezu, Hakubun; Amagasa, Teruo; Takahashi, Tetsu

    2004-04-01

    We developed a new instrument, which we call a lateral releaser, to improve the safety of either a blind lateral release or lateral stretching within the TMJ We used it during arthroscopic surgery in patients with chronic painful hypomobility of the temporomandibular joint (TMJ). We operated on 24 TMJs in 17 patients (15 women and 2 men). At operation, the mean increase in the interincisal distance was 22 mm (range 10-32). No instruments were broken. No serious surgical complications were reported during or after operation. Many of the patients currently have an interincisal distance exceeding 38 mm. PMID:15013553

  18. Pseudogout in the temporomandibular joint with imaging, arthroscopic, operative, and pathologic findings. Report of an unusual case.

    PubMed

    Laviv, Amir; Sadow, Peter M; Keith, David A

    2015-06-01

    The authors present a case of a 60-year-old woman with a destructive painful condition in the right temporomandibular joint (TMJ) that proved to be calcium pyrophosphate crystal deposits at subsequent biopsy examination. The patient presented with the chief complaints of pain and limitation that had not resolved with splint therapy, medications, and habit control. Magnetic resonance imaging studies showed internal derangement without reduction. Right TMJ arthroscopy with manipulation of the jaw under anesthesia showed unique findings of fronds of synovial tissue in the posterior joint space and areas of white matter. Because there was no long-term improvement in her clinical symptoms, she subsequently underwent arthroplasty of the right joint, with the white material clearly seen at surgery, and the biopsy examination confirmed the clinical and arthroscopic impression of pseudogout. The presentation, diagnosis, pathology, and treatment of pseudogout of the TMJ are discussed. PMID:25843817

  19. Modeling of temporomandibular joint function using MRI and jaw-tracking technologies--mechanics.

    PubMed

    Gallo, Luigi M

    2005-01-01

    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 mandibular kinematics permits the detection and assessment of irregularities of TMJ function due to internal obstacles such as a displaced articular disc. Furthermore, the measurement of the dynamic relationship between the articular surfaces of the TMJ is useful to determine the strains undergone by the disc that if too high might compromise its integrity. The development of our research in TMJ mechanics has evolved from the acquisition of the traces of single mandibular points to an accurate and compact description of mandibular motion, in which the mechanical advantage of jaw muscles, and forces and torques acting on the jaw are considered as well. The combination of three-dimensional software models of TMJ anatomies obtained from MRI and jaw tracking with six degrees of freedom permits a subject-specific dynamic analysis of the intra-articular space, providing insight into individual disc deformation during function and TMJ loading. Studies performed with this system indicate that both TMJs are loaded during chewing, the balancing more so than the working joint. In fact, during chewing, the intra-articular distance is smaller for hard than for soft food, on closing than on opening, on the balancing than on the working side. This last finding is confirmed by static biting experiments, in which the condyle-fossa distance decreases more on the side contralateral to the bite force, depending on its magnitude. Also studies on the dynamics of compression areas indicate that plowing can occur through the disc during function, especially mediolaterally, due to stress field translation. This effect might contribute to cartilage wear and fatigue also because the disc is weaker mediolaterally. Further data indicate that the lateral area of the disc is mostly exposed to a higher mechanical energy density. This will be more intensively investigated using finite element method. PMID:16088134

  20. ACTIVATION OF B-CATENIN SIGNALLING LEADS TO TEMPOROMANDIBULAR JOINT DEFECTS

    PubMed Central

    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

    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

  1. Wnt5a/Ror2 mediates temporomandibular joint subchondral bone remodeling.

    PubMed

    Yang, T; Zhang, J; Cao, Y; Zhang, M; Jing, L; Jiao, K; Yu, S; Chang, W; Chen, D; Wang, M

    2015-06-01

    Increased subchondral trabecular bone turnover due to imbalanced bone-resorbing and bone-forming activities is a hallmark of osteoarthritis (OA). Wnt5a/Ror2 signaling, which can derive from bone marrow stromal cells (BMSCs), takes a role in modulating osteoblast and osteoclast formation. We showed previously that experimentally unilateral anterior crossbites (UACs) elicited OA-like lesions in mice temporomandibular joints (TMJs), displaying as subchondral trabecular bone loss. Herein, we tested the role of BMSC-derived Wnt5a/Ror2 signaling in regulating osteoclast precursor migration and differentiation in this process. The data confirmed the decreased bone mass, increased tartrate-resistant acid phosphatase (TRAP)-positive cell number, and enhanced osteoclast activity in TMJ subchondral trabecular bone of UAC-treated rats. Interestingly, the osteoblast activity in the tissue of TMJ subchondral trabecular bone of these UAC-treated rats was also enhanced, displaying as upregulated expressions of osteoblast markers and increased proliferation, migration, and differentiation capabilities of the locally isolated BMSCs. These BMSCs showed an increased CXCL12 protein expression level and upregulated messenger RNA expressions of Rankl, Wnt5a, and Ror2. Ex vivo data showed that their capacities of inducing migration and differentiation of osteoclast precursors were enhanced, and these enhanced capabilities were restrained after blocking their Ror2 signaling using small interfering RNA (siRNA) assays. Reducing Ror2 expression in the BMSC cell line by siRNA or blocking the downstream signalings with specific inhibitors also demonstrated a suppression of the capacity of the BMSC cell line to promote Wnt5a-dependent migration (including SP600125 and cyclosporine A) and differentiation (cyclosporine A only) of osteoclast precursors. These findings support the idea that Wnt5a/Ror2 signaling in TMJ subchondral BMSCs enhanced by UAC promoted BMSCs to increase Cxcl12 and Rankl expression, in which JNK and/or Ca(2+)/NFAT pathways were involved and therefore were engaged in enhancing the migration and differentiation of osteoclast precursors, leading to increased osteoclast activity and an overall TMJ subchondral trabecular bone loss in the UAC-treated rats. PMID:25749876

  2. Upregulation of cystathionine-β-synthetase expression contributes to inflammatory pain in rat temporomandibular joint

    PubMed Central

    2014-01-01

    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-β-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

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

    PubMed Central

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

    2014-01-01

    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

  4. Comparison of the instructional efficacy of an internet-based temporomandibular joint (TMJ) tutorial with a traditional seminar.

    PubMed

    Al-Riyami, S; Moles, D R; Leeson, R; Cunningham, S J

    2010-12-11

    There has been growing interest in the use of virtual learning environments (VLEs) by universities over the past decade to supplement traditional teaching methods. In this study a tutorial providing information about the temporomandibular joint (TMJ), temporomandibular disorders and teaching of a thorough TMJ examination was developed on a VLE platform to enable students to enhance their examination and diagnostic skills. The success of this VLE tutorial was compared with conventional teaching by a cross-over trial. Thirty students were initially randomly allocated to one of two groups; Group 1 completed the VLE tutorial and Group 2 attended the face-to-face seminar in the first instance. The groups then crossed over and had the other method of teaching provided. The findings from the cross-over trial and the students' feedback indicated that no differences were found between either teaching modes, and both are equally effective at delivering information to students. In addition, the order in which the students received the teaching did not make a difference, but giving the teaching twice reinforced their knowledge. There is a strong case to be made for introducing clinical lectures on a VLE platform, and this form of e-learning is, in general, well perceived by new generations of students. PMID:21151070

  5. Derangement of the temporomandibular joint; a case study using Mechanical Diagnosis and Therapy.

    PubMed

    Krog, C; May, S

    2012-10-01

    Mechanical Diagnosis and Therapy (MDT) is widely used for spinal problems, and more recently the principles and mechanical syndromes have been applied to extremity musculoskeletal problems. One of the most common classifications is derangement syndrome, which describes a presentation in which repeated movements causes a decrease in symptoms and a restoration of restricted range of movement. The case study describes the application of repeated movements to a patient with a 7-year history of non-specific temporomandibular pain and reduced function, who had had lots of previous failed treatment. Examination using repeated movements resulted in a classification of derangement, and the patient rapidly responded in 4 treatment sessions, with an abolition of pain and full restoration of function, and remained improved after many years. The case study demonstrates the application of Mechanical Diagnosis and Therapy principles to a patient with a temporomandibular problem. PMID:22177711

  6. [Craniofacial architecture and temporomandibular joint pain-dysfunction syndrome. The possibility of orthodontic treatment].

    PubMed

    Blanchard, P; Scheffer, P; Lerondeau, J C; Nurit, Y

    1990-01-01

    The authors report the results of cephalographic studies in 65 cases of temporo-mandibular algo-dysfunctional syndromes. Cephalometric analysis according to the method described by Delaire allows specific cranio-facial morphotypic criteria to be defined. These results warrant presentation since they are frequently encountered but do not constitute a pathognomonic presentation. Statistical analysis of dento-maxillo-facial orthopedic abnormalities underlines their very frequent occurrence. The indications for maxillo-facial orthopedic surgery should therefore be widened. PMID:2130435

  7. Contribution of synovial lining cells to synovial vascularization of the rat temporomandibular joint.

    PubMed

    Nozawa-Inoue, Kayoko; Harada, Fumiko; Magara, Jin; Ohazama, Atsushi; Maeda, Takeyasu

    2016-03-01

    The lining layer of the synovial membrane in the temporomandibular joint (TMJ) contains two types of lining cells: macrophage-like type A and fibroblast-like type B cells. The type B cells are particularly heterogeneous in their morphology and immunoreactivity, so that details of their functions remain unclear. Some of the type B cells exhibit certain resemblances in their ultrastructure to those of an activated capillary pericyte at the initial stage of the angiogenesis. The articular surface, composed of cartilage and the disc in the TMJ, has few vasculatures, whereas the synovial lining layer is richly equipped with blood capillaries to produce the constituent of synovial fluid. The present study investigated at both the light and electron microscopic levels the immunocytochemical characteristics of the synovial lining cells in the adult rat TMJ, focusing on their contribution to the synovial vascularization. It also employed an intravascular perfusion with Lycopersicon esculentum (tomato) lectin to identify functional vessels in vivo. Results showed that several type B cells expressed desmin, a muscle-specific intermediate filament which is known as the earliest protein to appear during myogenesis as well as being a marker for the immature capillary pericyte. These desmin-positive type B cells showed immunoreactions for vimentin and pericyte markers (neuron-glial 2; NG2 and PDGFRβ) but not for the other markers of myogenic cells (MyoD and myogenin) or a contractile apparatus (αSMA and caldesmon). Immunoreactivity for RECA-1, an endothelial marker, was observed in the macrophage-like type A cells. The arterioles and venules inside the synovial folds extended numerous capillaries with RECA-1-positive endothelial cells and desmin-positive pericytes to distribute densely in the lining layer. The distal portion of these capillaries showing RECA-1-immunoreactivity lacked lectin-staining, indicating a loss of blood-circulation due to sprouting or termination in the lining layer. The desmin-positive type B and RECA-1-positive type A cells attached to this portion of the capillaries. Some capillaries in the lining layer also expressed ninein, a marker for sprouting endothelial cells, called tip cells. Since an activated pericyte, macrophage and tip cell are known to act together at the forefront of the vessel sprout during angiogenesis, the desmin-positive type B cell and RECA-1-positive type A cell might serve as these angiogenic cells in the synovial lining layer. Tomato lectin perfusion following decalcification would be a highly useful tool for research on the vasculature of the mineralized tissue. Use of this technique combined with immunohistochemistry should permit future extensive investigations on the presence of the physiological angiogenesis and on the function of the lining cells in the synovial membrane. PMID:26642772

  8. Immunohistochemical expression of types I and III collagen antibodies in the temporomandibular joint disc of human foetuses

    PubMed Central

    de Moraes, L.O.C.; Lodi, F.R.; Gomes, T.S.; Marques, S.R.; Oshima, C.T.F.; Lancellotti, C.L.P.; Rodríguez-Vázquez, J.F.; Mérida-Velasco, J.R.; Alonso, L.G.

    2011-01-01

    The objective was to study the morphology of the articular disc and analyse the immunohistochemical expression of types I and III collagen markers in the temporomandibular joint (TMJ) disc of human foetuses of different gestational ages. Twenty TMJ from human foetuses supplied by Universidade Federal de Uberaba with gestational ages from 17 to 24 weeks were studied. The gestational age of the foetuses was determined by measuring the crown-rump (CR) length. Macroscopically, the foetuses were fixed in 10% formalin solution and dissected by removing the skin and subcutaneous tissue and exposing the deep structures. Immunohistochemical markers of type I and III were used to characterize the existence of collagen fibres. Analysis of the immunohistochemical markers of types I and III collagen revealed the presence of heterotypical fibril networks. PMID:22073371

  9. Effect of clenching on biomechanical response of human mandible and temporomandibular joint to traumatic force analyzed by finite element method

    PubMed Central

    Yamamoto, Kazuhiko; Sugiura, Tsutomu; Kawakami, Masayoshi; Kang, Yu B.; Tsutsumi, Sadami; Kirita, Tadaaki

    2013-01-01

    Purpose: The purpose of the present study was to analyze the effect of clenching on the biomechanical response of human mandible and temporomandibular joint (TMJ) to traumatic force by the finite element (FE) method. Material and Methods: FE models of the mandible and the TMJ in resting and clenching positions were prepared. Distribution and magnitude of von Mises stress were analyzed by applying force as a point load in the symphyseal, canine, body and angle regions of the mandible. In addition, strain energy density (SED) at the articular disc and in posterior connective tissue of TMJ was analyzed. Results: In the resting position, von Mises stress was mainly concentrated at the condylar neck and in the retromolar region of the mandible. In the clenching position, the stress at the condylar neck decreased in all loadings. The stress in the retromolar region similary decreased in the symphyseal, canine and body loading, respectively; however, higher stress was observed in the retromolar region on the loading side in the angle loading. High SED was generated at the articular disc and in posterior connective tissues of TMJ in the resting position. The SED in these tissues decreased in all loadings in the clenching position. Conclusions: Clenching generally reduces stress at the condylar neck and in the retromolar region of the mandible, and strain energy at the articular disc and in posterior connective tissue of TMJ by traumatic forces on the mandible; however, clenching induces greater stress in the retromolar region on the loading side by traumatic force to the angle region. Key words:Mandibular, temporomandibular joint, traumatic force, clenching, finite element analysis. PMID:23524422

  10. The next step in the treatment of persistent temporomandibular joint pain following arthrocentesis: a retrospective study of 18 cases.

    PubMed

    Emes, Y; Arp?nar, I ?; Oncü, B; Aybar, B; Akta?, I; Al Badri, N; Atalay, B; I?sever, H; Yalç?n, S

    2014-07-01

    Temporomandibular joint disorders affect a big portion of the population. There are a variety of treatment methods currently in use. Conservative treatment modalities are followed by more invasive approaches like arthrocentesis or arthroscopy. The aim of the study is to compare the effects of intra-articular tenoxicam injection and arthrocentesis plus viscosupplementation on patients in which a previous arthrocentesis plus viscosupplementation has failed to relieve pain and restore function. The study group consists of 18 TMJs in 16 patients (15 female and 1 male) and the patients were randomly divided into two groups as the arthrocentesis plus viscosupplementation group (n: 8) and tenoxicam injection (n: 10). 20 mg of tenoxicam was injected to the upper compartments of 10 joints without arthrocentesis. The other 8 joints were treated with a second arthrocentesis and sodium hyaluronate injection. VAS scores and maximum mouth opening with and without assistance were recorded in the post operative first week, first month and third month. The results show that there is little benefit in using relatively conservative methods once an arthrocentesis together with viscosupplementation has failed to relieve the patients pain. It is concluded that more invasive procedures should be considered for the patients who do not benefit from arthrocentesis. PMID:23932198

  11. Comparison of stress distribution in the temporomandibular joint during jaw closing before and after symphyseal distraction: a finite element study.

    PubMed

    Savoldelli, C; Bouchard, P-O; Manière-Ezvan, A; Bettega, G; Tillier, Y

    2012-12-01

    The aim of this study was to predict stress modification in the temporomandibular joint (TMJ) after symphyseal distraction (SD). The study was performed using three-dimensional finite element analysis using a complete mastication model. Geometric data were obtained from MRI and CT scans of a healthy male patient and each component was meshed as various regions. The distraction was performed with a 10mm expansion after simulation of a surgical vertical osteotomy line on the model in the mandibular midline region. The geometry and mesh of the bone callus were constructed. The bone callus was modelled as a strengthened region characterized by a Young's modulus corresponding to consolidated bone to predict the long-term biomechanical effect of SD. Boundary conditions for jaw closing simulations were represented by different jaw muscle load directions. The von Mises stress distributions in both joint discs and condyles during closing conditions were analysed and compared before and after SD. Stress distribution was similar in discs and on condylar surfaces in the pre- and post-distraction models. The outcomes of this study suggest that anatomical changes in TMJ structures should not predispose to long-term tissue fatigue and demonstrate the absence of clinical permanent TMJ symptoms after SD. PMID:22771220

  12. Three-Dimensional Measurement and Cluster Analysis for Determining the Size Ranges of Chinese Temporomandibular Joint Replacement Prosthesis

    PubMed Central

    Zhang, Lu-Zhu; Meng, Shuai-Shuai; He, Dong-Mei; Fu, Yu-Zhuo; Liu, Ting; Wang, Fei-Yu; Dong, Min-Jun; Chang, Yu-Si

    2016-01-01

    Abstract The aim of this study was to investigate the osseous characteristics of Chinese temporomandibular joint (TMJ) and detect the size clusters for total joint prostheses design. Computer tomography (CT) data from 448 Chinese adults (226 male and 222 female, aged from 20 to 83 years, mean age 39.3 years) with 896 normal TMJs were chosen from the Department of Radiology in the Shanghai 9th People's Hospital. Proplan CMF 1.4 software was used to reconstruct the skulls. Three-dimensional (3D) measurements of the TMJ fossa and condyle-ramus units with 13 parameters were performed. Size clusters for prostheses design were determined by hierarchical cluster analyses, nonhierarchical (K-means) cluster analysis, and discriminant analysis. The glenoid fossa was grouped into 3 clusters, and the condyle-ramus units were grouped into 4 clusters. Discriminant analyses were capable of correctly classifying 97.24% of the glenoid fossa and 94.98% of the condyle-ramus units. The means and standard deviations for the parameter values in each cluster were determined. Fossa depth and angles between the condyle and ramus were important parameters for Chinese TMJ prostheses design. 3D measurements and cluster analysis of the osseous morphology of the TMJ provided an anatomical reference and identified the dimensions of the minimum numbers of prosthesis sizes required for Chinese TMJ replacement. PMID:26937929

  13. β2-adrenergic signal transduction plays a detrimental role in subchondral bone loss of temporomandibular joint in osteoarthritis

    PubMed Central

    Jiao, Kai; Niu, Li-Na; Li, Qi-hong; Ren, Gao-tong; Zhao, Chang-ming; Liu, Yun-dong; Tay, Franklin R.; Wang, Mei-qing

    2015-01-01

    The present study tested whether activation of the sympathetic tone by aberrant joint loading elicits abnormal subchondral bone remodeling in temporomandibular joint (TMJ) osteoarthritis. Abnormal dental occlusion was created in experimental rats, which were then intraperitoneally injected by saline, propranolol or isoproterenol. The norepinephrine contents, distribution of sympathetic nerve fibers, expression of β-adrenergic receptors (β-ARs) and remodeling parameters in the condylar subchondral bone were investigated. Mesenchymal stem cells (MSCs) from condylar subchondral bones were harvested for comparison of their β-ARs, pro-osteoclastic gene expressions and pro-osteoclastic function. Increases in norepinephrine level, sympathetic nerve fiber distribution and β2-AR expression were observed in the condylar subchondral bone of experimental rats, together with subchondral bone loss and increased osteoclast activity. β-antagonist (propranolol) suppressed subchondral bone loss and osteoclast hyperfunction while β-agonist (isoproterenol) exacerbated those responses. MSCs from experimental condylar subchondral bone expressed higher levels of β2-AR and RANKL; norepinephrine stimulation further increased their RANKL expression and pro-osteoclastic function. These effects were blocked by inhibition of β2-AR or the PKA pathway. RANKL expression by MSCs decreased after propranolol administration and increased after isoproterenol administration. It is concluded that β2-AR signal-mediated subchondral bone loss in TMJ osteoarthritisis associated with increased RANKL secretion by MSCs. PMID:26219508

  14. Assessment of magnetic resonance images of displacement of the disc of the temporomandibular joint in different types of condylar fracture.

    PubMed

    Zheng, JiSi; Zhang, ShanYong; Yang, Chi; Abdelrehem, Ahmed; He, DongMei; Chiu, HanHsuan

    2016-01-01

    To evaluate the displacement of the disc of the temporomandibular joint (TMJ) in different types of condylar fracture we studied 160 patients (222 joints) from May 2009-June 2014. All patients had computed tomographic scans (CT) and magnetic resonance images (MRI) taken preoperatively, and 24 patients (32 joints) had MRI postoperatively. CT scans were reviewed to categorise the types of condylar fracture (intracapsular, condylar neck, and subcondylar), and intracapsular condylar fractures were further classified into subtypes A, B, C, and M. MRI were then reviewed to record the position of the disc in each type of condylar fracture. The results were compared using the chi square test. There were 160 intracapsular condylar fractures, 40 fractures of the condylar neck, and 22 subcondylar fractures. Of the intracapsular condylar fractures, 75 were type A, 49 type B, 11 type C, and 25 type M. Discs were displaced in 153 intracapsular condylar fractures, 17 fractures of the condylar neck, and eight subcondylar fractures. Among the type A intracapsular condylar fractures, discs were displaced in 71/75, type B in 47/49, type C in 10/11, and in all 25 type M. The incidence of displaced discs between intracapsular condylar fractures on the one hand, and those of the condylar neck or subcondylar region on the other, was significant (p<0.001), but there were no differences among the various subtypes of intracapsular condylar fractures. Postoperative MRI showed successful results in 28/32 joints. Intracapsular condylar fractures were more likely to have displaced discs than the other types. But there were no differences among different subtypes of intracapsular condylar fractures. PMID:26628200

  15. Observing the development of the temporomandibular joint in embryonic and post-natal mice using various staining methods

    PubMed Central

    LIANG, WENNA; LI, XIHAI; GAO, BIZHEN; GAN, HUIJUAN; LIN, XUEJUAN; LIAO, LINGHONG; LI, CANDONG

    2016-01-01

    The temporomandibular joint (TMJ) is a specialized synovial joint that is essential for the movement and function of the mammalian jaw. The TMJ develops from two mesenchymal condensations, and is composed of the glenoid fossa that originates from the otic capsule by intramembranous ossification, the mandibular condyle of the temporal bone and a fibrocartilagenous articular disc derived from a secondary cartilaginous joint by endochondral ossification. However, the development of the TMJ remains unclear. In the present study, the formation and development of the mouse TMJ was investigated between embryonic day 13.5 and post-natal day 180 in order to elucidate the morphological and molecular alterations that occur during this period. TMJ formation appeared to proceed in three stages: Initiation or blastema stage; growth and cavitation stage; and the maturation or completion stage. In order to investigate the activity of certain transcription factors on TMJ formation and development, the expression of extracellular matrix (ECM), sex determining region Y-box 9, runt-related transcription factor 2, Indian hedgehog homolog, Osterix, collagen I, collagen II, aggrecan, total matrix metalloproteinase (MMP), MMP-9 and MMP-13 were detected in the TMJ using in situ and/or immunohistochemistry. The results indicate that the transcription factors, ECM and MMP serve critical functions in the formation and development of the mouse TMJ. In summary, the development of the mouse TMJ was investigated, and the molecular regulation of mouse TMJ formation was partially characterized. The results of the present study may aid the systematic understanding of the physiological processes underlying TMJ formation and development in mice. PMID:26893634

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

    PubMed Central

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

    2014-01-01

    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. PMID:25667719

  17. Lateral cephalometric analysis of mandibular morphology: discrimination among subjects with and without temporomandibular joint disk displacement and osteoarthrosis.

    PubMed

    Bertram, S; Moriggl, A; Neunteufel, N; Rudisch, A; Emshoff, R

    2012-02-01

    To assess whether in patients with temporomandibular joint (TMJ) arthralgia cephalometric variables of mandibular morphology may discriminate among the magnetic resonance (MR) imaging-based TMJ groups of 'bilateral presence of disk displacement without reduction (DDwoR) and osteoarthrosis (OA)' and 'bilateral absence of bilateral DDwoR and OA'. Bilateral MR imaging of the TMJ was performed in 45 consecutive TMJ arthralgia patients to identify individuals with the specific structural characteristics of bilateral TMJ DDwoR associated with OA. Linear and angular cephalometric measurements were taken from lateral cephalograms to apply selected criteria of mandibular morphology. A discriminant function analysis was used to investigate how cephalometric parameters discriminate among the TMJ groups of 'bilateral presence of DDwoR with OA' and 'bilateral absence of DDwoR and OA'. Ramus height (Ar-Go) and effective mandibular length (Ar-Pog) produced a significant discriminant function that predicted TMJ group membership (P?

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

    PubMed

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

    2015-08-01

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

  19. Strain induced in the condyle by self-tapping screws in the Biomet alloplastic temporomandibular joint: a preliminary experimental study.

    PubMed

    Ramos, A; Duarte, R J; Mesnard, M

    2015-11-01

    The main aim of this study was to analyze how screws affect the strain concentration induced on the mandibular condyle during implantation, screwing, and drilling, as well as after condylar loading. A clean cadaveric mandible was analyzed experimentally in the intact state and was then implanted with a Biomet/Lorenz Microfixation temporomandibular joint (TMJ) implant with seven bicortical self-tapping screws. The external surface of the mandible was instrumented with three strain gauges. A load of 500N on the TMJ was applied to the condyle before and after implantation. The results showed a strain concentration of -1500?? near the screws due to their implantation on the external surface of the mandible. The drilling process induced up to 80?? near the hole. The strain concentration did not change when there were more than six screws. Loading on the TMJ before and after implantation presented only a 10% difference in maximum principal strain. This study demonstrates the importance of the strain concentration induced by the screws. The process of implanting screws shows the importance of lateral surface preparation for a good fit in the condyle. Strain distribution after implantation and loading of the Biomet implant was found to be similar to that in the intact condyle. PMID:26194773

  20. Gap arthroplasty combined with distraction osteogenesis in the treatment of unilateral ankylosis of the temporomandibular joint and micrognathia.

    PubMed

    Yu, Hongbo; Shen, Guofang; Zhang, Shilei; Wang, Xudong

    2009-04-01

    Our aim was to evaluate the efficacy of simultaneous gap arthroplasty and distraction osteogenesis (DO) in the treatment of unilateral ankylosis of the temporomandibular joint (TMJ) in patients with micrognathia. During the period January 2000-December 2006, 11 patients with unilateral ankylosis of the TMJ and micrognathia were treated with simultaneous gap arthroplasty, mandibular osteotomy, and implantation of a distractor. Mouth opening exercises were started on the first postoperative day and distraction on the fifth postoperative day. All patients had satisfactory mouth opening at follow-up, the mean (range) being 32.4 (28-37) mm in 13 to 58 months' follow-up. Mean length (range) of the mandibular body increased by DO was 12.4 (7-15) mm. Facial asymmetry was corrected and satisfactory occlusions achieved with the help of postoperative orthodontic treatment. We conclude that DO and gap arthroplasty can be used simultaneously in the treatment of patients with ankylosis of the TMJ and micrognathia. PMID:18805606

  1. Effect of Stomatognathic Alignment Exercise on Temporomandibular Joint Function and Swallowing Function of Stroke Patients with Limited Mouth Opening

    PubMed Central

    Oh, Duck-Won; Kang, Tae-Woo; Kim, Sun-Ju

    2013-01-01

    [Purpose] This study investigated the effects of stomatognathic alignment exercise on temporomandibular joint function and swallowing function of stroke patients presenting limited mouth opening. [Subjects] Fourteen subjects with post-stroke hemiparesis presenting limited mouth opening were randomly assigned to either the experimental group or the control group, with 7 subjects in each group. [Methods] Subjects in the experimental group participated in a stomatognathic alignment exercise program that consisted of mobility exercises of the TMJ and neck and postural correction. Main outcome measures were neck mobility, the active maximum range of mouth opening, the craniomandibular index (CMI), and the Mann assessment of swallowing ability (MASA) score. [Results] The changes in the values of the range of mouth opening, CMI, MASA, and all the parameters of neck mobility were significantly different between the groups. Furthermore, post-test values appeared to be significantly different for the range of mouth opening, the craniomandibular index, and the MASA scores between the groups (p>0.05). [Conclusion] Stomatognathic alignment exercise may improve TMJ function and swallowing function of patients with post-stroke hemiparesis. PMID:24259786

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

    NASA Astrophysics Data System (ADS)

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

    1995-04-01

    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.

  3. Management of open bite that developed during treatment for internal derangement and osteoarthritis of the temporomandibular joint

    PubMed Central

    Choi, Jae Won; Nakaoka, Kazutoshi; Hamada, Yoshiki; Nakamura, Yoshiki

    2015-01-01

    This case report describes the orthodontic treatment performed for open bite caused by internal derangement (ID) and osteoarthritis (OA) of the temporomandibular joint (TMJ). A Japanese woman, aged 31 years and 11 months, referred to our department by an oral surgeon had an open bite with clockwise rotation of the mandible and degeneration of the condyle. The overbite was corrected through intrusion of the maxillary and mandibular molars using mini-screw implants to induce counterclockwise rotation of the mandible. Then, the mandibular second premolars were extracted and comprehensive orthodontic treatment was performed to establish a Class I molar relationship with distalization of the maxillary arch and to eliminate anterior crowding. Following treatment, her facial profile improved and a functional and stable occlusion was achieved without recurrence of the TMJ symptoms. These results suggest that orthodontic intrusion of the molars is one of the safer and less stressful alternatives for the management of open bite due to degeneration of the condyles caused by ID and OA of TMJ. PMID:26023542

  4. Temporomandibular joint ankylosis caused by condylar fractures: a retrospective analysis of cases at an urban teaching hospital in Nigeria.

    PubMed

    Anyanechi, C E

    2015-08-01

    Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. This study aimed to analyze cases of mandibular condylar fracture complicated by TMJ ankylosis after treatment. A 16-year retrospective analysis was performed at the dental and maxillofacial surgery clinic of the study institution; patient data were collected from the hospital records and entered into a pro-forma questionnaire. It was found that 56/3596 (1.6%) fractures resulted in TMJ ankylosis. The age of patients with ankylosis ranged from 12 to 47 years. The age (P=0.03) and gender (P=0.01) distributions were significant, with most cases of ankylosis occurring in those aged 11-30 years (n=43/56, 76.8%). Fractures complicated by ankylosis were intracapsular (n=22/56, 39.3%) and extracapsular (n=34/56, 60.7%). Ankylosis increased significantly with the increase in time lag between injury and fracture treatment (P=0.001). Ankylosis was associated with concomitant mandibular (85.7%) and middle third (66.1%) fractures. Treatment methods were not significantly related to ankylosis (P=0.32). All cases of ankylosis were unilateral, and complete (n=36, 64.3%) and incomplete ankylosis (n=20, 35.7%) were diagnosed clinically. The incorporation of computed tomography scans and rigid internal fixation in the management of condylar fractures will reduce ankylosis. PMID:26008733

  5. Intra-articular controlled release of anti-inflammatory siRNA with biodegradable polymer microparticles ameliorates temporomandibular joint inflammation.

    PubMed

    Mountziaris, Paschalia M; Tzouanas, Stephanie N; Sing, David C; Kramer, Phillip R; Kasper, F Kurtis; Mikos, Antonios G

    2012-10-01

    We investigated the in vivo therapeutic efficacy of an intra-articular controlled release system consisting of biodegradable poly(dl-lactic-co-glycolic acid) (PLGA) microparticles (MPs) encapsulating anti-inflammatory small interfering RNA (siRNA), together with branched poly(ethylenimine) (PEI) as a transfecting agent, in a rat model of painful temporomandibular joint (TMJ) inflammation. The in vivo effects of PLGA MP dose and siRNA-PEI polyplex delivery were examined via non-invasive meal pattern analysis and by quantifying the protein level of the siRNA target as well as of several downstream inflammatory cytokines. Controlled release of siRNA-PEI from PLGA MPs significantly reduced inflammation-induced changes in meal patterns compared to untreated rats with inflamed TMJs. These changes correlated to decreases in tissue-level protein expression of the siRNA target to 20-50% of the amount present in the corresponding control groups. Similar reductions were also observed in the expression of downstream inflammatory cytokines, e.g. interleukin-6, whose tissue levels in the siRNA-PEI PLGA MP groups were 50% of the values for the corresponding controls. This intra-articular sustained release system has significant implications for the treatment of severe TMJ pain, and also has the potential to be readily adapted and applied to mitigate painful, chronic inflammation in a variety of conditions. PMID:22750740

  6. Temporomandibular joint articulations on working side during chewing in adult females with cross-bite and mandibular asymmetry.

    PubMed

    Yashiro, K; Iwata, A; Takada, K; Murakami, S; Uchiyama, Y; Furukawa, S

    2015-03-01

    Influence of mandibular asymmetry and cross-bite on temporomandibular joint (TMJ) articulation remained unknown. This study aimed to investigate whether/how the working-side condylar movement irregularity and articular spaces during chewing differ between patients with mandibular asymmetry/cross-bite and control subjects. The cross-bite group and the control group consisted of 10 adult female patients and 10 adult female subjects, respectively. They performed unilateral gum-chewing. The mandibular movements were recorded using a video-based opto-electronic system. The 3D articular surface of the TMJ for each individual was reconstructed using CT/MRI data. For local condylar points, the normalised jerk cost (NJC) towards normal direction to the condylar surface, the angle between tangential velocity vector and condylar long axis and intra-articular space were measured. Three rotatory angles at centre of the condyle were also measured. During closing and intercuspation, (i) movements of posterior portion of the deviated side condyle showed significantly less smoothness as compared with those for the non-deviated side and control subjects, (ii) the rotations of the condyle on the deviated side induced greater intra-articular space at posterior and lateral portions. These findings suggest that chewing on the side of mandibular deviation/cross-bite may cause irregular movement and enlarged intra-articular space at posterior portion of the deviated side condyle. PMID:25545582

  7. Wear-testing of a temporomandibular joint prosthesis: UHMWPE and PTFE against a metal ball, in water and in serum.

    PubMed

    Van Loon, J P; Verkerke, G J; de Bont, L G; Liem, R S

    1999-08-01

    For a temporomandibular joint prosthesis, an estimation of the wear rate was needed, prior to patient application. Therefore, we determined the in vitro wear rate of the ball-socket articulation of this prosthesis, consisting of a metal head and an ultra-high molecular weight polyethylene (UHMWPE) cup. The basic testing configuration consisted of one 8-mm diameter stainless-steel ball, rotating between two conforming cups with a minimum thickness of 5 mm. For validation of the testing apparatus, two cup materials, in two lubricants, were tested. Both cup materials, UHMWPE and polytetrafluoroethylene (PTFE) were tested in deionized water, as well as in a serum-based solution. For UHMWPE in serum, eight samples were tested, for the other combinations four samples. For UHMWPE, the tests ran for 7 million cycles, for PTFE between 0.8 and 1.7 million cycles. For UHMWPE, the wear rate was 0.006 and 0.47 (mm3/10(6) cycles), in water and in serum, respectively. For PTFE, the wear rate was 2.8 and 47 (mm3/10(6) cycles), in water and in serum, respectively. For reason that testing in serum simulates the in vivo situation best, it was concluded that the wear rate of the TMJ prosthesis articulation is 0.47 (mm3/10(6) cycles), which is considered acceptable. PMID:10458560

  8. Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle.

    PubMed

    Campos, M I G; Campos, P S F; Cangussu, M C T; Guimarães, R C; Line, S R P

    2008-06-01

    The aim of this study was to investigate temporomandibular joint (TMJ) pain and magnetic resonance imaging characteristics in 104 TMJs with and 58 without degenerative changes of the condyle, such as osteophytes, erosion, avascular necrosis, subcondral cyst and intra-articular loose bodies. TMJ images were also assessed for flattening, retropositioning and hypomobility of condyle and disc displacement. Comparison of the TMJ side-related data showed a significant relationship between disc displacement without reduction (DDwoR) and the presence of degenerative bony changes (p=0.00). Flattening, retropositioning and hypomobility of condyle showed no significant difference in relation to the presence or absence of degenerative bony changes. Retropositioning of the condyle was significantly associated to disc displacement with reduction (DDwR) (p=0.00), while condylar hypomobility was significantly more frequent in TMJ with DDwoR (p<0.05). Independent of the presence or type of DD, TMJ pain was more frequent in the presence of degenerative bony changes. When considering only DDwR, TMJ pain was significantly associated to a degenerative condition (p=0.03). When there were no degenerative bony changes, TMJ pain was significantly more frequent in DDwoR (p=0.04). Despite the present findings, the absence of symptoms in some patients with condylar bony changes suggests that the diagnosis of osteoarthritis should be established by evaluation of magnetic resonance images in association with clinical examination. PMID:18440778

  9. Investigation of human frontal cortex under noxious thermal stimulation of temporo-mandibular joint using functional near infrared spectroscopy

    NASA Astrophysics Data System (ADS)

    Yennu, Amarnath; Rawat, Rohit; Manry, Michael T.; Gatchel, Robert; Liu, Hanli

    2013-03-01

    According to American Academy of Orofacial Pain, 75% of the U.S. population experiences painful symptoms of temporo-mandibular joint and muscle disorder (TMJMD) during their lifetime. Thus, objective assessment of pain is crucial for efficient pain management. We used near infrared spectroscopy (NIRS) as a tool to explore hemodynamic responses in the frontal cortex to noxious thermal stimulation of temporomadibular joint (TMJ). NIRS experiments were performed on 9 healthy volunteers under both low pain stimulation (LPS) and high pain stimulation (HPS), using a temperature-controlled thermal stimulator. To induce thermal pain, a 16X16 mm2 thermode was strapped onto the right TMJ of each subject. Initially, subjects were asked to rate perceived pain on a scale of 0 to 10 for the temperatures from 41°C to 47°C. For the NIRS measurement, two magnitudes of temperatures, one rated as 3 and another rated as 7, were chosen as LPS and HPS, respectively. By analyzing the temporal profiles of changes in oxy-hemoglobin concentration (HbO) using cluster-based statistical tests, we were able to identify several regions of interest (ROI), (e.g., secondary somatosensory cortex and prefrontal cortex), where significant differences (p<0.05) between HbO responses to LPS and HPS are shown. In order to classify these two levels of pain, a neural-network-based classification algorithm was used. With leave-one-out cross validation from 9 subjects, the two levels of pain were identified with 100% mean sensitivity, 98% mean specificity and 99% mean accuracy to high pain. From the receiver operating characteristics curve, 0.99 mean area under curve was observed.

  10. Association Between Harmful Oral Habits and Sign and Symptoms of Temporomandibular Joint Disorders Among Adolescents

    PubMed Central

    Kumar, Jayaprakash; Kamate, Shivalingesh; Kushwaha, Sumedha; Anand, Richa; Gupta, Neha; Gupta, Bhuvandeep; Singh, Ishan

    2015-01-01

    Context Temporomandibular disorder (TDM) is defined as a heterogenous group of psychophysiological disorders commonly characterised by orofacial pain, chewing dysfunction or both. Various Epidemiological studies had shown occurrence of TMD in all age groups including children. Also research had shown that non nutritional oral habits to be associated with TMD. Aim Present study aimed to find whether harmful oral habits are associated with sign and symptoms of TMD among adolescents in Greater Noida. Setting and Design Schools in Gautam Buddha district and descriptive study. Materials and Methods Cross sectional study was carried out among 240 adolescents (10 – 19 years) studying in schools of Greater Noida. Study population were selected by random sampling to whom screening questionnaires recommended by American Academy of Orofacial Pain (AAOP) were distributed. Patient history and clinical examination was used to determine harmful oral habits. Data analysis was done in SPSS version 21 and Chi-square test was applied. Results Sixty one participants (25.4%) displayed no sign and symptoms of TMD, 34 (14.2%) responded affirmatively to atleast one item on the questionnaire and 108(46%) gave at least three affirmative responses. Headache, Neckpain and Toothache were most frequent reported sign and symptoms of TMD (46.2%). There was statistically significant association between gender and sign and symptoms of TMD on three items of the questionnaire (p < 0.05). Nail Biting (45.8%), Biting Lips/objects (37%) were most common habits among the study group. There was statistically significant association between Nail Biting (p = 0.001), Lip Biting/ object biting (p=0.001), Grinding of teeth (p = 0.01) and sign and symptoms of TMD. Conclusion A statistically significant association was found between nail biting, lip/ object biting and grinding of teeth with signs and/or symptoms of TMD. Thus there is need for preventive dental treatment and community dental education so that young adults realize importance of early diagnosis and treatment of TMJ disorders. PMID:26436046

  11. Effects of tissue-engineered articular disc implants on the biomechanical loading of the human temporomandibular joint in a three-dimensional finite element model.

    PubMed

    Al-Sukhun, Jehad; Ashammakhi, Nureddin; Penttila, Heikki

    2007-07-01

    The purpose of this study was to evaluate biomechanical loading of the temporomandibular joint when using a biodegradable laminate implant to replace the articular disc and to test the hypothesis that the use of the implant reduces stress distribution in the condyle, implant, and glenoid fossa. A finite element model of a female human mandible, including the temporomandibular joint, which had two standard endosseous implants inserted bilaterally in the premolar region, was constructed from computed tomography scan images using a commercially available finite element software. The disc, condyle, and glenoid fossa were arbitrarily divided into five regions: the anterior, posterior, medial, lateral, and central. The disc was then replaced with a poly-L/DL-lactide biodegradable laminate. The finite element model was then used to predict principal and Von Mises stresses. The use of poly-L/DL-lactide implant resulted in remarkable reduction in Von Mises stresses (approximately threefold) in the anterior, central, and medial regions of the mandibular condyle in comparison with slight to moderate stress reductions in the corresponding regions of the implant and glenoid fossa. The mandibular condyle also demonstrated the largest total displacement in all directions followed by the implant and glenoid fossa. The use of an alloplastic implant such as the bioresorbable, poly-L/DL-lactide laminate to replace the articular disc reduces loading of the mandibular condyle rather than the implant and glenoid fossa. These findings lead to support the hypothesis that the mandibular condyle more likely functions as a shock absorber than the disc. The use of bioresorbable laminate implants might prove an efficient technique to replace the articular disc and promote normal function of the temporomandibular joint. PMID:17667665

  12. Changes in collagens and chondrocytes in the temporomandibular joint cartilage in growing rats fed a liquid diet.

    PubMed

    Uekita, Hiroki; Takahashi, Shigeru; Domon, Takanori; Yamaguchi, Taihiko

    2015-11-01

    The temporomandibular joint (TMJ) of growing rats fed a soft diet is reported to be smaller in size and to have thinner condyle and glenoid fossa cartilage than rats fed a solid diet. The aim of this study was to determine the effect of a soft diet on the collagens and chondrocytes in the growing TMJ cartilage. Forty-eight male Wistar rats were divided into a control group fed a solid diet and an experimental group fed a liquid diet for 1-8 weeks. After the experimental period, the TMJs were harvested and examined histologically, immunohistochemically for collagen types I, II, and X, and with transmission electron microscopy. The condylar cartilage in the experimental rats showed weak immunoreactions for three types of collagens compared with the controls. The ultrastructure had fewer fine collagen fibrils in the experimental rats compared with that of the controls. The glenoid fossa cartilage in the experimental rats showed narrower Alcian blue-positive areas than the control staining. The immunoreactions for three types of collagen in the experimental rats were also weaker than those of the controls. The chondrocytes in the experimental rats appeared dark, had extended thin cytoplasmic processes, and had formed gap junctions, as assessed by transmission electron microscopy. Fewer fine collagen fibrils, but thick bands of collagen fibrils were observed in the glenoid fossa of the experimental cartilage. The results of the present study showed that a liquid diet had deleterious effects on the quality and quantity of collagens and chondrocytes in the TMJ cartilage in growing rats. PMID:26434755

  13. Replacing Shox2 with human SHOX leads to congenital disc degeneration of the temporomandibular joint in mice

    PubMed Central

    Li, Xihai; Liu, Hongbing; Gu, Shuping; Liu, Chao; Sun, Cheng; Zheng, Yuqian; Chen, YiPing

    2013-01-01

    The temporomandibular joint (TMJ) consists of the glenoid fossa arising from the otic capsule through intramembranous ossification, the fibrocartilaginous disc and the condyle, derived from the secondary cartilage by endochondral ossification. We have reported previously that cranial neural crest-specific inactivation of the homeobox gene Shox2, which is expressed in the mesenchymal cells of maxilla-mandibular junction and later in the progenitor cells and perichondrium of the developing chondyle, led to dysplasia and ankylosis of the TMJ, and replacement of the mouse Shox2 with the human SHOX gene rescued the dysplastic and ankylosis phenotypes but developed a prematurely worn out articular disc. In this study, we investigated the molecular and cellular bases for the premature wear out articular disc in the TMJ of mice carrying the human SHOX replacement allele in the Shox2 locus (referred as Shox2SHOX-KI/KI). We found that the developmental process and expression of several key genes in the TMJ of Shox2SHOX-KI/KI mice appeared similar to the controls. However, the disc of the Shox2SHOX-KI/KI TMJ exhibited a reduced level of Col I and Aggrecan, accompanied by increased activities of matrix metalloproteinases (MMPs) and a down-regulation of Ihh expression. Dramatically increased cell apoptosis in the disc was also observed. These combinatory cellular and molecular defects appear to contribute to the observed disc phenotype, suggesting that while the human SHOX can exert similar function as the mouse Shox2 in regulating early TMJ development, it apparently has a distinct function in the regulation of those molecules that are involved in tissue homeostasis. PMID:24248941

  14. Synovial chondromatosis of the temporomandibular joint: a clinical, radiological and histological study.

    PubMed

    Martín-Granizo, Rafael; Sánchez, Juan Jesús; Jorquera, Manuela; Ortega, Luis

    2005-01-01

    Synovial chondromatosis (SC) is a cartilaginous metaplasy of the mesenchymal remnants of the synovial tissue of the joints. It is characterized by the formation of cartilaginous nodules in the synovium and inside the articular space (loose bodies). SC mainly affects to big synovial joints such as the knee and the elbow, being uncommon the onset within the TMJ, where 75 cases have been published. The main symptoms are pain, inflammation, limitation of the movements of the jaw and crepitation. Different methods of diagnosis include panoramic radiograph, CT, MR and arthroscopy of the TMJ. We report a new case of unilateral SC of the TMJ, including diagnostic images, treatment performed and histological analysis. PMID:15876973

  15. Reduction of temporomandibular joint dislocation: an ancient technique that has stood the test of time.

    PubMed

    Forshaw, R J

    2015-07-01

    The first known recorded evidence for the reduction of a mandibular joint dislocation is documented in a papyrus dated to c. 1500 BC that originated from ancient Egypt. This same technique was later discussed by Hippocrates in Greece and the Hippocratic corpus is referred to in early Islamic writings. It is detailed in medieval European texts and eventually was incorporated into modern dental and medical practice. Today, mandibular joint dislocation is probably not that common but to be included in an important ancient Egyptian treatise, predominately concerned with trauma to the head and neck, could suggest it was a more frequent occurrence in antiquity. This could relate to the heavy tooth wear, frequent antemortem tooth loss and the related sequelae of severe malocclusion and overclosure evident in many surviving ancient Egyptian skulls. PMID:26114704

  16. Differences in skeletal components of temporomandibular joint of an early medieval and contemporary Croatian population obtained by different methods.

    PubMed

    Kranjcic, Josip; Slaus, Mario; Persic, Sanja; Vodanovic, Marin; Vojvodic, Denis

    2016-01-01

    The temporomandibular joint (TMJ) is one of the most complex joints in the human body. The anatomical configuration of the TMJ allows for a large range of mandibular movements as well as transmission of masticatory forces and loads to the skull base. The measurements of the TMJ's anatomical structures and their interpretations contribute to the understanding of how pathological changes, tooth loss, and the type of diet (changing throughout human history) can affect biomechanical conditions of the masticatory system and the TMJ. The human TMJ and its constituent parts are still the subject of extensive investigation and comparisons of measurement methods are being made in order to determine the most precise and suitable measurement methods. The aim of this study has been to examine the morphology of skeletal components of TMJ of an early medieval population (EMP) in Croatia and to compare measured values with TMJ values of the contemporary Croatian population (CP) using various methods of measurement. The study was performed on 30 EMP specimens - human dry skulls, aged from 18 to 55 years, and 30 CP human dry skulls, aged from 18 to 65 years. Only fully preserved specimens (in measured areas) were included. The articular eminence (AE) inclination was measured in relation to the Frankfurt horizontal using two methods. Also, the AE height (glenoid fossa depth) and the length of the curved line - highest to the lowest point of the AE were measured. Measurements were performed on lateral skull photographs, panoramic radiographs and lateral cephalograms using VistaMetrix software on skull images. The results were statistically analyzed using SPSS statistical software. No statistically significant differences were obtained for AE parameters between the EMP and CP populations independent of age and gender. However, statistically significant (p<0.05) differences were revealed when comparing results of three different measuring methods. It could not be determined which of the used measurement methods is the most accurate due to the different results obtained as well as the presence of possible shortcomings and limitations of the various methods (measuring points are difficult to determine and/or they are not clearly observed in the investigated images to be precisely marked and measured; distortion and magnification of structures on radiographic images are present). Therefore, due to the limitations of this study, the obtained results could serve only as orienting information. PMID:25899341

  17. Calcium Pyrophosphate Dihydrate Crystal Deposition Disease of the Sternoclavicular Joint

    PubMed Central

    Borowski, Andreas; Heikaus, Sebastian; Kurt, Muhammed

    2014-01-01

    Deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the articular structures affects predominantly temporomandibular, knee, hip, spine, and wrist joints, and is a rare condition, often mimicking malignancy. Sternoclavicular joint is extremely rarely involved. We present a patient with swelling of the right upper extremity, in whom on computed tomography a mass posterior to the sternoclavicular joint causing compression of the brachiocephalic vein was detected. A modified resection arthroplasty was performed, and the histopathological findings revealed massive deposits of CPPD in the articular cartilage. To our knowledge, there is only one similar case published in the literature. PMID:26693128

  18. ESRRB polymorphisms are associated with comorbidity of temporomandibular disorders and rotator cuff disease.

    PubMed

    Bonato, L L; Quinelato, V; Pinheiro, A daR; Amaral, M V G; de Souza, F N; Lobo, J C; Aguiar, D P; Augusto, L M M; Vieira, A R; Salles, J I; Cossich, V R A; Guimarães, J A M; de Gouvêa, C V D; Granjeiro, J M; Casado, P L

    2016-03-01

    Temporomandibular disorders (TMD) are associated with comorbidity. Shoulder pain is among the symptoms associated with TMD. The purpose of this study was to investigate the association between TMD and rotator cuff disease (RCD) and related genetic aspects. All subjects underwent orofacial and shoulder examinations. The control group comprised 30 subjects with no pain. Affected subjects were divided into three groups: RCD (TMD-free, n=16), TMD (RCD-free, n=13), and TMD/RCD (patients with both RCD and TMD, n=49). A total of eight single nucleotide polymorphisms in the ESRRB gene were investigated. A chemiluminescent immunoassay was used to measure estradiol levels. Surface electromyography recorded head and cervical muscle activity. The χ(2) test and Student t-test/Mann-Whitney test were used to assess the significance of nominal and continuous variables. A P-value of <0.05 was considered significant. TMD subjects were seven times more susceptible to RCD than controls. The rs1676303 TT (P=0.02) and rs6574293 GG (P=0.04) genotypes were associated with RCD and TMD, respectively. TMD/RCD subjects showed associations with rs4903399 (P=0.02), rs10132091 (P=0.02), and CTTCTTAG/CCTCTCAG (P=0.01) haplotypes and lower muscle activity. Estradiol levels were similar among groups. This study supports TMD as a risk factor for RCD. ESRRB haplotypes and low muscle activity are common biomechanical characteristics in subjects with both diseases. PMID:26584852

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

    PubMed

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

    2014-04-01

    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

  20. Cephalometric Analysis of the Facial Skeletal Morphology of Female Patients Exhibiting Skeletal Class II Deformity with and without Temporomandibular Joint Osteoarthrosis

    PubMed Central

    Chen, Shuo; Lei, Jie; Fu, Kai-Yuan; Wang, Xing; Yi, Biao

    2015-01-01

    Purpose This study evaluated the differences in the facial morphological characteristics of female patients exhibiting skeletal class II deformity with and without temporomandibular joint osteoarthrosis. Methods Eighty-three female patients with skeletal class II deformity were included in this study; these patients were classified into three groups on the basis of the condylar features shown in cone-beam computed tomography scans: normal group, indeterminate for osteoarthrosis group, and osteoarthrosis group. The cephalometric differences among the three groups were evaluated through one-way ANOVA. Results Of the 83 patients, 52.4% were diagnosed with osteoarthrosis, as indicated by the changes in the condylar osseous component. The cephalometric measurements that represented skeletal characteristics, including mandibular position relative to the cranial base, mandibular plane angle (MP-SN), posterior facial height (S-Go), and facial height ratio, were significantly different among the three groups (p < 0.05). The patients in the osteoarthrosis group yielded the smallest S-Go, the highest MP-SN, and the most retruded mandible. Conclusions Temporomandibular joint osteoarthrosis is commonly observed in female patients with skeletal class II deformity. The morphological characteristics of the facial skeleton in patients with bilateral condylar osteoarthrosis may be altered. PMID:26474490

  1. Temporomandibular joint inflammation potentiates the excitability of trigeminal root ganglion neurons innervating the facial skin in rats.

    PubMed

    Takeda, Mamoru; Tanimoto, Takeshi; Ikeda, Mizuho; Nasu, Masanori; Kadoi, Jun; Shima, Yukio; Ohta, Hidehiko; Matsumoto, Shigeji

    2005-05-01

    The aim of this study was to test the hypothesis that temporomandibular joint (TMJ) inflammation alters the excitability of trigeminal root ganglion (TRG) neurons innervating the facial skin, by using behavioral, electrophysiological, molecular, and immunohistochemical approaches. Complete Freund's adjuvant (CFA) was injected into the rat TMJ to produce inflammation. The threshold for escape from mechanical stimulation applied to the orofacial area in TMJ-inflamed rats was significantly lower than that in naïve rats. The TRG neurons innervating the inflamed TMJ were labeled by 2% Fluorogold (FG) injection into the TMJ. The number of FG-labeled substance P (SP)-immunoreactive neurons in the inflamed rats was significantly increased compared with that in the naïve rats. On the other hand, medium- and large-diameter TRG neurons (>30 microm) innervating the facial skin were labeled by FG injection into the facial skin. In the FG-labeled cutaneous TRG neurons, the occurrence of SP (100 nM) induced membrane depolarization in inflamed rats (medium: 73.3%, large : 85.7%) was larger than that in the naïve rats (medium: 29.4%, large : 0%). In addition, SP application significantly increased the firing rate evoked by depolarizing pulses in the neurons of inflamed rats compared with those of naïve rats. Quantitative single-cell RT-PCR analysis showed the increased expression of mRNA for the NK1 receptor in FG-labeled TRG neurons in inflamed rats compared with that in naive rats. The numbers of SP and NK1 receptors/neurofilament 200 positive immunoreactive TRG neurons innervating the facial skin (FG-labeled) in the inflamed rats were significantly increased compared with those seen in naïve rats. These results suggest that TMJ inflammation can alter the excitability of medium- and large-diameter TRG neurons innervating the facial skin and that an increase in SP/NK1 receptors in their soma may contribute to the mechanism underlying the trigeminal inflammatory allodynia in the TMJ disorder. PMID:15625101

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

    PubMed

    Thompson, J R

    1986-07-01

    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

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

    PubMed Central

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

    2014-01-01

    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. PMID:25678945

  4. Effect of TLR4/MyD88 Signaling Pathway on Expression of IL-1? and TNF-? in Synovial Fibroblasts from Temporomandibular Joint Exposed to Lipopolysaccharide

    PubMed Central

    Lin, Xuefen; Kong, Jingjing; Wu, Qingting; Yang, Yingying; Ji, Ping

    2015-01-01

    Accumulating evidence from previous studies suggested that interleukin-1 (IL-1?) and tumor necrosis factor-? (TNF-?) play an important role in pathogenesis of temporomandibular disorders (TMD). However, the cell surface receptors and the intracellular signal pathways leading to these cytokines expression are not fully understood. In the current study, we investigated the roles of Toll-like receptor 4 (TLR4) and its adaptor myeloid differentiation factor 88 (MyD88) in the expression of IL-1? and TNF-? in synovial fibroblasts (SFs) separated from rat temporomandibular joint (TMJ) with lipopolysaccharide (LPS) stimulation. The results showed that treatment with LPS could increase TLR4, MyD88, IL-1?, and TNF-? expression at both mRNA and protein levels. In addition, increased expression of IL-1? and TNF-? could be blocked by treatment with TAK-242, a blocker of TLR4 signaling, and also by MyD88 inhibitory peptide (MIP). These findings suggested that maybe TLR4/MyD88 signal transduction pathway participates in enhanced expression of IL-1 and TNF-? in patients with TMD. The activation of TLR4/MyD88 signal transduction pathway which results in production of proinflammatory factors may play a role in the pathogenesis of TMD. PMID:25810567

  5. Impact in oral health and the prevalence of temporomandibular disorder in individuals with Parkinson’s disease

    PubMed Central

    Silva, Paula Fernanda da Costa; Biasotto-Gonzalez, Daniela Aparecida; Motta, Lara Jansiski; Silva, Soraia Micaela; Ferrari, Raquel Agnelli Mesquita; Fernandes, Kristianne Porta Santos; Bussadori, Sandra Kalil

    2015-01-01

    The aims of the present study were to investigate the prevalence of temporomandibular disorder (TMD) in a group of patients with Parkinson’s disease (PD), and to analyze oral health according to the severity of the disease. [Methods] Signs and symptoms of TMD were evaluated using the Research Diagnostic Criteria for Temporomandibular Disorders, and oral health impact was measured using the Oral Health Impact Profile. The unpaired Student’s t-test was used to compare groups with and without TMD. Pearson’s correlation coefficients were calculated to determine correlations between the level of functional independence and oral health impact. Fisher’s exact test was used to test the association between TMD and the severity of symptoms of PD. [Results] Fifty-nine individuals with PD were analyzed. The prevalence of TMD was 20.33%. No statistically significant associations were found between TMD and the severity of PD. Oral health impact was considered weak, but a statistically significant difference between groups with and without TMD was found for psychological disability (p = 0.003). No significant correlation was found between the level of functional independence and oral health impact. [Conclusion] The prevalence of TMD among patients with Parkinson’s disease was 20.33%. A statistically significant difference between groups with and without TMD was found regarding the psychological disability domain. PMID:25931752

  6. Temporomandibular Joint Disorder

    MedlinePLUS

    ... information you need from the Academy of General Dentistry Monday, March 21, 2016 About | Contact InfoBites Quick ... Terms and Conditions © 1996-2016 Academy of General Dentistry. All Rights Reserved.

  7. [Rheumatic joint diseases in the elderly].

    PubMed

    Kondo, Yuya; Yokosawa, Masahiro; Kaneko, Shunta; Sumida, Takayuki

    2014-10-01

    The most frequent rheumatic joint disease in the elderly is rheumatoid arthritis (RA). Recent advances in the treatment of RA improve prognosis, and gradually increase the elderly patients with RA. There are some differences in clinical features between the patients with elderly onset RA and young onset RA, such as systemic symptoms and distribution of affected joints. In addition, it is occasionally difficult to differentiate elderly onset RA from the other rheumatic diseases like polymyalgia rheumatica and RS3PE syndrome, pseudogout, and osteoarthritis. Since elderly patients tend to have more co-morbidity and co-existing diseases requiring treatment with other drugs, a risk/benefit profile must always be taken into consideration when choosing the treatment in elderly patients with rheumatic joint diseases. PMID:25509802

  8. Functional states of mandibular movements and synovial pumps of the temporomandibular joint. Is it possible to provide a biomechanically correct replacement for the TMJ?

    PubMed

    Kubein-Meesenburg, D; Nägerl, H; Fialka-Fricke, J; Hahn, W; Weber, S; Hönig, J; Hansen, C; Fanghänel, J; Thieme, K M; Ihlow, D

    2012-03-20

    Due to its complexity, there is currently an incomplete understanding of temporomandibular joint (TMJ) function, especially in relation to the morphological interplay of the condyle and the disc as well as the disc, the Os temporale and the lateral pterygoid muscle. This also holds true for synovial flow and synovial pumps, the existence of which we postulate and for which we present a theory of their mechanism. In view of the complexity of mandibular movements and the morphology and function of the TMJ, we need to know how precisely a reconstruction of the TMJ, if necessary, must be adapted to nature. An analysis of the morphology of the functional states of the mandible, as well as the synovial pump system, should at least provide a basis for moulding reconstructions. PMID:22079779

  9. Equine rehabilitation therapy for joint disease.

    PubMed

    Porter, Mimi

    2005-12-01

    The principles of physical rehabilitation therapy can be applied to the horse to provide a reduction in discomfort and dysfunction associated with the various forms of joint disease. Physical agents,such as ice, heat, electricity, sound, light, magnetic fields, compression, and movement, can be used by the rehabilitation therapist to attempt to control pain, reduce swelling, and restore optimal movement and function in the affected joint. The equine therapist's attention is focused not only on the affected joint but on the body as a whole to manage secondary or compensatory problems. PMID:16297723

  10. How muscle relaxation and laterotrusion resolve open locks of the temporomandibular joint. Forward dynamic 3D-modeling of the human masticatory system.

    PubMed

    Tuijt, M; Koolstra, J H; Lobbezoo, F; Naeije, M

    2016-01-25

    Patients with symptomatic hypermobility of the temporomandibular joint report problems with the closing movement of their jaw. Some are even unable to close their mouth opening wide (open lock). Clinical experience suggests that relaxing the jaw muscles or performing a jaw movement to one side (laterotrusion) might be a solution. The aim of our study was to assess the potential of these strategies for resolving an open lock and we hypothesised that both strategies work equally well in resolving open locks. We assessed the interplay of muscle forces, joint reaction forces and their moments during closing of mouth, following maximal mouth opening. We used a 3D biomechanical model of the masticatory system with a joint shape and muscle orientation that predispose for an open lock. In a forward dynamics approach, the effect of relaxation and laterotrusion strategies was assessed. Performing a laterotrusion movement was predicted to release an open lock for a steeper anterior slope of the articular eminence than relaxing the jaw-closing muscles, herewith we rejected our hypothesis. Both strategies could provide a net jaw closing moment, but only the laterotrusion strategy was able to provide a net posterior force for steeper anterior slope angles. For both strategies, the temporalis muscle appeared pivotal to retrieve the mandibular condyles to the glenoid fossa, due to its' more dorsally oriented working lines. PMID:26726782

  11. Three-dimensional assessment of the temporomandibular joint and mandibular dimensions after early correction of the maxillary arch form in patients with Class II division 1 or division 2 malocclusion

    PubMed Central

    Ciger, Semra

    2015-01-01

    Objective This study aimed to assess three-dimensional changes in the temporomandibular joint positions and mandibular dimensions after correction of dental factors restricting mandibular growth in patients with Class II division 1 or division 2 malocclusion in the pubertal growth period. Methods This prospective clinical study included 14 patients each with Class II division 1 (group I) and Class II division 2 (group II) malocclusions. The quad-helix was used for maxillary expansion, while utility arches were used for intrusion (group I) or protrusion and intrusion (group II) of the maxillary incisors. After approximately 2 months of treatment, an adequate maxillary arch width and acceptable maxillary incisor inclination were obtained. The patients were followed for an average of 6 months. Intraoral and extraoral photographs, plaster models, and cone-beam computed tomography (CBCT) images were obtained before and after treatment. Lateral cephalometric and temporomandibular joint measurements were made from the CBCT images. Results The mandibular dimensions increased in both groups, although mandibular positional changes were also found in group II. There were no differences in the condylar position within the mandibular fossa or the condylar dimensions. The mandibular fossa depth and condylar positions were symmetrical at treatment initiation and completion. Conclusions Class II malocclusion can be partially corrected by achieving an ideal maxillary arch form, particularly in patients with Class II division 2 malocclusion. Restrictions of the mandible in the transverse or sagittal plane do not affect the temporomandibular joint positions in these patients because of the high adaptability of this joint. PMID:26023540

  12. The potential role of joint injury and eustachian tube dysfunction in the genesis of secondary Ménière's disease.

    PubMed

    Franz, Burkhard; Anderson, Colin

    2007-01-01

    Ménière's diseasenot only includes the symptom complex consisting of attacks of vertigo, low-frequency hearing loss, and tinnitus but comprises symptoms related to the eustachian tube, the upper cervical spine, the temporomandibular joints, and the autonomic nervous system. Quantifiable experience shows that the insertion of a middle-ear ventilation tube can alleviate Ménière's disease symptoms, suggesting that eustachian tube dysfunction is a contributing feature. Clinical practice also shows that treating disorders of the upper cervical spine and temporomandibular joints can lessen Ménière's disease symptoms, suggesting a relationship. Similarly, stellate ganglion blocks can be beneficial in controlling Ménière's disease symptoms, highlighting the influence of the autonomic nervous system. Thus, contrasting symptoms associated with the eustachian tube, the upper cervical spine, the temporomandibular joints, and the autonomic nervous system relate to Ménière's disease, but the possible reflex pathway by which a link is established is unclear. We made an attempt in this study to describe a hypothetical reflex pathway that links joint injury and the autonomic nervous system, where eustachian tube function is under their influence and is the critical link. In this hypothetical reflex pathway, irritation of facet joints can first lead to an activated anterior cervical sympathetic system via an independent pathway in the mediolateral cell column; it can simultaneously lead to an axon reflex involving nociceptive neurons, resulting in neurogenic inflammation and the prospect of a eustachian tube dysfunction. The eustachian tube dysfunction is responsible for a disturbed middle ear-inner ear pressure relationship, circumstances that have the potential to develop into secondary Ménière's disease. This reflex pathway is supported by recent animal experiments. PMID:18229792

  13. Coronoid process and residual ankylotic mass as an autograft in the management of ankylosis of the temporomandibular joint in young adolescent patients: a retrospective clinical investigation.

    PubMed

    Bansal, Vishal; Mowar, Apoorva; Dubey, Prajesh; Bhatnagar, Aditi; Bansal, Avi

    2016-04-01

    The aim of this non-randomised investigation was to assess the feasibility of using autogenous grafts (such as coronoid process and the resected ankylotic mass) in reconstruction of the condyle after gap arthroplasty for ankylosis of the temporomandibular joint (TMJ). Sixteen patients (23 joints) operated on between 2007 and 2009 were studied and postoperative measurements of maximum interincisal opening, bite force, range of movement, and infection were recorded. After a mean (SD) follow up of 55 (2.25) months mouth opening improved from 3 (3.84) mm to 33 (1.66) mm in patients treated with coronoid graft, while in patients treated with an ankylotic mass after a mean (SD) follow up of 58 (1.58) months it increased from 4 (2.64) mm to 26 (8.04) mm. Bite force six months postoperatively ranged from 18.25kg/cm(2) - 27.5kg/cm(2) after reconstruction with the coronoid process and 18.5kg/cm(2) - 23.25kg/cm(2) after reconstruction with the ankylotic mass. One patient developed reankylosis postoperatively and another developed infection, in both of which the ankylotic mass had been used. Both were managed successfully. Both the ankylotic mass and the coronoid process gave satisfactory results and seem to be options for reconstruction. However, the coronoid process graft was better than residual ankylotic mass in terms of masticatory efficiency, bite force, and range of movement. PMID:26851147

  14. Effects of condylar fibrocartilage on the biomechanical loading of the human temporomandibular joint in a three-dimensional, nonlinear finite element model.

    PubMed

    Hu, Kai; Qiguo, Rong; Fang, Jing; Mao, Jeremy J

    2003-03-01

    The present study was undertaken to test a hypothesis that the addition of articular fibrocartilage in the condyle of the temporomandibular joint reduces three-dimensional stress distribution in the condyle, the disc and articular eminence. A three-dimensional, nonlinear finite-element model was developed for analysis of joint loading before and after the addition of condylar fibrocartilage to the osseous mandibular condyle reconstructed from spiral computer topography data. In the model, each of the disc, condyle and articular eminence was arbitrarily divided into five regions: the anterior, posterior, medial, lateral and central. Von Mises stresses that in virtually all regions of the disc, condyle and articular eminence became lower after the addition of condylar fibrocartilage. Especially remarkable was the approximately four-fold reduction in von Mises stresses in the anterior, central and medial regions of the mandibular condyle. In comparison, only slight to moderate stress reductions occurred in the disc and articular eminence, suggesting that condylar fibrocartilage absorbs considerable stresses and likely dampens more loads than the disc and articular eminence. The mandibular condyle demonstrated the largest total displacement in all directions after the addition of articular fibrocartilage, followed by the disc and articular eminence. We conclude that the addition of articular fibrocartilage primarily reduces loading of the mandibular condyle, rather than the disc and articular eminence. These findings lead to a hypothesis that the mandibular condyle more likely functions as a shock absorber than the disc. PMID:12538065

  15. Is running associated with degenerative joint disease

    SciTech Connect

    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

    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.

  16. [Bone and Joint Involvement in Celiac Disease].

    PubMed

    Hoffmanová, I; Sánchez, D; Džupa, V

    2015-01-01

    Celiac disease (gluten-sensitive enteropathy) is currently regarded as a multisystem autoimmune disorder; its clinical signs and symptoms do not involve merely the gastrointestinal tract but are associated with several other medical specialties, including orthopaedics and traumatology. In orthopaedic and trauma patients, celiac disease should be suspected in the following diagnoses: osteomalacia, premenopausal osteoporosis, post-menopausal osteoporosis more severe than expected and refractory to medication, osteoporosis in men under 55 years of age, recurrent bone fractures in the limbs, large joint arthralgia or arthritis of unclear aetiology, erosive spondyloarthropathy particularly in patients with the history of chronic diarrhoea, anaemia or associated autoimmune disorders (type 1 diabetes mellitus or autoimmune thyreopathy), and in women with secondary amenorrhea or early menopause. The orthopaedist or trauma surgeon should be aware of suspected celiac disease in patients who do not respond adequately to the standard treatment of pain related to the musculoskeletal system, in patients with recurrent fractures of the limb bones and in young patients with suspected secondary osteoporosis. With the use of appropriate screening methods, celiac disease as-yet undiagnosed can be revealed. A long-life gluten-free diet in these patients results in the alleviation of metabolic osteopathy and joint and muscle problems, in reduced requirements of analgesic and antiphlogistic drugs as well as in reduced risks of fracture. PMID:26516737

  17. Changes in temporomandibular joint morphology in class II patients treated with fixed mandibular repositioning and evaluated through 3D imaging: a systematic review.

    PubMed

    Al-Saleh, M A Q; Alsufyani, N; Flores-Mir, C; Nebbe, B; Major, P W

    2015-11-01

    To estimate the effects of skeletal class II malocclusion treatment using fixed mandibular repositioning appliances on the position and morphology of the temporomandibular joint (TMJ). Two independent reviewers performed comprehensive electronic searches of MEDLINE, EMBASE, EBM reviews and Scopus (until May 5, 2015). The references of the identified articles were also manually searched. All studies investigating morphological changes of the TMJ articular disc, condyle and glenoid fossa with 3D imaging following non-surgical fixed mandibular repositioning appliances in growing individuals with class II malocclusions were included in the analysis. Of the 269 articles initially reviewed, only 12 articles used magnetic resonance imaging and two articles used computed tomography (CT) or cone-beam CT images. Treatment effect on condyle and glenoid fossa was discussed in eight articles. Treatment effect on TMJ articular disc position and morphology was discussed in seven articles. All articles showed a high risk of bias due to deficient methodology: inadequate consideration of confounding variables, blinding of image assessment, selection or absence of control group and outcome measurement. Reported changes in osseous remodelling, condylar and disc position were contradictory. The selected articles failed to establish conclusive evidence of the exact nature of TMJ tissue response to fixed mandibular repositioning appliances. PMID:26260422

  18. 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

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

    2013-01-01

    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

  19. Dickkopf-related protein 1 induces angiogenesis by upregulating vascular endothelial growth factor in the synovial fibroblasts of patients with temporomandibular joint disorders

    PubMed Central

    JIANG, SHENG-JUN; LI, WEI; LI, YING-JIE; FANG, WEI; LONG, XING

    2015-01-01

    Angiogenesis has an important role in the progression of temporomandibular joint disorders (TMD). The aim of the present study was to explore the association between dickkopf-related protein 1 (DKK-1) and angiogenesis in TMD. The expression levels of DKK-1 and vascular endothelial growth factor (VEGF) were quantified by an ELISA assay of the synovial fluid from patients with TMD. The correlation between DKK-1 and VEGF was analyzed by Pearson correlation test. Synovial fibroblasts were isolated from patients with TMD and were subsequently treated with recombinant human DKK-1, anti-DKK-1 antibody, hypoxia inducible factor-1? (HIF-1?), or small interfering RNA (siRNA). The expression levels of DKK-1, HIF-1?, and VEGF were subsequently quantified. The present study also investigated the effects of DKK-1 on the migration of human umbilical vein endothelial cells (HUVEC). Increased expression levels of DKK-1 were concordant with increased expression levels of VEGF in the synovial fluid from patients with TMD. In the synovial fibroblasts, DKK-1 increased the expression levels of VEGF, and promoted HIF-1? nuclear localization. In addition, DKK-1 induced HUVEC migration, and HIF-1? siRNA inhibited DKK-1-induced cell migration. The results of the present study indicate that DKK-1 is associated with angiogenesis in the synovial fluid of patients with TMD. Furthermore, HIF-1? may be associated with DKK-1-induced HUVEC activation. PMID:26239269

  20. Maresin 1 Inhibits TRPV1 in Temporomandibular Joint-Related Trigeminal Nociceptive Neurons and TMJ Inflammation-Induced Synaptic Plasticity in the Trigeminal Nucleus

    PubMed Central

    Park, Chul-Kyu

    2015-01-01

    In the trigeminal system, disruption of acute resolution processing may lead to uncontrolled inflammation and chronic pain associated with the temporomandibular joint (TMJ). Currently, there are no effective treatments for TMJ pain. Recently, it has been recognized that maresin 1, a newly identified macrophage-derived mediator of inflammation resolution, is a potent analgesic for somatic inflammatory pain without noticeable side effects in mice and a potent endogenous inhibitor of transient receptor potential vanilloid 1 (TRPV1) in the somatic system. However, the molecular mechanisms underlying the analgesic actions of maresin 1 on TMJ pain are unclear in the trigeminal system. Here, by performing TMJ injection of a retrograde labeling tracer DiI (a fluorescent dye), I showed that maresin 1 potently inhibits capsaicin-induced TRPV1 currents and neuronal activity via Gαi-coupled G-protein coupled receptors in DiI-labeled trigeminal nociceptive neurons. Further, maresin 1 blocked TRPV1 agonist-evoked increases in spontaneous excitatory postsynaptic current frequency and abolished TMJ inflammation-induced synaptic plasticity in the trigeminal nucleus. These results demonstrate the potent actions of maresin 1 in regulating TRPV1 in the trigeminal system. Thus, maresin 1 may serve as a novel endogenous inhibitor for treating TMJ-inflammatory pain in the orofacial region. PMID:26617436

  1. Treatment of severe temporomandibular joint clicking with botulinum toxin in the lateral pterygoid muscle in two cases of anterior disc displacement.

    PubMed

    Bakke, Merete; Møller, Eigild; Werdelin, Lene M; Dalager, Torben; Kitai, Noriyuki; Kreiborg, Sven

    2005-12-01

    A novel treatment procedure is introduced for severe clicking of the temporomandibular joint (TMJ) associated with anterior disc displacement (ADD), using injections with botulinum toxin (BTX-A) in the lateral pterygoid muscle (LP). It has been suggested that ADD may be caused, precipitated, or maintained by LP activity, but the role of the LP in the dynamics of the TMJ clicking is uncertain. The case report includes 2 women, followed with clinical examinations, TMJ imaging, and electromyography (EMG), in whom local anesthetics in the LP could abolish the clicking for several days. BTX-A block of the LP (30 U Botox, given twice under EMG guidance with 6-month interval) temporarily reduced the action of the muscle, but the clicking was permanently eliminated and did not return during the observation period of 1 year, and a small but distinctive positional improvement in the disc-condyle relationship was obtained. However, the precise mechanisms behind the favourable treatment outcome are unclear. PMID:16301150

  2. Comparative evaluation of low-level laser and systemic steroid therapy in adjuvant-enhanced arthritis of rat temporomandibular joint: A histological study

    PubMed Central

    Khozeimeh, Faezeh; Moghareabed, Ahmad; Allameh, Maryam; Baradaran, Shahrzad

    2015-01-01

    Background: Low-level laser therapy (LLLT) has shown a promising effect in ameliorating symptoms of rheumatoid arthritis (RA). The aim of this investigation was to compare the early and late anti-inflammatory effects of LLLT and betamethasone in RA. Materials and Methods: In this animal experimental study, after inducing a model of RA in temporomandibular joint (TMJ) of 37 Wistar rats using adjuvant injection, they were randomly distributed into three experimental groups of 12 animals each: (1) LLLT group; (2) steroid group which received a single dose of betamethasone systemically; and (3) positive control group, which did not receive any treatment. One rat served as the negative control. Half of the animals in all the experimental groups were sacrificed on the 21st day after RA induction (early phase), and the other half were sacrificed 2 weeks later (late phase). Then, the severity of TMJ inflammation was assessed histologically in each group on a semi-quantitative scale. Kruskal-Wallis and Mann-Whitney tests were used to compare differences (? = 0.05). Results: The LLLT and steroid groups showed significantly (P < 0.05) lower inflammation mean scores in both early (5.66 [±1.86] and 1.66 [±1.21], respectively) and late phases of evaluation (1.16 [±1.47] and 6.50 [±1.04], respectively) compared to positive control group in early and late stages of assessment (11.66 [±3.50] and 8.66 [±1.36], respectively). However, the best results (P < 0.005) were achieved in early phase of the steroid group as well as late phase of the LLLT group. Conclusion: Within limitations of this study, it may be concluded that LLLT method has a long-term promising effect on reducing inflammation severity of TMJ similar to betamethasone in earlier stages. PMID:26005460

  3. Incidence of temporomandibular joint clicking in adolescents with and without unilateral posterior cross-bite: a 10-year follow-up study.

    PubMed

    Michelotti, A; Iodice, G; Piergentili, M; Farella, M; Martina, R

    2016-01-01

    Among different malocclusions, posterior cross-bite is thought to have a strong impact on the correct functioning of the masticatory system. The association between unilateral posterior cross-bite (UPCB) and temporomandibular joint (TMJ) clicking, however, remains still controversial. The aim of this study was to investigate whether the presence of UCPB during early adolescence increases the risk of reporting TMJ clicking after a long-term follow-up. A longitudinal survey design was carried out in a group of 12-year-old young adolescents, who were examined at baseline for TMJ clicking sounds and unilateral posterior cross-bite. After 10 years, 519 subjects could be reached by a telephone survey. Standardised questions were used to collect self-reported TMJ sounds and to determine whether participants had received an orthodontic treatment. Logistic regression analysis revealed a significant association between unilateral posterior cross-bite and subjectively reported TMJ clicking (odds ratio = 6·0; 95% confidence limits = 3·4-10·8; P < 0·0001). The incidence of TMJ clicking was 12%. At a ten-year follow-up, self-reports of TMJ clicking were significantly associated with the presence of UPCB at baseline, but not with the report of having received an orthodontic treatment. Within the limitation of this study, the presence of unilateral posterior cross-bite in young adolescents may increase the risk of reporting TMJ sounds at a 10-year follow-up. The provision of an orthodontic treatment, however, does not appear to reduce the risk of reporting TMJ sounds. PMID:26250478

  4. Overexpression of Indian hedgehog partially rescues short stature homeobox 2-overexpression-associated congenital dysplasia of the temporomandibular joint in mice

    PubMed Central

    LI, XIHAI; LIANG, WENNA; YE, HONGZHI; WENG, XIAPING; LIU, FAYUAN; LIN, PINGDONG; LIU, XIANXIANG

    2015-01-01

    The role of short stature homeobox 2 (shox2) in the development and homeostasis of the temporomandibular joint (TMJ) has been well documented. Shox2 is known to be expressed in the progenitor cells and perichondrium of the developing condyle. A previous study by our group reported that overexpression of shox2 leads to congenital dysplasia of the TMJ via downregulation of the Indian hedgehog (Ihh) signaling pathway, which is essential for embryonic disc primordium formation and mandibular condylar growth. To determine whether overexpression of Ihh may rescue the overexpression of shox2 leading to congenital dysplasia of the TMJ, a mouse model in which Ihh and shox2 were overexpressed (Wnt1-Cre; pMes-stop shox2; pMes-stop Ihh mice) was utilized to assess the consequences of this overexpression on TMJ development during post-natal life. The results showed that the developmental process and expression levels of runt-related transcription factor 2 and sex determining region Y-box 9 in the TMJ of the Wnt1-Cre; pMes-stop shox2; pMes-stop Ihh mice were similar to those in wild-type mice. Overexpression of Ihh rescued shox2 overexpression-associated reduction of extracellular matrix components. However, overexpression of Ihh did not inhibit the shox2 overexpression-associated increase of matrix metalloproteinases (MMPs) MMP9, MMP13 and apoptosis in the TMJ. These combinatory cellular and molecular defects appeared to account for the observed congenital dysplasia of TMJ, suggesting that overexpression of Ihh partially rescued shox2 overexpression-associated congenital dysplasia of the TMJ in mice. PMID:26096903

  5. Septic arthritis of the temporomandibular joint as a complication of acute otitis media in a child: A rare case and the importance of real-time PCR for diagnosis.

    PubMed

    Bast, F; Collier, S; Chadha, P; Collier, J

    2015-11-01

    We document the case of a 7-year-old boy who presented with pain in his left ear and trismus after a diagnosis of acute otitis media one week previously. His blood inflammatory markers were raised and magnetic resonance imaging (MRI) showed significant left temporomandibular joint effusion and partial attenuation of the left mastoid. A clinical diagnosis of septic arthritis of the TMJ was made and the patient was commenced on broad-spectrum antibiotics. Analysis using real time PCR enabled identification of the offending organism, confirmation of the diagnosis and antibiotic treatment to be specifically tailored for treatment. PMID:26340928

  6. Effects of glucosamine-chondroitin combination on synovial fluid IL-1?, IL-6, TNF-? and PGE2 levels in internal derangements of temporomandibular joint

    PubMed Central

    Esen, Emin; Tatli, Ufuk

    2015-01-01

    Background The aim of the present study was to evaluate the effects of glucosamine-chondroitin sulphate combination on internal derangements of temporomandibular joint in clinical and biochemical manners. Material and Methods This randomized clinical study included 31 cases reporting joint tenderness, in which disc displacement was detected on MR imaging. In all patients, synovial fluid sampling was performed under local anesthesia. In the study group, the patients were prescribed a combination of 1500 mg glucosamine and 1200 mg chondroitin sulphate, while patients in the control group were only prescribed 50 mg tramadol HCl (twice daily) for pain control. After 8 weeks, synovial fluid sampling was repeated in the same manner. The levels of pain, maximum mouth opening (MMO), synovial fluid IL-1ß, IL-6, TNF-? and PGE2 measured before and after pharmacological intervention were compared. Results The reduction in pain levels was significant in both groups. There was no significant difference between two groups in terms of pain reduction. The improvement in MMO was significant in the study group but it was not in the control group. The MMO improvement was significantly higher in the study group compared to the control group. In the study group, significant decrease was observed in PGE2 level, while the decreases in IL-1?, IL-6 and TNF-? levels were not significant. In the control group, no significant decrease was observed in any of the inflammatory cytokines after 8 weeks, moreover IL-1ß and IL-6 levels were increased. Alterations of IL-1ß and IL-6 levels were significant in study group while TNF-? and PGE2 levels were not, compared to control group. Conclusions In conclusion, these results might suggest that glucosamine-chondroitin combination significantly increases the MMO and decreases the synovial fluid IL1? and IL6 levels in internal derangements of TMJ compared to tramadol. The modifications of synovial fluid TNF-? and PGE2 levels do not reach statistical significance. This combination also provides efficient pain relief in similar level with tramadol, a narcotic analgesic. Key words: Chondroitin sulphate, glucosamine, internal derangement, TMJ, tramadol. PMID:25662545

  7. [Microbiologic aspects of inflammatory joint diseases].

    PubMed

    Köhler, W; Stelzner, A; Kittlick, M

    1987-08-01

    Regarding of microbiological aspects of arthritis three forms of joint diseases are under investigation: the septic arthritis, the reactive arthritis and the Rheumatoid Arthritis. In 95% of patients with septic arthritis microorganisms as causative agents responsible for the disease are described: Staphylococci, Streptococci, some gram-negative bacteria. By an haematogenic route of infection predominantly patients with immunosuppressive therapy are altered. In newborns and children septic arthritis is to observe more rarely. A reactive arthritis is a postinfectious sterile process in dependence on an infection occurred at an earlier time. As etiologic agents Yersinia, Enterobacteriaceae and Campylobacter have been discovered. 80% of the patients suffering such a reactive arthritis are carrier of the HLA-B27 system. The etiology of the Rheumatoid Arthritis is an open, unanswered problem. Of importance are: immunogenetic conditions, autoimmune phenomena, endocrinologic, dietetic and psychologic factors as well as bacteria and viruses as causative agents: cocci, bacilli, Diphteroids, endoparasitic bacteria (Listeria, L-forms, Mycoplasma, Chlamydiae), viruses (Adeno-, Mumps-, Measles-, ECHO-, Coxsackie-A- and B-, Hepatitis-, Cytomegalo-, Para-influenza-, Retro-, Parvo- and Rubella viruses). In the last years the EBV is of interest covering the question of a distinct virus persistence in tissues and the adequate limiting factors. Perhaps a defect of the hu-IFN-gamma-system might be of immunopathological and clinical significance. PMID:3673141

  8. Subchondral bone changes and chondrogenic capacity of progenitor cells from subchondral bone in the collagenase-induced temporomandibular joints osteoarthritis rabbit model

    PubMed Central

    Wu, Guomin; Zhu, Songsong; Sun, Xiumei; Hu, Jing

    2015-01-01

    Purpose: The goals of this study were to characterize subchondral bone changes, and to determine biological activity characteristics of progenitor cell populations from subchondral bone in the collagenase-induced temporomandibular joint osteoarthritis (TMJOA) rabbit model. Greater understanding of such pathological changes occurring in TMJOA samples is critical in the future treatment modalities regarding cartilage protection and repair. Furthermore, the use of progenitor cell populations in various cartilage regeneration strategies proves to be a fruitful avenue for research and clinical applications. Materials and methods: Bone remodeling and anabolic activity of subchondral bone was evaluated by hematoxylin-eosin (H&E), Alcian blue-periodic acid-Schiff (AB-PAS) staining and immuohistochemical staining. The biological activity characteristics of progenitor cells were assessed by expressions of collagen type II, CD44, SOX-9 and MMP-9 by immunohistochemistry and Western blot analysis. Results: In most of the specimens, cartilage of the digested area displayed a reaction characterized by thickening of the cartilage cellular structure with retraction structure formation in the subchondral bone. Most of the specimens focuses on chondroid metaplasia were observed in the subchondral bone, promoting its remodeling, which could develop to endochondral ossification and increasing subchondral bone size. Meanwhile, immunohistochemistry analysis revealed that CD44 expressions in subchondral bone were most significantly increased in TMJOA at 2 weeks group (P < 0.01). And, at 4, 6 and 8 weeks groups, the osteochondral junction had completely disappeared by active subchondral bone remodeling, and collagen type II, CD44, SOX-9 and MMP-9 expressions in active subchondral bone region were significantly increased in TMJOA (P < 0.05). In addition, western blot analysis revealed that CD44 expression significantly emerged in subchondral bone region at 2 weeks group (P < 0.01). Meanwhile, SOX-9 expression emerged in all group, and the intensity was increased in the experimental groups (P < 0.05). Conclusion: Our results suggest that the beneficial activation of progenitor cells and bone marrow stem cells in subchondral bone at early stage of TMJOA played an important role on renovation and remodeling of subchondral bone. PMID:26617688

  9. 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)

    Fries, Marc Douglas

    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.

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

    PubMed

    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

    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

  11. Electromyographic examination of jaw muscles in relation to symptoms and occlusion of patients with temporomandibular joint disorders.

    PubMed

    Liu, Z J; Yamagata, K; Kasahara, Y; Ito, G

    1999-01-01

    Clinical/occlusal scores and jaw-muscle EMGs were recorded in 24 TMD symptomatic (group S) and 20 normal (group N) subjects to evaluate the significance of EMG parameters and their clinical associations. Results indicated: (1) integrated EMG activity (IEMG) was larger at the rest position (RP) in anterior temporalis (Ta) but smaller at maximal voluntary clenching (MVC) in masseter (Ma) and Ta, and the ratios of IEMG at 70%MVC to the corresponding bite force (70%BF) were greater in group S; (2) mean power frequency (MPF) were almost the same in both groups but its shift was more rapid in group S; (3) silent period duration (SPD) was longer in group S; (4) asymmetry indices for SPD and silent period latency (SPL) were larger in group S; (5) muscle pain was associated negatively with IEMG at MVC and 70%BF but positively with IEMGs at RP and 70%MVC, and impaired jaw movements were associated negatively with the above EMG values; (6) muscle pain was positively associated with SPD in Ma, while joint pain and sound showed positive and negative associations with SPD, respectively; (7) associations between occlusion and EMG parameters were found more in group N. These findings verify: (1) jaw elevators in TMD may have hyper-tonic activities and a weak functional efficiency; (2) jaw muscles in TMD may become easily fatigued following a functional effort, and less relaxed following a muscle twitch; (3) the severity of pain could not be reflected in EMG activities, but impaired jaw movement may increase tonic activity and decrease functional effort; (4) TMD symptoms may alter the functional adaptation of jaw-muscle activities and occlusion. PMID:10080323

  12. Second metatarsophalangeal joint pathology and freiberg disease.

    PubMed

    Shane, Amber; Reeves, Christopher; Wobst, Garrett; Thurston, Paul

    2013-07-01

    Pain in the second metatarsophalangeal joint (MTPJ) is a complaint frequently encountered by foot and ankle specialists. The pathology associated with this joint is often painful and debilitating for the patient. In the past, typical treatment protocols for second MTPJ pathology were aimed at relief of patient symptoms. Conservative treatment and offloading devices have historically dominated treatment options for the clinician. However, recent surgical techniques and procedures have been developed to correct the mechanical and structural defects that can affect this joint. The aim of this review was to outline recent developments and treatment options for common second MTPJ pathologies. PMID:23827490

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

    PubMed Central

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

    2014-01-01

    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

  14. Orthodontics and temporomandibular disorders: a curriculum proposal for postgraduate programs.

    PubMed

    Greene, Charles S; Stockstill, John; Rinchuse, Donald; Kandasamy, Sanjivan

    2012-07-01

    In a previous article, we reported the results of a survey of American and Canadian orthodontic postgraduate programs to determine how the topics of occlusion, temporomandibular joint, and temporomandibular disorders were currently being taught. Based on the finding of considerable diversity among those programs, we decided to write a curriculum proposal for temporomandibular disorders that would be compatible with and satisfy the current curriculum guidelines for postgraduate orthodontic programs. These guidelines arose from a combination of the requirements published by the American Dental Association's Commission on Dental Accreditation and the written guide (July 2010) of the American Board of Orthodontics for the its clinical examination. The proposed curriculum, based on the latest scientific evidence in the temporomandibular disorder field, gives program directors a template for covering these subjects thoroughly. At the same time, they can focus on related orthodontic issues, so that their future graduates will be prepared to deal with patients who either have or later develop temporomandibular disorder problems. PMID:22748986

  15. Treatment of Nongout Joint Deposition Diseases: An Update

    PubMed Central

    Richette, Pascal; Flipo, René-Marc

    2014-01-01

    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

  16. Characterization of joint disease in mucopolysaccharidosis type I mice

    PubMed Central

    de Oliveira, Patricia G; Baldo, Guilherme; Mayer, Fabiana Q; Martinelli, Barbara; Meurer, Luise; Giugliani, Roberto; Matte, Ursula; Xavier, Ricardo M

    2013-01-01

    Mucopolysaccharidoses (MPS) are lysosomal storage disorders characterized by mutations in enzymes that degrade glycosaminoglycans (GAGs). Joint disease is present in most forms of MPS, including MPS I. This work aimed to describe the joint disease progression in the murine model of MPS I. Normal (wild-type) and MPS I mice were sacrificed at different time points (from 2 to 12 months). The knee joints were collected, and haematoxylin–eosin staining was used to evaluate the articular architecture. Safranin-O and Sirius Red staining was used to analyse the proteoglycan and collagen content. Additionally, we analysed the expression of the matrix-degrading metalloproteinases (MMPs), MMP-2 and MMP-9, using immunohistochemistry. We observed progressive joint alterations from 6 months, including the presence of synovial inflammatory infiltrate, the destruction and thickening of the cartilage extracellular matrix, as well as proteoglycan and collagen depletion. Furthermore, we observed an increase in the expression of MMP-2 and MMP-9, which could conceivably explain the degenerative changes. Our results suggest that the joint disease in MPS I mice may be caused by a degenerative process due to increase in proteases expression, leading to loss of collagen and proteoglycans. These results may guide the development of ancillary therapies for joint disease in MPS I. PMID:23786352

  17. Femoral neck erosions: sign of hip joint synovial disease

    SciTech Connect

    Goldberg, R.P.; Weissman, B.N.; Naimark, A.

    1983-07-01

    Pathologic synovial processes in the hip joint can cause characteristic extrinsic erosions of the femoral neck, which in extreme cases produce an ''apple core'' appearance. Nine such cases of synovial diseases, including synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis, and amyloidosis, that demonstrate this radiographic finding are presented. The anatomic relations of the hip joint that result in theis appearance, differential diagnosis, and radiographic techniques useful in diagnosis are discussed.

  18. An Evaluation of Nonsuppurative Joint Disease in Slaughter Pigs

    PubMed Central

    Johnston, Kathleen M.; Doige, Cecil E.; Osborne, A. Dudley

    1987-01-01

    Fifty-two joints from pigs with nonsuppurative joint disease from a local abattoir were examined grossly, histologically, and microbiologically in order to establish macroscopic differences between degenerative arthropathy and arthritis due to an infectious organism. The joints were grouped grossly according to the type and severity of lesions of the synovial membrane and cartilage, and microscopically according to the severity of synovial membrane lesions. Osteochondrosis and Erysipelothrix rhusiopathiae were the most common causes of nonsuppurative joint disease in the joints examined. The major macroscopic differences between these two arthropathies were in the nature and severity of the synovial and cartilaginous lesions and involvement of the lymph node draining the diseased joint. Typically, in osteochondrosis, the changes are feathery hypertrophy of villi, focal full-thickness cartilage buckles, ulcers or flaps, and no change in the draining lymph node, whereas in Erysipelothrix- caused arthritis, the villous hypertrophy is severe and polypoid in nature, there is diffuse erosion of articular cartilage, and the draining lymph node is consistently hypertrophic and often cystic. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8.Figure 9.Figure 10.Figure 11. PMID:17422755

  19. Prevalence of temporomandibular dysfunction in children and adolescents

    PubMed Central

    de Sena, Marina Fernandes; de Mesquita, Késsia Suênia F.; Santos, Fernanda Regina R.; Silva, Francisco Wanderley G. P.; Serrano, Kranya Victoria D.

    2013-01-01

    OBJECTIVE: To review the prevalence of temporomandibular disorders (TMD) in children and adolescents, verifying the methodological variations. DATA SOURCES: Research conducted in Medline, PubMed, Lilacs and BBO databases, including manuscripts (except reviews and case reports) published from 1990 to 2012. The descriptors were "temporomandibular joint syndrome", "temporomandibular joint dysfunction syndrome", "temporomandibular joint disorders", "prevalence studies", and "cross-sectional studies"; the words "dysfunction", "disorder", "temporomandibular", "children", "adolescents", "prevalence", "frequency", and "transversal" were used. DATA SYNTHESIS: Seventeen articles were selected, and the TMD frequency varied from 16 to 68%. Regarding the methodological criteria, only three articles (18%) reported sample size determination, three (18%) clearly described the sample selection process by stratified selection technique, and nine studies (53%) carried out the calibration of the examiners. The diagnostic criteria used in the studies were: Helkimo index (n=2; 12%), Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (n=4; 24%), the jaw index (n=1; 6%), clinical protocols (n=10; 59%), and anamnestic questionnaires (n=6; 35%). CONCLUSIONS: The TMD prevalence in children and adolescents varies in the literature. Appropriate and standardized methods are needed to identify, with greater validity, the presence of TMD in this population, allowing a better understanding of the pathological aspects in order to address more effective preventive and therapeutic procedures. PMID:24473961

  20. Temporomandibular juxtaarticular chondroma: case report.

    PubMed

    Vázquez Mahía, Inés; López-Cedrún Cembranos, José Luis; Ferreras Granado, José; Lorenzo Franco, Fernanda

    2007-03-01

    Chondromas are benign tumours composed of mature hyaline cartilage. We present here the first case in the English language medical literature of juxtaarticular chondroma of the temporomandibular joint in the parotid region. Within the rarity of cartilage disorders of the temporo-mandibular joint (TMJ), this particular condition is a diagnostic curiosity. The patient, a 54 year old woman, presented a right preauricular tumour of 3.5 cm. which had been developing for 4 years. It was not painful but there was a recent symptomology of TMJ dysfunction, with pain and clicks. The diagnostic possibilities of a parotid pleomorphic adenoma and of a cartilage tumour of the TMJ suggested a difficult preoperative differential diagnosis, which influenced our approach regarding therapy. The tumour was excised, preserving the parotid gland. This enabled us to confirm the histological diagnosis of chondroma, composed solely of chondroide tissue. We have described the clinical characteristics of our case, and carried out a review of the relevant literature, emphasising the differential diagnoses. PMID:17322809

  1. The radiology of joint disease. Volume 2. Third edition

    SciTech Connect

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

    1987-01-01

    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.

  2. Temporomandibular Disorders in Psoriasis Patients with and without Psoriatic Arthritis: An Observational Study

    PubMed Central

    Crincoli, Vito; Di Comite, Mariasevera; Di Bisceglie, Maria Beatrice; Fatone, Laura; Favia, Gianfranco

    2015-01-01

    AIMS: Psoriasis is a chronic, remitting and relapsing inflammatory disorder, involving the skin, nails, scalp and mucous membranes, that impairs patients' quality of life to varying degrees. Psoriatic arthritis is a chronic seronegative, inflammatory arthritis, usually preceded by psoriasis. Temporomandibular disorders is a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint. The aim of this study was to assess symptoms and signs of temporomandibular disorders in psoriasis patients with and without psoriatic arthritis. METHODS: The study group included 112 patients (56 men, 56 women; median age 49.7±12 years) with psoriasis, 25 of them were affected by psoriatic arthritis. A group of 112 subjects without psoriasis (56 men, 56 women; median age 47.7±17 years) served as controls. Signs and symptoms of temporomandibular disorders were evaluated according to the standardized Research Diagnostic Criteria for Temporomandibular Disorders. Psoriasis patients were subgrouped according to the presence/absence of psoriatic arthritis and by gender, to assess the prevalence of traditional symptoms and signs of temporomandibular disorders. RESULTS: Patients with psoriasis, and to an even greater extent those with psoriatic arthritis, were more frequently affected by symptoms and signs of temporomandibular disorders, including an internal temporomandibular joint opening derangement than healthy subjects. A statistically significant increase in symptoms of temporomandibular disorders, in opening derangement, bruxism and sounds of temporomandibular joint was found in patients with psoriatic arthritis as compared with psoriasis patients without arthritis and controls. CONCLUSIONS: psoriasis seems to play a role in temporomandibular joint disorders, causing an increase in orofacial pain and an altered chewing function. PMID:26019683

  3. TRPV4 as a therapeutic target for joint diseases.

    PubMed

    McNulty, Amy L; Leddy, Holly A; Liedtke, Wolfgang; Guilak, Farshid

    2015-04-01

    Biomechanical factors play a critical role in regulating the physiology as well as the pathology of multiple joint tissues and have been implicated in the pathogenesis of osteoarthritis. Therefore, the mechanisms by which cells sense and respond to mechanical signals may provide novel targets for the development of disease-modifying osteoarthritis drugs (DMOADs). Transient receptor potential vanilloid 4 (TRPV4) is a Ca(2+)-permeable cation channel that serves as a sensor of mechanical or osmotic signals in several musculoskeletal tissues, including cartilage, bone, and synovium. The importance of TRPV4 in joint homeostasis is apparent in patients harboring TRPV4 mutations, which result in the development of a spectrum of skeletal dysplasias and arthropathies. In addition, the genetic knockout of Trpv4 results in the development of osteoarthritis and decreased osteoclast function. In engineered cartilage replacements, chemical activation of TRPV4 can reproduce many of the anabolic effects of mechanical loading to accelerate tissue growth and regeneration. Overall, TRPV4 plays a key role in transducing mechanical, pain, and inflammatory signals within joint tissues and thus is an attractive therapeutic target to modulate the effects of joint diseases. In pathological conditions in the joint, when the delicate balance of TRPV4 activity is altered, a variety of different tools could be utilized to directly or indirectly target TRPV4 activity. PMID:25519495

  4. Temporomandibular dysfunction syndrome associated with scuba diving mouthpieces.

    PubMed Central

    Hobson, R S

    1991-01-01

    As previous reports have highlighted that temporomandibular joint dysfunction syndrome can occur during scuba diving due to the use of a diving mouthpiece, 74 divers of varied experience (62 male, 12 female) were asked to evaluate the efficiency of the mouthpiece for the ease of grip, insertion into the mouth, clearing of water, air sharing, comfort and overall efficiency. They also recorded the level of muscle and joint discomfort experienced during diving and non-diving activities. The results indicate that temporomandibular joint problems unrelated to diving are compounded by the use of a diving mouthpiece. The diver's assessment of muscle tension and comfort while using the mouthpiece was found to be a good predictor of whether temporomandibular dysfunction would occur and the assessment scores have been used in a formula to aid selection of a mouthpiece. PMID:1913032

  5. Angiogenesis in the pathogenesis of inflammatory joint and lung diseases

    PubMed Central

    Walsh, David A; Pearson, Claire I

    2001-01-01

    This paper reviews hypotheses about roles of angiogenesis in the pathogenesis of inflammatory disease in two organs, the synovial joint and the lung. Neovascularisation is a fundamental process for growth and tissue repair after injury. Nevertheless, it may contribute to a variety of chronic inflammatory diseases, including rheumatoid arthritis, osteoarthritis, asthma, and pulmonary fibrosis. Inflammation can promote angiogenesis, and new vessels may enhance tissue inflammation. Angiogenesis in inflammatory disease may also contribute to tissue growth, disordered tissue perfusion, abnormal ossification, and enhanced responses to normal or pathological stimuli. Angiogenesis inhibitors may reduce inflammation and may also help to restore appropriate tissue structure and function. PMID:11299055

  6. Non-invasive investigation in patients with inflammatory joint disease

    PubMed Central

    Dal Pont, Elisabetta; D’Incà, Renata; Caruso, Antonino; Sturniolo, Giacomo Carlo

    2009-01-01

    Gut inflammation can occur in 30%-60% of patients with spondyloarthropathies. However, the presence of such gut inflammation is underestimated, only 27% of patients with histological evidence of gut inflammation have intestinal symptoms, but subclinical gut inflammation is documented in two-thirds of patients with inflammatory joint disease. There are common genetic and immunological mechanisms behind concomitant inflammation in the joints and intestinal tract. A number of blood tests, e.g. erythrocyte sedimentation rate, orosomucoid, C-reactive protein, and white cell and platelet counts, are probably the most commonly used laboratory markers of inflammatory disease, however, these tests are difficult to interpret in arthropathies associated with gut inflammation, since any increases in their blood levels might be attributable to either the joint disease or to gut inflammation. Consequently, it would be useful to have a marker capable of separately identifying gut inflammation. Fecal proteins, which are indirect markers of neutrophil migration in the gut wall, and intestinal permeability, seem to be ideal for monitoring intestinal inflammation: they are easy to measure non-invasively and are specific for intestinal disease in the absence of gastrointestinal infections. Alongside the traditional markers for characterizing intestinal inflammation, there are also antibodies, in all probability generated by the immune response to microbial antigens and auto-antigens, which have proved useful in establishing the diagnosis and assessing the severity of the condition, as well as the prognosis and the risk of complications. In short, non-invasive investigations on the gut in patients with rheumatic disease may be useful in clinical practice for a preliminary assessment of patients with suspected intestinal disease. PMID:19468995

  7. Non-invasive investigation in patients with inflammatory joint disease.

    PubMed

    Dal Pont, Elisabetta; D'Incà, Renata; Caruso, Antonino; Sturniolo, Giacomo-Carlo

    2009-05-28

    Gut inflammation can occur in 30%-60% of patients with spondyloarthropathies. However, the presence of such gut inflammation is underestimated, only 27% of patients with histological evidence of gut inflammation have intestinal symptoms, but subclinical gut inflammation is documented in two-thirds of patients with inflammatory joint disease. There are common genetic and immunological mechanisms behind concomitant inflammation in the joints and intestinal tract. A number of blood tests, e.g. erythrocyte sedimentation rate, orosomucoid, C-reactive protein, and white cell and platelet counts, are probably the most commonly used laboratory markers of inflammatory disease, however, these tests are difficult to interpret in arthropathies associated with gut inflammation, since any increases in their blood levels might be attributable to either the joint disease or to gut inflammation. Consequently, it would be useful to have a marker capable of separately identifying gut inflammation. Fecal proteins, which are indirect markers of neutrophil migration in the gut wall, and intestinal permeability, seem to be ideal for monitoring intestinal inflammation: they are easy to measure non-invasively and are specific for intestinal disease in the absence of gastrointestinal infections. Alongside the traditional markers for characterizing intestinal inflammation, there are also antibodies, in all probability generated by the immune response to microbial antigens and auto-antigens, which have proved useful in establishing the diagnosis and assessing the severity of the condition, as well as the prognosis and the risk of complications. In short, non-invasive investigations on the gut in patients with rheumatic disease may be useful in clinical practice for a preliminary assessment of patients with suspected intestinal disease. PMID:19468995

  8. [Disability due to traumas and diseases of a knee joint].

    PubMed

    Strafun, S S; Kostogryz, O A; Rygan, M M; Ilyin, Yu V; Kostogryz, Yu O; Nechyporenko, R V

    2015-02-01

    The invalidism structure was analyzed for patients, suffering consequences of traumas and diseases of a knee joint (KJ). The primary invalidism level because of traumas and diseases of a KJ have constituted in 2013 yr 12.4%. The cause of invalidism in men is predominantly a one-side gonarthrosis, and in women--a bilateral one--due to concurrent aggravating causes (dishormonal changes, excessive body mass). The invalidism indices enhancement is caused by absence of a dispensary follow-up, insufficient treatment on various stages of the disease course, severity and irreversibility of pathological process in a KJ, socio-economic factors, low rehabilitational potential, prognosticated impossibility to conduct a professional-labour rehabilitation in a prepensionable and pensionable age. PMID:25985702

  9. Case-Based Learning for Orofacial Pain and Temporomandibular Disorders.

    ERIC Educational Resources Information Center

    Clark, Glenn T.; And Others

    1993-01-01

    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)

  10. The radiology of joint disease. 3rd Ed

    SciTech Connect

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

    1987-01-01

    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.

  11. [Relations between orthognathic surgery and temporomandibular disorders: a systematic review].

    PubMed

    Chauvel-Lebret, Dominique; Leroux, Agathe; Sorel, Olivier

    2013-06-01

    A painful and dysfunctional temporomandibular joint can be associated with a musculoskeletal anomaly. The multifactorial character of the etiology is now recognized. Among the etiologies, the role of orthognathic surgery is still debated. The analysis of the literature from 2000 to 2011 reveals for most authors a decrease in the frequency and intensity of signs and symptoms after surgery, especially pain and clicking. Risk factors may influence post-surgical results. Studies on patient risk factors such as age, sex, type of dysmorphia are inconclusive. Surgical techniques and the procedure used may have an influence on the development of post-surgical clinical signs and symptoms of temporomandibular disorders. PMID:23719245

  12. Temporomandibular disorders. Part 2: conservative management

    PubMed Central

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

    2014-01-01

    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

  13. Temporomandibular disorders. Part 2: conservative management.

    PubMed

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

    2014-02-01

    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

  14. Risk factors for temporomandibular disorder: Binary logistic regression analysis

    PubMed Central

    Magalhães, Bruno G.; de-Sousa, Stéphanie T.; de Mello, Victor V C.; da-Silva-Barbosa, André C.; de-Assis-Morais, Mariana P L.; Barbosa-Vasconcelos, Márcia M V.

    2014-01-01

    Objectives: To analyze the influence of socioeconomic and demographic factors (gender, economic class, age and marital status) on the occurrence of temporomandibular disorder. Study Design: One hundred individuals from urban areas in the city of Recife (Brazil) registered at Family Health Units was examined using Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) which addresses myofascial pain and joint problems (disc displacement, arthralgia, osteoarthritis and oesteoarthrosis). The Brazilian Economic Classification Criteria (CCEB) was used for the collection of socioeconomic and demographic data. Then, it was categorized as Class A (high social class), Classes B/C (middle class) and Classes D/E (very poor social class). The results were analyzed using Pearson’s chi-square test for proportions, Fisher’s exact test, nonparametric Mann-Whitney test and Binary logistic regression analysis. Results: None of the participants belonged to Class A, 72% belonged to Classes B/C and 28% belonged to Classes D/E. The multivariate analysis revealed that participants from Classes D/E had a 4.35-fold greater chance of exhibiting myofascial pain and 11.3-fold greater chance of exhibiting joint problems. Conclusions: Poverty is a important condition to exhibit myofascial pain and joint problems. Key words:Temporomandibular joint disorders, risk factors, prevalence. PMID:24316706

  15. Anesthesia for joint replacement surgery: Issues with coexisting diseases

    PubMed Central

    Kakar, P N; Roy, Preety Mittal; Pant, Vijaya; Das, Jyotirmoy

    2011-01-01

    The first joint replacement surgery was performed in 1919. Since then, joint replacement surgery has undergone tremendous development in terms of surgical technique and anesthetic management. In this era of nuclear family and independent survival, physical mobility is of paramount importance. In recent years, with an increase in life expectancy, advances in geriatric medicine and better insurance coverage, the scenario of joint replacement surgery has changed significantly. Increasing number of young patients are undergoing joint replacement for pathologies like rheumatoid arthritis and ankylosing spondylitis. The diverse pathologies and wide range of patient population brings unique challenges for the anesthesiologist. This article deals with anesthetic issues in joint replacement surgery in patients with comorbidities. PMID:21897499

  16. Temporomandibular disorders. A case-control study

    PubMed Central

    Bagán, Jose V.; Sanchis, Jose M.; Carbonell, Enrique

    2012-01-01

    Objective: To compare the risk factors and clinical manifestations of patients with temporomandibular disorders (TMDs) diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (axis I) versus an age and gender matched control group. Study Design: A total of 162 patients explored according to the RDC/TMD (mean age 40.6±18.8 years, range 7-90; 11.1% males and 88.9% females) were compared with 119 controls, measuring differences in TMD risk factors (sleep disturbances, stress, psychoactive medication, parafunctions, loss of posterior support, ligament hyperlaxity) and clinical variables (joint sounds, painful muscle and joint palpation, maximum aperture). Results: Myofascial pain (MFP) (single or multiple diagnoses) was the most frequent diagnosis (42%). The most common diagnostic combination was MFP plus arthralgia (16.0%). Statistically significant differences were observed in clenching (OR 2.3; 95%CI: 1.4-3.8) and in maximum active aperture (MAA) on comparing the two groups both globally (TMD vs. controls) (patients 36.7±8.6 mm, controls 43.1±5.8 mm; F=45.41, p = 0.000) and on comparing according to diagnostic categories. MFP explained most of the observed differences in the risk factors: stress perception (OR=1.98;I.C.:1.01-3.89), psychoactive medication (OR=2.21; I.C.:1.12-4.37), parafunctions (OR=2.14;I.C.:1.12-4.11), and ligament laxity (OR=2.6;I.C.:1.01-6.68). Joint sounds were more frequent in patients with MFP (39.7% vs. 24.0%; ?2=4.66; p=0.03), and painful joint palpation was more common in patients with disc displacement with reduction (DDWR)(15.9% vs. 5.0%; ?2 = 5.2; p = 0.02) and osteoarthrosis (20.8% vs. 5.0%; ?2 = 7.0; p = 0.008). Conclusions: There is a high prevalence of signs and symptoms of TMDs in the general population. Significant differences are observed in clenching and MAA between patients and controls considered both globally and for each diagnostic category individually. The analyzed risk factors (except loss of posterior support) show a statistically significant OR for the diagnosis of MFP. Key words:Disorder, dysfunction, temporomandibular, myofascial, osteoarthrosis, TMJ, disc displacement. PMID:22549687

  17. Radiographic evaluation of feline appendicular degenerative joint disease vs. Macroscopic appearance of articular cartilage.

    PubMed

    Freire, Mila; Robertson, Ian; Bondell, Howard D; Brown, James; Hash, Jon; Pease, Anthony P; Lascelles, B Duncan X

    2011-01-01

    Degenerative joint disease (DJD) is common in domesticated cats. Our purpose was to describe how radiographic findings thought to indicate feline DJD relate to macroscopic cartilage degeneration in appendicular joints. Thirty adult cats euthanized for reasons unrelated to this study were evaluated. Orthogonal digital radiographs of the elbow, tarsus, stifle, and coxofemoral joints were evaluated for the presence of DJD. The same joints were dissected for visual inspection of changes indicative of DJD and macroscopic cartilage damage was graded using a Total Cartilage Damage Score. When considering all joints, there was statistically significant fair correlation between cartilage damage and the presence of osteophytes and joint-associated mineralizations, and the subjective radiographic DJD score. Most correlations were statistically significant when looking at the different joints individually, but only the correlation between the presence of osteophytes and the subjective radiographic DJD score with the presence of cartilage damage in the elbow and coxofemoral joints had a value above 0.4 (moderate correlation). The joints most likely to have cartilage damage without radiographic evidence of DJD are the stifle (71% of radiographically normal joints) followed by the coxofemoral joint (57%), elbow (57%), and tarsal joint (46%). Our data support radiographic findings not relating well to cartilage degeneration, and that other modalities should be evaluated to aid in making a diagnosis of feline DJD. PMID:21418370

  18. Osteochondrosis, degenerative joint disease, and vertebral osteophytosis in middle-aged bulls.

    PubMed

    Weisbrode, S E; Monke, D R; Dodaro, S T; Hull, B L

    1982-10-01

    Twenty-five middle-age (65 +/- 18 months) dairy bulls sent to slaughter for nonmedical reasons were evaluated for joint disease in the stifle and the lumbar vertebrae. Fourteen bulls had degenerative joint disease and 3 had osteochondrosis (osteochondritis dissecans) of the distal end of the femur. These lesions predominantly involved the lateral trochlear ridge. Twenty-one bulls had vertebral osteophytosis. Degenerative joint disease and vertebral osteophytosis were common in these middle-aged bulls and, even when severe, were rarely associated with lameness. PMID:7141968

  19. Chronic bilateral dislocation of temporomandibular joint.

    PubMed

    Shakya, S; Ongole, R; Sumanth, K N; Denny, C E

    2010-01-01

    Dislocation of the condyle of the mandible is a common condition that may occur in an acute or chronic form. It is characterised by inability to close the mouth with or without pain. Dislocation has to be differentiated from subluxation which is a self reducible condition. Dislocation can occur in any direction with anterior dislocation being the commonest one. Various predisposing factors have been associated with dislocation like muscle fatigue and spasm, the defect in the bony surface like shallow articular eminence, and laxity of the capsular ligament. People with defect in collagen synthesis like Ehler Danlos syndrome, Marfan syndrome are said to be genetically predisposed to this condition. Various treatment modalities have been used ranging from conservative techniques to surgical methods. Acute dislocations can be reduced manually or with conservative approach and recurrent and chronic cases can be reduced by surgical intervention. Though the dislocation in our case was 4 months a simple manual reduction proved to be successful. We believe that manual reduction can be attempted as first line of treatment prior to surgical intervention. PMID:21209547

  20. [Computer-assisted temporomandibular joint reconstruction.

    PubMed

    Zwetyenga, N; Mommers, X-A; Cheynet, F

    2013-08-01

    Prosthetic replacement of TMJ is gradually becoming a common procedure because of good functional and aesthetic results and low morbidity. Prosthetic models available can be standard or custom-made. Custom-made prosthesis are usually reserved for complex cases, but we think that computer assistance for custom-made prosthesis should be indicated for each case because it gives a greater implant stability and fewer complications. Computer assistance will further enlarge TMJ prosthesis replacement indications. PMID:23916312

  1. 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 ...

  2. The craniocervical connection: a retrospective analysis of 300 whiplash patients with cervical and temporomandibular disorders.

    PubMed

    Friedman, M H; Weisberg, J

    2000-07-01

    Because the concept of whiplash as a causative factor for temporomandibular disorders (TMD) is highly controversial, we decided to do a retrospective analysis of patients treated in our office who had sustained whiplash injuries and were treated for cervical and temporomandibular disorders. The records of 300 patients with TMD preceded by a motor vehicle accident were examined retrospectively. The most common presenting symptoms, in order, were: jaw pain, neck pain, post-traumatic headache, jaw fatigue, and severe temporomandibular joint (TMJ) clicking. The most common TMD diagnoses were: masseter trigger points, closing jaw muscle hyperactivity, TMJ synovitis, opening jaw muscle hyperactivity, and advanced TMJ disk derangement. Based primarily on the physical examination, we concluded that the TMJ and surrounding musculature should be examined similarly to other joints, with no preconceived notion that TMD pathology after whiplash is unlikely. PMID:11202833

  3. Prognosis of inflammatory joint diseases. A three-year follow-up study.

    PubMed

    Nissilä, M; Isomäki, H; Kaarela, K; Kiviniemi, P; Martio, J; Sarna, S

    1983-01-01

    The prognosis 3 years after the onset of the disease was studied in 107 patients with definite rheumatoid arthritis, 161 with probable RA or non-specific arthritis, 84 with either ankylosing spondylitis, Reiter's disease or reactive arthritis, 14 with psoriatic arthritis and 10 with a systemic connective tissue disease. Prognosis was measured by clinical involvement of joints, radiological erosions in joints, deterioration in joint function, ESR, and working ability. A total of 44% of all patients were symptomless after 3 years. The prognosis was best in patients with an "HLA B 27-associated" disease and non-specific arthritis, and worst in RA. Two patients died during the follow-up of systemic connective tissue disease and one committed suicide with an overdose of hydroxychloroquine. Two HLA B27-positive patients developed systemic amyloidosis. PMID:6836238

  4. Patients' Priorities and Attitudes Towards Their Temporo-Mandibular Disorders.

    PubMed

    Kelleher, Martin; Ray-Chaudhuri, Arijit; Khawaja, Noman

    2015-08-01

    The diagnosis and appropriate management of temporo-mandibular disorders (TMDs) remains controversial. Current scientific evidence highlights the importance of psychosocial factors in sufferers and the reducing emphasis on occlusal or dental/prosthetic factors. This paper describes the findings of a survey of 211 patients reporting pain from their temporo-mandibular joint area and associated structures. This article offers busy primary dental care practitioners a cost effective questionnaire for obtaining relevant information from patients about the history of their condition and highlights what patients hope to achieve through the management of their disorder. It also emphasises the importance of communicating effectively with patients and offers practical tips for the management of TMDs in primary care. PMID:26556513

  5. Nutraceutical therapies for degenerative joint diseases: a critical review.

    PubMed

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

    2005-01-01

    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 dependent upon the regular provision of nutrients (glucose and amino acids), vitamins (particularly vitamin C), and essential trace elements (zinc, magnesium, and copper). Therefore, dietary supplementation programs and nutraceuticals used in conjunction with non-steroidal, anti-inflammatory drugs (NSAIDs) may offer significant benefits to patients with joint disorders, such as OA and OCD. This article examines the available clinical evidence for the efficacy of nutraceuticals, antioxidant vitamin C, polyphenols, essential fatty acids, and mineral cofactors in the treatment of OA and related joint disorders in humans and veterinary species. This article also attempts to clarify the current state of knowledge. It also highlights the need for additional targeted research to elucidate the changes in nutritional status and potential alterations to the expression of plasma membrane transport systems in synovial structures in pathophysiological states, so that current therapy and future treatments may be better focused. PMID:16048146

  6. Joint and fascia manifestations in chronic graft-versus-host disease and their assessment

    PubMed Central

    Inamoto, Yoshihiro; Pidala, Joseph; Chai, Xiaoyu; Kurland, Brenda F.; Weisdorf, Daniel; Flowers, Mary E.D.; Palmer, Jeanne; Arai, Sally; Jacobsohn, David; Cutler, Corey; Jagasia, Madan; Goldberg, Jenna D.; Martin, Paul J.; Pavletic, Steven Z.; Vogelsang, Georgia B.; Lee, Stephanie J.; Carpenter, Paul A.

    2014-01-01

    Objective Joint and fascia manifestations in patients with chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation need to be assessed reliably, simply and in a clinically meaningful way. Methods In a prospective, multicenter, longitudinal, observational cohort of patients with chronic GVHD (n=567), we evaluated 3 scales proposed for assessing joint status: National Institutes of Health (NIH) joint/fascia scale, Hopkins fascia scale and the Photographic Range of Motion (P-ROM) scale. Ten other scales were also tested for assessing symptoms, quality of life and physical functions. Results Joint and fascia manifestations were present at study enrollment in 164 (29%) patients. Limited range of motion was most frequent at wrists or fingers. Among the 3 joint scales, changes in the NIH scale correlated with both clinician and patient-perceived improvement of joint and fascia manifestations with higher sensitivity than the Hopkins fascia scale. Changes in all 3 scales correlated with clinician and patient-perceived worsening but the P-ROM scale was the most sensitive in this regard. Onset of joint and fascia manifestations was not associated with subsequent mortality. Conclusion Joint and fascia manifestations are common and should be assessed carefully in patients with chronic GVHD. Our results support the use of the NIH joint/fascia scale and P-ROM scale to assess joint and fascia manifestations. The NIH scale better captures improvement, while the P-ROM scale better captures worsening. The utility of these scales could also be tested in the rheumatic diseases. PMID:24757155

  7. The “at-home LLLT” in temporo-mandibular disorders pain control: a pilot study

    PubMed Central

    Pelosi, A; Queirolo, V; Vescovi, P; Merigo, E

    2015-01-01

    Objectives: The Temporo-Mandibular Disorders (TMD) are a set of dysfunctional patterns concerning the temporo-mandibular joints (TMJ) and the masticatory muscles; its main symptom is pain, probably caused by inflammatory changes in the synovial membrane, alterations in the bone marrow of the mandibular condyle and impingement and compression. The aim of this preliminary study was to investigate the effectiveness in the TMD pain reduction of a new laser device recently proposed by the commerce that, due to its reduced dimensions and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Material and methods: Twenty-four patients with TMD were randomly selected: the inclusion criteria for the sample was the diagnosis of mono- or bi-lateral TMD, with acute pain restricted to the joint area, associated with the absence of any muscle tenderness during palpation. The patients were randomly assigned to two groups: Group 1 (12 patients): patients receiving real LLLT (experimental group). Group 2 (12 patients): patients receiving inactive laser (placebo group). The treatment was performed once a day for two weeks with an 808 nm diode laser by the patient himself with irradiation of the cutaneous zone corresponding to the TMJ for 15 minutes each side. Each patient was instructed to express its pain in a visual analogue scale (VAS) making a perpendicular line between the two extremes representing the felt pain level. Statistical analysis was realized with GraphPad Instat Software, where P<0.05 was considered significant and P<0.01 very significant. Results: The patient's pain evaluation was expressed in the two study groups before the treatment, 1 week and two weeks after the treatment. The differences between the two groups result extremely significant with p<0.0001 for the comparison of VAS value after 1 and 2 weeks. Conclusion: This study, even if it may be considered such a pilot study, investigated a new way to control the pain in the temporo-mandibular diseases by an at home self administered laser device. Results are encouraging but they will have to be confirmed by greater studies. PMID:25941425

  8. Long-Term Follow-Up of the Cheilectomy for Degenerative Joint Disease of the First Metatarsophalangeal Joint.

    PubMed

    Nicolosi, Nicole; Hehemann, Chris; Connors, James; Boike, Allan

    2015-01-01

    Cheilectomy is the surgical resection of 20% to 30% of the dorsal metatarsal head and proximal phalanx. The present retrospective study evaluated the long-term efficacy of aggressive cheilectomy to address degenerative joint disease of the first metatarsophalangeal joint. To our knowledge, this is the second longest duration study to date to evaluate the long-term efficacy of the cheilectomy procedure, with a mean follow-up period of 7.14 years (range 39 weeks to 14.87 years). The mean patient age was 55.71 ± 9.51 years, and 37 (65%) of the patients were female. Age, sex, foot type, and preoperative radiographic parameters of hallux rigidus were also evaluated and correlated. The mean percentage of success with this operation was 87.69%. Of the 58 patients, 51 (87.93%) experienced no limitations in their daily activities. Only 2 patients (3.33%) subsequently required subsequent arthrodesis. The results of the present study suggest that cheilectomy offers long-term satisfaction for patients with hallux rigidus and is an acceptable alternative to the joint destructive procedure of first metatarsophalangeal arthrodesis. PMID:25981441

  9. Evaluation of Pain Regression in Patients with Temporomandibular Dysfunction Treated by Intra-Articular Platelet-Rich Plasma Injections: A Preliminary Report

    PubMed Central

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

    2014-01-01

    Objective. The objective of this study was to evaluate the regression of temporomandibular pain as a result of intra-articular injections of platelet-rich plasma (PRP) to patients with temporomandibular joint dysfunction previously subjected to prosthetic treatment. Materials and Methods. The baseline study material consisted of 10 patients, both males and females, aged 28 to 53 years, previously treated due to painful temporomandibular joint dysfunction using occlusal splints. All patients were carried out to a specialist functional assessment of the dysfunction using the Polish version of the RDC/TMD questionnaire axis I and II. Intra-articular injections were preceded by a preparation of PRP. The injection sites were determined by the method used during arthroscopic surgical procedures. Following aspiration, 0.5?mL of plasma was injected into each temporomandibular joint. Results. The comparison of the intensity of pain during all examinations suggests a beneficial effect of the procedure being performed as the mean VAS score was 6.5 at examination I, 2.8 at examination II, and 0.6 at examination III. Conclusion. Application of the intra-articular injections of platelet-rich plasma into the temporomandibular joints has a positive impact on the reduction of the intensity of pain experienced by patients treated for temporomandibular joint dysfunction. PMID:25157351

  10. Psycho-education programme for temporomandibular disorders: a pilot study

    PubMed Central

    Jerjes, Waseem; Madland, Geir; Feinmann, Charlotte; El Maaytah, Mohammed; Kumar, Mahesh; Hopper, Colin; Upile, Tahwinder; Newman, Stanton

    2007-01-01

    Background Temporomandibular disorders (TMDs) are by far the most predominant condition affecting the temporomandibular joint (TMJ), however many patients have mild self-limiting symptoms and should not be referred for specialist care. The aim of this pilot study was to develop a simple, cost-effective management programme for TMDs using CD-ROM. 41 patients (age 18–70) participated in this study, patients were divided into three groups: the 1st group were involved in an attention placebo CD-ROM (contain anatomical information about the temporomandibular system), the 2nd group received information on CD-ROM designed to increase their control and self efficacy, while the 3rd group received the same programme of the 2nd group added to it an introduction to self-relaxing techniques followed by audio tape of progressive muscle relaxation exercises. Each of the groups was asked to complete a number of questionnaires on the day of initial consultation and six weeks afterwards. Results The two experimental groups (2nd & 3rd) were equally effective in reducing pain, disability and distress, and both were more effective than the attention placebo group (1st), however the experimental groups appeared to have improved at follow-up relative to the placebo-group in terms of disability, pain and depressed mood. Conclusion This pilot study demonstrates the feasibility and acceptability of the design. A full, randomized, controlled trial is required to confirm the efficacy of the interventions developed here. PMID:17381840

  11. Risk management in clinical practice. Part 8. Temporomandibular disorders.

    PubMed

    Gray, R; Al-Ani, Z

    2010-11-01

    Temporomandibular disorders can arise apparently idiopathically, as a result of macro-trauma or micro-trauma such as parafunction, as a result of a separate disease process or as a consequence of dental treatment. The objectives of this chapter are to make the practitioner aware of his/her responsibilities in any of these situations. Precise record keeping and careful risk management are essential. Guidelines are given to protect not only the practitioner but also the patient. PMID:21072093

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

    PubMed Central

    2012-01-01

    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

  13. Radiological and Radionuclide Imaging of Degenerative Disease of the Facet Joints

    PubMed Central

    Shur, Natalie; Corrigan, Alexis; Agrawal, Kanhaiyalal; Desai, Amidevi; Gnanasegaran, Gopinath

    2015-01-01

    The facet joint has been increasingly implicated as a potential source of lower back pain. Diagnosis can be challenging as there is not a direct correlation between facet joint disease and clinical or radiological features. The purpose of this article is to review the diagnosis, treatment, and current imaging modality options in the context of degenerative facet joint disease. We describe each modality in turn with a pictorial review using current evidence. Newer hybrid imaging techniques such as single photon emission computed tomography/computed tomography (SPECT/CT) provide additional information relative to the historic gold standard magnetic resonance imaging. The diagnostic benefits of SPECT/CT include precise localization and characterization of spinal lesions and improved diagnosis for lower back pain. It may have a role in selecting patients for local therapeutic injections, as well as guiding their location with increased precision. PMID:26170560

  14. Radiological and Radionuclide Imaging of Degenerative Disease of the Facet Joints.

    PubMed

    Shur, Natalie; Corrigan, Alexis; Agrawal, Kanhaiyalal; Desai, Amidevi; Gnanasegaran, Gopinath

    2015-01-01

    The facet joint has been increasingly implicated as a potential source of lower back pain. Diagnosis can be challenging as there is not a direct correlation between facet joint disease and clinical or radiological features. The purpose of this article is to review the diagnosis, treatment, and current imaging modality options in the context of degenerative facet joint disease. We describe each modality in turn with a pictorial review using current evidence. Newer hybrid imaging techniques such as single photon emission computed tomography/computed tomography (SPECT/CT) provide additional information relative to the historic gold standard magnetic resonance imaging. The diagnostic benefits of SPECT/CT include precise localization and characterization of spinal lesions and improved diagnosis for lower back pain. It may have a role in selecting patients for local therapeutic injections, as well as guiding their location with increased precision. PMID:26170560

  15. Some cellular aspects of chronic inflammation in joint disease.

    PubMed

    Loewi, G; Reynolds, J

    1976-02-01

    We have examined the nature of some mononuclear cells from inflamed synovial membranes of patients with rheumatoid arthritis. It was found that cells which remained in the supernatant medium after overnight culture of trypsinized tissue contained a variable number of lymphocytes which were shown to be T cells by rosetting and mitogen response. This suggests a source of T cell lymphokines with an effect on macrophages and thus a role in the maintenance of inflammation. Another role for mononuclear cells is suggest by the cytotoxicity of blood mononuclear cells directed against cultured synovial cells. This was found to occur in an autologous system using fibroblasts from rheumatoid synovium, but was not specific for rheumatoid arthritis. Stimulatory factors from rheumatoid joint effusion macrophages for blood lymphocytes were sought, but although blast transformation occurred, the results were equivocal. In this communication we set out to examine the nature of lymphoid cells in the synovial membrane and the role which they may play in the pathogenesis of chronic inflammation. We also briefly consider cell-mediated mechanisms of tissue injury. Since an active role of lymphoid cells pre-supposes the presence of an agent or agents which serve to stimulate them, we also report some recent attempts to find evidence for this. One of the striking histological features of the inflamed synovial tissue in rheumatoid arthritis, but also in some other forms of chronic arthritis, is the presence of lymphocytes and plasma cells. Immunofluorescent studies and organ culture studies have shown the presence and synthesis of immunoglobulins, predominantly the domain of plasma cells. The production of immunoglobulins, formation of complexes and activation of complement is a major factor in pathogenesis, but lymphocytes may also have a direct role through the production of lymphokines. Until recently these substances have been attributed to T lymphocytes, but Rocklin et al. (1) have recently shown that B cells may also be involved in certain experimental circumstances. The availability of synovectomy specimens from patients with rheumatoid arthritis has enabled us to examine the nature of lymphoid cells from synovial membranes. (This part of the work is reported fully elsewhere. PMID:1085094

  16. [Update on current care guideline: temporomandibular disorders (TMD)].

    PubMed

    2013-01-01

    Temporomandibular disorders (TMD) are common. Usual symptoms are joint noises and pain, pain in masticatory muscles, difficulties in jaw movements and headache. Treatment of TMD includes information on the background and good response to treatment of these disorders. The patient is advised on self-care routines, including relaxing the lower jaw, massaging the masticatory muscles and hot or cold packs on painful sites. Pharmacotherapy consists of paracetamol or anti-inflammatory analgesics. Occlusal appliances, physiotherapy, cognitive therapies and acupuncture are recommended. Complicated cases not responding to treatment are referred to specialized care. PMID:24471211

  17. Lessons from a non-domestic canid: joint disease in captive raccoon dogs (Nyctereutes procyonoides).

    PubMed

    Lawler, Dennis F; Evans, Richard H; Nieminen, Petteri; Mustonen, Anne-Mari; Smith, Gail K

    2012-01-01

    The purpose of this study was to describe pathological changes of the shoulder, elbow, hip and stifle joints of 16 museum skeletons of the raccoon dog (Nyctereutes procyonoides). The subjects had been held in long-term captivity and were probably used for fur farming or research, thus allowing sufficient longevity for joint disease to become recognisable. The prevalence of disorders that include osteochondrosis, osteoarthritis and changes compatible with hip dysplasia, was surprisingly high. Other changes that reflect near-normal or mild pathological conditions, including prominent articular margins and mild bony periarticular rim, were also prevalent. Our data form a basis for comparing joint pathology of captive raccoon dogs with other mammals and also suggest that contributing roles of captivity and genetic predisposition should be explored further in non-domestic canids. PMID:23277118

  18. [Impact of a magnetic field on blood separation kinetics in patients with joint diseases].

    PubMed

    Cherniakova, Iu M; Pinchuk, L S; Titov, L P

    2011-01-01

    The paper gives the results of experiments on phase separation of blood in the constant magnetic field that allows the structure of blood to be regulated, without changing its cellular and chemical composition. Blood deposition kinetic relationships were obtained for patients with joint diseases of various etiology (osteoarthritis, osteoarthrosis deformans, endoprosthesis instability, contusions, and joint wounds). They correlate with the severity of an inflammatory process in the joint and its adjacent tissues, with a patient's resistance to the development of pathology, and with red blood cell mobility in the biophysical field of a living organism. Analysis of relationships gives information on concentrations in plasma and hence synovial fluid (the basis of which is blood dialysate) in the liquid-crystalline phospholipid and cholesterol phase that determines the lubricity of synovial fluid and a low friction in the joints. The method may be used for the primary evaluation of efficacy of drugs for joint treatment, which is made in vitro on the blood taken from the patients rather than on the latter. PMID:21427944

  19. Tophaceous calcium pyrophosphate dihydrate deposition disease of the knee mimicking an aggressive soft tissue tumour.

    PubMed

    Watura, Christopher; Saifuddin, Asif

    2014-01-01

    Calcium pyrophosphate crystal deposition disease (CPPD), previously pseudogout, is the second most common crystal arthropathy after gout. There is increased radiographic prevalence associated with age, trauma and several metabolic disorders. Tophaceous CPPD (T-CPPD) is a rare form of CPPD which, though non-neoplastic, mimics a bone or soft tissue malignancy. T-CPPD usually presents as a mass in the temporomandibular joint and occasionally in the paraspinal tissues, but rarely in the joints of the extremities. We present an exceptionally rare case of T-CPPD that was subtle on plain radiography, presenting as a soft tissue mass in the knee joint. PMID:24916978

  20. Influence of orthodontic treatment on temporomandibular disorders. A systematic review

    PubMed Central

    Cañigral, Aránzazu; López-Caballo, José L.; Brizuela, Aritza; Moreno-Hay, Isabel; del Río-Highsmith, Jaime; Vega, José A.

    2015-01-01

    Objectives The aim of this literature systematic review was to evaluate the possible association between malocclusions, orthodontic treatment and development of temporomandibular disorders. Material and Methods: A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords “orthodontics and temporomandibular disorders”, “orthodontics and facial pain” and “malocclusion and temporomandibular disorders”. Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. Material and Methods A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords “orthodontics and temporomandibular disorders”, “orthodontics and facial pain” and “malocclusion and temporomandibular disorders”. Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. Results The search strategy resulted in 61 articles. After selection according to the inclusion/exclusion criteria 9 articles qualified for the final analysis. The articles which linked orthodontics and development of temporomandibular disorders showed very discrepant results. Some indicated that orthodontic treatment could improve signs and symptoms of temporomandibular disorders, but none of them obtained statistically significant differences. Conclusions According to the authors examined, there is no evidence for a cause-effect relationship between orthodontic treatment and temporomandibular disorders, or that such treatment might improve or prevent them. More longitudinal studies are needed to verify any possible interrelationship. Key words:Malocclusion and temporomandibular disorders, orthodontics and facial pain, orthodontics and temporomandibular disorders, temporomandibular disorders, temporomandibular dysfunction. PMID:26155354

  1. Pharmacologic management of temporomandibular disorders.

    PubMed

    Hersh, Elliot V; Balasubramaniam, Ramesh; Pinto, Andres

    2008-05-01

    Although there are theoretically numerous pharmacologic targets for relieving temporomandibular disorder (TMD)-associated pains, evidence-based literature clearly establishing the efficacy and safety of drugs in the TMD population is limited at best. This article reviews the pharmacology, toxicology, and research supporting the use of a host of pharmacologic agents that have been used in patients who have TMD, including nonsteroidal anti-inflammatory drugs, corticosteroids, benzodiazepines, nonbenzodiazepine sedative hypnotics, opioids, skeletal muscle relaxants, capsaicin, transdermal lidocaine, antidepressants, and anticonvulsants. Recommendations regarding the proper use of each drug class are also made. PMID:18343325

  2. Host and parasite diversity jointly control disease risk in complex communities

    PubMed Central

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

    2013-01-01

    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

  3. A Rare Case of Tumoral Calcium Pyrophosphate Dihydrate Crystal Deposition Disease of the Wrist Joint

    PubMed Central

    Nakamura, Osamu; Kaji, Yoshio; Yamagami, Yoshiki; Yamaguchi, Kounosuke; Nishimura, Hideki; Fukuoka, Natsuko; Yamamoto, Tetsuji

    2015-01-01

    Introduction. Tumoral calcium pyrophosphate dihydrate (CPPD) crystal deposition disease (CPPDCD), also known as tophaceous calcium pyrophosphate deposition disease (CPDD), is a tumorlike lesion, and it should be distinguished from usual CPDD that causes severe joint inflammation and arthralgia. A case of tumoral CPPDCD of the wrist joint that required differentiation from synovial osteochondromatosis is described. Case Presentation. The patient was a 78-year-old woman with a 5-year history of nodular lesions at the right wrist that had gradually increased in size. An excisional biopsy and a histological examination of the excised nodular lesions by hematoxylin and eosin (H&E) staining were performed, demonstrating numerous polarizable, rhabdoid, and rectangular crystals, surrounded by fibroblasts, macrophages, and foreign body-type giant cells, consistent with tumoral CPPDCD. Conclusion. Tumoral CPPDCD, especially at the wrist joint, is rare, and, to the best of our knowledge, only 2 articles have been published. This case seems to need further follow-up for recurrence, because tumoral CPPDCD may recur after complete or incomplete surgical excision. PMID:26783477

  4. Photoacoustic tomography of the human finger: towards the assessment of inflammatory joint diseases

    NASA Astrophysics Data System (ADS)

    van Es, P.; Biswas, S. K.; Bernelot Moens, H. J.; Steenbergen, W.; Manohar, S.

    2015-03-01

    Inflammatory arthritis is often manifested in finger joints. The growth of new or withdrawal of old blood vessels can be a sensitive marker for these diseases. Photoacoustic (PA) imaging has great potential in this respect since it allows the sensitive and highly resolved visualization of blood. We systematically investigated PA imaging of finger vasculature in healthy volunteers using a newly developed PA tomographic system. We present the PA results which show excellent detail of the vasculature. Vessels with diameters ranging between 100 ?m and 1.5 mm are visible along with details of the skin, including the epidermis and the subpapillary plexus. The focus of all the studies is at the proximal and distal interphalangeal joints, and in the context of ultimately visualizing the inflamed synovial membrane in patients. This work is important in laying the foundation for detailed research into PA imaging of the phalangeal vasculature in patients suffering from rheumatoid arthritis.

  5. Chronic joint disease caused by persistent Chikungunya virus infection is controlled by the adaptive immune response.

    PubMed

    Hawman, David W; Stoermer, Kristina A; Montgomery, Stephanie A; Pal, Pankaj; Oko, Lauren; Diamond, Michael S; Morrison, Thomas E

    2013-12-01

    Chikungunya virus (CHIKV) is a reemerging mosquito-borne pathogen that causes incapacitating disease in humans characterized by intense joint pain that can persist for weeks, months, or even years. Although there is some evidence of persistent CHIKV infection in humans suffering from chronic rheumatologic disease symptoms, little is known about chronic disease pathogenesis, and no specific therapies exist for acute or chronic CHIKV disease. To investigate mechanisms of chronic CHIKV-induced disease, we utilized a mouse model and defined the duration of CHIKV infection in tissues and the associated histopathological changes. Although CHIKV RNA was readily detectable in a variety of tissues very early after infection, CHIKV RNA persisted specifically in joint-associated tissues for at least 16 weeks. Inoculation of Rag1(-/-) mice, which lack T and B cells, resulted in higher viral levels in a variety of tissues, suggesting that adaptive immunity controls the tissue specificity and persistence of CHIKV infection. The presence of CHIKV RNA in tissues of wild-type and Rag1(-/-) mice was associated with histopathological evidence of synovitis, arthritis, and tendonitis; thus, CHIKV-induced persistent arthritis is not mediated primarily by adaptive immune responses. Finally, we show that prophylactic administration of CHIKV-specific monoclonal antibodies prevented the establishment of CHIKV persistence, whereas therapeutic administration had tissue-specific efficacy. These findings suggest that chronic musculoskeletal tissue pathology is caused by persistent CHIKV infection and controlled by adaptive immune responses. Our results have significant implications for the development of strategies to mitigate the disease burden associated with CHIKV infection in humans. PMID:24131709

  6. Chronic Joint Disease Caused by Persistent Chikungunya Virus Infection Is Controlled by the Adaptive Immune Response

    PubMed Central

    Hawman, David W.; Stoermer, Kristina A.; Montgomery, Stephanie A.; Pal, Pankaj; Oko, Lauren; Diamond, Michael S.

    2013-01-01

    Chikungunya virus (CHIKV) is a reemerging mosquito-borne pathogen that causes incapacitating disease in humans characterized by intense joint pain that can persist for weeks, months, or even years. Although there is some evidence of persistent CHIKV infection in humans suffering from chronic rheumatologic disease symptoms, little is known about chronic disease pathogenesis, and no specific therapies exist for acute or chronic CHIKV disease. To investigate mechanisms of chronic CHIKV-induced disease, we utilized a mouse model and defined the duration of CHIKV infection in tissues and the associated histopathological changes. Although CHIKV RNA was readily detectable in a variety of tissues very early after infection, CHIKV RNA persisted specifically in joint-associated tissues for at least 16 weeks. Inoculation of Rag1?/? mice, which lack T and B cells, resulted in higher viral levels in a variety of tissues, suggesting that adaptive immunity controls the tissue specificity and persistence of CHIKV infection. The presence of CHIKV RNA in tissues of wild-type and Rag1?/? mice was associated with histopathological evidence of synovitis, arthritis, and tendonitis; thus, CHIKV-induced persistent arthritis is not mediated primarily by adaptive immune responses. Finally, we show that prophylactic administration of CHIKV-specific monoclonal antibodies prevented the establishment of CHIKV persistence, whereas therapeutic administration had tissue-specific efficacy. These findings suggest that chronic musculoskeletal tissue pathology is caused by persistent CHIKV infection and controlled by adaptive immune responses. Our results have significant implications for the development of strategies to mitigate the disease burden associated with CHIKV infection in humans. PMID:24131709

  7. Muscle disorders and dentition-related aspects in temporomandibular disorders: controversies in the most commonly used treatment modalities

    PubMed Central

    Jerjes, Waseem; Upile, Tahwinder; Abbas, Syedda; Kafas, Panagiotis; Vourvachis, Michael; Rob, Jubli; Mc Carthy, Eileen; Angouridakis, Nikolaos; Hopper, Colin

    2008-01-01

    This review explores the aetiology of temporomandibular disorders and discusses the controversies in variable treatment modalities. Pathologies of the temporomandibular joint (TMJ) and its' associated muscles of mastication are jointly termed temporomandibular disorders (TMDs). TMDs present with a variety of symptoms which include pain in the joint and its surrounding area, jaw clicking, limited jaw opening and headaches. It is mainly reported by middle aged females who tend to recognize the symptoms more readily than males and therefore more commonly seek professional help. Several aetiological factors have been acknowledged including local trauma, bruxism, malocclusion, stress and psychiatric illnesses. The Research Diagnostic Criteria of the Temporomandibular Disorders (RDC/TMD) is advanced to other criteria as it takes into consideration the socio-psychological status of the patient. Several treatment modalities have been recommended including homecare practices, splint therapy, occlusal adjustment, analgesics and the use of psychotropic medication; as well as surgery, supplementary therapy and cognitive behavioural therapy. Although splint therapy and occlusal adjustment have been extensively used, there is no evidence to suggest that they can be curative; a number of evidence-based trials have concluded that these appliances should not be suggested as part of the routine care. Surgery, except in very rare cases, is discouraged since it is the most invasive alternative; recent studies have shown healthier outcome with cognitive behavioural therapy. PMID:18973654

  8. Diagnosis and Treatment of Degenerative Joint Disease in a Captive Male Chimpanzee (Pan troglodytes)

    PubMed Central

    Videan, Elaine N; Lammey, Michael L; Lee, D Rick

    2011-01-01

    Degenerative joint disease (DJD), also known as osteoarthritis, has been well documented in aging populations of captive and free-ranging macaques; however, successful treatments for DJD in nonhuman primates have not been published. Published data on chimpanzees show little to no DJD present in the wild, and there are no published reports of DJD in captive chimpanzees. We report here the first documented case of DJD of both the right and left femorotibial joints in a captive male chimpanzee. Progression from minimal to moderate to severe osteoarthritis occurred in this animal over the course of 1 y. Treatment with chondroprotective supplements (that is, glucosamine chondroitin, polysulfated glycosaminoglycan) and intraarticular corticosteroid injections (that is, methylprednisolone, ketorolac), together with pain management (that is, celecoxib, tramadol, carprofen), resulted in increased activity levels and decreased clinical signs of disease. DJD has a considerable negative effect on quality of life among the human geriatric population and therefore is likely to be one of the most significant diseases that will affect the increasingly aged captive chimpanzee population. As this case study demonstrates, appropriate treatment can improve and extend quality of life dramatically in these animals. However, in cases of severe osteoarthritis cases, medication alone may be insufficient to increase stability, and surgical options should be explored. PMID:21439223

  9. Picking a bone with WISP1 (CCN4): new strategies against degenerative joint disease

    PubMed Central

    Maiese, Kenneth

    2016-01-01

    As the world’s population continues to age, it is estimated that degenerative joint disease disorders such as osteoarthritis will impact at least 130 million individuals throughout the globe by the year 2050. Advanced age, obesity, genetics, gender, bone density, trauma, and a poor level of physical activity can lead to the onset and progression of osteoarthritis. However, factors that lead to degenerative joint disease and involve gender, genetics, epigenetic mechanisms, and advanced age are not within the control of an individual. Furthermore, current therapies including pain management, improved nutrition, and regular programs for exercise do not lead to the resolution of osteoarthritis. As a result, new avenues for targeting the treatment of osteoarthritis are desperately needed. Wnt1 inducible signaling pathway protein 1 (WISP1), a matricellular protein and a downstream target of the wingless pathway Wnt1, is one such target to consider that governs cellular protection, stem cell proliferation, and tissue regeneration in a number of disorders including bone degeneration. However, increased WISP1 expression also has been associated with the progression of osteoarthritis. WISP1 has an intricate relationship with a number of proliferative and protective pathways that include phosphoinositide 3-kinase (PI 3-K), protein kinase B (Akt), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukin -6 (IL-6), transforming growth factor-β, matrix metalloproteinase, small non-coding ribonucleic acids (RNAs), sirtuin silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae) (SIRT1), and the mechanistic target of rapamycin (mTOR). Taken together, this complex association WISP1 holds with these signaling pathways necessitates a fine biological regulation of WISP1 activity that can offset the progression of degenerative joint disease, but not limit the cellular protective capabilities of the WISP1 pathway. PMID:26893943

  10. Temporomandibular disorders and functional somatic syndromes: deliberations for the dentist.

    PubMed

    Suma, S; Veerendra Kumar, B

    2012-01-01

    Temporomandibular disorder (TMD) is an umbrella term for a collection of disorders affecting the temporomandibular joint (TMJ) and associated tissues. TMD is not a rare pathology for the dentist. The most common presenting symptom is pain, which causes the patient seek immediate treatment. Management is dictated by the cause. The most 'famed' causes include trauma, inflammation, aging, parafunctional habits, infections, neoplasms, and stress; and these are always considered in the differential diagnosis of TMJ pain. There are some less 'famed' causes of TMD, which are characterized by increased pain sensitivity due to psychosocial factors; these include myofascial pain syndrome and functional somatic syndromes (FSS) such as fibromyalgia and chronic fatigue syndrome. They present with chronic pain, fatigue, disability, and impairment in ability to perform daily activities. A non-systematic search in the English literature revealed numerous studies describing the occurrence of TMD in these conditions, along with few other oral manifestations. TMD has been even considered to be a part of the FSS by some. In these patients, TMD remains a recurring problem, and adequate management cannot be achieved by traditional treatment protocols. Awareness of these conditions, with correct diagnosis and modification of management protocols accordingly, may resolve this problem. PMID:23257491

  11. Treatment of temporomandibular myofascial pain with deep dry needling

    PubMed Central

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

    2012-01-01

    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

  12. Masticatory function in temporomandibular dysfunction patients: electromyographic evaluation.

    PubMed

    Berretin-Felix, Giédre; Genaro, Katia Flores; Trindade, Inge Elly Kiemle; Trindade Júnior, Alceu Sergio

    2005-12-01

    Temporomandibular dysfunction (TMD) is a complex disturbance that involves the masticatory muscles and/or temporomandibular joint, causing damage to the masticatory function. This study evaluated the electromyographic activity of the masseter muscle during habitual mastication of bread, apple, banana, cashew nut and paraffin film (Parafilm M) in 25 adult subjects, of both gender, with TMD. The results were compared to those of a control group, composed of 15 adult subjects, of both sexes, free of signs and/or symptoms of TMD. The MYO-TRONICS Inc., K6-I computer software was used for electromyographic processing and analyzed the following parameters: duration of the act, duration of the masticatory cycle and number of cycles. No significant differences were found between subjects in the control group and individuals with TMD as to duration of the masticatory act and of the masticatory cycle, considering all materials used for mastication. The duration of the masticatory act and cycle was longer during mastication of paraffin film in both groups. The number of masticatory cycles was higher for mastication of apple in comparison to mastication of banana, in both groups. It can be concluded that the consistency of foods influences the duration parameters of the act, duration of the cycle and the number of masticatory cycles, and the behavior of the masticatory muscles in individuals with TMD during habitual mastication is similar to that verified in individuals without TMD. PMID:20865220

  13. 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, ...

  14. Rheumatoid arthritis-celiac disease relationship: joints get that gut feeling.

    PubMed

    Lerner, Aaron; Matthias, Torsten

    2015-11-01

    Rheumatoid arthritis (RA) and celiac disease (CD) belong to the autoimmune disease family. Despite being separate entities they share multiple aspects. Epidemiologically they share comparable incidence environmental influences, associated antibodies and a recent incidental surge. They differ in their HLA pre-dispositions and specific predictive and diagnostic biomarkers. At the clinical level, celiac disease exhibits extra-intestinal rheumatic manifestations and RA gastrointestinal ones. Small bowel pathology exists in rheumatic patients. A trend towards responsiveness to a gluten free diet has been observed, ameliorating celiac rheumatic manifestations, whereas dietary interventions for rheumatoid arthritis remain controversial. Pathophysiologically, both diseases are mediated by endogenous enzymes in the target organs. The infectious, dysbiotic and increased intestinal permeability theories, as drivers of the autoimmune cascade, apply to both diseases. Contrary to their specific HLA pre-disposition, the diseases share multiple non-HLA loci. Those genes are crucial for activation and regulation of adaptive and innate immunity. Recently, light was shed on the interaction between host genetics and microbiota composition in relation to CD and RA susceptibility, connecting bugs and us and autoimmunity. A better understanding of the above mentioned similarities in the gut-joint inter-relationship, may elucidate additional facets in the mosaic of autoimmunity, relating CD to RA. PMID:26190704

  15. Local Gene Transfer of OPG Prevents Joint Damage and Disease Progression in Collagen-Induced Arthritis

    PubMed Central

    Zhang, Qingguo; Gong, Weiming; Ning, Bin; Nie, Lin; Wooley, Paul H.

    2013-01-01

    This study examined the influence of osteoprotegerin (OPG) gene transfer on a murine collagen-induced arthritis model. A single periarticular injection of AAV-OPG or AAV-LacZ on the arthritic paw successfully incorporated the exogenous gene to the local tissue and resulted in marked transgene expression in the joint homogenate for at least three weeks. Clinical disease scores were significantly improved in OPG treated mice starting at 28-day post-treatment (P < 0.05). Histological assessment demonstrated that OPG gene transfer dramatically protected mice from erosive joint changes compared with LacZ controls (P < 0.05), although treatment appeared less effective on the local inflammatory progress. MicroCT data suggested significant protection against subchondral bone mineral density changes in OPG treated CIA mice. Interestingly, mRNA expressions of IFN-g and MMP3 were noticeably diminished following OPG gene transfer. Overall, gene transfer of OPG effectively inhibited the arthritis-associated periarticular bone erosion and preserved the architecture of arthritic joints, and the study provides evidence that the cartilage protection of the OPG gene therapy may be associated with the down-regulation of MMP3 expression. PMID:24222748

  16. Widespread pain in temporomandibular disorders.

    PubMed

    Lim, Pei Feng; Maixner, William; Khan, Asma A

    2011-03-01

    SUMMARY Chronic widespread pain (CWP) represents pain involving several regions of the body. Various psychological and social risk factors such as poor general health status, sleep disturbance, fatigue and high psychological distress have been identified for the development of CWP. Numerous chronic pain conditions are comorbid, resulting in the development of CWP in many of these patients. Temporomandibular disorder is one of the most extensively studied chronic musculoskeletal pain condition in terms of its comorbidity with CWP and fibromyalgia. It has been proposed that these comorbid pain disorders share common denominators, including exposure to certain environmental events, elevated psychological distress, pain amplification and genetic predisposition. Increased awareness of CWP is important for improved diagnoses and more effective pain management. Patients with CWP can be effectively managed in multidisciplinary pain clinics. PMID:24646357

  17. Perspectives on the Use of Gene Therapy for Chronic Joint Diseases

    PubMed Central

    Ghivizzani, Steven C.; Gouze, Elvire; Gouze, Jean-Noel; Kay, Jesse D.; Bush, Marsha L.; Watson, Rachael S.; Levings, Padraic P.; Nickerson, David M.; Colahan, Patrick T.; Robbins, Paul D.; Evans, Christopher H.

    2015-01-01

    Advances in molecular and cellular biology have identified a wide variety of proteins including targeted cytokine inhibitors, immunomodulatory proteins, cytotoxic mediators, angiogenesis inhibitors, and intracellular signalling molecules that could be of great benefit in the treatment of chronic joint diseases, such as osteo- and rheumatoid arthritis. Unfortunately, protein-based drugs are difficult to administer effectively. They have a high rate of turnover, requiring frequent readministration, and exposure in non-diseased tissue can lead to serious side effects. Gene transfer technologies offer methods to enhance the efficacy of protein-based therapies, enabling the body to produce these molecules locally at elevated levels for extended periods. The proof of concept of gene therapies for arthritis has been exhaustively demonstrated in multiple laboratories and in numerous animal models. This review attempts to condense these studies and to discuss the relative benefits and limitations of the methods proposed and to discuss the challenges toward translating these technologies into clinical realities. PMID:18691023

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

    PubMed Central

    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

    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

  19. Preliminary results of automated removal of degenerative joint disease in bone scan lesion segmentation

    NASA Astrophysics Data System (ADS)

    Chu, Gregory H.; Lo, Pechin; Kim, Hyun J.; Auerbach, Martin; Goldin, Jonathan; Henkel, Keith; Banola, Ashley; Morris, Darren; Coy, Heidi; Brown, Matthew S.

    2013-03-01

    Whole-body bone scintigraphy (or bone scan) is a highly sensitive method for visualizing bone metastases and is the accepted standard imaging modality for detection of metastases and assessment of treatment outcomes. The development of a quantitative biomarker using computer-aided detection on bone scans for treatment response assessment may have a significant impact on the evaluation of novel oncologic drugs directed at bone metastases. One of the challenges to lesion segmentation on bone scans is the non-specificity of the radiotracer, manifesting as high activity related to non-malignant processes like degenerative joint disease, sinuses, kidneys, thyroid and bladder. In this paper, we developed an automated bone scan lesion segmentation method that implements intensity normalization, a two-threshold model, and automated detection and removal of areas consistent with non-malignant processes from the segmentation. The two-threshold model serves to account for outlier bone scans with elevated and diffuse intensity distributions. Parameters to remove degenerative joint disease were trained using a multi-start Nelder-Mead simplex optimization scheme. The segmentation reference standard was constructed manually by a panel of physicians. We compared the performance of the proposed method against a previously published method. The results of a two-fold cross validation show that the overlap ratio improved in 67.0% of scans, with an average improvement of 5.1% points.

  20. JOINT DISEASE MAPPING OF CERVICAL AND MALE OROPHARYNGEAL CANCER INCIDENCE IN BLACKS AND WHITES IN SOUTH CAROLINA

    PubMed Central

    Onicescu, Georgiana; Hill, Elizabeth G.; Lawson, Andrew B.; Korte, Jeffrey E.; Gillespie, M. Boyd

    2010-01-01

    Human papillomavirus (HPV) infection is an established causal agent for cervical cancer and a subset of oropharyngeal cancers. It is hypothesized that orogenital transmission results in oral cavity infection. In this paper we explore the geographical association between cervical and male oropharyngeal cancer incidence in blacks and whites in South Carolina using Bayesian joint disease mapping models fit to publicly available data. Our results suggest weak evidence for county-level association between the diseases, and different patterns of joint disease behavior for blacks and whites. PMID:20563237

  1. Therapeutic and physical fitness exercise prescription for older adults with joint disease: an evidence-based approach.

    PubMed

    O'Grady, M; Fletcher, J; Ortiz, S

    2000-08-01

    Aging with joint disease does necessarily result in chronic pain, adoption of a sedentary lifestyle, and functional dependency. Several randomized controlled trials clearly show that regular exercise does not exacerbate pain or accelerate disease progression. On the contrary, these studies suggest that exercise training may increase the physiologic reserve and reduce the risk for functional dependency in older adults with joint disease. The goals for an exercise program should be directed toward increasing flexibility, muscle strength, endurance, and cardiovascular fitness. An exercise training program that is tailored specifically to an older adult's physical limitations may achieve these goals, and by optimizing patient safety lead to improve long-term exercise compliance. PMID:10989515

  2. Orofacial myofunctional disorder in subjects with temporomandibular disorder.

    PubMed

    Ferreira, Cláudia Lúcia Pimenta; Da Silva, Marco Antônio M Rodrigues; de Felício, Cláudia Maria

    2009-10-01

    To determine the frequency and degree of orofacial myofunctional disorder (OMD) in a sample of patients with temporomandibular disorder (TMD), the dental records of 240 patients with a diagnosis of TMD were reviewed. Mean patient age and mean TMD duration, gender frequency, complaints, and signs and symptoms were calculated. The results showed that the sample studied was quite characteristic of a TMD group. The presence of the following signs/symptoms was significant: muscular pain, TMJ pain, joint noise, at least one otologic symptom, headache, and neck and shoulder pain. Most subjects presented some degree of OMD, with grade high prevailing over grade low. The importance of evaluating the stomatognathic structures and functions during the clinical examination of patients with TMD is emphasized. PMID:19891261

  3. [Tracheal intubation in a case of Still's disease].

    PubMed

    Carlot, A; Gallo, F; Alberti, A; Fongaro, A; Valenti, S

    1995-03-01

    The authors report the case of a patient with juvenile rheumatoid arthritis (Still's disease) who underwent laparotomic hysterectomy under general anesthesia. Tracheal intubation was performed with the aid of a fibroscope, as recommended in the literature, given that impairment of the cervical spine and the temporo-mandibular joint made it extremely unlikely that direct laryngoscopy could be performed. The authors also report the methods recommended by other authors in order to guarantee a sufficiently deep anesthetic plane together with patency of the airways in patients suffering from Still's disease. PMID:7675258

  4. Treating temporomandibular disorders with permanent mandibular repositioning: is it medically necessary?

    PubMed

    Greene, Charles S; Obrez, Ales

    2015-05-01

    In this paper, the authors review the rationale and history of mandibular repositioning procedures in relation to temporomandibular disorders (TMDs) as these procedures have evolved over time. A large body of clinical research evidence shows that most TMDs can and should be managed with conservative treatment protocols that do not include any mandibular repositioning procedures. Although this provides a strong clinical argument for avoiding such procedures, very few reports have discussed the biologic reasons for either accepting or rejecting them. This scientific information could provide a basis for determining whether mandibular repositioning procedures can be defended as being medically necessary. This position paper introduces the biologic concept of homeostasis as it applies to this topic. The continuing adaptability of teeth, muscles, and temporomandibular joints throughout life is described in terms of homeostasis, which leads to the conclusion that each person's current temporomandibular joint position is biologically "correct." Therefore, that position does not need to be changed as part of a TMD treatment protocol. This means that irreversible TMD treatment procedures, such as equilibration, orthodontics, full-mouth reconstruction, and orthognathic surgery, cannot be defended as being medically necessary. PMID:25864818

  5. Application of Infrared Thermal Imaging in a Violinist with Temporomandibular Disorder.

    PubMed

    Clemente, M; Coimbra, D; Silva, A; Aguiar Branco, C; Pinho, J C

    2015-12-01

    Temporomandibular disorders (TMD) consist of a group of pathologies that affect the masticatory muscles, temporomandibular joints (TMJ), and/or related structures. String instrumentalists, like many orchestra musicians, can spend hours with head postures that may influence the biomechanical behavior of the TMJ and the muscles of the craniocervicomandibular complex (CCMC). The adoption of abnormal postures acquired during performance by musicians can lead to muscular hyperactivity of the head and cervical muscles, with the possible appearance of TMD. Medical infrared thermography is a non-invasive procedure that can monitor the changes in the superficial tissue related to blood circulation and may serve as a complement to the clinical examination. The objective of this study was to use infrared thermography to evaluate, in one subject, the cutaneous thermal changes adjacent to the CCMC that occur before, during, and after playing a string instrument. PMID:26614980

  6. Temporomandibular Disorders (TMD) in Edentulous Patients: A Review and Proposed Classification (Dr. Bader’s Classification).

    PubMed Central

    2015-01-01

    Temporomandibular disorders (TMD) are a collective term given to a number of clinical problems that involve the masticatory musculature, the temporomandibular joints and associated structures, or both. Although the aetiology of TMD has not been fully understood, in general it is considered to be multifactorial. The signs and symptoms of TMD which present in patients with natural teeth may also occur in edentulous patients. These symptoms may appear in various combinations and degrees. TMD has attained a prominent role within the context of dental care due to its high prevalence. The present paper is a review of the current literature on TMD in edentulous patients; with an attempt to propose a classification for the same. PMID:26023660

  7. Innate Immunity Sensors Participating in Pathophysiology of Joint Diseases: A Brief Overview

    PubMed Central

    Gallo, Jiri; Raska, Milan; Konttinen, Yrjö T.; Nich, Christophe; Goodman, Stuart B.

    2015-01-01

    The innate immune system consists of functionally specialized “modules” that are activated in response to a particular set of stimuli via sensors located on the surface or inside the tissue cells. These cells screen tissues for a wide range of exogenous and endogenous danger/damage-induced signals with the aim to reject or tolerate them and maintain tissue integrity. In this line of thinking, inflammation evolved as an adaptive tool for restoring tissue homeostasis. A number of diseases are mediated by a maladaptation of the innate immune response, perpetuating chronic inflammation and tissue damage. Here, we review recent evidence on the cross talk between innate immune sensors and development of rheumatoid arthritis, osteoarthritis, and aseptic loosening of total joint replacements. In relation to the latter topic, there is a growing body of evidence that aseptic loosening and periprosthetic osteolysis results from long-term maladaptation of periprosthetic tissues to the presence of by-products continuously released from an artificial joint. PMID:25747032

  8. Expression and functions of very late antigen 1 in inflammatory joint diseases.

    PubMed

    Bank, I; Roth, D; Book, M; Guterman, A; Shnirrer, I; Block, R; Ehrenfeld, M; Langevitz, P; Brenner, H; Pras, M

    1991-01-01

    In the human immune system, very late antigen 1 (VLA-1), a putative collagen receptor, is expressed on the surface of T lymphocytes that have undergone mitogenic or antigenic stimulation. A new VLA-1-specific monoclonal antibody, 1B3.1, was used to probe the expression and function of VLA-1 on T lymphocytes in patients with arthritis. Synovial mononuclear cells from the joints of patients with rheumatoid arthritis or other joint diseases contained 32.9 +/- 13.8% 1B3.1-positive cells (42.8 +/- 10.4% in patients with rheumatoid arthritis and 28 +/- 12.6% in non rheumatoid patients). In the peripheral blood, patients with active rheumatoid arthritis expressed VLA-1 on 11.7 +/- 6.0% of their mononuclear cells, compared to 1.9 +/- 1.5% in controls (P less than 0.001). Using dual fluorescence analysis, virtually all the 1B3.1-positive synovial cells were CD3+ T lymphocytes and included both CD4+ and CD8+ T cells. When 1B3.1-expressing synovial mononuclear cells or in vitro activated T lymphocytes were triggered with anti-CD3 antibodies, marked augmentation of their proliferation occurred if they were simultaneously cross-linked with mab 1B3.1. Collagen type IV, a putative ligand of VLA-1, also augmented T-cell proliferation to anti-CD3. The data suggest that the VLA-1 molecule could play an important role in the pathophysiology of arthritis by modulating T-cell activation in these diseases. PMID:1827128

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

    PubMed Central

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

    2014-01-01

    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

  10. Force distribution through the wrist joint in patients with different stages of Kienböck's disease: using computed tomography osteoabsorptiometry.

    PubMed

    Iwasaki, N; Minami, A; Miyazawa, T; Kaneda, K

    2000-09-01

    The pattern of subchondral bone density has been considered to reflect the stress distribution that occurs under physiologic loading conditions. To determine the force distribution through the wrist joint with Kienböck's disease in living subjects, we applied a computed tomography osteoabsorptiometry and investigated the subchondral bone density pattern across the radio-carpal joint of 6 normal subjects and 10 patients suffering from Kienböck's disease (Lichtman's stage IIIA, 5 patients; stage IIIB, 5 patients). A single density maximum was found in each scaphoid and lunate fossa in all normal subjects. Among the subjects with Kienböck's disease, the current analysis demonstrated that the density maximum area significantly increased in the scaphoid fossa and decreased in the lunate fossa from stage IIIA to IIIB group. These findings indicate that the load is shifted away from the lunate to the scaphoid with the progression of Kienböck's disease in living subjects. PMID:11040302

  11. The Effects on Knowledge of the Systematic Education of Patients with Joint Diseases Treated with NSAIDs and Diuretics.

    ERIC Educational Resources Information Center

    Linne, Agneta Bjorck; Liedholm, Hans; Jacobsson, Lennart

    2001-01-01

    In a randomized, controlled trial, patients with joint diseases and concomitant treatment with NSAIDs and diuretics received systematic education. The intervention group was given information focusing on awareness of drug interactions and encouragement of self-adjustment of treatment. Results reveal that the intervention group achieved greater…

  12. A digital-signal-processor-based optical tomographic system for dynamic imaging of joint diseases

    NASA Astrophysics Data System (ADS)

    Lasker, Joseph M.

    Over the last decade, optical tomography (OT) has emerged as viable biomedical imaging modality. Various imaging systems have been developed that are employed in preclinical as well as clinical studies, mostly targeting breast imaging, brain imaging, and cancer related studies. Of particular interest are so-called dynamic imaging studies where one attempts to image changes in optical properties and/or physiological parameters as they occur during a system perturbation. To successfully perform dynamic imaging studies, great effort is put towards system development that offers increasingly enhanced signal-to-noise performance at ever shorter data acquisition times, thus capturing high fidelity tomographic data within narrower time periods. Towards this goal, I have developed in this thesis a dynamic optical tomography system that is, unlike currently available analog instrumentation, based on digital data acquisition and filtering techniques. At the core of this instrument is a digital signal processor (DSP) that collects, collates, and processes the digitized data set. Complementary protocols between the DSP and a complex programmable logic device synchronizes the sampling process and organizes data flow. Instrument control is implemented through a comprehensive graphical user interface which integrates automated calibration, data acquisition, and signal post-processing. Real-time data is generated at frame rates as high as 140 Hz. An extensive dynamic range (˜190 dB) accommodates a wide scope of measurement geometries and tissue types. Performance analysis demonstrates very low system noise (˜1 pW rms noise equivalent power), excellent signal precision (˜0.04%--0.2%) and long term system stability (˜1% over 40 min). Experiments on tissue phantoms validate spatial and temporal accuracy of the system. As a potential new application of dynamic optical imaging I present the first application of this method to use vascular hemodynamics as a means of characterizing joint diseases, especially effects of rheumatoid arthritis (RA) in the proximal interphalangeal finger joints. Using a dual-wavelength tomographic imaging system and previously implemented reconstruction scheme, I have performed initial dynamic imaging case studies on healthy volunteers and patients diagnosed with RA. These studies support our hypothesis that differences in the vascular and metabolic reactivity exist between affected and unaffected joints and can be used for diagnostic purposes.

  13. A joint model for multistate disease processes and random informative observation times, with applications to electronic medical records data

    PubMed Central

    Lange, Jane M.; Hubbard, Rebecca A.; Inoue, Lurdes Y. T.; Minin, Vladimir N.

    2015-01-01

    Summary Multistate models are used to characterize individuals’ natural histories through diseases with discrete states. Observational data resources based on electronic medical records pose new opportunities for studying such diseases. However, these data consist of observations of the process at discrete sampling times, which may either be pre-scheduled and non-informative, or symptom-driven and informative about an individual’s underlying disease status. We have developed a novel joint observation and disease transition model for this setting. The disease process is modeled according to a latent continuous-time Markov chain; and the observation process, according to a Markov-modulated Poisson process with observation rates that depend on the individual’s underlying disease status. The disease process is observed at a combination of informative and non-informative sampling times, with possible misclassification error. We demonstrate that the model is computationally tractable and devise an expectation-maximization algorithm for parameter estimation. Using simulated data, we show how estimates from our joint observation and disease transition model lead to less biased and more precise estimates of the disease rate parameters. We apply the model to a study of secondary breast cancer events, utilizing mammography and biopsy records from a sample of women with a history of primary breast cancer. PMID:25319319

  14. [Relations between extraction of wisdom teeth and temporomandibular disorders: a case/control study].

    PubMed

    Duval, Florian; Leroux, Agathe; Bertaud, Valérie; Meary, Fleur; Le Padellec, Clément; Refuveille, Laura; Lemaire, Arnaud; Sorel, Olivier; Chauvel-Lebret, Dominique

    2015-09-01

    The aim of this study was to assess the impact of extraction of third molars on the occurrence of temporo-mandibular disorders (TMD). A review of the literature and a case-control study have been conducted. The case-control study compares the frequency of extraction of third molars between the sample with TMD (case) and the sample without TMD (control). The proportion of patients who had undergone extractions of wisdom teeth was higher in the case group than in the control group. The difference was statistically significant when patients had undergone extraction of all four wisdom teeth or when the extraction of four wisdom teeth underwent in one sitting or under general anesthesia. The study of patients in case sample shows that all signs of TMD were more common in patients who had undergone extractions in several sessions and under local anesthesia. The temporomandibular joint sounds are significantly more frequent with local anesthesia. In the case group, 85 to 92% of patients have parafunctions and 5 to 11% have malocclusion. This demonstrates the multifactorial etiology of temporomandibular disorders. PMID:26370592

  15. Association between estrogen levels and temporomandibular disorders: a systematic literature review

    PubMed Central

    Berger, Marcin; Szalewski, Leszek; Bakalczuk, Magdalena; Bakalczuk, Szymon; Szkutnik, Jacek

    2015-01-01

    Introduction To evaluate whether the hypothesis that estrogen levels are associated with temporomandibular disorders (TMD) in humans can be confirmed or contradicted by available literature. Material and methods A systematic review based on the content of PubMed, Scopus, and Cochrane Library databases was performed. Studies were identified using a combination of key words ‘temporomandibular disorder’ and ‘estrogen’. Nine studies were included into our review. Results The relationship between estrogen levels and TMD was found in seven out of nine reviewed papers. Results from two papers suggest that a high estrogen level is associated with an increased prevalence of TMD. Five additional papers found a relationship between a low estrogen level and an increase in TMD pain. In considering the value of evidence and inconsistencies of results in the reviewed publications, we state that there is weak evidence to support the hypothesis that estrogen levels are associated with TMD. Conclusions Results of reviewed studies were divergent and sometimes contradictory. One possible explanation is that estrogen influences TMD pain processing differently than temporomandibular joints (TMJ) structures, as shown in many animal studies. Estrogen may influence TMD pain processing differently than TMJ structures. We suggest consideration of the dual action of estrogen when planning future studies on its association with TMD. PMID:26848299

  16. Temporomandibular ankylosis in the cat: a review of seven cases.

    PubMed

    Meomartino, L; Fatone, G; Brunetti, A; Lamagna, F; Potena, A

    1999-01-01

    Ankylosis of the temporomandibular joint (TMJ) in the cat is an unusual complication of traumatic lesions involving articular (true ankylosis) or periarticular structures (false ankylosis). Seven cats with true ankylosis of the TMJ (four cases unilateral and three cases bilateral), of which previous trauma had been documented in five cases, were referred to the authors' clinic between September 1991 and October 1996. Radiographic assessment was performed in all cases, using dorsoventral and oblique projections. Five subjects underwent arthroplastic excision of the TMJ and, in the remaining two cases, stretching of the jaws was performed under general anaesthesia. The surgical outcome was satisfactory in all but one case, where partially decreased joint mobility was observed (follow-up time one to five years), but in the two cases where non-surgical treatment was carried out, recurrence of TMJ ankylosis was observed (follow-up time two to five months). In the authors' experience, surgery represents the treatment of choice for TMJ ankylosis in cats. Additional mandibular symphysiotomy can confirm the radiological findings in unilateral cases. PMID:10092035

  17. Toward a joint health and disease management program. Toronto hospitals partner to provide system leadership.

    PubMed

    Macleod, Anne Marie; Gollish, Jeffrey; Kennedy, Deborah; McGlasson, Rhona; Waddell, James

    2009-01-01

    The Joint Health and Disease Management Program in the Toronto Central Local Health Integration Network (TC LHIN) is envisioned as a comprehensive model of care for patients with hip and knee arthritis. It includes access to assessment services, education, self-management programs and other treatment programs, including specialist care as needed. As the first phase of this program, the hospitals in TC LHIN implemented a Hip and Knee Replacement Program to focus on improving access and quality of care, coordinating services and measuring wait times for patients waiting for hip or knee replacement surgery. The program involves healthcare providers, consumers and constituent hospitals within TC LHIN. The approach used for this program involved a definition of governance structure, broad stakeholder engagement to design program elements and plans for implementation and communication to ensure sustainability. The program and approach were designed to provide a model that is transferrable in its elements or its entirety to other patient populations and programs. Success has been achieved in creating a single wait list, developing technology to support referral management and wait time reporting, contributing to significant reductions in waits for timely assessment and treatment, building human resource capacity and improving patient and referring physician satisfaction with coordination of care. PMID:19369812

  18. Stomatognathic adaptive motor syndrome is the correct diagnosis for temporomandibular disorders.

    PubMed

    Douglas, Carlos Roberto; Avoglio, José Luiz Villaça; de Oliveira, Heloisa

    2010-04-01

    Temporomandibular disorder is a generic and inadequate conception to be used as a diagnosis. It fails to express the etiology or the pathophysiology and it is mainly associated with the anatomical site. Moreover, the clinical condition presents a mandibular motor problem and not a joint problem. The hypothesis presents the new diagnosis stomatognathic motor adaptive syndrome, which comprehend a motor response and the adaptive processes it induces. Inadequate occlusal contacts cause the mandible to shift in order to reach an ideal intercuspal position. The condylar displacements are proportional to such movements. Temporomandibular joint (TMJ) receptors respond to the capsular mechanical stress and the information reaches the trigeminal sensory nuclei. The mandibular modified position seems to be relevant information and may interfere with catecholaminergic neurotransmission in basal ganglia. The main motor responses comprise increased jaw muscle tone, decreased velocity of movements and incoordination. The overload of muscle function will produce adaptive responses on many stomatognathic structures. The muscle adaptive responses are hypertonia, pain, fatigue and weakness. Temporomandibular joint presents tissue modification, disc alteration and cracking noise. Periodontium show increased periodontal membrane, bone height loss and gingival recession. Teeth manifest increased wear facets, abfraction and non-accidental fractures. The periodontal and teeth adaptive processes are usually identified as occlusal trauma. The altered stomatognathic functions will show loss of velocity during mastication and speech. Fatigue, weakness in jaw muscle and difficulties to chew hard food are related to hypertonia. Incoordination between stomatognathic muscles groups is found, causing involuntary tongue/cheek biting and lateral jaw movements on speech. Otologic complaints, as aural fullness and tinnitus, are related to the tensor tympani muscle, innervated by the trigeminal nerve. PMID:19910127

  19. Interposition of lateral pterygoid in temporomandibular joint ankylosis.

    PubMed

    Pappachan, Biju; Snehal, B

    2009-06-01

    Conventionally temporalis myofascial flap is popular for interposition in TMJ ankylosis. Medial pterygoid and masseter also has been used in the past for interposition. We introduce here lateral pterygoid for interposition in cases of mild ankylosis where condylar bony architecture is not distorted. PMID:23139490

  20. A Missed Case of Occult Bilateral Temporomandibular Dislocation Mistaken for Dystonia

    PubMed Central

    Lee, Evelyn; Shoenberger, Jan; Wagner, Jonathan

    2015-01-01

    A 24-year-old male with a history of psychiatric disorder and no prior significant temporomandibular joint (TMJ) pathology presented to the emergency department for “lockjaw.” Plain film X-rays of the mandible were read as unremarkable by an attending radiologist, leading to the initial diagnosis of medication-induced dystonic reaction. Following unsuccessful medical treatment a maxillofacial computed tomography (CT) was ordered. CT confirmed bilateral dislocation, illustrating the importance of clinical judgment, and limitations of certain radiographic images. The authors believe this case to be the first reported case in the medical literature of bilateral anterior TMJ dislocation with a false negative X-ray. PMID:26435859

  1. Joint Aspiration (Arthrocentesis)

    MedlinePLUS

    ... arthritis, or JRA), systemic lupus erythematosus (SLE), and Lyme disease. Joint aspiration is diagnostic but it also can ... Parents MORE ON THIS TOPIC Evaluate Your Child's Lyme Disease Risk Living With Lupus Bones, Muscles, and Joints ...

  2. [Changes of urinary hydroxylysylpyridinoline in patients with rheumatic diseases and after operation of prostheses of the hip joint.].

    PubMed

    Becvár, R; Lichý, A; Macek, J; Adam, M

    1992-01-01

    Urinary hydroxylysylpyridinoline (MHP), an indicator of the catabolism of cartilage and bone was assessed in patients with various rheumatic diseases - rheumatoid arthritis (RA) and ankylosing spopndylitis (AS). It was also assessed in patients with coxarthrosis (OA) and AS who had an endopro-thesis of the hip joint and in patients with OA who had a re-operation of a loosened total endoprothesis of the hip joint. A group of healthy subjects served as controls. In all groups of patients the MHP values were elevated as compared with controls. In operated patients different values were recorded - in patients with OA the values did not change after operation, while in AS a marked rise was found. Conversely, after re-operations a drop of MHP levels was observed. Key words: hydroxylysylpyridinoline, urinary excretion, rheumatic diseases, endoprothesis of the hip. PMID:20438693

  3. Elbow clinical, ultrasonographic and radiographic study in patients with inflammatory joint diseases.

    PubMed

    Uson, Jacqueline; Miguélez-Sánchez, Roberto; de Los Riscos, Marina; Martínez-Blasco, María Jesús; Fernández-Espartero, Cruz; Villaverde-García, Virginia; Garrido, Jesús; Naredo, Esperanza

    2016-03-01

    The main objective of this cross-sectional observational study was to investigate the relationship between clinical, ultrasonographic (US) and radiographic elbow features in patients with inflammatory joint diseases (IJD). The secondary objective was to evaluate the association between regional clinical elbow diagnoses and imaging findings. Consecutive patients with IJD attending follow-up visits were assessed for elbow pain and standardized elbow examination. Seven regional clinical  diagnoses were defined. Digital elbow radiographs were read for 9 abnormalities. A standardized elbow grayscale (GS) and power Doppler (PD) scan recorded 13 defined abnormalities. Analysis encompassed 361 clinical, 361 US and 340 radiographic elbow assessments from 181 patients. US and clinical assessments showed an overall higher agreement than radiographic and clinical assessments (68.8 vs 59.1 %, p = 0.001). When structural US abnormalities were compared with radiographic findings, agreement was slightly higher than when comparing all US abnormalities with radiographic findings (77.3 %, k 0.533 and 73.5 %, k 0.492). Enthesophytes, the most common abnormalities, were not associated with clinical findings. Subclinical US-synovitis and US-enthesopathy were found, respectively, in 17.3 and 14.1 % of the clinically normal elbows. Clinical elbow arthritis prevalence and bias-adjusted kappa (PABAK) agreement was good for radiographic fat pad sign, PD-synovitis and GS-synovitis. Clinical elbow enthesopathy PABAK agreement was moderate for GS-enthesopathy and radiographic calcifications. US showed acceptable agreement with clinical and radiographic assessments for detecting elbow inflammatory and structural abnormalities in patients with IJD. Because US detected more abnormalities than radiography and has the capability to detect more subclinical abnormalities, US may be potentially used as a first-line elbow diagnostic tool in this clinical setting. PMID:26597491

  4. Criterion Validation Testing of Clinical Metrology Instruments for Measuring Degenerative Joint Disease Associated Mobility Impairment in Cats

    PubMed Central

    Gruen, Margaret E.; Griffith, Emily H.; Thomson, Andrea E.; Simpson, Wendy; Lascelles, B. Duncan X.

    2015-01-01

    Introduction Degenerative joint disease and associated pain are common in cats, particularly in older cats. There is a need for treatment options, however evaluation of putative therapies is limited by a lack of suitable, validated outcome measures that can be used in the target population of client owned cats. The objectives of this study were to evaluate low-dose daily meloxicam for the treatment of pain associated with degenerative joint disease in cats, and further validate two clinical metrology instruments, the Feline Musculoskeletal Pain Index (FMPI) and the Client Specific Outcome Measures (CSOM). Methods Sixty-six client owned cats with degenerative joint disease and owner-reported impairments in mobility were screened and enrolled into a double-masked, placebo-controlled, randomized clinical trial. Following a run-in baseline period, cats were given either placebo or meloxicam for 21 days, then in a masked washout, cats were all given placebo for 21 days. Subsequently, cats were given the opposite treatment, placebo or meloxicam, for 21 days. Cats wore activity monitors throughout the study, owners completed clinical metrology instruments following each period. Results Activity counts were increased in cats during treatment with daily meloxicam (p<0.0001) compared to baseline. The FMPI results and activity count data offer concurrent validation for the FMPI, though the relationship between baseline activity counts and FMPI scores at baseline was poor (R2=0.034). The CSOM did not show responsiveness for improvement in this study, and the relationship between baseline activity counts and CSOM scores at baseline was similarly poor (R2=0.042). Conclusions Refinements to the FMPI, including abbreviation of the instrument and scoring as percent of possible score are recommended. This study offered further validation of the FMPI as a clinical metrology instrument for use in detecting therapeutic efficacy in cats with degenerative joint disease. PMID:26162101

  5. Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases.

    PubMed

    Zilkens, Christoph; Tiderius, Carl Johann; Krauspe, Rüdiger; Bittersohl, Bernd

    2015-08-01

    Accurate assessment of early hip joint cartilage alterations may help optimize patient selection and follow-up of hip joint preservation surgery. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is sensitive to the glycosaminoglycan content in cartilage that is lost early in the development of osteoarthritis (OA). Hence, the dGEMRIC technique holds promise for the development of new diagnostic and therapeutic procedures. However, because of the location of the hip joint deep within the body and due to the fairly thin cartilage layers that require high spatial resolution, the diagnosis of early hip joint cartilage alterations may be problematic. The purpose of this review is to outline the current status of dGEMRIC in the assessment of hip joint cartilage. A literature search was performed with PubMed, using the terms "cartilage, osteoarthritis, hip joint, MRI, and dGEMRIC", considering all levels of studies. This review revealed that dGEMRIC can be reliably used in the evaluation of early stage cartilage pathology in various hip joint disorders. Modifications in the technique, such as the operation of three-dimensional imaging and dGEMRIC after intra-articular contrast medium administration, have expanded the range of application. Notably, the studies differ considerably in patient selection and technical prerequisites. Furthermore, there is a need for multicenter prospective studies with the required technical conditions in place to establish outcome based dGEMRIC data to obtain, in conjunction with clinical data, reliable threshold values for normal and abnormal cartilage, and for hips that may benefit from conservative or surgical treatment. PMID:25913097

  6. Mandibular manipulation for the treatment of temporomandibular disorder.

    PubMed

    Alves, Betania Mara Franco; Macedo, Cristiane Rufino; Januzzi, Eduardo; Grossmann, Eduardo; Atallah, Álvaro Nagib; Peccin, Stella

    2013-03-01

    The aim of this study was to conduct a systematic review to identify the randomized clinical studies that had investigated the following research question: Is the mandibular manipulation technique an effective and safe technique for the treatment of the temporomandibular joint disk displacement without reduction? The systematic search was conducted in the electronic databases: PubMed (Medical Publications), LILACS (Latin American and Caribbean Literature in Health Sciences), EMBASE (Excerpta Medica Database), PEDro (Physiotherapy Evidence Database), BBO (Brazilian Library of Odontology), CENTRAL (Library Cochrane), and SciELO (Scientific Electronic Library Online). The abstracts of presentations in physical therapy meetings were manually selected, and the articles of the ones that meet the requirements were investigated. No language restrictions were considered. Only randomized and controlled clinical studies were included. Two studies of medium quality fulfilled all the inclusion criteria. There is no sufficient evidence to support the effectiveness of the mandibular manipulation therapy, and therefore its use remains questionable. Being minimally invasive, this therapy is attractive as an initial approach, especially considering the cost of the alternative approaches. The analysis of the results suggests that additional high-quality randomized clinical trials are necessary on the topic, and they should focus on methods for data randomization and allocation, on clearly defined outcomes, on a priori calculated sample size, and on an adequate follow-up strategy. PMID:23524722

  7. A Bamboo Joint-Like Appearance is a Characteristic Finding in the Upper Gastrointestinal Tract of Crohn's Disease Patients

    PubMed Central

    Fujiya, Mikihiro; Sakatani, Aki; Dokoshi, Tatsuya; Tanaka, Kazuyuki; Ando, Katsuyoshi; Ueno, Nobuhiro; Gotoh, Takuma; Kashima, Shin; Tominaga, Motoya; Inaba, Yuhei; Ito, Takahiro; Moriichi, Kentaro; Tanabe, Hiroki; Ikuta, Katsuya; Ohtake, Takaaki; Yokota, Kinnichi; Watari, Jiro; Saitoh, Yusuke; Kohgo, Yutaka

    2015-01-01

    Abstract The clinical importance of Crohn's disease (CD)-specific lesions in the upper gastrointestinal tract (upper GIT) has not been sufficiently established. The aim of this case-control study is to investigate the characteristic findings of CD in the upper GIT. In 2740 patients who underwent gastroduodenoscopy at Asahikawa Medical University between April 2011 and December 2012, 81 CD patients, 81 gender- and age-matched non-IBD patients, and 66 ulcerative colitis (UC) patients were investigated in the present study. (1) The diagnostic ability and odds ratio of each endoscopic finding (a bamboo joint-like appearance in the cardia, erosions, and/or ulcers in the antrum, notched signs, and erosions and/or ulcers in the duodenum) were compared between the CD and non-IBD patients or UC patients. (2) The interobserver agreement of the diagnosis based on the endoscopic findings was evaluated by 3 experienced and 3 less-experienced endoscopists. The incidence of detecting a bamboo joint-like appearance, notched signs, and erosions and/or ulcers in the duodenum was significantly higher in the CD patients than in the non-IBD and UC patients. In addition, the diagnostic ability and odds ratio of a bamboo joint-like appearance for CD were higher than those for the other findings. Kendall's coefficients of concordance in the group of experienced and less-experienced endoscopists were relatively high for a bamboo joint-like appearance (0.748 and 0.692, respectively). A cardiac bamboo joint-like appearance is a useful finding for identifying high-risk groups of CD patients using only gastroduodenoscopy. PMID:26376393

  8. Functional anatomy of the distal radioulnar joint in health and disease

    PubMed Central

    2013-01-01

    The distal radioulnar joint (DRUJ) is critical to the function of the forearm as a mechanical unit. This paper is concerned with the concepts and observations that have changed understanding of the function of the DRUJ, notably with respect to the biomechanics of this joint. The DRUJ has been shown to be important in acting to distribute load and removal of the ulna head leads to the biomechanical equivalent of a one-bone forearm. The soft tissues with topographical relations to the distal forearm and DRUJ have also been investigated in our experimental series with findings including the description of a clinical disorder termed subluxation-related ulna neuropathy syndrome. PMID:23827285

  9. Prediction of Large Joint Destruction in Patients With Rheumatoid Arthritis Using 18F-FDG PET/CT and Disease Activity Score.

    PubMed

    Suto, Takahito; Okamura, Koichi; Yonemoto, Yukio; Okura, Chisa; Tsushima, Yoshito; Takagishi, Kenji

    2016-02-01

    The assessments of joint damage in patients with rheumatoid arthritis (RA) are mainly restricted to small joints in the hands and feet. However, the development of arthritis in RA patients often involves the large joints, such as the shoulder, elbow, hip, knee, and ankle. Few studies have been reported regarding the degree of large joint destruction in RA patients. F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) visualizes the disease activity in large joints affected by RA. In this study, the associations between destruction of the large joints and the findings of FDG-PET/CT as well as laboratory parameters were investigated, and factors associated with large joint destruction after the administration of biological therapy were identified in RA patients.A total of 264 large joints in 23 RA patients (6 men and 17 women; mean age of 66.9?±?7.9 years) were assessed in this study. FDG-PET/CT was performed at baseline and 6 months after the initiation of biological therapy. The extent of FDG uptake in large joints (shoulder, elbow, wrist, hip, knee, and ankle) was analyzed using the maximum standardized uptake value (SUVmax). Radiographs of the 12 large joints per patient obtained at baseline and after 2 years were assessed according to Larsen's method. A logistic regression analysis was performed to determine the factors most significantly contributing to the progression of joint destruction within 2 years.Radiographic progression of joint destruction was detected in 33 joints. The SUVmax at baseline and 6 months, and the disease activity score (DAS) 28-erythrocyte sedimentation rate (ESR) at 6, 12, and 24 months were significantly higher in the group with progressive joint destruction. The SUVmax at baseline and DAS28-ESR at 6 months were found to be factors associated with joint destruction at 2 years (P?joints with destruction was higher than that observed in the joints without destruction. The SUVmax at baseline and the DAS28-ESR at 6 months after the biological treatment were identified to be significant factors predicting destruction of the large joints at 2 years. PMID:26886646

  10. The infrapatellar fat pad from diseased joints inhibits chondrogenesis of mesenchymal stem cells.

    PubMed

    Wei, W; Rudjito, E; Fahy, N; Verhaar, J A; Clockaerts, S; Bastiaansen-Jenniskens, Y M; van Osch, G J

    2015-01-01

    Cartilage repair by bone marrow derived mesenchymal stem cells (MSCs) can be influenced by inflammation in the knee. Next to synovium, the infrapatellar fat pad (IPFP) has been described as a source for inflammatory factors. Here, we investigated whether factors secreted by the IPFP affect chondrogenesis of MSCs and whether this is influenced by different joint pathologies or obesity. Furthermore, we examined the role of IPFP resident macrophages. First, we made conditioned medium from IPFP obtained from osteoarthritic joints, IPFP from traumatically injured joints during anterior cruciate ligament reconstruction, and subcutaneous adipose tissue. Additionally, we made conditioned medium of macrophages isolated from osteoarthritic IPFP and of polarised monocytes from peripheral blood. We evaluated the effect of different types of conditioned medium on MSC chondrogenesis. Conditioned medium from IPFP decreased collagen 2 and aggrecan gene expression as well as thionin and collagen type 2 staining. This anti-chondrogenic effect was the same for conditioned medium from IPFP of osteoarthritic and traumatically injured joints. Furthermore, IPFP from obese (Body Mass Index >30) donors did not inhibit chondrogenesis more than that of lean (Body Mass Index <25) donors. Finally, conditioned medium from macrophages isolated from IPFP decreased the expression of hyaline cartilage genes, as did peripheral blood monocytes stimulated with pro-inflammatory cytokines. The IPFP and the resident pro-inflammatory macrophages could therefore be targets for therapies to improve MSC-based cartilage repair. PMID:26629970

  11. [Analysis of Musculoskeletal Systems and Their Diseases. Genomic medicine of bone and joint diseases : present and future].

    PubMed

    Ikegawa, Shiro

    2015-08-01

    Susceptibility genes for various kinds of common diseases have been identified by the genome-wide association study (GWAS) and the outcome is changing the clinical medicine significantly. Musculoskeletal disease is no exception. In this paper, I review the current status and prospect of GWAS in musculoskeletal diseases in Japan by focusing on representative common musculoskeletal diseases : disc herniation, adolescent idiopathic scoliosis and ossification of the posterior longitudinal ligament of the spine. PMID:26224668

  12. High Spatial Resolution MRI of Cystic Adventitial Disease of the Iliofemoral Vein Communicating with the Hip Joint

    SciTech Connect

    Michaelides, Michael; Pantziara, Maria Ioannidis, Kleanthis

    2013-05-14

    Venous cystic adventitial disease (CAD) is an extremely rare entity, and so far less than 20 cases have been described in the literature. Herein, we describe the imaging findings of CAD of iliofemoral vein in a 51-year-old woman who presented with leg swelling with special emphasis on high spatial resolution MRI, which demonstrated communication of the cyst with the hip joint. To our knowledge, this is the first description of high spatial resolution MRI findings in venous CAD supporting a new theory about the pathogenesis of venous CAD.

  13. Possible involvement of histamine in muscular fatigue in temporomandibular disorders: animal and human studies.

    PubMed

    Watanabe, M; Tabata, T; Huh, J I; Inai, T; Tsuboi, A; Sasaki, K; Endo, Y

    1999-03-01

    As an approach to clarifying the molecular basis of pain and fatigue in muscles involved in temporomandibular disorders, we examined the activity of histidine decarboxylase (HDC), the enzyme which forms histamine, in the masseter muscles of mice. In the resting muscle, HDC activity was very low. Direct electrical stimulation of the muscle markedly elevated HDC activity. HDC activity rose within 3 hrs of the electrical stimulation, peaked at 6 to 8 hrs, and then gradually declined. Intraperitoneal injection of a small amount of interleukin-1 (IL-1) (from 1 to 10 microg/kg) produced a similar elevation of HDC activity in the masseter muscle. We also examined the effect of an antihistamine, chlorphenylamine (CP), on temporomandibular disorders in humans and compared it with that of an anti-inflammatory analgesic, flurbiprofen (FB). Two groups received one or the other of the drugs daily for 7 days, and they were asked about their signs and symptoms before and after the treatment. A positive evaluation of their treatment was made by 74% of the CP group, but by only 48% of the FB group. Although the effects of CP on the limitation of mouth-opening and on joint noise were negligible, about 50% of the CP group answered positively concerning the drug's effect on spontaneous pain or pain induced by chewing or mouth-opening. The positive evaluation for CP (50%) in relieving associated symptoms (headache or shoulder stiffness) was significantly greater than for FB (13%). FB showed effectiveness similar to but sometimes weaker than that of CP on several symptoms. On the basis of these and previous results and the known actions of histamine, we propose that the histamine newly formed following the induction of HDC activity, which is itself mediated by IL-1, may be involved in inducing pain and, possibly, stiffness in muscles in temporomandibular disorders. PMID:10096452

  14. Effect of Facial Massage on Static Balance in Individuals with Temporomandibular Disorder – a Pilot Study

    PubMed Central

    El Hage, Yasmin; Politti, Fabiano; Herpich, Carolina Marciela; de Souza, Dowglas Fernando Magalhães; de Paula Gomes, Cid André Fidelis; Amorim, Cesar Ferreira; de Oliveira Gonzalez, Tabajara; Biasotto-Gonzalez, Daniela Aparecida

    2013-01-01

    Introduction The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture. Purpose The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoPAP) and mediolateral (CoPML) directions in individuals with temporomandibular disorder (TMD). Methods Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoPAP and CoPML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage). Results No significant differences were found regarding CoPAP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoPML velocity, RMS of CoPAP, RMS of CoPML, and sway area. The only significant difference was found for mean CoPAP velocity with eyes closed. Conclusions While the results of the present study demonstrate the reliability of the reproduction of the data, facial massage had no immediate influence on postural control in individuals with TMD. PMID:24298296

  15. Current panorama of temporomandibular disorders' field in Brazil

    PubMed Central

    MACHADO, Naila Aparecida de Godoi; LIMA, Fernanda Ferruzzi; CONTI, Paulo César Rodrigues

    2014-01-01

    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

  16. In an interconnected world: joint research priorities for the environment, agriculture and infectious disease

    PubMed Central

    2014-01-01

    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

  17. In an interconnected world: joint research priorities for the environment, agriculture and infectious disease.

    PubMed

    Brijnath, Bianca; Butler, Colin D; McMichael, Anthony J

    2014-01-01

    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

  18. Dynamic activation of bone morphogenetic protein signaling in collagen-induced arthritis supports their role in joint homeostasis and disease

    PubMed Central

    Daans, Melina; Lories, Rik JU; Luyten, Frank P

    2008-01-01

    Introduction Rheumatoid arthritis is a chronic systemic autoimmune disease affecting peripheral joints and leading to loss of joint function. The severity and outcome of disease are dependent on the balance between inflammatory/destructive and homeostatic or repair pathways. Increasing evidence suggests a role for bone morphogenetic protein (BMP) signaling in joint homeostasis and disease. Methods Activation of BMP signaling in collagen-induced arthritis as a model of rheumatoid arthritis was studied by immunohistochemistry and Western blot for phosphorylated SMAD1/5 at different time points. Expression of different BMP ligands and noggin, a BMP antagonist, was determined on synovium and cartilage extracts of arthritic knees, at different time points, with quantitative polymerase chain reaction. At the protein level, BMP2 and BMP7 were studied with immunohistochemistry. Finally, the effect of anti-tumor necrosis factor-alpha (TNF?) treatment on the expression of BMP2, BMP7, and growth and differentiation factor-5 (GDF5) in synovium and cartilage of arthritic knees was investigated. Results A time-dependent activation of the BMP signaling pathway in collagen-induced arthritis was demonstrated with a dynamic and characteristic expression pattern of different BMP subfamily members in synovium and cartilage of arthritic knees. As severity increases, the activation of BMP signaling becomes more prominent in the invasive pannus tissue. BMP2 is present in cartilage and the hyperplastic lining layer. BMP7 is found in the sublining zone and inflammatory infiltrate. Treatment with etanercept slowed down progression of disease, but no change in expression of GDF5, BMP2, and BMP7 in synovium was found; in the cartilage, however, blocking of TNF? increased the expression of BMP7. Conclusions BMP signaling is dynamically activated in collagen-induced arthritis and is partly TNF?-independent. TNF? blocking increased the expression of BMP7 in the articular cartilage, possibly enhancing anabolic mechanisms. Different types of source and target cells are recognized. These data further support a role for BMP signaling in arthritis. PMID:18816401

  19. Analgesia Evaluation of 2 NSAID Drugs as Adjuvant in Management of Chronic Temporomandibular Disorders

    PubMed Central

    Kurita Varoli, Fernando; Sucena Pita, Murillo; Sato, Sandra; Issa, João Paulo Mardegan; do Nascimento, Cássio

    2015-01-01

    The aim of this triple-blind full-randomized clinical trial was to quantify analgesia in masticatory muscles and temporomandibular joints after occlusal splint therapy associated with the adjuvant administration of nonsteroidal anti-inflammatory drugs (NSAID) isolated or associated with other therapeutic agents. Pain relief was also recorded. Eighteen volunteers who had been suffering from chronic pain in masticatory muscles due to temporomandibular disorders were selected after anamnesis and assessment using RDC/TMD translated to Portuguese. The 3 proposed treatments were NSAID (sodium diclofenac), panacea (sodium diclofenac + carisoprodol + acetaminophen + caffeine), and a placebo. The total treatment duration was 10 days, preceded and succeeded by patients' pain assessment. A washout interval of 11 days was established between each therapy. All participants received all treatments in different moments, in a full randomized crossover methodology. The assessment of drug therapies was performed using visual analogue scale for pain on palpation followed by 11-point numerical scale to quantify pain during treatment. Statistical analysis has shown that, after 10 days of treatment, all therapies were effective for pain relief. NSAID therapy promoted analgesia on the third day, while placebo only promoted analgesia in the eighth day. It has been concluded that sodium diclofenac used as splint adjuvant therapy, promotes significant analgesia in a shorter time. PMID:25874243

  20. Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students

    PubMed Central

    Iunes, Denise Hollanda; Chaves, Érika de Cássia Lopes; Moura, Caroline de Castro; Côrrea, Bruna; Carvalho, Leonardo César; Silva, Andreia Maria; de Carvalho, Emília Campos

    2015-01-01

    Introduction. The aim of this study was to evaluate the role of auriculotherapy with mustard seeds in the treatment of temporomandibular disorders (TMDs), anxiety, and electromyographic (EMG) activity in university students. Methodology. The State Trait Anxiety Inventory (STAI), Research Diagnostic Criteria (RDC) for TMDs (RDC/TMDs), and electromyography were used in this study of 44 college students with high levels of anxiety and TMDs. The subjects were divided into two groups: an auriculotherapy (AA) group (n = 31) and an AA sham group (n = 13). The mustard seeds were applied to the shenmen, rim, sympathetic, brain stem, and temporomandibular joint (TMJ) points in the AA group and to sham points in the external ear and wrist in the AA sham group. The treatment protocol was 10 sessions (two treatments per week). Results. Anxiety (p < 0.01) was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region (p = 0.04) and in the right side of the submandibular region (p = 0.02). Complaints of bilateral pain were reduced in the temporal tendon (p ≤ 0.01) and in the left side of the ATM (p < 0.01). In addition, electromyographic (EMG) activity was reduced during temporal muscle contraction (p = 0.03).  Conclusion. Auriculotherapy was effective in the treatment of students with anxiety and TMDs. PMID:26495012

  1. Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students.

    PubMed

    Iunes, Denise Hollanda; Chaves, Érika de Cássia Lopes; Moura, Caroline de Castro; Côrrea, Bruna; Carvalho, Leonardo César; Silva, Andreia Maria; de Carvalho, Emília Campos

    2015-01-01

    Introduction. The aim of this study was to evaluate the role of auriculotherapy with mustard seeds in the treatment of temporomandibular disorders (TMDs), anxiety, and electromyographic (EMG) activity in university students. Methodology. The State Trait Anxiety Inventory (STAI), Research Diagnostic Criteria (RDC) for TMDs (RDC/TMDs), and electromyography were used in this study of 44 college students with high levels of anxiety and TMDs. The subjects were divided into two groups: an auriculotherapy (AA) group (n = 31) and an AA sham group (n = 13). The mustard seeds were applied to the shenmen, rim, sympathetic, brain stem, and temporomandibular joint (TMJ) points in the AA group and to sham points in the external ear and wrist in the AA sham group. The treatment protocol was 10 sessions (two treatments per week). Results. Anxiety (p < 0.01) was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region (p = 0.04) and in the right side of the submandibular region (p = 0.02). Complaints of bilateral pain were reduced in the temporal tendon (p ≤ 0.01) and in the left side of the ATM (p < 0.01). In addition, electromyographic (EMG) activity was reduced during temporal muscle contraction (p = 0.03).  Conclusion. Auriculotherapy was effective in the treatment of students with anxiety and TMDs. PMID:26495012

  2. Analgesia evaluation of 2 NSAID drugs as adjuvant in management of chronic temporomandibular disorders.

    PubMed

    Kurita Varoli, Fernando; Sucena Pita, Murillo; Sato, Sandra; Issa, João Paulo Mardegan; do Nascimento, Cássio; Pedrazzi, Vinícius

    2015-01-01

    The aim of this triple-blind full-randomized clinical trial was to quantify analgesia in masticatory muscles and temporomandibular joints after occlusal splint therapy associated with the adjuvant administration of nonsteroidal anti-inflammatory drugs (NSAID) isolated or associated with other therapeutic agents. Pain relief was also recorded. Eighteen volunteers who had been suffering from chronic pain in masticatory muscles due to temporomandibular disorders were selected after anamnesis and assessment using RDC/TMD translated to Portuguese. The 3 proposed treatments were NSAID (sodium diclofenac), panacea (sodium diclofenac + carisoprodol + acetaminophen + caffeine), and a placebo. The total treatment duration was 10 days, preceded and succeeded by patients' pain assessment. A washout interval of 11 days was established between each therapy. All participants received all treatments in different moments, in a full randomized crossover methodology. The assessment of drug therapies was performed using visual analogue scale for pain on palpation followed by 11-point numerical scale to quantify pain during treatment. Statistical analysis has shown that, after 10 days of treatment, all therapies were effective for pain relief. NSAID therapy promoted analgesia on the third day, while placebo only promoted analgesia in the eighth day. It has been concluded that sodium diclofenac used as splint adjuvant therapy, promotes significant analgesia in a shorter time. PMID:25874243

  3. The effects of seasonal changes on temporomandibular disorders.

    PubMed

    Ibrahim, Ziad G; Strempel, Jürgen; Tschernitschek, Harald

    2005-01-01

    The aim of our study was the evaluation of seasonal influences on development and evolution of temporomandibular disorders (TMD). In a retrospective study based on data from 1997 and 1998, we analyzed the monthly number of patients at the Department of Prosthodontics. The total number of first time examinations during these two years was 11,747. Nine hundred and sixty-one (961) patients showed symptoms frequently found in TMD. These patients were submitted to a special TMD diagnosis based on the criteria of a validated craniomandibular index questionnaire. In 568 patients (group A1), a TMD was confirmed, in the other 393 patients (group A2), the disorder could not be confirmed. Dividing up the numbers of patients into summer and winter half years, we found statistically significant relationships between patient numbers and season in TMD patients (A1) as well as in all patients (group B). The distribution of the monthly numbers of TMD patients with its maximum in winter, however, was characteristically different from that of all patients with the maximum in summer. The number of TMD patients per month was significantly correlated to the mean daily sunshine duration per month. Parallels could be drawn to seasonal variations of symptoms in Seasonal Affective Disorders (SAD). As the mechanisms which influence the emergence of psychologically impacted disease in TMD patients might be comparable to SAD, we propose that a similar therapy may be applied. PMID:15727323

  4. Temporomandibular Disorders in Burning Mouth Syndrome Patients: An Observational Study

    PubMed Central

    Corsalini, Massimo; Di Venere, Daniela; Pettini, Francesco; Lauritano, Dorina; Petruzzi, Massimo

    2013-01-01

    BACKGROUND: Burning Mouth Syndrome (BMS) is a chronic disease characterized by absence of any lesions and burning of the oral mucosa associated to a sensation of dry mouth and/or taste alterations. The purpose of our study is to estimate signs and symptoms of Temporomandibular Disorders (TMD) in patients with BMS and to investigate for the existence of an association between BMS and TMD. MATERIALS AND METHODS: Forty-four BMS patients were enrolled; BMS subtype was established according to the classification of Lamey. After a gnathological evaluation, according to the protocol of the European Academy of Craniomandibular Disorders, patients were classified by RDC/TMD criteria. The data were compared and analyzed using a chi-square test to describe the existence of an association between BMS and TMD. RESULTS: 65.9% the BMS patients showed disorders classified as primary signs and symptoms of TMD according to RDC / TMD criteria, and 72.7% showed parafunctional habits. The chi-square test revealed a statistically significant association (p = 0.035) between BMS and TMD. CONCLUSION: The data suggest that there is a possible relationship not yet well understood between BMS and TMD, may be for neurophatic alterations assumed for BMS that could be also engaged in TMD pathogenesis. PMID:24273452

  5. Vaccinations in adults with chronic inflammatory joint disease: Immunization schedule and recommendations for patients taking synthetic or biological disease-modifying antirheumatic drugs.

    PubMed

    Morel, Jacques; Czitrom, Séverine Guillaume; Mallick, Auriane; Sellam, Jérémie; Sibilia, Jean

    2016-03-01

    The risk of infection associated with autoimmune diseases is further increased by the use of biotherapies. Recommendations to minimize this risk include administering the full complement of vaccines on the standard immunization schedule, as well as the pneumococcal and influenza vaccines. Adults with chronic inflammatory joint disease (IJD) may receive a 13-valent pneumococcal conjugate vaccine, as well as a live attenuated vaccine against recurrent herpes zoster, recently licensed by European regulatory authorities. Live attenuated vaccines can be given only after an interval without immunosuppressant and/or glucocorticoid therapy. The effectiveness of vaccines, as assessed based on titers of protective antibodies, varies across vaccine types and disease-modifying antirheumatic drugs (DMARDs). Thus, methotrexate and rituximab are usually associated with decreased vaccine responses. The risks associated with vaccines are often considerably exaggerated by the media, which serve lobbies opposed to immunizations and make some patients reluctant to accept immunizations. Increasing immunization coverage may diminish the risk of treatment-related infections. A physician visit dedicated specifically to detecting comorbidities in patients with chronic IJD may result in improved immunization coverage. In this review, we discuss immunizations for adults with chronic IJD based on the treatments used, as well as immunization coverage. Many questions remain unanswered and warrant investigation by studies coordinated by the French networks IREIVAC (Innovative clinical research network in vaccinology) and IMIDIATE (Immune-Mediated Inflammatory Disease Alliance for Translational and Clinical Research). PMID:26453106

  6. Prevalence of the different Axis I clinical subtypes in a sample of patients with orofacial pain and temporomandibular disorders in the Andalusian Healthcare Service

    PubMed Central

    Blanco-Aguilera, Antonio; Blanco-Aguilera, Elena; Serrano-del-Rosal, Rafael; Biedma-Velázquez, Lourdes; Rodríguez-Torronteras, Alejandro; Segura-Saint-Gerons, Rafael

    2016-01-01

    Background The main objective of this paper is to analyze the prevalence of each of the different clinical subtypes of temporomandibular disorders (TMD) in a sample of patients with this pathology. In addition, a second objective was to analyze their distribution according to gender. Material and Methods To this end, the results of 1603 patients who went to the Unit of Temporomandibular Disorders in the Córdoba Healthcare District because they suffered from this pathology were analyzed. In order to diagnose them, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were applied, analyzing the different Axis I subtypes (myopathy, discopathy and arthropathy) and obtaining the combined Axis I for each patient and the relation of all these variables according to gender. The null-hypothesis test confirmed the lack of connection between the gender variable and the different subtypes in the clinical analysis, and between the former and the combined Axis I of the RDC/TMD. Results The prevalence was high for the muscle disorders subtype in general, showing an 88.7% prevalence, while the presence of discopathies or arthropathies was much lower. Among discopathies, the most frequent ones were disc displacements with reduction, with 39.7% and 42.8% for the left and right temporomandibular joints (TMJ), respectively, while the prevalence of arthropathies was 26.3% for the right TMJ and 32.9% for the left TMJ. The bivariate analysis on the connection with gender reveals a p≥ 0.05 value for the muscle and arthralgia subtypes. Conclusions The patients seen at the TMD Unit where mostly middle-aged women whose main clinical axis subtype was the muscle disorder subtype. For their part, both discopathies and arthropathies, although present, are much less prevalent. Key words:RDCTMD, axis I, orofacial pain, temporomandibular disorders, gender. PMID:26615508

  7. Preliminary study of joint disease in poultry by the analysis of synovial fluid.

    PubMed

    Corr, S A; Maxwell, M; Gentle, M J; Bennett, D

    2003-05-01

    Samples of synovial fluid and synovial membrane were obtained from the hock joints of several groups of broilers, including lame birds and two strains of broilers raised on different feeding regimens and given different drug treatments (carprofen or placebo). There were more significant differences between the groups on the basis of the analysis of the synovial fluid samples than the synovial membrane samples. Experimental birds fed ad libitum had the highest median red blood cell counts and median ghost cell counts of all of the groups, but there were no differences between the groups in the thickness of the synovial lining cell layer or the degree of cellular infiltrate in the synovial membrane. The synovial fluid from the broilers and lame birds fed ad libitum was more turbid, suggestive of intra-articular pathology, and the large numbers of heterophils in samples from the lame birds indicated an inflammatory arthropathy. The birds fed ad libitum which were treated with carprofen had more cells in the synovial fluid than the birds given the placebo. A large number of the samples of synovial fluid from the ad libitum-fed broilers contained blood. PMID:12751605

  8. Factors involved in the etiology of temporomandibular disorders - a literature review

    PubMed Central

    CHISNOIU, ANDREA MARIA; PICOS, ALINA MONICA; POPA, SEVER; CHISNOIU, PETRE DANIEL; LASCU, LIANA; PICOS, ANDREI; CHISNOIU, RADU

    2015-01-01

    Background and aim This review aims at presenting a current view on the most frequent factors involved in the mechanisms causing temporomandibular disorders (TMD). Method We conducted a critical review of the literature for the period January 2000 to December 2014 to identify factors related to TMD development and persistence. Results The etiology of TMD is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. Occlusal overloading and parafunctions (bruxism) are frequently involved as biomechanical factors; increased levels of estrogen hormones are considered biological factors affecting the temporo-mandibular-joint. Among bio-psychosocial factors, stress, anxiety or depression, were frequently encountered. Conclusions The etiopathogenesis of this condition is poorly understood, therefore TMDs are difficult to diagnose and manage. Early and correct identification of the possible etiologic factors will enable the appropriate treatment scheme application in order to reduce or eliminate TMDs debilitating signs and symptoms. PMID:26732121

  9. Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations

    PubMed Central

    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

    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

  10. How can calcium pyrophosphate crystals induce inflammation in hypophosphatasia or chronic inflammatory joint diseases?

    PubMed

    Beck, C; Morbach, H; Richl, P; Stenzel, M; Girschick, H J

    2009-01-01

    Hypophosphatasia (HP) is a rare inborn error of bone and mineral metabolism characterized by a defect in the tissue non-specific alkaline phosphatase (TNSALP) gene. Calcium pyrophosphate dihydrate (CPPD) crystals are known to accumulate as substrates of TNSALP in tissues and joints of patients with HP. In CPPD-induced arthritis these crystals are known to induce an inflammatory response. HP patients do suffer from pain in their lower extremities. However, it is not clear whether CPPD crystals contribute to these musculoskeletal complaints in HP. As long as there is no curative treatment of HP, symptomatic treatment in order to improve clinical features, especially with regard to pain and physical activity, is of major interest to the patients. Knowledge of the mechanisms underlying crystal-induced cell activation, however, is limited. Here we describe recent advances in elucidating the signal transduction pathways activated by CPPD crystals as endogenous "danger signals". Recent investigations provided evidence that Toll/interleukin-1 receptor (TIR) domain containing receptors including Toll-like receptors (TLRs) and interleukin-1 receptor (IL-1R), as well as the triggering receptor expressed on myeloid cells 1 (TREM-1) and the NACHT-leucin rich repeat and pyrin-domain-containing protein (NALP3) containing inflammasome are essentially involved in acute CPPD crystal-induced inflammation. These receptors are considered in part as components of the innate immune system. Further studies are needed to improve our understanding of the pathophysiological mechanisms leading to inflammation and tissue destruction associated with deposition of microcrystals. They might support the development of new therapeutic strategies for crystal-induced inflammation. Eventually, patients with HP might as well profit from such strategies addressing these metabolic disorders secondary to the gene defect. PMID:18821074

  11. Birth cohorts in asthma and allergic diseases: Report of a NIAID, NHLBI, MeDALL joint workshop

    PubMed Central

    Bousquet, J; Gern, JE; Martinez, FD; Anto, JM; Johnson, CC; Holt, PG; Lemanske, RF; Le Souef, PN; Tepper, R; von Mutius, ERM; Arshad, SH; Bacharier, LB; Becker, A; Belanger, K; Bergstrom, A; Bernstein, D; Cabana, MD; Carroll, KN; Castro, M; Cooper, PJ; Gillman, MW; Gold, DR; Henderson, J; Heinrich, J; S-J, Hong; Jackson, DJ; Keil, T; Kozyrskyj, AL; Lodrup-Carlsen, K; Miller, RL; Momas, I; Morgan, WJ; Noel, P; Ownby, DR; Pinart, M; Ryan, P; Schwaninger, JM; Sears, MR; Simpson, A; Smit, HA; Stern, D; Subbarao, P; Valenta, R; Wang, X; Weiss, ST; Wood, R; Wright, AL; Wright, RJ; Togias, A; Gergen, PJ

    2014-01-01

    Population-based birth cohorts on asthma and allergies increasingly provide new insights into the development and natural history of the diseases. Over 130 birth cohorts focusing on asthma and allergy have been initiated in the last 30 years. A NIAID (National Institute of Allergy and Infectious Diseases), NHLBI (National Heart Lung and Blood Institute), MeDALL (Mechanisms of the Development of Allergy, Framework Programme 7 of the European Commission) joint workshop was held in Bethesda, MD, USA September 11–12, 2012 with 3 objectives (1) documenting the knowledge that asthma/allergy birth cohorts have provided, (2) identifying the knowledge gaps and inconsistencies and (3) developing strategies for moving forward, including potential new study designs and the harmonization of existing asthma birth cohort data. The meeting was organized around the presentations of 5 distinct workgroups: (1) clinical phenotypes, (2) risk factors, (3) immune development of asthma and allergy, (4) pulmonary development and (5) harmonization of existing birth cohorts. This manuscript presents the workgroup reports and provides web links (AsthmaBirthCohorts.niaid.nih.gov or www.medall-fp7.eu) where the reader will find tables describing the characteristics of the birth cohorts included in this report, type of data collected at differing ages, and a selected bibliography provided by the participating birth cohorts. PMID:24636091

  12. Birth cohorts in asthma and allergic diseases: report of a NIAID/NHLBI/MeDALL joint workshop.

    PubMed

    Bousquet, Jean; Gern, James E; Martinez, Fernando D; Anto, Josep M; Johnson, Christine C; Holt, Patrick G; Lemanske, Robert F; Le Souëf, Peter N; Tepper, Robert S; von Mutius, Erika R M; Arshad, S Hasan; Bacharier, Leonard B; Becker, Allan; Belanger, Kathleen; Bergström, Anna; Bernstein, David I; Cabana, Michael D; Carroll, Kecia N; Castro, Mario; Cooper, Philip J; Gillman, Matthew W; Gold, Diane R; Henderson, John; Heinrich, Joachim; Hong, Soo-Jong; Jackson, Daniel J; Keil, Thomas; Kozyrskyj, Anita L; Lødrup Carlsen, Karin C; Miller, Rachel L; Momas, Isabelle; Morgan, Wayne J; Noel, Patricia; Ownby, Dennis R; Pinart, Mariona; Ryan, Patrick H; Schwaninger, Julie M; Sears, Malcolm R; Simpson, Angela; Smit, Henriette A; Stern, Debra A; Subbarao, Padmaja; Valenta, Rudolf; Wang, Xiaobin; Weiss, Scott T; Wood, Robert; Wright, Anne L; Wright, Rosalind J; Togias, Alkis; Gergen, Peter J

    2014-06-01

    Population-based birth cohorts on asthma and allergies increasingly provide new insights into the development and natural history of the diseases. More than 130 birth cohorts focusing on asthma and allergy have been initiated in the last 30 years. A National Institute of Allergy and Infectious Diseases; National Heart, Lung, and Blood Institute; Mechanisms of the Development of Allergy (MeDALL; Framework Programme 7 of the European Commission) joint workshop was held in Bethesda, Maryland, on September 11-12, 2012, with 3 objectives: (1) documenting the knowledge that asthma/allergy birth cohorts have provided, (2) identifying the knowledge gaps and inconsistencies, and (3) developing strategies for moving forward, including potential new study designs and the harmonization of existing asthma birth cohort data. The meeting was organized around the presentations of 5 distinct workgroups: (1) clinical phenotypes, (2) risk factors, (3) immune development of asthma and allergy, (4) pulmonary development, and (5) harmonization of existing birth cohorts. This article presents the workgroup reports and provides Web links (AsthmaBirthCohorts.niaid.nih.gov or www.medall-fp7.eu), where the reader will find tables describing the characteristics of the birth cohorts included in this report, the type of data collected at differing ages, and a selected bibliography provided by the participating birth cohorts. PMID:24636091

  13. A randomized controlled clinical trial evaluating the effectiveness of an external mandibular support device during dental care for patients with temporomandibular disorders.

    PubMed

    Fernandes, Patricia; Velly, Ana Miriam; Anderson, Gary C

    2013-01-01

    This study tested a jaw support device for patients receiving dental care while suffering from temporomandibular joint pain. This crossover randomized trial used 31 subjects with jaw pain. Subjects underwent 2 consecutive dental scaling sessions of 30 minutes each. For each subject, the device was used for 1 of the sessions. Subjects completed questionnaires regarding jaw pain and jaw fatigue before and after each session. Multivariate analyses were performed to assess the device's effectiveness in preventing the aggravation of pain and fatigue during dental treatment. Statistically significant differences were found for jaw pain (P = 0.001), and fatigue (P = 0.04), indicating the effectiveness of the device. Based on the results, supporting the mandible of patients with temporomandibular disorders during dental treatments may prevent further pain. PMID:24064159

  14. Local Massage with Topical Analgesic, a Novel Treatment Modality for Temporomandibular Muscular Pain, a Case Study Report of 5 Consecutive Cases

    PubMed Central

    Wong, R.W.K; Rabie, A.B.M

    2008-01-01

    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

  15. Joint recognition-expression impairment of facial emotions in Huntington's disease despite intact understanding of feelings.

    PubMed

    Trinkler, Iris; Cleret de Langavant, Laurent; Bachoud-Lévi, Anne-Catherine

    2013-02-01

    Patients with Huntington's disease (HD), a neurodegenerative disorder that causes major motor impairments, also show cognitive and emotional deficits. While their deficit in recognising emotions has been explored in depth, little is known about their ability to express emotions and understand their feelings. If these faculties were impaired, patients might not only mis-read emotion expressions in others but their own emotions might be mis-interpreted by others as well, or thirdly, they might have difficulties understanding and describing their feelings. We compared the performance of recognition and expression of facial emotions in 13 HD patients with mild motor impairments but without significant bucco-facial abnormalities, and 13 controls matched for age and education. Emotion recognition was investigated in a forced-choice recognition test (FCR), and emotion expression by filming participants while they mimed the six basic emotional facial expressions (anger, disgust, fear, surprise, sadness and joy) to the experimenter. The films were then segmented into 60 stimuli per participant and four external raters performed a FCR on this material. Further, we tested understanding of feelings in self (alexithymia) and others (empathy) using questionnaires. Both recognition and expression were impaired across different emotions in HD compared to controls and recognition and expression scores were correlated. By contrast, alexithymia and empathy scores were very similar in HD and controls. This might suggest that emotion deficits in HD might be tied to the expression itself. Because similar emotion recognition-expression deficits are also found in Parkinson's Disease and vascular lesions of the striatum, our results further confirm the importance of the striatum for emotion recognition and expression, while access to the meaning of feelings relies on a different brain network, and is spared in HD. PMID:22244587

  16. Joint swelling

    MedlinePLUS

    ... care provider if you have: Unexplained joint swelling Joint swelling after an injury ... Your health care provider will examine you. The joint will be closely examined. You will be asked about your joint swelling, such as when it began, ...

  17. Detection and classification of interstitial lung diseases and emphysema using a joint morphological-fuzzy approach

    NASA Astrophysics Data System (ADS)

    Chang Chien, Kuang-Che; Fetita, Catalin; Brillet, Pierre-Yves; Prêteux, Françoise; Chang, Ruey-Feng

    2009-02-01

    Multi-detector computed tomography (MDCT) has high accuracy and specificity on volumetrically capturing serial images of the lung. It increases the capability of computerized classification for lung tissue in medical research. This paper proposes a three-dimensional (3D) automated approach based on mathematical morphology and fuzzy logic for quantifying and classifying interstitial lung diseases (ILDs) and emphysema. The proposed methodology is composed of several stages: (1) an image multi-resolution decomposition scheme based on a 3D morphological filter is used to detect and analyze the different density patterns of the lung texture. Then, (2) for each pattern in the multi-resolution decomposition, six features are computed, for which fuzzy membership functions define a probability of association with a pathology class. Finally, (3) for each pathology class, the probabilities are combined up according to the weight assigned to each membership function and two threshold values are used to decide the final class of the pattern. The proposed approach was tested on 10 MDCT cases and the classification accuracy was: emphysema: 95%, fibrosis/honeycombing: 84% and ground glass: 97%.

  18. Three-Dimensional Quantitative Morphometric Analysis (QMA) for In Situ Joint and Tissue Assessment of Osteoarthritis in a Preclinical Rabbit Disease Model

    PubMed Central

    Stok, Kathryn S.; Besler, Bryce A.; Steiner, Thomas H.; Villarreal Escudero, Ana V.; Zulliger, Martin A.; Wilke, Markus; Atal, Kailash; Quintin, Aurelie; Koller, Bruno; Müller, Ralph; Nesic, Dobrila

    2016-01-01

    This work utilises advances in multi-tissue imaging, and incorporates new metrics which define in situ joint changes and individual tissue changes in osteoarthritis (OA). The aims are to (1) demonstrate a protocol for processing intact animal joints for microCT to visualise relevant joint, bone and cartilage structures for understanding OA in a preclinical rabbit model, and (2) introduce a comprehensive three-dimensional (3D) quantitative morphometric analysis (QMA), including an assessment of reproducibility. Sixteen rabbit joints with and without transection of the anterior cruciate ligament were scanned with microCT and contrast agents, and processed for histology. Semi-quantitative evaluation was performed on matching two-dimensional (2D) histology and microCT images. Subsequently, 3D QMA was performed; including measures of cartilage, subchondral cortical and epiphyseal bone, and novel tibio-femoral joint metrics. Reproducibility of the QMA was tested on seven additional joints. A significant correlation was observed in cartilage thickness from matching histology-microCT pairs. The lateral compartment of operated joints had larger joint space width, thicker femoral cartilage and reduced bone volume, while osteophytes could be detected quantitatively. Measures between the in situ tibia and femur indicated an altered loading scenario. High measurement reproducibility was observed for all new parameters; with ICC ranging from 0.754 to 0.998. In conclusion, this study provides a novel 3D QMA to quantify macro and micro tissue measures in the joint of a rabbit OA model. New metrics were established consisting of: an angle to quantitatively measure osteophytes (σ), an angle to indicate erosion between the lateral and medial femoral condyles (ρ), a vector defining altered angulation (λ, α, β, γ) and a twist angle (τ) measuring instability and tissue degeneration between the femur and tibia, a length measure of joint space width (JSW), and a slope and intercept (m, Χ) of joint contact to demonstrate altered loading with disease progression, as well as traditional bone and cartilage and histo-morphometry measures. We demonstrate correlation of microCT and histology, sensitive discrimination of OA change and robust reproducibility. PMID:26808542

  19. Three-Dimensional Quantitative Morphometric Analysis (QMA) for In Situ Joint and Tissue Assessment of Osteoarthritis in a Preclinical Rabbit Disease Model.

    PubMed

    Stok, Kathryn S; Besler, Bryce A; Steiner, Thomas H; Villarreal Escudero, Ana V; Zulliger, Martin A; Wilke, Markus; Atal, Kailash; Quintin, Aurelie; Koller, Bruno; Müller, Ralph; Nesic, Dobrila

    2016-01-01

    This work utilises advances in multi-tissue imaging, and incorporates new metrics which define in situ joint changes and individual tissue changes in osteoarthritis (OA). The aims are to (1) demonstrate a protocol for processing intact animal joints for microCT to visualise relevant joint, bone and cartilage structures for understanding OA in a preclinical rabbit model, and (2) introduce a comprehensive three-dimensional (3D) quantitative morphometric analysis (QMA), including an assessment of reproducibility. Sixteen rabbit joints with and without transection of the anterior cruciate ligament were scanned with microCT and contrast agents, and processed for histology. Semi-quantitative evaluation was performed on matching two-dimensional (2D) histology and microCT images. Subsequently, 3D QMA was performed; including measures of cartilage, subchondral cortical and epiphyseal bone, and novel tibio-femoral joint metrics. Reproducibility of the QMA was tested on seven additional joints. A significant correlation was observed in cartilage thickness from matching histology-microCT pairs. The lateral compartment of operated joints had larger joint space width, thicker femoral cartilage and reduced bone volume, while osteophytes could be detected quantitatively. Measures between the in situ tibia and femur indicated an altered loading scenario. High measurement reproducibility was observed for all new parameters; with ICC ranging from 0.754 to 0.998. In conclusion, this study provides a novel 3D QMA to quantify macro and micro tissue measures in the joint of a rabbit OA model. New metrics were established consisting of: an angle to quantitatively measure osteophytes (σ), an angle to indicate erosion between the lateral and medial femoral condyles (ρ), a vector defining altered angulation (λ, α, β, γ) and a twist angle (τ) measuring instability and tissue degeneration between the femur and tibia, a length measure of joint space width (JSW), and a slope and intercept (m, Χ) of joint contact to demonstrate altered loading with disease progression, as well as traditional bone and cartilage and histo-morphometry measures. We demonstrate correlation of microCT and histology, sensitive discrimination of OA change and robust reproducibility. PMID:26808542

  20. Correlation Between Clinical Findings of Temporomandibular Disorders and MRI Characteristics of Disc Displacement

    PubMed Central

    Kumar, Raman; Pallagatti, Shambulingappa; Sheikh, Soheyl; Mittal, Amit; Gupta, Deepak; Gupta, Sonam

    2015-01-01

    Objectives : Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers. It is important for the maxillofacial radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its advanced and irreversible phase which is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further the MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms. Henceforth, the aim of the study was to evaluate whether MRI findings of various degrees of disk displacement could be correlated with the presence or absence of clinical signs and symptoms of temporomandibular disorders in symptomatic and asymptomatic subjects. Materials and Methods : In this clinical study, 44 patients (88 TMJs) were examined clinically and divided into two groups. Group 1 consisted of 22 patients with clinical signs and symptoms of TMDs either unilaterally or bilaterally and considered as study group. Group 2 consisted of 22 patients with no signs and symptoms of TMDs and considered as control group. MRI was done for both the TMJs of each patient. Displacement of the posterior band of articular disc in relation to the condyle was quantified as anterior disc displacement with reduction (ADDR), anterior disc displacement without reduction (ADDWR), posterior disc displacement (PDD). Results : Disk displacement was found in 18 (81.8%) patients of 22 symptomatic subjects in Group 1 on MRI and 4 (18.1%) were diagnosed normal with no disc displacement. In Group 2, 2 (9.1%) of 22 asymptomatic patients were diagnosed with disc displacement while 20 (90.1%) were normal. Sensitivity and Specificity tests were applied in both the groups to correlate clinical findings of TMD and MRI characterstics of disc displacement and results showed Sensitivity of 90% and Specificity of 83.3%. Conclusion : Disk displacement on MRI correlated well with presence or absence of clinical signs and symptoms of temporomandibular disorders with high Sensitivity and Specificity of 90% and 83.3% respectively. PMID:26464595

  1. Oral parafunctions, piercing and signs and symptoms of temporomandibular disorders in high school students.

    PubMed

    Mejersjö, Christina; Ovesson, Daniel; Mossberg, Birgitta

    2016-05-01

    Objective The use of chewing-gum and piercing has become common among adolescents and might result in increased oral muscle activity and overloading. Aim To investigate the frequency of oral piercing and parafunctions in relation to symptoms of temporomandibular disorders (TMD) among adolescents. Materials and methods One hundred and twenty-four third level high school students, living either in a city or in a small town, enrolled in either science or media programmes, were included. The students completed a questionnaire regarding different parafunctions and symptoms of TMD. A clinical examination of the temporomandibular system and estimation of the tooth wear was performed in 116 students. Results Chewing-gum was used by 86% of the students (25% with a daily use) and 14% had an oral piercing. The science students used more chewing gum than the media students (p = 0.008), while the media students had more piercings (p < 0.001). Symptoms once a week or more were reported with 39% for headache, 18% for clicking, 7% for facial pain and 6% for difficulty to open wide. Girls reported more headaches (p = 0.007) and more severe symptoms (p = 0.003), had more medical consultations and used more analgesics (both p < 0.05) and had more clinical signs (p = 0.01) than boys. Girls had more oral piercings and used more chewing gum than boys (both p < 0.05). The media students had more sick leave (p < 0.01) than the science students. Chewing-gum use was associated with headache (p < 0.01), with difficulty to open wide (p < 0.05) and with tenderness of the temporomandibular joints and muscles (both p < 0.05). Oral piercing was associated with headache and muscle tenderness (both p < 0.05) and daily nail biting with headache (p < 0.05) and tooth wear (p = 0.004). Conclusions There is an association between use of chewing gum, nail biting, oral piercing, and symptoms of TMD. PMID:26621674

  2. The True-Positive Rate of a Screening Questionnaire for Temporomandib-ular Disorders

    PubMed Central

    Nishiyama, Akira; Otomo, Natsuko; Tsukagoshi, Kaori; Tobe, Shoko; Kino, Koji

    2014-01-01

    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. PMID:25614769

  3. Expanding the Taxonomy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

    PubMed Central

    Peck, Christopher C.; Goulet, Jean-Paul; Lobbezoo, Frank; Schiffman, Eric L.; Alstergren, Per; Anderson, Gary C.; de Leeuw, Reny; Jensen, Rigmor; Michelotti, Ambra; Ohrbach, Richard; Petersson, Arne; List, Thomas

    2014-01-01

    Background There is a need to expand the current temporomandibular disorder (TMD) classification to include less common, but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing, and further criteria refinement. Methods A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria, and the ability to operationalize and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMD taxonomy was presented for feedback at international meetings. Results Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders, and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalized diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. Conclusions The expanded TMD taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalize and test the proposed taxonomy and diagnostic criteria. PMID:24443898

  4. Laser Acupuncture Therapy in Patients with Treatment-Resistant Temporomandibular Disorders

    PubMed Central

    Hung, Yu-Chiang; Tseng, Ying-Jung; Hung, I-Ling; Hsu, Sheng-Feng

    2014-01-01

    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

  5. Correlation of stress and muscle activity of patients with different degrees of temporomandibular disorder

    PubMed Central

    Tosato, Juliana de Paiva; Caria, Paulo Henrique Ferreira; Gomes, Cid Andre Fidelis de Paula; Berzin, Fausto; Politti, Fabiano; Gonzalez, Tabajara de Oliveira; Biasotto-Gonzalez, Daniela Aparecida

    2015-01-01

    [Purpose] Temporomandibular disorder is one of the many different adverse health conditions that can be triggered by stress. Therefore, a biopsychosocial model has been proposed to characterize the multifactorial nature of temporomandibular disorder. The aim of the present study was investigate the correlation of salivary cortisol levels with the activities of the masseter and anterior temporal muscles of patients with different degrees of temporomandibular disorder. [Subjects and Methods] Forty-nine women between 18 and 40 years of age with a diagnosis of myogenous temporomandibular disorder based on the Research Diagnostic Criteria for temporomandibular disorders were evaluated using the Fonseca Index to determine the degree of the disorder. Salivary cortisol levels were determined and surface electromyography was used to evaluate electrical activity in the masticatory muscles. [Results] Positive correlations were found among the degree of temporomandibular disorder, electromyographic activity and salivary cortisol: as women with more severe temporomandibular disorder had greater electrical activity in the muscles analyzed, especially the anterior temporal muscle, and higher levels of cortisol. [Conclusion] Muscle activity was greater among individuals with severe temporomandibular disorder and positive correlations were found among electromyographic activity, salivary cortisol and the degree of temporomandibular disorder severity. PMID:25995595

  6. Ear Acupuncture Therapy for Masticatory Myofascial and Temporomandibular Pain: A Controlled Clinical Trial

    PubMed Central

    Ferreira, Luciano Ambrosio; Grossmann, Eduardo; Januzzi, Eduardo; Gonçalves, Rafael Tardin Rosa Ferraz; Mares, Fernando Antonio Guedes; de Paula, Marcos Vinicius Queiroz; Carvalho, Antonio Carlos Pires

    2015-01-01

    Ear acupuncture works by reducing painful sensations with analgesic effect through microsystem therapy and has been demonstrated to be as effective as conventional therapies in the control of facial pain. This clinical trial aimed to evaluate the adjuvant action of auricular acupuncture through an observation of the evolution of temporomandibular and masticatory myofascial symptoms in two groups defined by the therapies elected: auricular acupuncture associated with occlusal splint (study) and the use of the occlusal splint plate alone (control). We have selected 20 patients, who were randomly allocated into two groups of ten individuals. Symptoms were evaluated in five different moments, every seven days. We analyzed the orofacial muscle and joint palpation in order to measure the intensity of the experienced pain. Both groups showed a statistically significant decrease in muscle and joint symptoms (p < 0.05). However, comparisons between the groups showed an expressive and significant reduction of symptomatology in the study group (p < 0.05) already on the first week of therapy. According to the results, to the methodological criteria developed and statistical analysis applied, the conclusion is that auricular acupuncture therapy has synergistic action on conventional occlusal splint treatment. It was demonstrated to be effective in the reduction of symptoms in the short term. PMID:26351510

  7. Ear Acupuncture Therapy for Masticatory Myofascial and Temporomandibular Pain: A Controlled Clinical Trial.

    PubMed

    Ferreira, Luciano Ambrosio; Grossmann, Eduardo; Januzzi, Eduardo; Gonçalves, Rafael Tardin Rosa Ferraz; Mares, Fernando Antonio Guedes; de Paula, Marcos Vinicius Queiroz; Carvalho, Antonio Carlos Pires

    2015-01-01

    Ear acupuncture works by reducing painful sensations with analgesic effect through microsystem therapy and has been demonstrated to be as effective as conventional therapies in the control of facial pain. This clinical trial aimed to evaluate the adjuvant action of auricular acupuncture through an observation of the evolution of temporomandibular and masticatory myofascial symptoms in two groups defined by the therapies elected: auricular acupuncture associated with occlusal splint (study) and the use of the occlusal splint plate alone (control). We have selected 20 patients, who were randomly allocated into two groups of ten individuals. Symptoms were evaluated in five different moments, every seven days. We analyzed the orofacial muscle and joint palpation in order to measure the intensity of the experienced pain. Both groups showed a statistically significant decrease in muscle and joint symptoms (p < 0.05). However, comparisons between the groups showed an expressive and significant reduction of symptomatology in the study group (p < 0.05) already on the first week of therapy. According to the results, to the methodological criteria developed and statistical analysis applied, the conclusion is that auricular acupuncture therapy has synergistic action on conventional occlusal splint treatment. It was demonstrated to be effective in the reduction of symptoms in the short term. PMID:26351510

  8. Comparison of Diagnostic Performance Between Visual and Quantitative Assessment of Bone Scintigraphy Results in Patients With Painful Temporomandibular Disorder.

    PubMed

    Choi, Bong-Hoi; Yoon, Seok-Ho; Song, Seung-Il; Yoon, Joon-Kee; Lee, Su Jin; An, Young-Sil

    2016-01-01

    This retrospective clinical study was performed to evaluate whether a visual or quantitative method is more valuable for assessing painful temporomandibular disorder (TMD) using bone scintigraphy results.In total, 230 patients (172 women and 58 men) with TMD were enrolled. All patients were questioned about their temporomandibular joint (TMJ) pain. Bone scintigraphic data were acquired in all patients, and images were analyzed by visual and quantitative methods using the TMJ-to-skull uptake ratio. The diagnostic performances of both bone scintigraphic assessment methods for painful TMD were compared.In total, 241 of 460 TMJs (52.4%) were finally diagnosed with painful TMD. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the visual analysis for diagnosing painful TMD were 62.8%, 59.6%, 58.6%, 63.8%, and 61.1%, respectively. The quantitative assessment showed the ability to diagnose painful TMD with a sensitivity of 58.8% and specificity of 69.3%. The diagnostic ability of the visual analysis for diagnosing painful TMD was not significantly different from that of the quantitative analysis.Visual bone scintigraphic analysis showed a diagnostic utility similar to that of quantitative assessment for the diagnosis of painful TMD. PMID:26765456

  9. Comparison of Diagnostic Performance Between Visual and Quantitative Assessment of Bone Scintigraphy Results in Patients With Painful Temporomandibular Disorder

    PubMed Central

    Choi, Bong-Hoi; Yoon, Seok-Ho; Song, Seung-Il; Yoon, Joon-Kee; Lee, Su Jin; An, Young-Sil

    2016-01-01

    Abstract This retrospective clinical study was performed to evaluate whether a visual or quantitative method is more valuable for assessing painful temporomandibular disorder (TMD) using bone scintigraphy results. In total, 230 patients (172 women and 58 men) with TMD were enrolled. All patients were questioned about their temporomandibular joint (TMJ) pain. Bone scintigraphic data were acquired in all patients, and images were analyzed by visual and quantitative methods using the TMJ-to-skull uptake ratio. The diagnostic performances of both bone scintigraphic assessment methods for painful TMD were compared. In total, 241 of 460 TMJs (52.4%) were finally diagnosed with painful TMD. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the visual analysis for diagnosing painful TMD were 62.8%, 59.6%, 58.6%, 63.8%, and 61.1%, respectively. The quantitative assessment showed the ability to diagnose painful TMD with a sensitivity of 58.8% and specificity of 69.3%. The diagnostic ability of the visual analysis for diagnosing painful TMD was not significantly different from that of the quantitative analysis. Visual bone scintigraphic analysis showed a diagnostic utility similar to that of quantitative assessment for the diagnosis of painful TMD. PMID:26765456

  10. [Contribution of air computerized tomography of the joint in the assessment of algo-dysfunctional syndromes of the mastication system].

    PubMed

    Bertrand, J L; Rives, J M; Cantaloube, D; Proust, J

    1990-01-01

    The prospective study of evaluation temporomandibular dysfunction by air computerized tomography of the joint are reported. The authors propose a new injection technique of both articular compartments by CT Scan location. With thin sagittal computed tomography sections, closed mouth and open mouth position, this study is made. Preliminary data from air computerized tomography of the joint imaging show directly the disk with anterior and posterior attachments. The authors present the normal results and major pathology found in the evaluationof temporomandibular dysfunction. CT Scan puncture is more precise. The air computerized tomography imaging of the joint was undoubtedly superior to that of conventional opaque joint tomography, but dynamic notion is much less than in the absence of videoscopy. PMID:2309085

  11. Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection

    PubMed Central

    Mor, Niv; Tang, Christropher; Blitzer, Andrew

    2015-01-01

    This article reviews the diagnoses and treatment of temporomandibular disorders (TMD) and outlines of the role of botulinum toxin (BoNT) in the treatment of myofacial TMD. This manuscript includes a brief history of the use of BoNT in the treatment of pain, the mechanism of action of BoNT, and the techniques for injections, adverse effects and contraindications when using BoNT to treat mayofacial pain caused by TMD. PMID:26213970

  12. A Bamboo Joint-Like Appearance is a Characteristic Finding in the Upper Gastrointestinal Tract of Crohn's Disease Patients: A Case-Control Study.

    PubMed

    Fujiya, Mikihiro; Sakatani, Aki; Dokoshi, Tatsuya; Tanaka, Kazuyuki; Ando, Katsuyoshi; Ueno, Nobuhiro; Gotoh, Takuma; Kashima, Shin; Tominaga, Motoya; Inaba, Yuhei; Ito, Takahiro; Moriichi, Kentaro; Tanabe, Hiroki; Ikuta, Katsuya; Ohtake, Takaaki; Yokota, Kinnichi; Watari, Jiro; Saitoh, Yusuke; Kohgo, Yutaka

    2015-09-01

    The clinical importance of Crohn's disease (CD)-specific lesions in the upper gastrointestinal tract (upper GIT) has not been sufficiently established. The aim of this case-control study is to investigate the characteristic findings of CD in the upper GIT. In 2740 patients who underwent gastroduodenoscopy at Asahikawa Medical University between April 2011 and December 2012, 81 CD patients, 81 gender- and age-matched non-IBD patients, and 66 ulcerative colitis (UC) patients were investigated in the present study. (1) The diagnostic ability and odds ratio of each endoscopic finding (a bamboo joint-like appearance in the cardia, erosions, and/or ulcers in the antrum, notched signs, and erosions and/or ulcers in the duodenum) were compared between the CD and non-IBD patients or UC patients. (2) The interobserver agreement of the diagnosis based on the endoscopic findings was evaluated by 3 experienced and 3 less-experienced endoscopists. The incidence of detecting a bamboo joint-like appearance, notched signs, and erosions and/or ulcers in the duodenum was significantly higher in the CD patients than in the non-IBD and UC patients. In addition, the diagnostic ability and odds ratio of a bamboo joint-like appearance for CD were higher than those for the other findings. Kendall's coefficients of concordance in the group of experienced and less-experienced endoscopists were relatively high for a bamboo joint-like appearance (0.748 and 0.692, respectively). A cardiac bamboo joint-like appearance is a useful finding for identifying high-risk groups of CD patients using only gastroduodenoscopy. PMID:26376393

  13. Temporomandibular disorders in fibromyalgia syndrome: a short-communication.

    PubMed

    Gui, Maísa Soares; Pimentel, Marcele Jardim; Rizzatti-Barbosa, Célia Marisa

    2015-01-01

    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

  14. Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

    PubMed Central

    Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2016-01-01

    Background The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. Material and Methods A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (? = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Results Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (p<0.001 - OR=5.77, 95%CI 3.86-8.62), AT or masseter palpation-induced pain (p<0.001 - OR=2.39, 95%CI 1.57-3.63), bilateral AT palpation-induced pain (p<0.001 - OR=2.67, 95%CI 1.64-4.32), masseter and AT palpation-induced pain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain (p=0.01 - OR=1.74, 95%CI 1.13-2.69). Conclusions Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among painful TMD, primary headaches and bruxism. Key words:Diagnosis, temporomandibular joint disorders, migraine, tension-type headache, bruxism. PMID:26615507

  15. Comparative degenerative joint disease of the vertebral column in the medieval monastic cemetery of the Gilbertine priory of St. Andrew, Fishergate, York, England.

    PubMed

    Knüsel, C J; Göggel, S; Lucy, D

    1997-08-01

    The pattern of degenerative joint disease (DJD) of the intervertebral and apophyseal joints of the vertebral column of 81 skeletons from the thirteenth to fourteenth century medieval priory cemetery of St. Andrew, Fishergate, York, was recorded in relation to their location of interment: eastern cemetery, southern cemetery, and intramurally (within the priory buildings). Archaeological context and ethnohistorical accounts support the interpretation that people of different social status were buried in these areas. Linear discriminant function analysis and paired Kolmogorov-Smirnov tests showed that the differences in vertebral column DJD pattern and severity among the three subgroups were not statistically significant. As the archaeological and historical evidence seems reliable, it is argued that the analysis of DJD of the vertebral column might not be ideal to study the effects of normal activity patterns, a conclusion which supports the results of recent bioarchaeological research. Further, high-low plots demonstrate that the differences in DJD pattern were located between intervertebral and apophyseal joints of individuals rather than between subgroups of the cemetery. It is thought that this difference was produced as a response to erect posture during bipedal locomotion, reflecting vertebral curvatures, rather than differing occupational stresses. Thus, due to biological constraints on its function, the vertebral column might not be an ideal structure to study markers of occupational stress. PMID:9292166

  16. The time-averaged inflammatory disease activity estimates the progression of erosions in MRI of the sacroiliac joints in ankylosing spondylitis.

    PubMed

    Wick, Marius C; Grundtman, Cecilia; Weiss, Rüdiger J; Gruber, Johann; Kastlunger, Martin; Jaschke, Werner; Klauser, Andrea S

    2012-07-01

    A method to estimate the individual ankylosing spondylitis (AS) patient radiological progression of semi-quantitative magnetic resonance imaging (MRI) changes in the sacroiliac joints has not been described yet, which this study examines. Inflammatory disease activity and MRIs of the sacroiliac joints of 38 patients with recent onset established AS were analyzed at baseline and during follow-up. Sacroiliac MRIs were semi-quantitatively assessed using a modification of the "Spondylarthritis Research Consortium of Canada" (SPARCC) method. In each patient, the annual inflammatory disease activity was estimated by the time-averaged C-reactive protein (CRP; mg/l), calculated as the area under the curve. The mean (SD) CRP decreased from 1.3 (1.8) at baseline to 0.5 (0.6) at follow-up MRI (p < 0.04), which has been performed after a mean (SD) disease course of 2.8 (1.5) years. The mean (SD) annual increase (?) of SPARCC score from baseline to follow-up MRI was 0.4 (0.4). Baseline individual SPARCC sub-score for bone marrow edema did not statistically significantly correlate with individual ?SPARCC sub-score for erosions (p = N.S.). The individual AS patient correlation between annual time-averaged inflammatory disease activity and each annual ?SPARCC sub-scores was only statistically significant for erosions (p < 0.01; r = 0.71). Our results show that bone marrow edema and contrast-medium enhancement at baseline do not relate to the progression of erosions but the calculation of the individual patient annual time-averaged inflammatory disease activity allows to estimate the annual progression of erosions in sacroiliac MRIs of patients with AS. PMID:22422197

  17. [Role of computeric tomography and magnetic resonance imaging in diagnosis of inflammatory diseases of sacro-ileal joint].

    PubMed

    Ba?ramov, R B

    2012-05-01

    Sensitivity of computeric tomography (CT) and magnetic resonance imaging (MRI) for sacroileitis diagnosis was studied, optimal for MRI investigation was established. In 31 patients, owing obvious clinical signs of inflammatory sacroileitis (at average more than 5 mo duration of a low back pain) MRI of sacroiliac joint was conducted in a T1, T2 FS, 2D T2 FLASH regimes and after intravenous infusion of a contrast substance (gadolinium) - in a T1 FS regime, using system, owing a 1,5 T magnetic field intensity. The data obtained were compared with results of CT. Sacroileitis signs were revealed in 27 patients - according to CT data, and in 22 - MRI. CT have demonstrated as a more sensitive method of the bone erosion and sclerosis diagnosis, than MRI. MRI is more sensitive while revealing an active inflammatory process in the bone and joint space. While T1 FS application no additional information for sacroileitis diagnosis was obtained. PMID:22888553

  18. Soft versus hard occlusal splint therapy in the management of temporomandibular disorders (TMDs)

    PubMed Central

    Seifeldin, Sameh A; Elhayes, Khaled A.

    2015-01-01

    Aim To compare between soft and hard occlusal splint therapy for the management of myofacial pain dysfunction (MPD) or internal derangement (ID) of the temporomandibular joint (TMJ) with reciprocal clicking. Patients and methods This study included 50 patients (age range: 24–47 years) who had been diagnosed with MPD or ID of the TMJ in the form of reciprocal clicking. Patients were divided into two groups. They were treated for 4 months with either a vacuum-formed soft occlusal splint constructed from 2-mm-thick elastic rubber sheets (soft splint group) or a hard flat occlusal splint fabricated from transparent acrylic resin (hard splint group). Monthly follow-up visits were performed during the treatment period. Before treatment and 1, 2, 3 and 4 months after treatment, the dentist measured all parameters of TMJ function (pain visual analog scores, tenderness of masticatory muscles, clicking and tenderness of the TMJ, and range of mouth opening). Results All parameters of TMJ function showed significant improvement in both groups during the follow-up period, with a statistically significant difference between the two groups at the 4-month follow-up visit. Conclusions Both forms of occlusal splints (soft and hard) improved TMJ symptoms in patients with MPD or ID of the TMJ. However, the soft occlusal splints exhibited superior results after 4 months of use. PMID:26644756

  19. Eagle’s syndrome—A non-perceived differential diagnosis of temporomandibular disorder

    PubMed Central

    Thoenissen, P.; Bittermann, G.; Schmelzeisen, R.; Oshima, T.; Fretwurst, T.

    2015-01-01

    Introduction This article unveils a case of the classic styloid syndrome and states that panoramic imaging and ultrasound can be an alternative to computed tomography. In addition, the endoscope-assisted extraoral approach using CT-based navigation is useful. Eagle’s Syndrome is an aggregate of symptoms described by Eagle in 1937. He described different forms: the classic styloid syndrome consisting of elongation of the styloid process which causes pain. Second, the stylo-carotid-artery syndrome which is responsible for transient ischemic attack or stroke. Presentation of case Using the example of a 66 years old male patient suffering from long term pain, we explain our diagnostic and surgical approach. After dissecting the styloid process of the right side using an extraoral approach, the pain ceased and the patient could be discharged without any recurrence of the pain up to this point. Discussion Eagle’s syndrome, with its similar symptoms, is rather difficult to differentiate from temporomandibular joint disorders (TMD), but can be easily excluded from possible differential diagnoses of TMD using panoramic radiographs and ultrasound. Conclusion Making use of low cost and easily accessible diagnostic workup techniques can reveal this particular cause for chronic pain restricting quality of life. Thereby differentiation from the TMD symptomatic complex is possible. PMID:26342352

  20. Increased risk of tinnitus in patients with temporomandibular disorder: a retrospective population-based cohort study.

    PubMed

    Lee, Chun-Feng; Lin, Ming-Chia; Lin, Hui-Tzu; Lin, Cheng-Li; Wang, Tang-Chuan; Kao, Chia-Hung

    2016-01-01

    This study determined whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). We used information from health insurance claims obtained from Taiwan National Health Insurance (TNHI). Patients aged 20 years and older who were newly diagnosed with TMJ disorder served as the study cohort. The demographic factors and comorbidities that may be associated with tinnitus were also identified, including age, sex, and comorbidities of hearing loss, noise effects on the inner ear, and degenerative and vascular ear disorders. A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). Patients with TMJ disorder might be at increased risk of tinnitus. PMID:25573837

  1. Adaptation of DICOM 3.0 to jaw joint movement images

    NASA Astrophysics Data System (ADS)

    Negishi, Tohru; Katoh, Tsuguhisa; Fukushi, Masahiro; Senoo, Atsushi; Nomura, Yukihiro; Shimanishi, Satoshi

    2000-05-01

    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.

  2. Development and application of a radioimmunoassay for interleukin-8: detection of interleukin-8 in synovial fluids from patients with inflammatory joint disease.

    PubMed

    Rampart, M; Herman, A G; Grillet, B; Opdenakker, G; Van Damme, J

    1992-04-01

    A sensitive and specific radioimmunoassay for human interleukin-8 (IL-8) was developed using isotopically labeled homogenous natural protein. The detection limit (20% inhibition of 125I-IL-8 binding) was 30 pg/100 microliters; 50% displacement occurred at 140 pg/100 microliters. There was no cross-reactivity with the structurally and functionally related neutrophil-activating peptides 2 and 3 up to 500 ng/100 microliters. The intra- and inter-assay coefficients of variation were 4 and 7%, respectively. In vitro experiments showed that human fibroblasts triggered by interleukin-1, double-stranded RNA or virus release immunoreactive and biologically active IL-8 in a dose- and time-dependent manner. Monocytes produce immunoreactive IL-8 in the 100 ng/ml range when exposed to plant mitogen, bacterial endotoxin, virus or IL-1. Although the radioimmunoassay was more sensitive than the chemotaxis assay (detection limit 0.6 ng/ml versus 10 ng/ml) a correlation between concentrations of immunoreactive IL-8 and neutrophil chemotactic activity in the supernatants from stimulated monocytes and fibroblasts was observed. In synovial fluids from patients with inflammatory joint disease, IL-8 was clearly demonstrable, but there was no correlation between IL-8 levels and general parameters of disease activity (erythrocyte sedimentation rate and serum levels of C-reactive protein). Synovial fluids from patients with rheumatoid arthritis, seropositive for rheumatoid factor, contained significantly higher concentrations of IL-8 than synovial fluids from seronegative rheumatoid arthritis patients and patients with non-rheumatoid arthritis joint inflammation. There was a highly significant correlation between IL-8 levels and serum titers of rheumatoid factor. These findings suggest that the molecular mechanisms underlying joint inflammation may be distinct in different types of arthritis. PMID:1583890

  3. Novel cartilage oligomeric matrix protein (COMP) neoepitopes identified in synovial fluids from patients with joint diseases using affinity chromatography and mass spectrometry.

    PubMed

    Åhrman, Emma; Lorenzo, Pilar; Holmgren, Kristin; Grodzinsky, Alan J; Dahlberg, Leif E; Saxne, Tore; Heinegård, Dick; Önnerfjord, Patrik

    2014-07-25

    To identify patients at risk for progressive joint damage, there is a need for early diagnostic tools to detect molecular events leading to cartilage destruction. Isolation and characterization of distinct cartilage oligomeric matrix protein (COMP) fragments derived from cartilage and released into synovial fluid will allow discrimination between different pathological conditions and monitoring of disease progression. Early detection of disease and processes in the tissue as well as an understanding of the pathologic mechanisms will also open the way for novel treatment strategies. Disease-specific COMP fragments were isolated by affinity chromatography of synovial fluids from patients with rheumatoid arthritis, osteoarthritis, or acute trauma. Enriched COMP fragments were separated by SDSPAGE followed by in-gel digestion and mass spectrometric identification and characterization.Using the enzymes trypsin, chymotrypsin, and Asp-N for the digestions, an extensive analysis of the enriched fragments could be accomplished. Twelve different neoepitopes were identified and characterized within the enriched COMP fragments. For one of the neoepitopes, Ser77, an inhibition ELISA was developed. This ELISA quantifies COMP fragments clearly distinguishable from total COMP. Furthermore, fragments containing the neoepitope Ser77 were released into the culture medium of cytokine (TNF-? and IL-6/soluble IL-6 receptor)-stimulated human cartilage explants. The identified neoepitopes provide a complement to the currently available commercial assays for cartilage markers. Through neoepitope assays, tools to pinpoint disease progression, evaluation methods for therapy, and means to elucidate disease mechanisms will be provided. PMID:24917676

  4. Adaptive plasticity in mammalian masticatory joints

    NASA Astrophysics Data System (ADS)

    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

    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.

  5. Serum and synovial fluid C-reactive protein level variations in dogs with degenerative joint disease and their relationships with physiological parameters.

    PubMed

    Boal, S; Miguel Carreira, L

    2015-09-01

    Degenerative joint disease (DJD) is a progressive, chronic joint disease with an inflammatory component promoting an acute phase protein (APP) response. C-reactive protein (CRP) is one of the most important APPs, used as an inflammation marker in human, but not veterinary medicine. The study was developed in a sample of 48 dogs (n = 48) with DJD and aimed to: 1) identify and quantify the synovial fluid CRP (SFCRP) in these specimens using a validated ELISA test for serum CRP (SCRP) detection and quantification; and 2) to study the possible relationship between SCRP and SFCRP levels variations in DJD patients evaluating the influence of some physical parameters such as gender, body weight, pain level, DJD grade, and the physical activity (PA) of the patients. Statistical analysis considered the results significant for p values <0.05. Our study showed that it is possible to detect and quantify SFCRP levels in DJD patients using a previously validated canine SCRP ELISA test, allowing us to point out a preliminary reference value for SFCRP in patients with DJD. Although, individuals with DJD presents SCRP values within the normal reference range and the SFCRP levels were always lower. Obesity, pain, and the DJD grade presented by the patients are conditions which seem to influence the SCRP levels but not the SFCRP. PMID:26178643

  6. Anti-Lubricin Monoclonal Antibodies Created Using Lubricin-Knockout Mice Immunodetect Lubricin in Several Species and in Patients with Healthy and Diseased Joints

    PubMed Central

    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

    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 μl 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

  7. Joint use of skull base surgery in a case of pediatric parotid gland carcinoma.

    PubMed

    Ueda, Yuri; Tsukahara, Kiyoaki; Nakamura, Kazuhiro; Motohashi, Ray; Endo, Minoru; Sato, Hiroki; Katsube, Yasuaki; Suzuki, Mamoru

    2014-01-01

    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

  8. Proceedings of Joint International Symposium on the role of noninvasive imaging modalities in clinical decision making of coronary artery disease

    SciTech Connect

    Mena, I.G.; Strauss, H.W.

    1986-01-01

    This report contains ten papers on the use of noninvasive imaging in clinical diagnosis and decision making. Topics include a cost analysis of magnetic resonance imaging in medical technology, diagnostic uses of MRI in chronic coronary artery disease, clinical applications of cine computed tomography, the use of PET as a clinical tool, and the use of echocardiography in coronary artery disease. Individual papers are processed separately for the data base. (TEM)

  9. Effects of Deep Brain Stimulation and Medication on Strength, Bradykinesia, and Electromyographic Patterns of the Ankle Joint in Parkinson’s Disease

    PubMed Central

    Vaillancourt, David E.; Prodoehl, Janey; Sturman, Molly M.; Bakay, Roy A.E.; Metman, Leo Verhagen; Corcos, Daniel M.

    2008-01-01

    We investigated the control of movement in 12 patients with Parkinson’s disease (PD) after they received surgically implanted high-frequency stimulating electrodes in the subthalamic nucleus (STN). The experiment studied ankle strength, movement velocity, and the associated electromyographic patterns in PD patients, six of whom had tremor at the ankle. The patients were studied off treatment, ON STN deep brain stimulation (DBS), on medication, and on medication plus STN DBS. Twelve matched control subjects were also examined. Medication alone and STN DBS alone increased patients’ ankle strength, ankle velocity, agonist muscle burst amplitude, and agonist burst duration, while reducing the number of agonist bursts during movement. These findings were similar for PD patients with and without tremor. The combination of medication plus STN DBS normalized maximal strength at the ankle joint, but ankle movement velocity and electromyographic patterns were not normalized. The findings are the first to demonstrate that STN DBS and medication increase strength and movement velocity at the ankle joint. PMID:16124011

  10. Joint Effects of Intraocular Pressure and Myopia on Risk of Primary Open-Angle Glaucoma: The Singapore Epidemiology of Eye Diseases Study.

    PubMed

    Tham, Yih-Chung; Aung, Tin; Fan, Qiao; Saw, Seang-Mei; Siantar, Rosalynn Grace; Wong, Tien Y; Cheng, Ching-Yu

    2016-01-01

    We examined the joint effects of intraocular pressure (IOP) and myopia on the risk of primary open angle glaucoma (POAG) in a multi-ethnic Asian population. A total of 9,422 participants (18,469 eyes) in the Singapore Epidemiology of Eye Diseases Study were included. Of them, 213 subjects (273 eyes) had POAG. All participants underwent standardised examinations. The independent and joint effects of IOP and myopia on POAG were examined using logistic regression models. Generalised estimating equation models were used to account for correlation between eyes. Higher IOP, longer axial length, and more negative spherical equivalent were independently associated with POAG, after adjusting for relevant covariates (all P???0.005). Significant interaction between IOP and myopia on POAG was observed (P interaction?=?0.025). Eyes with moderate-to-high myopia (<-3.0 dioptres) with high IOP (?20?mmHg) were 4.27 times (95% CI, 2.10-8.69) likely to have POAG, compared to eyes without myopia (>-0.5 dioptres) and with IOP <20?mmHg. Eyes with AL of ?25.5?mm and high IOP (?20?mmHg) were 16.22 times (95% CI, 7.73 to 34.03) likely to have POAG, compared to eyes with shorter AL (<23.5?mm) and lower IOP (<20?mmHg). These findings may provide additional insights into the pathophysiology of POAG and are particularly relevant for Asian populations. PMID:26758554

  11. Effects of controlled condylar rotation exercise on symmetrical mouth opening in patients with temporomandibular disorder

    PubMed Central

    Oh, Jae-Seop; Kim, Si-Hyun; Park, Kyue-Nam

    2015-01-01

    [Purpose] The purpose of this study was to determine the effects of a 4-week program of active condylar rotation exercise on the extent of the lateral mandibular shift during mouth opening in patients with temporomandibular disorder. [Subjects and Methods] Patients with temporomandibular disorder (n = 12; 7 men and 5 women) were recruited. The active range of temporomandibular motion was recorded using 3-dimensional ultrasound-based motion analysis. The paired t-test was used to assess changes in lateral mandibular shift before and after active condylar rotation exercise. [Results] The degree of the lateral mandibular shift during mouth opening and the mouth opening-lateral mandibular shift ratio were significantly lower after active condylar rotation exercise than before the exercise. [Conclusion] Active condylar rotation exercise may effectively reduce the degree of the lateral mandibular shift during mouth opening to produce symmetrical mouth opening in patients with mild temporomandibular disorder. PMID:26157210

  12. Bamboo Joint-Like Appearance of the Stomach: A Stable Endoscopic Landmark for Crohn’s Disease Regardless of Anti-Tumor Necrosis Factor alpha Treatment

    PubMed Central

    Hashiguchi, Keiichi; Takeshima, Fuminao; Akazawa, Yuko; Matsushima, Kayoko; Minami, Hitomi; Yamaguchi, Naoyuki; Shiozawa, Ken; Ohnita, Ken; Ichikawa, Tatsuki; Isomoto, Hajime; Nakao, Kazuhiko

    2014-01-01

    Background Bamboo joint-like appearance is a common yet easy-to-miss endoscopic finding in the stomach of patients with Crohn’s disease (CD). Bamboo joint-like appearance (BJA) is characterized by swollen longitudinal folds transversed by erosive fissures or linear furrows. However, whether BJA is observed during the remission stage of CD and during the active stage is unclear. In particular, the relationship between the course of BJA and anti-tumor necrosis factor (TNF) ? therapy has not been studied. We aimed to evaluate the course of BJA in CD patients treated with anti-TNF ? therapy. Material/Methods We examined 22 CD patients who underwent esophagogastroduodenal endoscopy before undergoing anti-TNF ? treatment. We evaluated the changes in BJA, clinical activity using the CD activity index (CDAI), and endoscopic activity using the simple endoscopic score for CD (SES-CD) from 6 months to 1 year after anti-TNF ? therapy. Results Fifteen of 22 patients (68.1%) presented with BJA in the stomach, 13 of whom received follow-up esophagogastroduodenal endoscopy after anti-TNF ? therapy. The mean CDAI and SES-CD scores significantly improved after anti-TNF ? therapy (P<0.01). Despite the marked improvements in clinical and endoscopic findings, the BJA of the stomach remained unchanged in all the patients. Conclusions The findings indicate that BJA is frequently observed in the stomach of CD patients, regardless of whether the patient has active disease or is in remission, even after anti-TNF ? therapy. Thus, BJA may be a stable endoscopic landmark in CD. PMID:25308423

  13. Ceramic joints

    DOEpatents

    Miller, Bradley J. (Worcester, MA); Patten, Jr., Donald O. (Sterling, MA)

    1991-01-01

    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 joint interface and not joining the narrow-tapered surface to the material having the higher coefficient of thermal expansion.

  14. Estimating genetic effect sizes under joint disease-endophenotype models in presence of gene-environment interactions

    PubMed Central

    Bureau, Alexandre; Croteau, Jordie; Couture, Christian; Vohl, Marie-Claude; Bouchard, Claude; Pérusse, Louis

    2015-01-01

    Effects of genetic variants on the risk of complex diseases estimated from association studies are typically small. Nonetheless, variants may have important effects in presence of specific levels of environmental exposures, and when a trait related to the disease (endophenotype) is either normal or impaired. We propose polytomous and transition models to represent the relationship between disease, endophenotype, genotype and environmental exposure in family studies. Model coefficients were estimated using generalized estimating equations and were used to derive gene-environment interaction effects and genotype effects at specific levels of exposure. In a simulation study, estimates of the effect of a genetic variant were substantially higher when both an endophenotype and an environmental exposure modifying the variant effect were taken into account, particularly under transition models, compared to the alternative of ignoring the endophenotype. Illustration of the proposed modeling with the metabolic syndrome, abdominal obesity, physical activity and polymorphisms in the NOX3 gene in the Quebec Family Study revealed that the positive association of the A allele of rs1375713 with the metabolic syndrome at high levels of physical activity was only detectable in subjects without abdominal obesity, illustrating the importance of taking into account the abdominal obesity endophenotype in this analysis. PMID:26284107

  15. Resilient appliance therapy of temporomandibular disorders. Subdiagnoses, sense of coherence and treatment outcome.

    PubMed

    Nilsson, Håkan

    2010-01-01

    Temporomandibular disorders (TMD) with orofacial pain with or without reduced jaw function, are frequent conditions in the general population. Different factors such as tooth clenching and grinding, sometimes due to enhanced psychosocial stress, and trauma to the jaws may be important as etiologic factors. Signs and symptoms of TMD are a common cause for general practitioners to use different intraoral appliances as pain and bite-force reducing devices and for improvement of a reduced jaw function. Intraoral appliances are often used parallel to other treatment modalities. Before treatment start a thorough history taking and clinical examination is necessary for a relevant diagnosis. Sometimes the diagnostic process has to be complemented with proper radiographic imaging in order to support the diagnostic process. The overall aim of this thesis was to compare magnetic resonance imaging (MRI) findings of the TMJ on the clinically assessed diagnoses and to evaluate short- and long-term treatment outcome of a resilient intraoral appliance, in patients with TMD pain. A further aim was to study Sense of Coherence as an influencing factor on treatment outcome, on these patients. In article I the aim was to compare findings on MRI in TMD pain patients with clinical diagnoses of myofascial pain or arthralgia/osteoarthritis in combination with myofascial pain according to the Research Diagnostic Criteria for TMD (RDC/TMD). The temporomandibular joints of 60 consecutive patients, 19 with myofascial pain and 41 patients with arthralgia/osteoarthritis in combination with myofascial pain were examined clinically and with MRI. The most common MRI findings were disc displacements with or without reduction and structural bone changes. These findings were found in both pain groups, however, disc displacements were found significantly more often in patients with arthralgia/osteoarthritis in combination with myofascial pain. Joint fluid was found in both pain groups. The clinical diagnoses for subdivision into myogenous only or combined arthrogenous and myogenous pain groups were not confirmed by MRI findings. In article II the short-term efficacy of a resilient appliance compared to a non-occluding control appliance was studied in a randomised, controlled trial with 80 recruited TMD pain patients. They were randomly allocated to one of two groups: treatment with a resilient appliance or treatment with a hard, palatal, nonoccluding appliance. After 6 and 10 weeks of treatment, characteristic pain intensity (CPI) decreased in both groups. There was no statistically significant difference found between the resilient appliance and the non-occluding control appliance in reducing TMD pain in a short-term perspective. In article III possible factors of importance for treatment outcome were studied as well as the association between Sense of Coherence and grade of depression, and grade of non-specific physical symptoms and general health, in the TMD pain patients. A total of 73 TMD pain patients participated; 36 were treated with a resilient appliance and 37 with a non-occluding control appliance. The findings indicated that none of the studied background variables (age, gender, SoC, depression, nonspecific physical symptoms or general health) seemed to influence the short-term efficacy of intraoral appliances. In the TMD pain patients, no associations were found between SoC and depression, non-specific physical symptoms or general health. In article IV the long-term efficacy was evaluated of the resilient appliance compared to the non-occluding control appliance in the TMD pain patients. Appliance wear was also studied in this article. As in the short-term follow-up, there was no statistically significant difference between the resilient appliance and the non-occluding control appliance in reducing TMD pain in the long-term perspective. PMID:20626187

  16. P2X(7) receptor-mediated release of cathepsins from macrophages is a cytokine-independent mechanism potentially involved in joint diseases.

    PubMed

    Lopez-Castejon, Gloria; Theaker, Jill; Pelegrin, Pablo; Clifton, Andrew D; Braddock, Martin; Surprenant, Annmarie

    2010-08-15

    The ATP-gated P2X(7) receptor (P2X(7)R) is a promising therapeutic target in chronic inflammatory diseases with highly specific antagonists currently under clinical trials for rheumatoid arthritis. Anti-inflammatory actions of P2X(7)R antagonists are considered to result from inhibition of P2X(7)R-induced release of proinflammatory cytokines from activated macrophages. However, P2X(7)Rs are also expressed in resting macrophages, suggesting that P2X(7)R may also signal via cytokine-independent mechanisms involved in joint disease. In this study, we examined P2X(7)R function in resting human lung macrophages and mouse bone marrow-derived macrophages and found that ATP induced rapid release of the lysosomal cysteine proteases cathepsin B, K, L, and S and that was independent of the presence of the proinflammatory cytokines IL-1beta and IL-18. Cathepsins released into the medium were effective to degrade collagen extracellular matrix. ATP-induced cathepsin release was abolished by P2X(7)R antagonists, absent from P2X(7)R(-/-) mouse macrophages, and not associated with cell death. Our results suggest P2X(7)R activation may play a novel and direct role in tissue damage through release of cathepsins independently of its proinflammatory actions via IL-1 cytokines. PMID:20639492

  17. An Atraumatic Symphysiolysis with a Unilateral Injured Sacroiliac Joint in a Patient with Cushing's Disease: A Loss of Pelvic Stability Related to Ligamentous Insufficiency?

    PubMed Central

    Höch, Andreas; Pieroh, Philipp; Dehghani, Faramarz; Josten, Christoph; Böhme, Jörg

    2016-01-01

    Glucocorticoids are well known for altering bone structure and elevating fracture risk. Nevertheless, there are very few reports on pelvic ring fractures, compared to other bones, especially with a predominantly ligamentous insufficiency, resulting in a rotationally unstable pelvic girdle. We report a 39-year-old premenopausal woman suffering from an atraumatic symphysiolysis and disruption of the left sacroiliac joint. She presented with external rotational pelvic instability and immobilization. Prior to the injury, she received high-dose glucocorticoids for a tentative diagnosis of rheumatoid arthritis over two months. This diagnosis was not confirmed. Other causes leading to the unstable pelvic girdle were excluded by several laboratory and radiological examinations. Elevated basal cortisol and adrenocorticotropic hormone levels were measured and subsequent corticotropin-releasing hormone stimulation, dexamethasone suppression test, and petrosal sinus sampling verified the diagnosis of adrenocorticotropic hormone-dependent Cushing's disease. The combination of adrenocorticotropic hormone-dependent Cushing's disease and the additional application of exogenous glucocorticoids is the most probable cause of a rare atraumatic rotational pelvic instability in a premenopausal patient. To the authors' knowledge, this case presents the first description of a rotationally unstable pelvic ring fracture involving a predominantly ligamentous insufficiency in the context of combined exogenous and endogenous glucocorticoid elevation. PMID:26904337

  18. The joint effects of water and sanitation on diarrheal disease: A multi-country analysis of the Demographic and Health Surveys

    PubMed Central

    Fuller, James A.; Westphal, Joslyn A.; Kenney, Brooke; Eisenberg, Joseph N. S.

    2014-01-01

    Objectives To assess the joint effects of water and sanitation infrastructure, whether they are redundant services preventing the same cases of diarrheal disease, act independently, or act synergistically; and to assess how these effects vary by country and over time. Methods We used data from 217 Demographic and Health Surveys conducted in 90 countries between 1986 and 2013. We used modified Poisson regression to assess the impact of water and sanitation infra-structure on the prevalence of diarrhea among children under five. Results The impact of water and sanitation varied across surveys, and adjusting for socioeconomic status drove these estimates towards the null. Sanitation had a greater effect than water infrastructure when all 217 surveys were pooled; however, the impact of sanitation diminished over time. Based on survey data from the past ten years, we saw no evidence for benefits in improving drinking water or sanitation alone, but we estimated a 6% reduction of both combined (prevalence ratio = 0.94, 95% confidence limit 0.91-0.98). Conclusions Water and sanitation interventions should be combined to maximize the number of cases of diarrheal disease prevented in children under five. Further research should identify the sources of variability seen between countries and across time. These national surveys likely include substantial measurement error in the categorization of water and sanitation, making it difficult to interpret the roles of other pathways. PMID:25430739

  19. Tomographic evaluation of the temporomandibular joint in malocclusion subjects: condylar morphology and position.

    PubMed

    Merigue, Luciana Fonseca; Conti, Ana Cláudia de Castro Ferreira; Oltramari-Navarro, Paula Vanessa Pedron; Navarro, Ricardo de Lima; Almeida, Marcio Rodrigues de

    2016-01-01

    The aim of this study was to investigate condyle concentricity and morphology, and their association with Class I and II malocclusions (Angle). The sample consisted of 49 individuals of both genders, between 11 and 35 years old, divided into two groups, G1: 26 patients with Class I malocclusion, and G2: 23 patients with Class II malocclusion, selected for orthodontic treatment. Evaluation of the condyle morphology and position was performed by the same previously calibrated examiner using cone-beam computed tomography (CBCT) images of the subjects. The CBCT scans were analyzed by means of a 3D program (Dolphin 11.5, Dolphin Imaging & Management Solutions, Chatsworth, CA, USA), with a 25% level of sensitivity. The images obtained from the coronal slices were employed for the condyle morphology analysis, which classified the condyle form as rounded, as flat or convex, and as triangular or angled. The sagittal slices were used to classify further the condyles as concentric and displaced anteriorly or posteriorly. A clinical examination was also performed, including TMJ and muscle palpation. The kappa test was used to evaluate investigator calibration; the Chi-square and paired t-tests were used for analysis. The convex and anteriorly positioned condyles were found most frequently, regardless of the type of malocclusion. No association was observed between the groups regarding condylar characteristics. PMID:26981751

  20. Temporomandibular joint: conservative care of TMJ dysfunction in a competitive swimmer

    PubMed Central

    Yuill, Erik; Howitt, Scott D.

    2009-01-01

    Objective To detail the progress of a patient with TMJ dysfunction and headaches due to swimming, who underwent a conservative treatment plan featuring soft tissue therapy, spinal manipulative therapy, and rehabilitation. Clinical Features The most important features were initial bilateral temporal headaches and persistent left sided TMJ pain brought about by bilateral breathing while swimming. Conventional treatment aimed at decreasing hypertonic muscles, increasing hyoid mobility, improving TMJ mobility, resolving cervical restrictions, and improving digastric facilitation. Intervention and Outcome The conservative treatment approach utilized in this case involved soft tissue therapy, hyoid mobility treatment, TMJ mobilization, spinal manipulative therapy, and digastric facilitation. Outcome measures included subjective pain ratings, range of motion, and motion palpation of the cervical spine. Conclusion A patient with bilateral temporal headaches and TMJ pain due to bilateral breathing while swimming appeared to be relieved of his pain after three treatments of soft tissue therapy, hyoid mobility treatment, spinal manipulative therapy, and digastric facilitation. PMID:19714231

  1. Immediate changes in temporomandibular joint opening and pain following vibration therapy: a feasibility pilot study

    PubMed Central

    Muir, Brad; Brown, Courtney; Brown, Tara; Tatlow, Dionne; Buhay, Jeremy

    2014-01-01

    Objective The purpose of this pilot study was to determine the scientific and process feasibility in an effort to direct future larger trials. Methods: Scientific Feasibility: Twelve subjects were randomly allocated to an intervention and a control group. The intervention protocol consisted of intraoral vibration therapy on the muscles of mastication bilaterally for a period of 1 minute per muscle. Process Feasibility: Several feasibility outcomes were examined including recruitment and retention rates and consent. Results: Scientific Feasibility: Large effect sizes were generated for both mouth opening and VAS in favour of the intervention group. Process Feasibility: a recruitment ratio of 2.3 respondents to 1 participant was determined, along with a retention to loss ratio of 13:1 and a consent to loss ratio of 12:0. Conclusion: Scientific Feasibility: The scientific results should be interpreted with caution due to the small sample sizes employed. The study seems to support the scientific feasibility of a future larger single treatment trial. Process Feasibility: Recruitment and retention rates and ratios seem to support future studies. Utilizing the feasibility results of the current study to direct a future larger multiple treatment trial consistent with other comparable TMD studies however is limited. PMID:25550672

  2. Interaction of 308-nm excimer laser light with temporomandibular joint related structures

    NASA Astrophysics Data System (ADS)

    Liesenhoff, Tim; Funk, Armin

    1994-02-01

    Arthroscopy of TMJ has become a clinically important and more and more accepted method for diagnosis and treatment of TMJ alteration. This minimal invasive method is clearly limited by the anatomical dimensions of the TMJ. A 308 nm excimer laserlight has already found clinical applications in angioplasty, ophthalmology, and dentistry. The aim of the presented study was to find out if it is possible to ablate TMJ related structures under arthroscopic conditions. It also aims to evaluate the energy-threshold for ablation and the maximal possible rate of ablation. Contrary to other laser systems it offers a unique combination of minimal tissue alteration, precise tissue ablation guidability through optical fibers, and a good transmission through water.

  3. [The role of muscle rehabilitation in the treatment of temporomandibular joint pain-dysfunction syndrome].

    PubMed

    Psaume-Vandenbeek, D; Dichamp, J; Goudot, P; Guilbert, F

    1990-01-01

    Physiotherapy in association with mechanotherapy provides a functional treatment for T.M. algo-dysfunctional syndromes. The authors review the indications for this treatment and distinguish two varieties requiring different treatments: syndromes with a defect in propulsion and a limitation of mouth opening and syndromes with hyperpropulsion and subluxation. PMID:2130439

  4. Consequences of fiducial marker error on three-dimensional computer animation of the temporomandibular joint

    NASA Astrophysics Data System (ADS)

    Leader, J. Ken, III; Boston, J. Robert; Rudy, Thomas E.; Greco, Carol M.; Zaki, Hussein S.

    2001-05-01

    Jaw motion has been used to diagnose jaw pain patients, and we have developed a 3D computer animation technique to study jaw motion. A customized dental clutch was worn during motion, and its consistent and rigid placement was a concern. The experimental protocol involved mandibular movements (vertical opening) and MR imaging. The clutch contained three motion markers used to collect kinematic data and four MR markers used as fiducial markers in the MR images. Fiducial marker misplacement was mimicked by analytically perturbing the position of the MR markers +/- 2, +/- 4, and +/- 6 degrees in the three anatomical planes. The percent difference between the original and perturbed MR marker position was calculated for kinematic parameters. The maximum difference across all perturbations for axial rotation, coronal rotation, sagittal rotation, axial translation, coronal translation, and sagittal translation were 176.85%, 191.84%, 0.64%, 9.76%, 80.75%, and 8.30%, respectively, for perturbing all MR markers, and 86.47%, 93.44%, 0.23%, 7.08%, 42.64%, and 13.64%, respectively, for perturbing one MR marker. The parameters representing movement in the sagittal plane, the dominant plane in vertical opening, were determined to be reasonably robust, while secondary movements in the axial and coronal planes were not considered robust.

  5. Maxillary sinusitis as a differential diagnosis in temporomandibular joint pain-dysfunction syndrome.

    PubMed

    Rihani, A

    1985-01-01

    Maxillary sinusitis may be diagnosed incorrectly as TMJ pain-dysfunction syndrome because of a similarity of signs and symptoms. Both conditions can manifest with headache, facial pain radiating to the ear and the maxillary teeth, preauricular pain, and pain in the buccal vestibule posterior and superior to the maxillary tuberosity. It can be concluded that (1) more consideration should be given to sinus disturbances as a differential diagnosis in TMJ pain-dysfunction syndrome, (2) it may be preferable to refer some patients with TMJ pain to a medical center where specialists in dentistry, otolaryngology, neurology, rheumatology, and psychiatry can evaluate the patient, and (3) TMJ pain-dysfunction syndrome should be evaluated and treated by a dentist experienced in management of this disorder. PMID:3856028