Sample records for temporomandibular joint disease

  1. Pathogenesis of Degenerative Joint Disease in the Human Temporomandibular Joint

    Microsoft Academic Search

    Christine L. Haskin; Stephen B. Milam; Ivan L. Cameron

    1995-01-01

    The wide range of disease prevalences reported in epidemiological studies of temporomandibular degenerative joint disease reflects the fact that diagnoses are frequently guided by the presence or absence of non-specific signs and symptoms. Treatment is aimed at alleviating the disease symptoms rather than being guided by an understanding of the underlying disease processes. Much of our current understanding of disease

  2. Molecular biology of temporomandibular joint disorders: Proposed mechanisms of disease

    Microsoft Academic Search

    Stephen B Milam; John P Schmitz

    1995-01-01

    Purpose: The biologic processes of temporomandibular joint adaptation and disease are poorly understood. However, recent technologic advances have provided methods that allow sophisticated studies of the molecular mechanisms that are relevant to the pathophysiology of degenerative temporomandibular joint diseases. This review examines current models of the molecular events that may underlie both adaptive and pathologic responses of the articular tissues

  3. Oxidative stress and degenerative temporomandibular joint disease: A proposed hypothesis

    Microsoft Academic Search

    Stephen B Milam; Gustavo Zardeneta; John P Schmitz

    1998-01-01

    The molecular events that underlie degenerative temporomandibular joint diseases are poorly understood. Recent studies have provided evidence that a variety of molecular species, including cytokines, matrix degrading enzymes, neuropeptides, and arachidonic acid catabolites may be involved. This paper advances the theory that mechanical stresses lead to the accumulation of damaging free radicals in affected articular tissues of susceptible individuals. This

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

    Microsoft Academic Search

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

    Summary 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

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

    SciTech Connect

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

    1980-10-01

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

  6. Pathogenesis of degenerative temporomandibular joint arthritides

    Microsoft Academic Search

    Stephen B. Milam

    2005-01-01

    Over the past decade, remarkable progress has been made in the study of molecular mechanisms involved in degenerative temporomandibular joint arthritides. Based on recent findings, models of degenerative temporomandibular joint disease predict that mechanical loads trigger a cascade of molecular events leading to disease in susceptible individuals. These events involve the production or release of free radicals, cytokines, fatty acid

  7. Synovial chondromatosis of the temporomandibular joint with calcium pyrophosphate dihydrate crystal deposition disease (pseudogout)

    PubMed Central

    Matsumura, Y; Nomura, J; Nakanishi, K; Yanase, S; Kato, H; Tagawa, T

    2012-01-01

    This report describes a very rare case of synovial chondromatosis with deposition of calcium pyrophosphate dihydrate (CPPD) crystals (pseudogout) in the temporomandibular joint (TMJ) of a 46-year-old male patient. Synovial chondromatosis is a non-neoplastic disease characterized by metaplasia of the connective tissue leading to chondrogenesis in the synovial membrane. Pseudogout is an inflammatory disease of the joints caused by the deposition of CPPD, producing similar symptoms to those observed in gout but not hyperuricaemia. Both diseases commonly affect the knee, hip and elbow joints, but rarely affect the TMJ. PMID:23166363

  8. Temporomandibular joint dislocation.

    PubMed

    Liddell, Aaron; Perez, Daniel E

    2015-02-01

    Dislocation of the temporomandibular joint is one of many pathophysiologic joint conditions that the oral and maxillofacial surgeon is challenged with managing. Managing a dislocated joint will inevitably be the challenge of most surgeons or physicians, whether in private or academic practice. Accordingly, this article addresses the pathophysiology associated with dislocation, in addition to treatment strategies aimed at managing acute, chronic, and recurrent dislocation. PMID:25483448

  9. Temporomandibular signs, symptoms, joint alterations and disease activity in juvenile idiopathic arthritis – an observational study

    PubMed Central

    2013-01-01

    Background Juvenile idiopathic arthritis (JIA) is a heterogeneous disease that frequently affects also the temporomandibular joint (TMJ) and associated structures. The main aim of this observational study was to describe systematically orofacial clinical signs and subjective symptoms in JIA patients, classified according to the International League of Associations for Rheumatology (ILAR) criteria, and to relate the findings to disease activity and radiological TMJ condyle lesions. Methods The study was a retrospective evaluation of dental and medical records in consecutive JIA patients referred to one of three dental specialist clinics in Sweden during an eight-year period. Data concerning temporomandibular signs, symptoms and general disease activity were collected and condylar alterations were judged on panoramic radiographs. Results All ILAR categories of JIA were represented among the 266 referrals included in the study. The distribution of patients among categories resembled the pattern seen in epidemiological studies. Persistent oligoarthritis was the largest category with 36.5% of the patients. Temporomandibular clinical signs (mild, moderate or severe) occurred in 57.7% to 92.0%, and subjective symptoms (mild or severe) in 32.0% to 76.0% of the patients in all categories. Patients in the juvenile psoriatic arthritis category had the largest number of orofacial signs and symptoms, and patients in the persistent oligoarthritis category had the fewest signs and symptoms. There were significant associations between clinical signs as well as subjective symptoms and overall disease activity. Half of all the patients had undergone panoramic examinations and 37.9% of those were judged to have condylar alterations after a mean of 2.9 years after onset. No associations between radiological findings and variables, such as signs, symptoms or disease activity, were found. Conclusions Temporomandibular signs and symptoms can be expected to a varying degree, including severe cases, in all JIA categories. Clinical and subjective orofacial involvement appears to be related to disease activity but not to condylar lesions. PMID:24134193

  10. Temporomandibular Joint Disorders

    NSDL National Science Digital Library

    Patient Education Institute

    This patient education program explains temporomandibular joint disorders (TMJ). It reviews the anatomy of the jaw, plus symptoms, causes, diagnosis, and treatment options for TMJ disorders. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

  11. 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

  12. Pathogenesis of degenerative temporomandibular joint arthritides.

    PubMed

    Milam, Stephen B

    2005-09-01

    Over the past decade, remarkable progress has been made in the study of molecular mechanisms involved in degenerative temporomandibular joint arthritides. Based on recent findings, models of degenerative temporomandibular joint disease predict that mechanical loads trigger a cascade of molecular events leading to disease in susceptible individuals. These events involve the production or release of free radicals, cytokines, fatty acid catabolites, neuropeptides, and matrix-degrading enzymes. Under normal circumstances, these molecules may be involved in the remodeling of articular tissues in response to changing functional demands. However, if functional demands exceed the adaptive capacity of the temporomandibular joint or if the affected individual is susceptible to maladaptive responses, then a disease state will ensue. An individual's susceptibility to degenerative temporomandibular joint disease may be determined by several factors, including genetic backdrop, sex, age, and nutritional status. It is hoped that, by furthering our understanding of the molecular events that underlie degenerative temporomandibular joint diseases, improved diagnostics and effective therapies for these debilitating conditions will be developed. PMID:16170470

  13. 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

  14. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...false Total temporomandibular joint prosthesis. 872.3940 Section 872.3940...3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended...

  15. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...false Total temporomandibular joint prosthesis. 872.3940 Section 872.3940...3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended...

  16. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  17. Management of temporomandibular joint ankylosis.

    PubMed

    Movahed, Reza; Mercuri, Louis G

    2015-02-01

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

  18. Temporomandibular joint dysfunction in children: evaluation of treatment

    Microsoft Academic Search

    Lipa Bodner; Victor J Miller

    1998-01-01

    Thirty-eight pediatric patients with temporomandibular joint (TMJ) dysfunction were diagnosed and treated. The etiology for the TMJ dysfunction was trauma in 30 (79%) patients, degenerative joint disease in two (5%) patients, growth disturbances in two (5%) patients and tumor in one (3%) patient. In three (8%) patients the etiology was unclear. The treatment modalities were: non-invasive therapy in 19 (50%)

  19. [Temporomandibular joint primitive tumors and pseudo tumors].

    PubMed

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

    2013-02-01

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

  20. Temporomandibular joint dislocation: experiences from Zaria, Nigeria

    PubMed Central

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

    2014-01-01

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

  1. 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

  2. Unilateral temporomandibular joint ankylosis with contralateral aplasia

    PubMed Central

    Singh, Nimisha; Pal, U. S.; Mohammad, S.; Singh, R. K.; Mehta, Gagan; Makadia, Hardik S.

    2013-01-01

    The temporomandibular joint (TMJ) is considered as one of the complex joints of the human body. Mandibular condylysis is distinguished from condylar aplasia by its non-association with aural/facial anomalies, and also as normal development appears to proceed until the lytic event occurs. It is further distinguished from primary and secondary condylar hypoplasia by the following: Absence of condyle rather than it being small, the normal development appears to proceed until the lytic event occurs, and its non-association with aural/facial anomalies or temporomandibular ankylosis. In the present report, a patient with a unilateral missing mandibular condyle with contralateral TMJ ankylosis is presented and the treatment is outlined and discussed. PMID:24665190

  3. Surgery of temporomandibular joint under local anaesthesia

    PubMed Central

    Gajiwala, Kalpesh J.

    2008-01-01

    Temporomandibular joint ankylosis is a debilitating disorder arising from an inability to open the mouth. This leads to poor nutrition, poor dental hygiene, and stunted growth. Anaesthesia, especially general anaesthesia, is very difficult to administer. There is a lack of direct visualization of the vocal cords, tongue fall following relaxation, and an already narrowed passage due to a small mandible, which makes even the blind nasal intubation difficult. There are various techniques described in literature to overcome these challenges, failing which, one needs to do tracheostomy. All the risks of difficult intubation and general anaesthesia can be avoided if the surgery is done under local anaesthesia. A simple but effective method of successful local anaesthesia is described, which allows successful temporomandibular joint reconstruction. PMID:19753260

  4. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total...

  5. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total...

  6. Radiation dose in temporomandibular joint zonography

    SciTech Connect

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

    1991-06-01

    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.

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

    PubMed Central

    2014-01-01

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

  8. Rationale of arthroscopic surgery of the temporomandibular joint

    PubMed Central

    Murakami, KenIchiro

    2013-01-01

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

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

    PubMed

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

    1997-08-01

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

  10. Longitudinal Changes in Temporomandibular Disorders in Young Adults: Indication for Systematic Temporomandibular Joint Screening

    Microsoft Academic Search

    Ute Jensen; Sabine Ruf

    2007-01-01

    Objective:  The aim of this study was to investigate longitudinal changes in temporomandibular joint function in young adults in terms\\u000a of clinical and subclinical temporomandibular disorders (TMD), and to identify patients at risk for clinically manifest TMD.\\u000a \\u000a \\u000a \\u000a Subjects and Methods:  Ninetyone consecutive dental students were surveyed over a mean period of 2.4 years. The temporomandibular joint and masticatory\\u000a muscles were analyzed by

  11. The acoustical characteristics of the normal and abnormal temporomandibular joint.

    PubMed

    Gay, T; Bertolami, C N; Donoff, R B; Keith, D A; Kelly, J P

    1987-05-01

    This paper describes the results of a clinical study that recorded and analyzed sounds emitted from the temporomandibular joint (TMJ) during simple function as a means for differentially diagnosing disorders of the joint. The technique is based on the principle that each different disorder of the TMJ produces a different effect on the mechanical relationship between the articulating surfaces of the joint, and that these mechanical effects can be determined by analyzing joint sounds in relation to joint movement. A total of 79 patients (101 joints) were studied; 32 (46 joints) were diagnosed as having extracapsular disorders, (primarily MPD), 27 (32 joints) were diagnosed as having a displaced disc with reduction, nine (10 joints) were diagnosed as having a displaced disc without reduction, and 11 (13 joints) were diagnosed as degenerative disease (osteoarthritis/arthrosis). In addition, 25 adults (50 joints) with normal TMJs were included as controls. The results of this study demonstrated that each specific disease of the TMJ is characterized by a unique relationship between the sounds propagated by the joint and the movement of the joint. Essentially, an extracapsular disease was characterized by acoustic quiescence during natural (as opposed to maximal) jaw movement, an internal derangement by a usually symmetrical short duration click/reciprocal click, or random click complex, depending on the subcategory of the disorder, and a degenerative disease by a long duration noise during either or both jaw opening and closing. The data further suggest that the technique serves to reflect the mechanical events (and abnormalities) that are involved in function of the diseased joint and has potential for use as a clinical diagnostic tool. PMID:3471925

  12. 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

  13. Primary synovial chondromatosis of the temporomandibular joint with suspected traumatic etiology

    Microsoft Academic Search

    Eddie I. Reinish; Stephen E. Feinberg; Kenneth Devaney

    1997-01-01

    Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare disease that is characterized by the development of nodules of cartilage within the synovial connective tissues of articulating joints. Reports of extracapsular TMJ SC are rate. A case is presented of primary SC of the TMJ with extension to the pterygoid plates, with a suspected traumatic etiology. The differences

  14. Absorbed doses from temporomandibular joint radiography

    SciTech Connect

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

    1985-06-01

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

  15. A Case of Chondrosarcoma Arising in the Temporomandibular Joint

    PubMed Central

    Shingaki, Susumu; Saito, Chikara

    2015-01-01

    Chondrosarcoma is a malignant tumor originating in cartilaginous cells. And there are only few reports of the case of chondrosarcoma in temporomandibular joint. We discuss a case of chondrosarcoma in temporomandibular joint in a 28-year-old man. Tumor was in contact with the dura, but en bloc resection was performed. After surgical resection of the tumor, face defect was reconstructed by rectus abdominis-free flap. And there is no recurrence after ten years from the resection. PMID:25688316

  16. Review article: Maxillofacial emergencies: dentoalveolar and temporomandibular joint trauma.

    PubMed

    DeAngelis, Adrian F; Barrowman, Roland A; Harrod, Richard; Nastri, Alf L

    2014-10-01

    Dentoalveolar trauma and dislocations of the temporomandibular joint are common reasons for patients to present to EDs in Australia. The majority of medical practitioners receive very little formal training in the management of these injuries and might not have ready access to dental services out of hours for advice. This article focuses on the emergency assessment, triage and non-specialist management of dentoalveolar trauma and injuries to the temporomandibular joint. PMID:25041648

  17. A Biphasic Finite Element Model of In   Vitro Plowing Tests of the Temporomandibular Joint Disc

    Microsoft Academic Search

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

    2009-01-01

    Disorders of the temporomandibular joint (TMJ) afflict 3–29% of people aged 19–40 years. Degenerative joint disease (DJD)\\u000a 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\\u000a TMJ disc is the primary stress distribution mechanism within the joint. Mechanical failure of the TMJ disc precedes clinical\\u000a signs of DJD.

  18. Temporomandibular joint ankylosis consequent to ear suppuration.

    PubMed

    Kumar, Rajeev; Hota, Ashutosh; Sikka, Kapil; Thakar, Alok

    2013-12-01

    The objective of this study is to describe the complication of temporomandibular joint (TMJ) ankylosis consequent to otitis media. The method applied is prospective case series and data collection done in tertiary referral centre from April 2012 to April 2013. Case description of three adolescent male patients with unilateral TMJ ankylosis consequent to ipsilateral chronic suppurative otitis media. Further literature review of TMJ ankylosis in relation to otitis media for evaluation for predisposing conditions. Surgical treatment by ipsilateral canal wall down mastoidectomy and concurrent TMJ gap arthroplasty. Surgical exposure confirmed ipsilateral bony ankylosis in all three. Two cases with long standing trismus had developed contralateral disuse fibrous ankylosis and required bilateral gap arthroplasty. Relief of trismus achieved in all three cases. Literature review indicated three similar cases secondary to otitis media. A universal feature among all previous case reports and the current case series was the age at onset of trismus, being at 10 years or less in all. TMJ ankylosis is a rare but potential complication of paediatric ear suppuration. Dehiscence along the tympanosquamosal fissure, tympanic plate and the foraminae of Huschke and Santorini in the paediatric population may predispose to extension of tympanic suppuration to the TMJ. PMID:24427727

  19. Multifactorial modeling of temporomandibular anatomic and orthopedic relationships in normal versus undifferentiated disk displacement joints

    Microsoft Academic Search

    Andrew G. Pullinger; Donald A. Seligman; Mike T. John; Stephen Harkins

    2002-01-01

    Statement of Problem. There is persistent dispute about the diagnostic value of hard tissue anatomic relationships in predicting temporomandibular joint disorders and normals. Purpose. The goal of this study was identification of multifactorial temporomandibular hard tissue relationships that differentiate asymptomatic normal joints. Material and Methods. Central section lateral tomograms of 162 female temporomandibular joints with pooled diagnoses of unilateral disk

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

    PubMed

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

    2015-03-01

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

  1. 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. (Univ. of Groningen, (Netherlands))

    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.

  2. Treatment of patients with arthrosis of the temporomandibular joint by infiltration of sodium hyaluronate: a preliminary study

    Microsoft Academic Search

    L. Guarda-Nardini; R. Tito; A. Staffieri; A. Beltrame

    2002-01-01

    Patients with degenerative disease of the temporomandibular joint (TMJ) who did not respond to conservative medical therapy (splint therapy, selected grinding or physiotherapy) can be treated by arthrocentesis, which is associated with intra-articular injections of sodium hyaluronate (Hyalgan). In this study, we treated ten dysfunctional patients with degenerative joint disease (DJD) who had been diagnosed clinically and had had the

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

    PubMed

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

    2014-09-01

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

  4. Biomechanical response of the temporomandibular joint from impacts in boxing

    Microsoft Academic Search

    Timothy J Walilko

    2004-01-01

    This multi-phase project was the first to explore the biomechanical response of the temporomandibular joint (TMJ) from a straight punch in boxing. During the first phase, a technique was developed that combined the head impact response from a biofidelic anthropometric test device (ATD) with the calculated punch force from an Olympic class boxer throwing straight punches. The results derived from

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

    PubMed Central

    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

  6. 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

  7. Functional magnetic resonance imaging of temporomandibular joint disorders

    Microsoft Academic Search

    D. Eberhard; H. P. Bantleon; W. Steger

    2000-01-01

    SUMMARY Fifty-eight temporomandibular joints (TMJs) from 40 patients with TMJ-related symptoms were examined by means of magnetic resonance scans with modified gradient echo sequences and a special double coil. This technique yielded a good spatial resolution of the intra-articular soft tissues, especially the articular disc and the bone structure of the TMJ. In combination with an incremental jaw opener, the

  8. Effect of marrow perforation on the sheep temporomandibular joint.

    PubMed

    Ishimaru, J I; Kurita, K; Handa, Y; Goss, A N

    1992-08-01

    The effect of surgically perforating the mandibular condyle to allow synovial fluid to contact the marrow was examined in 5 sheep temporomandibular joints. The surgical defect showed replacement of the marrow with fibro-osseous tissue and subcortical cysts. A vertical, central osteophyte emerged from the perforation, causing attenuation or perforation of the disc and temporal surface proliferation. These changes were radiographically and histologically similar to advanced osteoarthritis. This supports the concept that intraarticular micro or macrofracture may result in osteoarthritis. PMID:1402055

  9. Clinical evaluation of patients with temporomandibular joint implants

    Microsoft Academic Search

    Lauren E. Ta; James C. Phero; Stanley R. Pillemer; Hollie Hale-Donze; Nancy McCartney-Francis; Albert Kingman; Mitchell B. Max; Sharon M. Gordon; Sharon M. Wahl; Raymond A. Dionne

    2002-01-01

    Purpose: An undetermined number of patients with temporomandibular joint (TMJ) symptoms have been treated with intra-articular disc implants composed of Teflon ethylene\\/propylene or Teflon polytetrafluoroethylene and aluminum oxide (Proplast-Teflon; Vitek, Houston, TX). These implants have shown the potential to fragment in situ resulting in nonbiodegradable particles that stimulate a giant cell reaction and lead to degeneration of local structures, pain,

  10. 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

  11. Impact of Temporomandibular Joint Pain in Rheumatoid Arthritis

    PubMed Central

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

    2013-01-01

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

  12. 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

  13. Distribution of temporomandibular joint vibration transfer to the opposite side.

    PubMed

    Radke, John C; Kull, Robert S

    2012-07-01

    A vibration produced when a displaced temporomandibular disc reduces during opening can transfer some of its energy from the ipsilateral joint to the contralateral joint. The objective of this study was to measure what percentage of the ipsilateral vibration is transferred to the contralateral joint. The study included the temporomandibular joint (TMJ) vibrations of 144 (informed consent) subjects, (113 F, 31 M), with reducing displaced discs (DDR). Vibrations from 165 joints were recorded bilaterally with BioJVA (BioResearch Associates, Inc. Milwaukee, WI). In each case, any contralateral vibration was analyzed to verify that it was caused by the ipsilateral joint. The contralateral amplitude was divided by the ipsilateral amplitude and multiplied by 100 to produce a percentage of transfer. The percentage values (0-100%) were used to create a Relative Frequency Histogram with 20 classes (1-5%, 6-10%, 11-15%, etc.). The Relative Frequency Histogram graph revealed a three-mounded distribution of the percentage of transfer. One mound fell between 5 and 34 percent, one between 35 and 69 percent and the third between 70 and 98 percent. The appearance of a three-mounded distribution suggests that there may be three different failure modes leading to TMJ intemal derangements. Alternatively, it may be that failure of the disc's stabilizing ligaments leads to three different internal derangement conditions that are in some way distinct. The evidence of apparent tri-modality in this vibration data distribution suggests that there may be three different failure modes of disc displacement with reduction (e.g., anterior, anteromedial, and medio-lateral disc displacement). If so, identifying them could allow for a more detailed description of DDR. Therefore, further investigation of this 'tri-modal' distribution should be undertaken. PMID:22916672

  14. Multifactorial comparison of disk displacement with and without reduction to normals according to temporomandibular joint hard tissue anatomic relationships

    Microsoft Academic Search

    Andrew G. Pullinger; Donald A. Seligman; Mike T. John; Stephen Harkins

    2002-01-01

    Statement of Problem. There is disagreement about the predictive value of temporomandibular joint tomographic anatomy in the diagnosis of internal derangements. Purpose. This study aimed to identify multifactorial temporomandibular hard tissue relationships that differentiate disk displacement with reduction and disk displacement without reduction from normals. Material and Methods. Temporomandibular joint tomograms from females diagnosed with unilateral disk displacement with (n=84)

  15. A study of temporomandibular joint sounds. Part 2. Acoustic characteristics of joint sounds.

    PubMed

    Motoyoshi, M; Matsumoto, Y; Ohnuma, M; Arimoto, M; Takahashi, K; Namura, S

    1995-03-01

    In an attempt to gain a better understanding of temporomandibular joint (TMJ) sounds, we recorded joint sounds from 14 non-orthodontically treated dental students, analyzed the acoustic characteristics of the TMJ sounds, and correlated the sound characteristics with axiographic features, morphologic observations of X-ray images and clinical history. The group with a low peak frequency (< 500 Hz) of the opening click had a shorter history of subjective joint sound, a longer distance between the opening and closing curves, and a low rate of TMJ transformation. For the closing click, the history of subjective joint sounds tended to be longer when the duration of the wave was short. Acoustic analysis of TMJ sounds could be an aid to the differential diagnosis of temporomandibular disorders, although it is difficult to deduce the clinical history and internal deformities of the TMJ based solely on acoustic characteristics. PMID:7782822

  16. Pigmented villonodular synovitis of the temporomandibular joint with intracranial extension.

    PubMed

    Chen, Ying; Cai, Xie-Yi; Yang, Chi; Chen, Min-Jie; Qiu, Ya-Ting; Zhuo, Ziang

    2015-03-01

    Pigmented villonodular synovitis is an uncommon benign tumor-like proliferative lesion with an undetermined origin. Involvement of the temporomandibular joint is uncommon. Although pigmented villonodular synovitis is a benign lesion, it can grow with an aggressive pattern, and it extends extra-articularly in most of the reported cases, about one-third of them exhibiting intracranial involvement. The authors reported an additional case of a 47-year-old woman with intracranial extension, who had a history of joint pain and trismus. The preoperative diagnosis was made with arthroscopy. The lesion was completely excised via preauricular approach and condylotomy. The bone defect was covered by the pedicled temporalis myofascial fat flap. The patient has been symptom-free for 40 months postoperatively. PMID:25699525

  17. Enlarged follicles and temporomandibular joint abnormalities in mucolipidosis Type III

    PubMed Central

    Khalifa, H; Grubisa, HS; Lee, L; Lam, EWN

    2013-01-01

    Mucolipidosis Type III, or pseudo-Hurler polydystrophy, is a rare genetic abnormality, the result of a mutation to one of two genes that encode the hexameric protein N-acetylglucosaminyl-1-phosphotransferase (Glc-NAc-PT). The abnormality results in the accumulation of unprocessed macromolecules in cell and tissue compartments throughout the body. In this case report, we describe the clinical and radiographic findings of a 15-year-old male with this disorder. He presented with bilateral ectopically developing mandibular molar teeth with enlarged follicles and multiple joint involvement, including the temporomandibular joints. The patient underwent surgical removal of the molar teeth and curettage of the associated follicles. The subsequent histopathological examination of the tissues revealed hyperplastic follicles suggestive of dentigerous cysts. This report presents the plain film and cone beam CT examinations of the patient. PMID:22241869

  18. Bilateral temporomandibular joint dislocation in a 29-year-old man: a case report

    Microsoft Academic Search

    Tanujan Thangarajah; Neil Mcculloch; Suthan Thangarajah; Judith Stocker

    2010-01-01

    INTRODUCTION: A dislocation of the temporomandibular joint represents three percent of all reported dislocated joints. The treatment entails reduction of the deformity and this can often be achieved in a ward setting. CASE PRESENTATION: We present the case of a 29-year-old Caucasian man with a non-traumatic bilateral anterior temporomandibular joint dislocation. Following several unsuccessful attempts, due to both inadequate patient

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

    PubMed Central

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

    2013-01-01

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

  20. UK temporomandibular joint replacement database: report on baseline data.

    PubMed

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

    2014-03-01

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

  1. 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

  2. Sleep deprivation induces abnormal bone metabolism in temporomandibular joint

    PubMed Central

    Geng, Wei; Wu, Gaoyi; Huang, Fei; Zhu, Yong; Nie, Jia; He, Yuhong; Chen, Lei

    2015-01-01

    Background: The purpose of this study was to explore the effect of experimental sleep deprivation (SD) on the temporomandibular joint (TMJ) of rats and the possible mechanism related to abnormal bone metabolism. Material and methods: SD was induced by a modified multiple platform method and assessed by serum adrenocorticotropic hormone (ACTH) level. TMJs were detached and stained with hematoxylin and eosin (H&E). Expression of interleukin-1? (IL-1?), tumor necrosis factor alpha (TNF-?), osteoprotegerin (OPG) and receptor activator of nuclear factor kappa B ligand (RANKL) was evaluated by quantitative reverse transcription polymerase chain reaction, H&E staining, immunohistochemical staining and enzyme linked immunosorbent assay. Results: Compared with controls, SD significantly increased serum ACTH, indicating that the SD model was successful. In the SD group, H&E staining revealed greater vessel hyperplasia in the synovial membrane and thicker hypertrophic layers in condylar cartilages. Compared with controls, RNA and protein expression of the inflammatory factors IL-1? and TNF-? and the bone metabolism-related factor RANKL increased in condylar cartilage in the SD group, whereas OPG and the OPG/RANKL ratio decreased. Immunohistochemical staining revealed that OPG/RANKL immunopositive cells were mainly located in hypertrophic layers. Conclusions: These results suggest that sleep deprivation might play an important role in the occurrence and development of temporomandibular disorders, which may occur through abnormal secretion of inflammatory and bone metabolism-related factors.

  3. 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.

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

    PubMed

    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. PMID:3458137

  5. General joint hypermobility and temporomandibular joint derangement in adolescents

    Microsoft Academic Search

    L Westling; A Mattiasson

    1992-01-01

    Joint mobility was assessed in each member of an epidemiological sample of 96 girls and 97 boys, 17 years old, and graded by means of the hypermobility score of Beighton et al. Twenty two per cent of the girls and 3% of the boys could perform five or more of the nine manoeuvres. The prevalence of symptoms and signs of

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

    Microsoft Academic Search

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

    2007-01-01

    Temporomandibular disorders (TMD) are common pain problems in the population with uncertain pathophysiology and mechanisms.\\u000a The aim of this experimental study was to: (1) Establish an experimental pain model using electrical stimuli to describe characteristics\\u000a of nociception from the human temporomandibular joint (TMJ) and overlying skin. (2) Test the hypothesis that there would be\\u000a sex-related differences in TMJ sensitivity. Forty-three

  7. Increased Risk of Temporomandibular Joint Closed Lock: A Case-Control Study of ANKH Polymorphisms

    Microsoft Academic Search

    Boyen Huang; Katsu Takahashi; Tomoko Sakata; Honoka Kiso; Manabu Sugai; Kazuma Fujimura; Akira Shimizu; Shinji Kosugi; Tosiya Sato; Kazuhisa Bessho; Alejandro Almarza

    2011-01-01

    ObjectivesThis study aimed to carry out a histological examination of the temporomandibular joint (TMJ) in ank mutant mice and to identify polymorphisms of the human ANKH gene in order to establish the relationship between the type of temporomandibular disorders (TMD) and ANKH polymorphisms.Materials and MethodsSpecimens from the TMJ of ank mutant and wild-type mice were inspected with a haematoxylin and

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

    PubMed

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

    2015-01-01

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

  9. 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

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

    NASA Astrophysics Data System (ADS)

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

    2010-02-01

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

  11. Upper airway obstruction in patients with rheumatoid arthritis and temporomandibular joint destruction.

    PubMed

    Redlund-Johnell, I

    1988-01-01

    Among 400 patients with rheumatoid arthritis and measurable ramus height there were 76 patients with mutilating arthritis of the temporomandibular joints. In 30 of these 400 patients, episodes of upper airway obstruction had occurred, mostly when the patient lay supine. Laryngoscopy had been performed in only 7 patients, and in 3 of those a laryngeal arthritis was detected. Upper airway obstruction had occurred significantly more often in patients with arthritis of the temporomandibular joints than in those with normal joints. In 70% of the patients with a severe arthritic destruction of the temporomandibular joints, episodes of airway obstruction had occurred. Upper airway obstruction is assumed to occur in those patients due to a pharyngeal obstruction, as in other patients with micrognathia or sleep apnea syndrome. PMID:3187458

  12. Stress relaxation behaviors of articular cartilages in porcine temporomandibular joint.

    PubMed

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

    2014-05-01

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

  13. Effects of four treatment strategies for temporomandibular joint closed lock

    PubMed Central

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

    2013-01-01

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

  14. Sustained Inflammation Induces Degeneration of the Temporomandibular Joint

    PubMed Central

    Wang, X.D.; Kou, X.X.; Mao, J.J.; Gan, Y.H.; Zhou, Y.H.

    2012-01-01

    The temporomandibular joint (TMJ) undergoes degenerative changes among patients who suffer from arthritis, and yet the pathogenesis of TMJ osteoarthritis and rheumatoid arthritis is poorly understood. We hypothesized that sustained inflammation in the TMJ induces structural abnormalities, and accordingly characterized the disc and synovium in a novel model with double injections of complete Freund’s adjuvant (CFA), using behavioral, morphological, cellular, and molecular assessments. Thirty-five days following double CFA injections in seven-week-old female Sprague-Dawley rats, the disc in the CFA-induced inflammation group demonstrated multiple degenerative changes, including marked thickening, opacity, and deformation. The discs in the CFA group further showed significantly greater wet and net weights, and elevated collagen, aggrecan, and total glycosaminoglycan contents. The synovium in the CFA-induced inflammation group showed marked infiltration of mononucleated cells and accumulated sub-synovial adipose tissue. Both the disc and synovium had significantly higher iNOS and IL-1? mRNA expression than controls (saline injections). These findings are consistent with our hypothesis that sustained TMJ inflammation, even within the presently observed 35 days, may be a predisposing factor for structural abnormalities. Insight into TMJ inflammation and degeneration is anticipated to improve our understanding of the pathogenesis of TMJ arthritis and help design clinically relevant strategies for tissue engineering. PMID:22427270

  15. Estrogen aggravates iodoacetate-induced temporomandibular joint osteoarthritis.

    PubMed

    Wang, X D; Kou, X X; Meng, Z; Bi, R Y; Liu, Y; Zhang, J N; Zhou, Y H; Gan, Y H

    2013-10-01

    Temporomandibular joint osteoarthritis (TMJOA) is clinically characterized by female preponderance, with a female-to-male ratio of more than 2:1; however, the underlying mechanism remains obscure. We examined the effects of estrogen on TMJOA induced by monosodium iodoacetate. Female rats were randomly and equally divided into 5 groups: control, sham-ovariectomized, and ovariectomized rats treated, respectively, with 17?-estradiol (E2) at doses of 0 µg, 20 µg, and 80 µg/day until the end of the experiment. After induction of TMJOA, TMJs were evaluated by histopathology and microCT, and the expression of Fas, FasL, caspase 3, and caspase 8 was evaluated by real-time polymerase chain-reaction or immunohistochemistry. Another 5 groups of female rats were used to evaluate the effect of estrogen receptor antagonist ICI 182780 on E2 effects on TMJOA, when injected intraperitoneally into the control, sham-ovariectomized, and 80-µg-E2-treated groups. We found that E2 potentiated cartilage degradation and subchondral bone erosion in iodoacetate-induced TMJOA. E2 also potentiated mRNA expression of Fas, FasL, caspase 3, and caspase 8 in the condylar cartilage. Moreover, the estrogen receptor antagonist partially blocked E2 effects on TMJOA. These findings suggest that E2 could aggravate TMJOA, which may be an important mechanism underlying the sexual dimorphism of TMJOA. PMID:23934157

  16. Multifactorial analysis of differences in temporomandibular joint hard tissue anatomic relationships between disk displacement with and without reduction in women

    Microsoft Academic Search

    Andrew G. Pullinger; Donald A. Seligman

    2001-01-01

    Statement of problem. Without multifactorial models, it is difficult to resolve whether hard tissue tomographic relationships can distinguish differences between temporomandibular joint (TMJ) internal derangement diagnoses. Purpose. The purpose of this study was to use multifactorial models to examine whether there are hard tissue anatomic and orthopedic characteristics that distinguish temporomandibular joints with disk displacement with reduction from disk displacement

  17. Arthroscopic surgery for treatment of anterior displacement of the disc without reduction of the temporomandibular joint

    Microsoft Academic Search

    Yaomin Zhu; Cangshang Zheng; Yongqiang Deng; Yang Wang

    The aim of this study was to investigate the clinical results and efficacy of an arthroscopic approach to correct anterior displacement of the disc without reduction of the temporomandibular joint (TMJ) with limitation of mouth opening. We studied 28 joints with internal derangement in 23 patients, all of whom had had arthroscopic surgery (lavage, lysis of adhesions in the superior

  18. 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

  19. 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

  20. 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.

  1. Long-term viability of the temporalis muscle/fascia flap used for temporomandibular joint reconstruction.

    PubMed

    Umeda, H; Kaban, L B; Pogrel, M A; Stern, M

    1993-05-01

    Temporalis muscle/fascia axial flaps (TFs) were used in 115 temporomandibular joints (TMJs) in 81 patients to correct ankylosis (n = 25 joints), traumatic defects (n = 8), congenital anomalies (n = 4), defects resulting from tumor resection (n = 2), degenerative joint disease (n = 52), autoimmune arthritides (n = 21), and lateral capsule flaccidity (n = 3). The follow-up period ranged from 6 months to 5.5 years. Seven patients (8.6% of the group; 10 TMJs) were reevaluated for recurrent symptoms (pain and decreased motion), with a mean of 1.7 years (range = 1 to 3 years) postoperatively. Four of these patients (seven TMJs) had magnetic resonance imaging (MRI) as part of their diagnostic workup and four patients (five TMJs) required a second operative procedure. This study reports the results of the MRI, intraoperative, and histologic evaluations of the TFs in these seven patients. The MRIs showed vascularized tissue between the condyle and roof of the glenoid fossa in all seven joints examined. The signal was consistent with muscle and/or fat as opposed to scar tissue. All flaps examined at the time of surgery (arthroscopy, n = 1; arthrotomy, n = 4) were in place and had the gross appearance of normal muscle. Histologic examination of biopsies of four flaps indicated the presence of viable muscle with normal-appearing nuclei. The results of this study indicate that the TF does survive when it is carefully dissected and inferiorly based to preserve blood supply. PMID:8478760

  2. Emerging Intra-Articular Drug Delivery Systems for the Temporomandibular Joint

    PubMed Central

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

    2009-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  5. 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

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

    ERIC Educational Resources Information Center

    Funch, Donna P.; Gale, Elliot N.

    1984-01-01

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

  7. Temporomandibular joint injury potential imposed by the low-velocity extension-flexion maneuver

    Microsoft Academic Search

    Richard P Howard; Charles P Hatsell; Herbert M Guzman

    1995-01-01

    Purpose: It has been proposed that significant temporomandibular joint injury can occur as a result of rapid extension-flexion motion of the neck (whiplash). This motion, which is experienced by passengers in vehicles that undergo rear-end collisions, has been described as causing rapid protrusion and opening of the mandible. It has been speculated that this relative motion between the mandible and

  8. The use of a collagen sheet as a disc replacement in the rabbit temporomandibular joint

    Microsoft Academic Search

    Stephen E. Feinberg; Edward J. McDonnell

    1995-01-01

    Purpose: This study evaluated a biocompatible, preformed collagen sheet as a disc replacement after temporomandibular joint (TMJ) surgery in the rabbit and compared its performance with that of an autogenous dermal graft.Materials and Methods: Twenty adult New Zealand white rabbits were divided into four groups of five animals: 1) nonoperated control; 2) TMJ discectomy without replacement; 3) discectomy with dermal

  9. Temporomandibular joint loading generated during bilateral static bites at molars and premolars

    Microsoft Academic Search

    Makoto Abe; Raul U. Medina-Martinez; Ken-ichi Itoh; Shoji Kohno

    2006-01-01

    The aim of this study was to investigate the features of the loading vectors of the temporomandibular joint (TMJ) generated during bilateral static bites at the molars and at the premolars, and to determine the major factors affecting the difference between the two loading vectors. We computed the subjects’ estimated and theoretical minimum TMJ loadings under the two different bite

  10. MR Imaging of the Temporomandibular Joint: A Cadaver Study of the Value of Coronal Images

    Microsoft Academic Search

    Bernhard W. Schwaighofer; Terry T. Tanaka; David J. Sartons; Donald Resnick

    Recent studies comparing cryosectional anatomy of the temporomandibular joint (TMJ) to its MR appearance have shown that the assessment of disk displacement is inaccurate when based on the sagittal plane alone. This article describes the MR appearance of the normal and abnormal (positional and osseous changes) TMJ in the coronal plane and compares these findings with their cryosectional anatomy. Twenty-

  11. Difficult Tracheal Intubation as a Result of Unsuspected Abnormality of the Temporomandibular Joint

    Microsoft Academic Search

    Yun-Hou Liu; Jhi-Joung Wang; Ching-Fong Chang; Chan-Hui Jin

    2001-01-01

    n immobile temporomandibular joint (TMJ) sec- ondary to rheumatoid arthritis (RA) or other eti- ologies can be recognized easily before anesthe- sia. However, it is uncommon in a patient who can open his mouth widely before the administration of anesthesia but whose mouth cannot be opened after the induction of anesthesia. We report a case of diffi- cult endotracheal intubation

  12. The temporomandibular joint in juvenile idiopathic arthritis: frequently used and frequently arthritic

    Microsoft Academic Search

    Sarah Ringold; Randy Q Cron

    2009-01-01

    Recent recognition of the markedly high prevalence of temporomandibular joint (TMJ) arthritis in children with juvenile idiopathic arthritis (JIA) coupled with the significant morbidity associated with TMJ damage has prompted increased interest in both the clinical and pathological aspects of TMJ arthritis. This review focuses on the prevalence of TMJ arthritis in JIA, the imaging modalities used to detect TMJ

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

    PubMed Central

    Schmolke, C

    1994-01-01

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

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

    Microsoft Academic Search

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

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

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

    PubMed Central

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

    2014-01-01

    Aim The purpose of the present study was to correlate the degree of temporomandibular disorder (TMD) severity and skin temperatures over the temporomandibular joint (TMJ) and masseter and anterior temporalis muscles. Materials and methods This blind cross-sectional study involved 60 women aged 18–40 years. The volunteers were allocated to groups based on Fonseca anamnestic index (FAI) score: no TMD, mild TMD, moderate TMD, and severe TMD (n = 15 each). All volunteers underwent infrared thermography for the determination of skin temperatures over the TMJ, masseter and anterior temporalis muscles. The Shapiro–Wilk test was used to determine the normality of the data. The Kruskal–Wallis test, followed by Dunn’s test, was used for comparisons among groups according to TMD severity. Spearman’s correlation coefficients were calculated to determine the strength of associations among variables. Results Weak, positive, significant associations were found between FAI score and skin temperatures over the left TMJ (rs = 0.195, p = 0.009) and right TMJ (rs = 0.238, p = 0.001). Temperatures over the right and left TMJ were significantly higher in groups with more severe TMD (p < 0.05). Conclusion FAI score was associated with skin temperature over the TMJ, as determined by infrared thermography, in this sample. Women with more severe TMD demonstrated a bilateral increase in skin temperature. PMID:25544814

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

    PubMed

    De La Hoz Polo, M; Navallas, M

    2014-01-01

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

  17. Asymptomatic cervical spine dysfunction (CSD) in patients with internal derangement of the temporomandibular joint.

    PubMed

    Fink, Matthias; Tschernitschek, Harald; Stiesch-Scholz, Meike

    2002-07-01

    Patients with temporomandibular disorders (TMDs) frequently show symptoms related to the cervical spine. It is however unknown whether patients with TMD who have no symptoms in the neck region often have signs of cervical spine dysfunction (CSD) and whether there is a predominant localization of these asymptomatic CSDs. In a prospective and controlled examiner-blinded clinical trial, the prevalence and localization of asymptomatic CSD in patients with TMD was examined. Thirty patients with internal derangement of the temporomandibular joint but without any neck problems were compared with 30 age and gender matched healthy controls. Significantly more asymptomatic dysfunctions of the vertebral joints and increased muscle tenderness were found in the patient group. The difference between patents and nonpatients for vertebral joint dysfunction and muscle tenderness was greatest in the upper cervical spine. These findings support the thesis that a complementary examination of this area should be performed, even when TMD patents do not report any neck problems. PMID:12150265

  18. Finite element analysis of a condylar support prosthesis to replace the temporomandibular joint.

    PubMed

    Abel, Eric W; Hilgers, André; McLoughlin, Philip M

    2015-04-01

    This paper presents a finite element study of a temporomandibular joint (TMJ) prosthesis in which the mandibular component sits on the condyle after removal of only the diseased articular surface and minimal amount of condylar bone. The condylar support prosthesis (CSP) is customised to fit the patient and allows a large part of the joint force to be transmitted through the condyle to the ramus, rather than relying only on transfer of the load by the screws that fix the prosthesis to the ramus. The 3-dimensional structural finite element analysis compared a design of CSP with a standard commercial prosthesis and one that was modified to fit the ramus, to relate the findings to the different designs and geometrical features. The models simulated an incisal bite under high loading. In the CSP and in its fixation screws, the stresses were much lower than those in the other 2 prostheses and the bone strains were at physiological levels. The CSP gives a more physiological form of load transfer than is possible without the condylar contact, and considerably reduces the amount of strain on the bone around the screws. PMID:25703687

  19. Autologous fat grafts placed around temporomandibular joint total joint prostheses to prevent heterotopic bone formation

    PubMed Central

    Morales-Ryan, Carlos A.; Morales, Patricia Garcia; Cassano, Daniel Serra

    2008-01-01

    This study evaluated 1) the efficacy of packing autologous fat grafts around temporomandibular joint (TMJ) total joint prosthetic reconstructions to prevent fibrosis and heterotopic bone formation and 2) the effects on postsurgical joint mobility and jaw function. One hundred fifteen patients (5 males and 110 females) underwent TMJ reconstruction with total joint prostheses and simultaneous fat grafts (88 bilateral and 27 unilateral) for a total of 203 joints. The abdominal fat grafts were packed around the articulating portion of the joint prostheses after the fossa and mandibular components were stabilized. Patients were divided into two groups: group 1 (n = 76 joints) received Christensen total joint prostheses, and group 2 (n = 127 joints) received TMJ Concepts total joint prostheses. Clinical and radiographic assessments were performed before surgery, immediately after surgery, and at long-term follow-up. In group 1, maximal incisal opening (MIO) increased 3.5 mm, lateral excursions (LE) decreased 0.2 mm, and jaw function improved 1.9 levels. In group 2, MIO increased 6.8 mm, LE decreased 1.4 mm, and jaw function improved 2.4 levels. The improvement for MIO and patient perception of jaw function in both groups was statistically significant; no significant difference was found for LE. There was no radiographic or clinical evidence of heterotopic calcifications or limitation of mobility secondary to fibrosis in either group. Twenty-five Christensen prostheses (33%) were removed because of device failure and/or metal hypersensitivity; no fibrosis or heterotopic bone formation was seen at surgical removal. Four TMJ Concepts prostheses (3%) were removed because of metal hypersensitivity. In all instances, removal of the prostheses was unrelated to the autologous fat grafting. Ten patients (8.7%) developed complications involving the fat donor site: two patients (1.8%) developed abdominal cysts requiring surgery, and eight patients (6.9%) developed seroma formation requiring aspiration. Autologous fat transplantation is a useful adjunct to prosthetic TMJ reconstruction to minimize the occurrence of excessive joint fibrosis and heterotopic calcification, consequently providing improved range of motion and jaw function. PMID:18628972

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

    PubMed

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

    2002-02-01

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

  1. Magnetic resonance characteristics of temporomandibular joint disc displacement in elderly patients

    PubMed Central

    Ogura, I; Kaneda, T; Mori, S; Sakayanagi, M; Kato, M

    2012-01-01

    Objectives The purpose of this study was to evaluate the MR characteristics of temporomandibular joint (TMJ) disc displacement in elderly patients. Methods Of the MR images of 1660 TMJs in 847 patients with disc displacement who underwent MRI for suspected temporomandibular disorders, 301 TMJs in 154 patients aged over 50 years were studied as an elderly group. These MR images of the elderly group were compared with those of a control group (1359 TMJs in 693 patients aged under 51 years) concerning disc displacement with or without reduction, joint effusion and osteoarthrosis. Results The incidence of disc displacement with osteoarthrosis was significantly different between the elderly (41.9%) and the control (19.8%) groups (p = 0.000). Logistic multivariate regression analysis demonstrated that the osteoarthrosis was a significant variable (odds ratio = 2.94, p = 0.000). Conclusions This study suggests that MR characteristics of TMJ disc displacement in elderly patients includes osteoarthrosis. PMID:22116131

  2. 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

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

    Microsoft Academic Search

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

    2009-01-01

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

  4. The Efficacy of Therapeutic Exercise and Manual Therapy for Temporomandibular Joint Disorders

    Microsoft Academic Search

    Analee Edlefsen; Jenn Wangerin

    2009-01-01

    For adult subjects with temporomandibular disorders (TMD) of myofascial or joint origin, including arthritic changes, a self-care protocol with postural correction and active and passive jaw exercises decreases subjects’ pain at rest and with movement as well as increases jaw range of motion greater than no treatment, self-care protocol alone or surgery. Self-care protocol consists mainly of the application of

  5. Long-term evaluation following temporomandibular joint arthroscopy with lysis and lavage

    Microsoft Academic Search

    Bertrand Sorel; Joseph F. Piecuch

    2000-01-01

    Although temporomandibular joint arthrocentesis has been utilized for almost 20 years, most papers which evaluate the success of this procedure present relatively short-term data (less than two years). The purpose of this paper is to present the longer-term condition of 22 patients who were re-examined 2 to 10.8 years after arthroscopic surgery with lysis and lavage. Assessment of symptoms reported

  6. Estrogenic effect on swelling and monocytic receptor expression in an arthritic temporomandibular joint model

    Microsoft Academic Search

    Guoqiang Guan; Carolyn C. Kerins; Larry L. Bellinger; Phillip R. Kramer

    2005-01-01

    Clinical presentation of temporomandibular joint (TMJ) disorders are more common in women and changes in the female hormone estrogen affect the level of swelling, pro-inflammatory cytokine release and pain in animal models of TMJ arthritis. Estrogen also modulates the expression of the CD16 receptor in vitro. This alters pro-inflammatory cytokine release in monocytes\\/macrophages when auto-antigens and arthritic factors bind the

  7. A Girl With Bilateral Temporomandibular Joint Pain, Generalized Arthralgias, and Inability to Walk

    Microsoft Academic Search

    Evgenia Sklirou; Mersini Mavrikou; Konstantinos A. Voudris; Lela Stamoyannou

    2010-01-01

    The authors present the case of a 6.5-year-old girl with bilateral temporomandibular joint (TMJ) pain, generalized arthralgias, inability to walk, and absence of deep tendon reflexes in the context of Guillain—Barrè syndrome. TMJ pain was the sole manifestation for 3 days, before other typical symptoms appeared, an issue that initially led to an improper diagnosis. A thorough clinical examination along

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

    Microsoft Academic Search

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

    2009-01-01

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

  9. 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

  10. Signs and Symptoms of Temporomandibular Joint Disorders Related to the Degree of Mouth Opening and Hearing Loss

    Microsoft Academic Search

    Panagiotis Kitsoulis; Aikaterini Marini; Kalliopi Iliou; Vasiliki Galani; Aristides Zimpis; Panagiotis Kanavaros; Georgios Paraskevas

    2011-01-01

    Background  The temporomandibular joint is a unique bi-condylar joint involved in mastication and speech. Temporomandibular joint disorders\\u000a (TMD) have a range of symptoms, including aural symptoms, and are present in approximately 75% of normal populations. The\\u000a present study examined the relationship between signs and symptoms of TMD and mouth opening, gender, joint and aural symptoms,\\u000a and hearing loss.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The study involved

  11. 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

  12. Osteoarthritis in Temporomandibular Joint of Col2a1 Mutant Mice

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-11-01

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

  14. MRI assessment of the normal temporomandibular joint with the use of projective geometry.

    PubMed

    Silverstein, R; Dunn, S; Binder, R; Maganzini, A

    1994-05-01

    A new analysis, the Projective Invariant Analysis, was developed for the evaluation of magnetic resonance images of the temporomandibular joint. This method was used because it takes into account factors such as linear and angular measurements that simple Euclidean geometric methods fail to address. Forty "normal" joints (20 subjects) and 65 "abnormal" joints were analyzed. Joints were defined as normal if they had a Class I skeletal pattern and a Class I occlusion. In addition, a history was obtained and a clinical examination was performed on each of these subjects to rule out any temporomandibular joint dysfunction, masticatory muscle myalgia, or cervicalgia. The images of the 40 normal joints were compared with 65 previously taken images of 53 patients with conditions that had been diagnosed as anteriorly displaced disks with reduction. These two groups were compared with the use of the analysis method described by Drace and Enzmann that uses angular measurements. The groups were also analyzed with the use of a new method in which the structural relationships of the articular eminence, gleniod fossa, mandibular condyle, and articular disk were related to each other using projective geometry. For the projective invariant analysis, a 95% confidence ellipse was constructed on the basis of the normal data. All but one of the 40 normal points fell within this ellipse, and only three of the 65 abnormal points were inside the ellipse. Both analyses showed a significant difference between the normal and abnormal groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8028877

  15. Transcriptional regulation of proteoglycan 4 by 17?-estradiol in immortalized baboon temporomandibular joint disc cells.

    PubMed

    McDaniel, Jennifer S; Akula Suresh Babu, Ramya; Navarro, Mary M; LeBaron, Richard G

    2014-04-01

    Temporomandibular joint disorders (TMDs) affect a significant portion of the population of the USA, with the majority of those seeking treatment being women of childbearing age. Owing to this striking sexual dimorphism it has been postulated that sex hormones play a role in the maintenance of normal temporomandibular joint (TMJ) function. Proteoglycan 4 (PRG4) is a secreted lubricating molecule required for maintaining low frictional levels within articular joints; however, its role in the TMJ is not well characterized. In this study we describe the development of immortalized baboon cells isolated from specific regions of the TMJ disc and their use in the investigation of PRG4 expression and localization patterns in the TMJ. We identified conserved estrogen response elements within the 5' flanking region of the PRG4 gene of several species, and found that treatment of baboon TMJ disc cells with estrogen led to reduced PRG4 promoter activity and reduced expression of PRG4 mRNA in vitro. The observed negative regulation of PRG4 by estrogen could lead to increased friction and degradation of joint components over time. This study, for the first time, provides evidence of the regulatory potential of estrogen on PRG4 gene expression and suggests a novel etiology for the gender disparity observed among TMD patients. PMID:24621258

  16. Giant Cell Tumor of the Temporal Bone Invading into the Pterygoid Muscle through the Temporomandibular Joint

    PubMed Central

    Mohamed, Aboshanif; Ishikawa, Kazuo; Omi, Eigo; Honda, Kohei; Suzuki, Shinsuke; Sato, Teruyuki; Fukui, Naoko; Takahasi, Masataka

    2014-01-01

    We report a case of giant cell tumor of the temporal bone invading into the pterygoid muscle through the temporomandibular joint. The patient was a 43-year-old woman who developed left ear fullness 2 years earlier with a mass in the external auditory canal. Radiologic evaluation revealed extension into the infratemporal fossa and confirmed that the tumor was invading into pterygoid muscle. A middle cranial fossa approach along with tympanoplasty was used for total resection of the tumor. Once a tumor invades into muscle tissue, meticulous care is required to remove it because identification of tumor tissue becomes extremely difficult. PMID:25083373

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

    PubMed Central

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

    2012-01-01

    Objective The aim of the present study was to describe the clinical and MRI findings of the temporomandibular joint (TMJ) in patients with major depressive disorders (MDDs) of the non-psychotic type. Methods 40 patients (80 TMJs) who were diagnosed as having MDDs were selected for this study. The clinical examination of the TMJs was conducted according to the research diagnostic criteria and temporomandibular disorders (TMDs). The MRIs were obtained bilaterally in each patient with axial, parasagittal and paracoronal sections within a real-time dynamic sequence. Two trained oral radiologists assessed all images. For statistical analyses, Fisher's exact test and ?2 test were applied (? = 0.05). Results Migraine was reported in 52.5% of subjects. Considering disc position, statistically significant differences between opening patterns with and without alteration (p = 0.00) and between present and absent joint noises (p = 0.00) were found. Regarding muscular pain, patients with and without abnormalities in disc function and patients with and without abnormalities in disc position were not statistically significant (p = 0.42 and p = 0.40, respectively). Significant differences between mandibular pathway with and without abnormalities (p = 0.00) and between present and absent joint noises (p = 0.00) were observed. Conclusion Based on the preliminary results observed by clinical and MRI examination of the TMJ, no direct relationship could be determined between MDDs and TMDs. PMID:22517997

  18. SAPHO Syndrome of the Temporomandibular Joint Associated with Sudden Deafness

    Microsoft Academic Search

    Kathlyn Marsot-Dupuch; Jacques E. Doyen; Walter O. Grauer; Sebastien C. de Givry

    Summary: We report a case of arthritis of the temporo- mandibular joint (TMJ) associated with sclerosing osteo- myelitis of the mandible and temporal bone, causing deaf- ness. The presence of a palmoplantar pustulosis established the diagnosis of SAPHO syndrome. SAPHO (an acronym referring to synovitis, acne, palmoplantar pustulosis, hy- perostosis, and osteitis) syndrome is defined by the associ- ation of

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

    PubMed

    An, S-Y; Jung, J-K

    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

  20. 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

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

    PubMed Central

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

  2. Clinical investigation of early post-traumatic temporomandibular joint ankylosis and the role of repositioning discs in treatment

    Microsoft Academic Search

    Y. Zhang; D. M. He

    2006-01-01

    This study investigated the development of temporomandibular joint (TMJ) ankylosis after condylar fracture and the functional results of surgery that included repositioning of the articular discs. In a total of 18 patients, there were 13 cases of fibrous ankylosis (type I) and 11 of partial bony ankylosis (type II). CT scans for both groups and MRI scans for type I

  3. Unrecognized bilateral temporomandibular joint dislocation after general anesthesia with a delay in diagnosis and management: a case report

    PubMed Central

    2013-01-01

    Introduction Anterior bilateral temporomandibular joint dislocation is not an uncommon occurrence and has been reported before. However, its diagnosis can easily be overlooked, especially by clinicians who are unfamiliar with this pathology. Continuous discussion of the pathology is required to prevent delays in diagnosis, which can lead to long-term sequelae for the patient. Case presentation We present the case of a 66-year-old Somali woman who experienced a bilateral anterior temporomandibular joint dislocation after a general anesthetic for an exploratory laparotomy for excision of a pelvic sarcoma. She first presented in the intensive care unit with preauricular pain and an inability to close her mouth, and was initially misdiagnosed and treated for a muscle spasm. The cause of her misdiagnosis was multifactorial - opioid-related sedation, language and cultural barrier, and unfamiliarity with the pathology. Her diagnosis was proven 18 hours after the completion of surgery with a plain X-ray. A manual closed reduction was performed with minimal sedation by oral surgery. Conclusion We provided an in-depth discussion of temporomandibular joint dislocation and suggest a simple test that would prevent delayed diagnosis of temporomandibular joint dislocation in any patient undergoing general anesthesia. A normal mandibular excursion should be tested in every patient after surgery in the postoperative care unit, by asking the patient to open and close their mouth during the immediate postoperative recovery period or passively performing the range of motion test. PMID:24139071

  4. 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??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 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

  5. Estrogen and inflammation increase the excitability of rat temporomandibular joint afferent neurons.

    PubMed

    Flake, Natasha M; Bonebreak, David B; Gold, Michael S

    2005-03-01

    Several painful conditions, including temporomandibular disorders (TMD), are more prevalent and more severe in women than in men. Although the physiological basis for this sex difference remains to be determined, it is likely that estrogen is an underlying factor. The present study was performed to test the hypotheses that estrogen increases the excitability of rat temporomandibular joint (TMJ) afferents and exacerbates the inflammation-induced sensitization of these sensory neurons. Retrogradely labeled TMJ neurons from ovariectomized rats and ovariectomized rats receiving chronic estrogen replacement were studied using whole cell patch-clamp techniques three days after injecting the TMJ with either saline or Complete Freund's Adjuvant to induce inflammation. Excitability was assessed with depolarizing current injection to determine action potential threshold, rheobase, and the response to suprathreshold stimuli. Spontaneous activity was also assessed. Both inflammation and estrogen increased the excitability of TMJ neurons as reflected by decreases in action potential threshold and rheobase and increases in the incidence of spontaneous activity. The effects were additive with neurons from rats receiving both estrogen and inflammation being the most excitable. The increases in excitability were associated with changes in passive properties and action potential waveform, suggesting that estrogen and inflammation affect the expression and/or properties of ion channels in TMJ neurons. Importantly, the influence of estrogen on both baseline and inflammation-induced changes in TMJ neuronal excitability may help explain the profound sex difference observed in TMD as well as suggest a novel target for the treatment of this pain condition. PMID:15525813

  6. Osteoarthritic changes and condylar positioning of the temporomandibular joint in Korean children and adolescents

    PubMed Central

    Cho, Bong-Hae

    2012-01-01

    Purpose To investigate the prevalence of osteoarthritic changes and condylar positioning of the temporomandibular joint (TMJ) in Korean children and adolescents with or without temporomandibular disorders (TMDs). Materials and Methods A total of 101 asymptomatic and 181 symptomatic children and adolescents aged 10 to 18 years old were included in the study. Osteoarthritic changes such as flattening, sclerosis, osteophytes, or erosion, and the parasagittal positioning of the condyle were assessed using cone-beam computed tomography (CBCT) images. Results The overall prevalence of osteoarthritic changes was higher in symptomatic (26.8%) than in asymptomatic adolescents (9.9%) (p<0.05). In the symptomatic group, the frequency was higher in males (33.3%) than in females (23.0%) (p<0.05). Erosion was the most common change for the symptomatic group (15.6%), whereas sclerosis was the most common change for the asymptomatic group (5.4%). Posterior condylar position was more frequently observed in the symptomatic group (p<0.05). Erosion was more common in the samples with TMJ pain or mouth opening limitations as compared to those without them (p<0.05). Conclusion This study showed that osteoarthritic changes in TMJ were common in children and adolescents, with a much higher prevalence in symptomatic patients. PMID:23071967

  7. 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

  8. 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

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

    PubMed

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

    2015-04-01

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

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

    PubMed

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

    2014-03-01

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

  11. 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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-02-01

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

  14. Dedifferentiated Chondrosarcoma of Temporomandibular Joint: Atypical Features of a Rare Case

    PubMed Central

    Das, B. K.; Baisakh, Manas; Das, S. N.

    2014-01-01

    Chondrosarcoma (CS) is an uncommon malignant mesenchymal tumour showing cartilaginous differentiation which rarely presents in the jaws. CS represents 10-20% of all malignant bone tumours and less than 5% of tumours in head and neck region. Among the infrequent subtypes of CS, dedifferentiated CS is a sinister variant that presents with singular features and has extremely poor prognosis. We report a unique case of dedifferentiated CS that presented in the temporomandibular joint (TMJ) with extra articular involvement of the infratemporal space. This high grade CS is reviewed due to its rarity and the dentist is implored to take this variant into account when considering the differential diagnosis of destructive TMJ lesions. PMID:25386536

  15. Dedifferentiated chondrosarcoma of temporomandibular joint: atypical features of a rare case.

    PubMed

    Rath, Rachna; Das, B K; Baisakh, Manas; Das, S N

    2014-09-01

    Chondrosarcoma (CS) is an uncommon malignant mesenchymal tumour showing cartilaginous differentiation which rarely presents in the jaws. CS represents 10-20% of all malignant bone tumours and less than 5% of tumours in head and neck region. Among the infrequent subtypes of CS, dedifferentiated CS is a sinister variant that presents with singular features and has extremely poor prognosis. We report a unique case of dedifferentiated CS that presented in the temporomandibular joint (TMJ) with extra articular involvement of the infratemporal space. This high grade CS is reviewed due to its rarity and the dentist is implored to take this variant into account when considering the differential diagnosis of destructive TMJ lesions. PMID:25386536

  16. 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

  17. Treatment of a case of skeletal class II malocclusion with temporomandibular joint disorder using miniscrew anchorage.

    PubMed

    Kaku, Masato; Koseki, Hiroyuki; Kawazoe, Aki; Abedini, Sara; Kojima, Shunichi; Motokawa, Masahide; Ohtani, Junji; Fujita, Tadashi; Kawata, Toshitsugu; Tanne, Kazuo

    2011-04-01

    At the present time, there are no reports in the literature on the treatment of temporomandibular joint disorder (TMD) by intrusion of molars using mini-screws. This case report describes the treatment for a female patient, aged 19 years seven months, with a TMD and an excessive lower anterior facial height. Overjet and overbite were +5.0 mm and +0.5 mm, respectively. The patient had a history of orthodontic treatment in which her first premolars were all extracted. During the first orthodontic treatment, a clockwise mandibular rotation was observed as a result of the increase of posterior dentoalveolar height. She had temporomandibular joint (TMJ) pain during mouth opening and complained of difficulty in eating due to masticatory dysfunction. The pretreatment Schuller views of both TMJ showed a posterior condyle position. In order to correct the overjet, molar relationship and the mandibular condyle position, a miniscrew was inserted into the palatal region of the upper first molar to intrude the upper posterior teeth. As the upper molars were intruded, the overjet was decreased, and a class I molar relationship was achieved by a counterclockwise mandibular rotation. After one year of treatment, an acceptable occlusion was achieved, and the condyle moved into centric position in the glenoid fossa. The patient's teeth continued to be stable, and she had no pain in TMJ after a retention period of three years. The result of this treatment showed that molar intrusion using miniscrew anchorage is effective for treatment of a TMD patient with a posterior condyle position. PMID:21661590

  18. 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

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

    PubMed Central

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

    2009-01-01

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

  20. Effect of estrogen on bone resorption and inflammation in the temporomandibular joint cellular elements.

    PubMed

    Galal, Nadia; El Beialy, Waleed; Deyama, Yoshiaki; Yoshimura, Yoshitaka; Yoshikawa, Tetsuya; Suzuki, Kuniaki; Totsuka, Yasunori

    2008-06-01

    Several epidemiological studies have reported that temporomandibular disorder is more prevalent in women, which suggests the involvement of sex hormones, such as estrogen, in the pathogenesis of this disease. PCR amplification and Western blotting were employed to target the expression of estrogen receptors (ERs) in human fibroblast-like synovial and ATDC5 cells. The effect of estrogen was investigated through the expression of RANKL, osteoprotegerin (OPG), M-CSF/CSF-1 and c-fms. We showed expression of M-CSF/ CSF-1 and c-fms, with time-dependent increase in both after the addition of estrogen. Based on previous studies reporting that M-CSF/CSF-1 regulates the proliferation and differentiation of hemopoietic progenitor cells into mature macrophages, we put forward a new hypothesis based on the increased inflammation and tendency of females to suffer more from temporomandibular disorder (TMD) in the presence of external exacerbating factors. Detection of RANKL and OPG in ATDC5 and expression of both in HFLS was confirmed with complete disappearance of the RANKL band, and marked increase in the expression of OPG after 1 h from the addition of estrogen. PMID:18506373

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

    PubMed Central

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

    2014-01-01

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

  2. BMPRIA Mediated Signaling Is Essential for Temporomandibular Joint Development in Mice

    PubMed Central

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

    2014-01-01

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

  3. Arthroscopic surgery for treatment of anterior displacement of the disc without reduction of the temporomandibular joint.

    PubMed

    Zhu, YaoMin; Zheng, CangShang; Deng, YongQiang; Wang, Yang

    2012-03-01

    The aim of this study was to investigate the clinical results and efficacy of an arthroscopic approach to correct anterior displacement of the disc without reduction of the temporomandibular joint (TMJ) with limitation of mouth opening. We studied 28 joints with internal derangement in 23 patients, all of whom had had arthroscopic surgery (lavage, lysis of adhesions in the superior compartment, incision parallel to the disc-synovial crease of the upper joint compartment, and pull back of the anteriorly located disc). Objective and subjective data (increase in maximal interincisal opening, magnetic resonance imaging, and visual analogue pain score, VAS) were collected preoperatively and at 7, 30, 60 days, and 6 months or more postoperatively. Maximal interincisal opening improved from a mean (SD) of 20.4 (±4.5) mm preoperative measurement to 38.9 (±3.2) mm by 6 months postoperatively where indicated in previous line. The VAS showed a significant improvement in pain score (p=0.0023). Sixty days postoperatively the positions of the discs in 14 of the TMJs had improved considerably. In 13 of the TMJs the positions had improved slightly. Only 1 of the TMJs had not improved at all. There were no complications in any patient. Our arthroscopic procedure is safe, minimally invasive, and effective for the treatment of patients with displacement of the disc anteriorly without reduction of the TMJ. PMID:21377774

  4. 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

  5. ESTROGEN AND INFLAMMATION INCREASE THE EXCITABILITY OF RAT TEMPOROMANDIBULAR JOINT AFFERENT NEURONS

    PubMed Central

    Flake, Natasha M.; Bonebreak, David B.; Gold, Michael S.

    2010-01-01

    Several painful conditions, including temporomandibular disorders (TMD), are more prevalent and more severe in women than in men. Although the physiological basis for this sex difference remains to be determined, it is likely that estrogen is an underlying factor. The present study was performed in order to test the hypotheses that estrogen increases the excitability of rat temporomandibular joint (TMJ) afferents and exacerbates the inflammation-induced sensitization of these sensory neurons. Retrogradely-labeled TMJ neurons from ovariectomized rats and ovariectomized rats receiving chronic estrogen replacement were studied using whole cell patch clamp techniques three days after injecting the TMJ with either saline or Complete Freund’s Adjuvant to induce inflammation. Excitability was assessed with depolarizing current injection in order to determine action potential threshold, rheobase and the response to suprathreshold stimuli. Spontaneous activity was also assessed. Both inflammation and estrogen increased the excitability of TMJ neurons as reflected by decreases in action potential threshold and rheobase and increases in the incidence of spontaneous activity. The effects were additive, with neurons from rats receiving both estrogen and inflammation being the most excitable. The increases in excitability were associated with changes in passive properties and action potential waveform, suggesting that estrogen and inflammation affect the expression and/or properties of ion channels in TMJ neurons. Importantly, the influence of estrogen on both baseline and inflammation-induced changes in TMJ neuronal excitability may help explain the profound sex difference observed in TMD, as well as suggest a novel target for the treatment of this pain condition. PMID:15525813

  6. Crosslinking of fibrinogen and fibronectin by free radicals: A possible initial step in adhesion formation in osteoarthritis of the temporomandibular joint

    Microsoft Academic Search

    Leonore C. Dijkgraaf; Gustavo Zardeneta; Fabian W. Cordewener; Robert S. B. Liem; John P. Schmitz; Lambert G. M. de Bont; Stephen B. Milam

    2003-01-01

    Purpose: Adhesion formation in osteoarthritis (OA) of the temporomandibular joint (TMJ) typically results in a sustained limitation of joint movement. We propose the hypothesis that free-radical[ndash ]mediated crosslinking of proteins underlies this adhesion formation in affected joints. Free radicals may cause oxidative modification of proteins, creating an opportunity for the formation of intramolecular and intermolecular crosslinks via covalent bonds. This

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

    PubMed

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

    2015-01-01

    Synovial chondromatosis (SC) of temporomandibular joint is rare proliferative disorder featured by the formation of cartilaginous nodules in synovium and joint space. Transforming growth factor beta 3 (TGF-?3) is closely related to chondrogenic differentiation, and might participate in pathogenesis of SC. We discovered that increased quantity of synoviocytes and blood vessels were observed in SC synovium. The vessel wall and sublining fibroblasts were stained positively by the antibodies against TGF-?3, fibroblast growth factor 2 (FGF-2), and CD34. In loose bodies (LBs), TGF-?3 was mainly expressed in chondrocytes and FGF-2 was expressed in chondrocytes, fibroblasts, and vessel walls. Expressions of TGF-?1, TGF-?3, FGF-2, Sox9, Wnt-4, Foxc2, and VEGF-A mRNA were significantly higher in SC synovium. Stimulation of TGF-?3 on synoviocytes increased alkaline phosphatase (ALP) activity and expressions of chondrogenic genes (Sox9, Col2?1, Aggrecan, Wnt-4, and Wnt-11), osteogenic genes (Runx2, Foxc2, osteocalcin, and Col1?1), and VEGF-A, but failed to influence FGF-2 expression. However, the addition of FGF-2 increased TGF-?3 expression. In conclusion, TGF-?3 existed in synovium and LBs of SC, and was responsible for the pathogenesis of SC. PMID:25742744

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

    PubMed Central

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

    2015-01-01

    Synovial chondromatosis (SC) of temporomandibular joint is rare proliferative disorder featured by the formation of cartilaginous nodules in synovium and joint space. Transforming growth factor beta 3 (TGF-?3) is closely related to chondrogenic differentiation, and might participate in pathogenesis of SC. We discovered that increased quantity of synoviocytes and blood vessels were observed in SC synovium. The vessel wall and sublining fibroblasts were stained positively by the antibodies against TGF-?3, fibroblast growth factor 2 (FGF-2), and CD34. In loose bodies (LBs), TGF-?3 was mainly expressed in chondrocytes and FGF-2 was expressed in chondrocytes, fibroblasts, and vessel walls. Expressions of TGF-?1, TGF-?3, FGF-2, Sox9, Wnt-4, Foxc2, and VEGF-A mRNA were significantly higher in SC synovium. Stimulation of TGF-?3 on synoviocytes increased alkaline phosphatase (ALP) activity and expressions of chondrogenic genes (Sox9, Col2?1, Aggrecan, Wnt-4, and Wnt-11), osteogenic genes (Runx2, Foxc2, osteocalcin, and Col1?1), and VEGF-A, but failed to influence FGF-2 expression. However, the addition of FGF-2 increased TGF-?3 expression. In conclusion, TGF-?3 existed in synovium and LBs of SC, and was responsible for the pathogenesis of SC. PMID:25742744

  9. 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

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

    PubMed Central

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

    2013-01-01

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

  11. A technique to investigate the three-dimensional kinesiology of the human temporomandibular joint.

    PubMed

    Siegler, S; Hayes, R; Nicolella, D; Fielding, A

    1991-06-01

    Previous kinesiological studies of the temporomandibular joint (TMJ) were based on the motion of only one or two selected points on the mandible (such as the lower central incisor, the mandibular condyle). In the present study, a technique was developed to measure, analyze, and describe the full three-dimensional kinematic characteristics of the TMJ during any mandibular activity. The technique was based on determination of the relative position between the mandible and the temporal bone from measurement of the location of points on light-weight frames rigidly attached through splints to the maxillary and mandibular teeth. An optoelectric kinematic data acquisition system has been used to record the location of these points. The results of the study indicate the following major advantages of this technique over previously reported kinesiological methods: (1) the technique provides a full description of the motion of the mandible with respect to the temporal bone, including all the six degrees of freedom associated with this motion; (2) the description of motion in terms of joint parameters enhances interpretation of the data by clinicians; (3) the motion of any point of interest on the mandible can be easily derived from the data and; (4) the system provides only negligible interference with the natural jaw motion of the subject. It does not require head fixation, does not alter or interfere with the natural occlusion, and its light weight causes only minimal (and negligible) loading of the mandible. PMID:2072331

  12. Sexual dimorphism on cytokines expression in the temporomandibular joint: the role of gonadal steroid hormones.

    PubMed

    Torres-Chávez, Karla E; Fischer, Luana; Teixeira, Juliana Maia; Fávaro-Moreira, Nadia Cristina; Obando-Pereda, Gustavo Alberto; Parada, Carlos Amílcar; Tambeli, Claudia Herrera

    2011-10-01

    Temporomandibular joint pain-related conditions are generally characterized by local inflammation; however, little studies have focused on the role of gonadal hormones in the expression of inflammatory mediators, such as cytokines. Therefore, we asked whether gonadal steroid hormones affect formalin-induced cytokines expression in the rat temporomcandibular joint. The expression of tumor necrosis factor alpha (TNF-?), interleukin (IL)-1?, and cytokine-induced neutrophil chemoattractant (CINC)-1 was significantly higher in males than in diestrus and proestrus females and was decreased by orchiectomy and restored by testosterone replacement. The expression of IL-6 was significantly higher in diestrus and proestrus females than in males, and was decreased by ovariectomy and restored by estradiol or progesterone administration. We conclude that testosterone increases the expression of TNF-?, IL-1? and CINC-1, and estradiol and progesterone increase the expression of IL-6. New clinical approaches based on inhibition of pro-inflammatory mediators are starting to supplant traditional immunosuppressive therapies and gonadal hormones may influence their effectiveness or clinical dosage. PMID:20865308

  13. The use of virtual planning and navigation in the treatment of temporomandibular joint ankylosis.

    PubMed

    Jones, Rhb

    2013-09-01

    Temporomandibular joint ankylosis is not common in our community but can occur as a result of severe facial trauma or significant connective tissue disorders such as rheumatoid arthritis, osteoarthritis and psoriatic arthritis, and unfortunately as a result of iatrogenic causes. Ankylosis surgery is aimed at gap arthroplasty and mobilization of the joints. However, the removal of the bony ankylosis and the production of a gap between the ramus of the mandible and the base of the skull is often difficult because of the size of the ankylosis and the anatomy on the inner aspect of the mandible. As a result of this, the author has found that surgical navigation has been useful with the removal of the ankylosis, both on the medial side of the mandible and the cranial base. Once the ankylosis has been freed and the mandible mobilized, the gap arthroplasty needs to be maintained or the release of the ankylosis will fail and the joints will re-ankylose. It is important to maintain the space produced by the arthroplasty but this is difficult when autogenous materials such as temporalis muscle, dermis fat and other like materials are used. The gap ultimately closes under the influence of the masseter and medial pterygoid muscles and the ankylosis may return. This case report presents three representative patients in whom ankylosis has been released and the gap reconstructed with a total alloplastic joint replacement. All patients have had their ankylosis removed with the aid of a navigation system and all patients have been reconstructed with bilateral Biomet prosthesis. One patient has had their implant selected using virtual planning and the production of templates to help with placement of the stock implant. PMID:23981219

  14. Septic arthritis of the temporomandibular joint caused by Aspergillus flavus infection as a complication of otitis externa.

    PubMed

    Varghese, Lalee; Chacko, Rabin; Varghese, George M; Job, Anand

    2015-03-01

    Septic arthritis of the temporomandibular joint (TMJ) is a very rare complication of otitis externa that can lead to ankylosis and destruction of the joint. We report the case of a 74-year-old man who developed aspergillosis of the TMJ following otitis externa. To the best of our knowledge, this is the first reported case of TMJ septic arthritis secondary to otitis externa caused by Aspergillus flavus. The patient was successfully managed with condylectomy, debridement, and drug treatment with voriconazole. PMID:25738723

  15. 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

  16. Early-onset osteoarthritis of mouse temporomandibular joint induced by partial discectomy

    PubMed Central

    Xu, L.; Polur, I.; Lim, C.; Servais, J. M.; Dobeck, J.; Li, Y.; Olsen, B. R.

    2010-01-01

    Summary Objective The objective of this study is to characterize mouse temporomandibular joint (TMJ) following partial discectomy, since there is no documentation of whether or not partial discectomy can induce early-onset osteoarthritis (OA) in mouse TMJ. Methods Partial discs of TMJ in mice were removed by microsurgery. Histology was performed to characterize articular cartilages from the TMJ of mice. The morphology of the articular cartilages was evaluated using a modified Mankin scoring system. Immunohistostaining was carried out to examine the expression of discoidin domain receptor 2 (Ddr2), a type II collagen receptor, matrix metalloproteinase 13 (Mmp-13), and Mmp-derived type II collagen fragments in the articular cartilage of condyles from the mouse TMJ. Results Articular cartilage degeneration was seen in the mouse TMJ post discectomy, including increased proteoglycan staining in the extracellular matrix at 4 weeks, the appearance of chondrocyte clusters at 8 weeks, reduced proteoglycan staining and fibrillation at 12 weeks and the loss of articular cartilage at 16 weeks. Increased immunostaining for Ddr2, Mmp-13, and Mmp-derived type II collagen fragments was detected. Conclusion Results indicate that partial discectomy induces early-onset OA in mouse TMJ and that increased expression of Mmp-13, likely due to the elevated expression of Ddr2, may be one of the factors responsible for the early-onset OA in mouse TMJ. PMID:19230720

  17. 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

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  2. Small field of view cone beam CT temporomandibular joint imaging dosimetry

    PubMed Central

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

    2013-01-01

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

  3. Management of temporomandibular joint ankylosis type III: lateral arthroplasty as a treatment of choice.

    PubMed

    Singh, V; Bhagol, A; Dhingra, R; Kumar, P; Sharma, N; Singhal, R

    2014-04-01

    Many surgical techniques for the management of temporomandibular joint (TMJ) ankylosis have been described in the literature. The purpose of this study was to report our experience using a lateral arthroplasty technique in the management of type III ankylosis. The records of 15 patients treated for TMJ ankylosis at our institution between 2007 and 2011 were reviewed. Pre- and postoperative information collected included age, gender, aetiology, ankylosis type/classification, existing facial asymmetry, maximum pre- and postoperative mouth opening, complications, and recurrence of ankylosis. The mean maximum inter-incisal opening in the preoperative period was 12.9 mm and in the postoperative period was 36.2mm. No major complication was observed in any patient. No recurrence was noted in any patient. Our working hypothesis was that for patients with ankylosis type III, the medially displaced condyle and disc can fulfil their role in mandibular function and growth after extirpation of the ankylozed mass. Although they are located in an awkward medial position, they should function exactly as they would after a properly treated, displaced condylar fracture. PMID:24100155

  4. The cerebral representation of temporomandibular joint occlusion and its alternation by occlusal splints.

    PubMed

    Lotze, Martin; Lucas, Christian; Domin, Martin; Kordass, Bernd

    2012-12-01

    Occlusal splints are a common and effective therapy for temporomandibular joint disorder. Latest hypotheses on the impact of occlusal splints suggest an altered cerebral control on the occlusion movements after using a splint. However, the impact of using a splint during chewing on its cerebral representation is quite unknown. We used functional magnetic resonance imaging (fMRI) to investigate brain activities during occlusal function in centric occlusion on natural teeth or on occlusal splints in fifteen healthy subjects. Comparisons between conditions revealed an increased activation for the bilateral occlusion without a splint in bilateral primary and secondary sensorimotor areas, the putamen, inferior parietal and prefrontal cortex (left dorsal and bilateral orbital) and anterior insular. In contrast, using a splint increased activation in the bilateral prefrontal lobe (bilateral BA 10), bilateral temporo-parietal (BA 39), occipital and cerebellar hemispheres. An additionally applied individually based evaluation of representation sites in regions of interest demonstrated that the somatotopic representation for both conditions in the pre- and postcentral gyri did not significantly differ. Furthermore, this analysis confirmed the decreasing effect of the splint on bilateral primary and secondary motor and somatosensory cortical activation. In contrast to the decreasing effect on sensorimotor areas, an increased level of activity in the fronto-parieto-occipital and cerebellar network might be associated with the therapeutic effect of occlusal splints. PMID:22102437

  5. Tumor necrosis factor mediates temporomandibular joint bone tissue resorption in rheumatoid arthritis.

    PubMed

    Ahmed, Neveen; Petersson, Arne; Catrina, Anca Irinel; Mustafa, Hamid; Alstergren, Per

    2015-04-01

    Abstract Objective. To investigate if TNF, IL-1 or their endogenous controls, in relation to ACPA, are associated with radiological signs of ongoing temporomandibular joint (TMJ) bone tissue resorption and disc displacement in RA patients. Methods. Twenty-two consecutive outpatients with TMJ of RA were included. Systemic inflammatory activity was assessed by DAS28. The number of painful regions in the body and ESR, CRP, RF and ACPA were analyzed. TMJ synovial fluid and blood samples were obtained and analyzed for TNF, TNFsRII, IL-1ra, IL-1sRII and ACPA. The ratios between the mediators and their endogenous control receptors were used in the statistical analysis. Magnetic resonance imaging was performed in closed- and open-mouth positions and evaluated regarding disc position and presence of condylar and temporal erosions of the TMJ. Results. A high TNF level in relation to TNFsRII in TMJ synovial fluid correlated to the degree of TMJ condylar erosion. A high IL-1ra level in relation to TNF in TMJ synovial fluid was also correlated to the degree of TMJ condylar erosion. The total degree of TMJ condylar erosion was correlated with the number of painful regions. Conclusion. This study indicates that TNF in TMJ synovial fluid mediates TMJ cartilage and bone tissue resorption in RA. The study also suggests that the degree of endogenous cytokine control is of importance for development of bone tissue destruction. PMID:25515682

  6. Estrogen and progesterone receptors in temporomandibular joint discs of symptomatic and asymptomatic persons: a preliminary study.

    PubMed

    Abubaker, A O; Raslan, W F; Sotereanos, G C

    1993-10-01

    Numerous studies have shown the presence of estrogen receptors and a mediated effect of estrogen through these receptors in the articular cartilage of various species, including humans. Because temporomandibular joint (TMJ) symptoms are more prevalent among women, this study was performed to investigate the presence of estrogen and progesterone receptors in the human TMJ. Seven TMJ disc specimens obtained from women with TMJ symptoms with documented internal derangement were analyzed for the presence of these receptors. These were compared with another group of 15 TMJ discs removed from men and women with no TMJ symptoms undergoing skull base surgery who had extirpation of the TMJ for access to the skull base. Detection of these receptors was done by an immunohistochemical technique using mouse monoclonal antibody. The results showed the presence of these receptors in both symptomatic and asymptomatic men and women. Although these receptors were found in more of the women with TMJ symptoms than the other two groups, due to the small number of the specimens studies no definitive conclusions as to the correlation between female sex hormones and TMJ symptoms could be drawn. However it was concluded that the TMJ disc is, at least in some men and women, potentially a female sex hormone target tissue. PMID:7692023

  7. Sexual dimorphism in the antinociception mediated by kappa opioid receptors in the rat temporomandibular joint.

    PubMed

    Clemente, Juliana T; Parada, Carlos A; Veiga, Maria C Arruda; Gear, Robert W; Tambeli, Cláudia H

    2004-12-01

    This study assessed the effect of the kappa opioid receptor agonist U50,488 administered into the rat temporomandibular joint (TMJ) on nociceptive behavioral responses evoked by formalin injected into the same site. Groups consisted of females, stratified into proestrus and diestrus phases of the estrous cycle, and males. Intra-TMJ formalin induced significantly different dose-dependent responses among the three groups, with diestrus females showing greater responses than males or proestrus females; therefore, equi-nociceptive formalin doses were chosen to test the effects of U50,488. U50,488 significantly reduced formalin-induced nociceptive behavior in all groups, but the reduction was significantly greater in females, especially those in diestrus. Pre-injection of the selective kappa opioid receptor antagonist nor-binaltorphimine (nor-BNI) into the same site significantly attenuated the effect of U50488; U50,488 injection into the contralateral TMJ failed to reduce nociceptive behavior. These findings support a role for kappa opioid receptors local to the site of inflammation to modulate inflammatory pain. Furthermore, since plasma levels of ovarian hormones are low during diestrus, these findings are consistent with the suggestion that sex hormones may play an antagonistic role in these peripheral kappa-mediated effects. PMID:15542250

  8. GABAergic influence on temporomandibular joint-responsive spinomedullary neurons depends on estrogen status

    PubMed Central

    Tashiro, Akimasa; Bereiter, David A.; Thompson, Randall; Nishida, Yasuhiro

    2014-01-01

    Sensory input from the temporomandibular joint (TMJ) to neurons in superficial laminae at the spinomedullary (Vc/C1–2) region is strongly influenced by estrogen status. This study determined if GABAergic mechanisms play a role in estrogen modulation of TMJ nociceptive processing in ovariectomized female rats treated with high (HE) or low dose (LE) estradiol (E2) for two days. Superficial laminae neurons were activated by ATP (1 mM) injections into the joint space. The selective GABAA receptor antagonist, bicuculline methiodide (BMI, 5 or 50 ?M, 30 ?l), applied at the site of recording greatly enhanced the magnitude and duration of ATP-evoked responses in LE rats, but not in units from HE rats. The convergent cutaneous receptive field (RF) area of TMJ neurons was enlarged after BMI in LE but not HE rats, while resting discharge rates were increased after BMI independent of estrogen status. By contrast, the selective GABAA receptor agonist, muscimol (50 ?M, 30 ?l), significantly reduced the magnitude and duration of ATP-evoked activity, resting discharge rate, and cutaneous RF area of TMJ neurons in LE and HE rats, whereas lower doses (5 ?M) affected only units from LE rats. Protein levels of GABAA receptor ?3 isoform at the Vc/C1–2 region were similar for HE and LE rats. These results suggest that GABAergic mechanisms contribute significantly to background discharge rates and TMJ-evoked input to superficial laminae neurons at the Vc/C1–2 region. Estrogen status may gate the magnitude of GABAergic influence on TMJ neurons at the earliest stages of nociceptive processing at the spinomedullary region. PMID:24316475

  9. GABAergic influence on temporomandibular joint-responsive spinomedullary neurons depends on estrogen status.

    PubMed

    Tashiro, A; Bereiter, D A; Thompson, R; Nishida, Y

    2014-02-14

    Sensory input from the temporomandibular joint (TMJ) to neurons in superficial laminae at the spinomedullary (Vc/C1-2) region is strongly influenced by estrogen status. This study determined if GABAergic mechanisms play a role in estrogen modulation of TMJ nociceptive processing in ovariectomized female rats treated with high- (HE) or low-dose (LE) estradiol (E2) for 2days. Superficial laminae neurons were activated by ATP (1mM) injections into the joint space. The selective GABAA receptor antagonist, bicuculline methiodide (BMI, 5 or 50?M, 30?l), applied at the site of recording greatly enhanced the magnitude and duration of ATP-evoked responses in LE rats, but not in units from HE rats. The convergent cutaneous receptive field (RF) area of TMJ neurons was enlarged after BMI in LE but not HE rats, while resting discharge rates were increased after BMI independent of estrogen status. By contrast, the selective GABAA receptor agonist, muscimol (50?M, 30?l), significantly reduced the magnitude and duration of ATP-evoked activity, resting discharge rate, and cutaneous RF area of TMJ neurons in LE and HE rats, whereas lower doses (5?M) affected only units from LE rats. Protein levels of GABAA receptor ?3 isoform at the Vc/C1-2 region were similar for HE and LE rats. These results suggest that GABAergic mechanisms contribute significantly to background discharge rates and TMJ-evoked input to superficial laminae neurons at the Vc/C1-2 region. Estrogen status may gate the magnitude of GABAergic influence on TMJ neurons at the earliest stages of nociceptive processing at the spinomedullary region. PMID:24316475

  10. Expression of hyaluronan synthase 3 in deformed human temporomandibular joint discs: in vivo and in vitro studies

    PubMed Central

    Matsumoto, T.; Inayama, M.; Tojyo, I.; Kiga, N.; Fujita, S.

    2010-01-01

    The present study aimed at investigating the expression of a hyaluronan synthase (HAS) 3 in tissue samples of deformed human temporomandibular joint (TMJ) discs and cells obtained from the discs. Fifteen adult human TMJ discs (twelve diseased discs and three normal discs) were used in this study. The twelve diseased discs were obtained from twelve patients with internal derangement (ID) of TMJ. These patients all had anteriorly displaced discs and deformed discs. The tissues were immunohistochemically stained using HAS3 antibodies. In addition, the subcultured TMJ disc cells under both normal and hypoxic conditions (O2: 2%) were incubated for 3, 6, 12, and 24 h after addition of interleukin-1? (IL-1?) (1 ng/mL). Subsequently, the expression of HAS3 was examined using real-time reverse transcription-polymerase chain reaction (RT-PCR). The control group showed from negative to weak positive reactions for HAS3 on immunohistochemical staining. The discs extracted from twelve cases with ID presented from moderate to strong positive reactions for HAS3. The quantity of HAS3 mRNA was compared with a control group, and showed a 204-fold increase at 3 h, a 26-fold increase at 6 h, a 2.5-fold increase at 12 h and a 32-fold increase at 24 h under hypoxia with the addition of IL-1?. The expression of HAS3 mRNA was significantly enhanced at 3 h and 24 h. The results obtained suggest that HAS3 is related to the pathological changes of human TMJ discs affected by ID. PMID:21263749

  11. Transcriptional regulation of Proteoglycan 4 (PRG4) by 17?-estradiol in immortalized baboon temporomandibular joint disc cells

    PubMed Central

    McDaniel, Jennifer S.; Babu, Ramya Akula Suresh; Navarro, Mary M.; LeBaron, Richard G.

    2015-01-01

    Temporomandibular joint disorders (TMDs) affect a significant portion of the U.S. population with the majority seeking treatment being women of childbearing age. Due to this striking sexual dimorphism it has been postulated that there is a role for sex hormones in the maintenance of normal temporomandibular joint (TMJ) function. Proteoglycan 4 (PRG4) is a secreted lubricating molecule required for maintaining low frictional levels within articular joints, however its role in the TMJ is not well characterized. In this study we describe the development of immortalized baboon cells isolated from specific regions of the TMJ disc and their use in the investigation of PRG4 expression and localization patterns in the TMJ. We identified conserved estrogen response elements within the 5? flanking region of the PRG4 gene of several species, and found that treatment of baboon TMJ disc cells with estrogen led to reduced PRG4 promoter activity and mRNA expression in vitro. The observed negative regulation of PRG4 by estrogen could lead to increased friction and degradation of joint components over time. This study, for the first time, provides evidence of the regulatory potential of estrogen on PRG4 gene expression and suggests a novel etiology for the gender disparity observed among TMD patients. PMID:24621258

  12. 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. Anat Rec, 298:680-690, 2015. © 2014 Wiley Periodicals, Inc. PMID:25737135

  13. 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

  14. An adult case of temporomandibular joint osteoarthritis treated with splint therapy and the subsequent orthodontic occlusal reconstruction

    PubMed Central

    Kurt, Hanefi; Özta?, Evren; Gençel, Burç; Ta?an, Demet Ataman; Özta?, Derya

    2011-01-01

    Herein we report treatment for a 19-year-old female patient with severe osteoarthritis of the temporomandibular joint. The patient had severe open bite with a Class II molar relationship. She had limited mouth opening and pain. Clinical examination and magnetic resonance imaging revealed that she had anterior disc displacement without reduction. By splint therapy, limited mouth opening and pain was eliminated, but an anterior open bite developed after the treatment. By orthodontic treatment, an acceptable occlusion was achieved with a Class I molar relationship. PMID:22346169

  15. 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

  16. Temporomandibular Joint Condylar Changes Following Maxillomandibular Advancement and Articular Disc Repositioning

    PubMed Central

    Goncalves, Joao Roberto; Wolford, Larry Miller; Cassano, Daniel Serra; da Porciuncula, Guilherme; Paniagua, Beatriz; Cevidanes, Lucia Helena

    2014-01-01

    Purpose To evaluate condylar changes 1 year after bimaxillary surgical advancement with or without articular disc repositioning using longitudinal quantitative measurements in 3-dimensional (3D) temporomandibular joint (TMJ) models. Methods Twenty-seven patients treated with maxillomandibular advancement (MMA) underwent cone-beam computed tomography before surgery immediately after surgery and at 1-year follow-up. All patients underwent magnetic resonance imaging before surgery to assess disc displacements. Ten patients without disc displacement received MMA only. Seventeen patients with articular disc displacement received MMA with simultaneous TMJ disc repositioning (MMA-Drep). Pre- and postsurgical 3D models were superimposed using a voxel-based registration on the cranial base. Results The location, direction, and magnitude of condylar changes were displayed and quantified by graphic semitransparent overlays and 3D color-coded surface distance maps. Rotational condylar displacements were similar in the 2 groups. Immediately after surgery, condylar translational displacements of at least 1.5 mm occurred in a posterior, superior, or mediolateral direction in patients treated with MMA, whereas patients treated with MMA-Drep presented more marked anterior, inferior, and mediolateral condylar displacements. One year after surgery, more than half the patients in the 2 groups presented condylar resorptive changes of at least 1.5 mm. Patients treated with MMA-Drep presented condylar bone apposition of at least 1.5 mm at the superior surface in 26.4%, the anterior surface in 23.4%, the posterior surface in 29.4%, the medial surface in 5.9%, or the lateral surface in 38.2%, whereas bone apposition was not observed in patients treated with MMA. Conclusions One year after surgery, condylar resorptive changes greater than 1.5 mm were observed in the 2 groups. Articular disc repositioning facilitated bone apposition in localized condylar regions in patients treated with MMA-Drep. PMID:24040949

  17. Temporomandibular Joint and Muscle Disorder-type Pain in US Adults: The National Health Interview Survey

    PubMed Central

    Isong, Umo; Gansky, Stuart A.; Plesh, Octavia

    2015-01-01

    Aims To compare prevalences of self-reported temporomandibular joint and muscle disorders (TM]MD)-type pain in the 2001 US National Health Interview Survey (NHIS) by age and gender for non-Hispmric whites (Caucasians) and non-Hispanic blacks (African Americans). Methods Data from the 2002 NHIS included information on gender, age, race, ethnicity, education, and TMJMD-type pain. Rao-Scott survey chi-square and survey logistic regression analyses using sampling weights and accounting for the complex design were used to analyze variables relating to prevalences. Results A total of 30,978 people, 17,498 females and 13,480 males, 20,389 non-Hispanic whites and 4,179 non-Hispanic blacks, were included. The overall prevalence of TMJMD-type pain was 4.6%, with 6.3% for women and 1.8% for men. However, based on age, a significant but modest racial/ethnic difference emerged after adjusting for socioeconomic status. For non-Hispanic white women up to age 50, the prevalence was ~7% to 8%, but it decreased after age 55. Non-Hispanic black women had much lower prevalence at younger ages (~4% at 25 to 34 years), which increased thereafter up to 55 to 64 years of age. A similar racial pattern seemed to emerge for non-Hispanic black men, with the lowest prevalence at ages 25 to 34 years, while non-Hispanic white men had higher prevalences. Overall, however, age seemed to play more of a role in women than men. Conclusion This is the first report of findings from a nationally representative US sample for TMJMD-type pain by age and race/ethnicity TMJMD-type-pain differed significantly by race, age, and gender after adjusting for socioeconomic status. PMID:19090404

  18. 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.

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

    PubMed

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

    2008-12-01

    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

  20. 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

  1. Influence of sex on reflex jaw muscle activity evoked from the rat temporomandibular joint.

    PubMed

    Cairns, Brian E; Sim, Yiin; Bereiter, David A; Sessle, Barry J; Hu, James W

    2002-12-13

    Injection of glutamate into the rat temporomandibular joint (TMJ) evoked a concentration-dependent increase in jaw muscle activity. We investigated whether there are sex-related differences in glutamate-evoked jaw muscle activity that are mediated by sex hormones and whether prior injection of glutamate into the TMJ alters the magnitude of jaw muscle activity evoked by a subsequent injection of the algesic and inflammatory compound mustard oil (MO) into the TMJ. The magnitude of glutamate-evoked digastric and masseter muscle activity was significantly greater in female than male rats when 1000 mM glutamate was injected into the TMJ. Gonadectomy significantly reduced the magnitude of glutamate-evoked digastric muscle activity in female rats. Treatment of gonadectomized female rats with estrogen (20 microg/day) increased the magnitude of glutamate-evoked digastric muscle activity. Glutamate-evoked jaw muscle activity in gonadectomized and estrogen-treated gonadectomized males was not significantly different from intact males. Prior injection of glutamate over a concentration range of 10-1000 mM significantly increased digastric muscle activity evoked by MO injection into the TMJ 30 min later. In contrast, MO-evoked masseter muscle activity was significantly increased by prior injection of 250 mM glutamate only. There were, however, no sex-related differences in the enhancement of MO-evoked jaw muscle activity by prior injection of glutamate. These findings indicate that there are sex-related differences in glutamate-evoked jaw muscle activity that are dependent on female sex hormones, and increased glutamate concentrations sensitize the TMJ to noxious chemical stimuli. PMID:12445976

  2. Meal pattern changes associated with temporomandibular joint inflammation/pain in rats; analgesic effects.

    PubMed

    Kerins, C A; Carlson, D S; McIntosh, J E; Bellinger, L L

    2003-04-01

    Establishing a valid animal model to study temporomandibular joint (TMJ) pain has proven extremely difficult. Using complete Freund's adjuvant (CFA) to induce TMJ inflammation, we recently showed that meal pattern analysis could be used as a noninvasive biological marker to study TMJ pain in an animal model. The purpose of this study was to further validate our animal model by determining whether aspects of CFA-induced TMJ inflammation/pain are reversed with ibuprofen (IBU) treatment. In the first trial, 48 male rats were used and in the second trial, 32 female ovariectomized rats, given 17beta-estradiol replacement, were used. The rats were assigned to one of four groups: control (CON-CON); control+IBU (CON+IBU); CFA-CON; and CFA+IBU. In the male trial, CFA injection (P<.01) caused TMJ swelling and chromodacryorrhea (CFA-CON); IBU eliminated these changes in the CFA+IBU group. Meal pattern analysis showed the pertinent CFA-induced change and the IBU effect was that meal duration was increased in the CFA-CON group (P<.01), but normal in the CFA+IBU-treated group on the first, but not second, day postinjection. In the female trial, CFA increased TMJ swelling, but did not cause significant chromodacryorrhea (CFA-CON); IBU eliminated swelling in the CFA+IBU group. Meal duration was increased (P<.01) in the CFA-CON group, but was normal in the CFA+IBU-treated group on both the first and second days postinjection. In both trials, interleukin-1beta (IL-1beta) levels were increased similarly in CFA-CON and CFA+IBU groups (P<.01). This study shows that CFA-induced TMJ inflammation/pain can cause changes in meal patterns (i.e., meal duration), which may be used as a behavioral marker for TMJ inflammation/pain. PMID:12759126

  3. Effectiveness of Dexamethasone Iontophoresis for Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis

    PubMed Central

    Mina, Rina; Melson, Paula; Powell, Stephanie; Rao, Marepalli; Hinze, Claas; Passo, Murray; Graham, T. Brent; Brunner, Hermine I.

    2011-01-01

    Objective Temporomandibular joint (TMJ) involvement is common in Juvenile Idiopathic Arthritis (JIA). Dexamethasone iontophoresis (DIP) uses low-grade electric currents for transdermal dexamethasone delivery into deeper anatomic structures. The purpose of this study was to assess the safety and effectiveness of DIP for the treatment of TMJ involvement in JIA, and to delineate variables that are associated with improvement after DIP. Methods Medical records of all JIA patients who underwent DIP for TMJ involvement at a larger tertiary pediatric rheumatology center from 1997 to 2011 were reviewed. DIP was performed using a standard protocol. The effectiveness of DIP was assessed by comparing the maximal inter-incisor opening (MIOTMJ) and the maximal lateral excursion (MLETMJ) before and after treatment. Results Twenty-eight patients (ages 2– 21 years) who received an average of eight DIP treatment sessions per involved TMJ were included in the analysis. Statistically significant improvement in the median MIOTMJ (p< 0.0001) was observed in 68%. The median MLETMJ (p= 0.03) improved in 69%, and resolution of TMJ pain occurred in 73% of the patients who had TMJ pain at baseline. Side effects of DIP were transient site erythema (86%), skin blister (4%), and metallic taste (4%). Improvement in TMJ range of motion from DIP is associated with lower MIOTMJ, lower MLETMJ, and absence of TMJ crepitus at baseline. Conclusion In this pilot study DIP appeared to be an effective and safe initial treatment of TMJ involvement in JIA, especially among patients with decreased TMJ measurements. Prospective controlled studies are needed. PMID:22034112

  4. Testosterone and estrogen have opposing actions on inflammation-induced plasma extravasation in the rat temporomandibular joint.

    PubMed

    Flake, Natasha M; Hermanstyne, Tracey O; Gold, Michael S

    2006-08-01

    The present study was designed to test the hypothesis that estrogen exacerbates inflammation of the temporomandibular joint (TMJ). Evans blue dye was used to quantify plasma extravasation (PE) around the rat TMJ. In an initial set of experiments, TMJ PE was compared in naïve intact male and female rats, as well as in both groups after complete Freund's adjuvant (CFA)-induced inflammation of the TMJ. In contrast to our hypothesis, TMJ PE was significantly greater in both naïve and CFA-inflamed male rats than in females. To determine whether these differences were due to gonadal hormones, four additional groups of rats were studied: gonadectomized (Gx) males and females, Gx males with chronic testosterone (T) replacement, and Gx females with chronic estrogen (E) replacement. The sex difference in baseline TMJ PE appeared to reflect the actions of T. However, in the presence of TMJ inflammation, T augmented TMJ PE in males, while E attenuated TMJ PE in females. Changes in PE were also assessed in the contralateral TMJ. Results from this analysis indicated that there is a transient contralateral increase in TMJ PE in females but not males. Given that there is an inverse relationship between PE and joint damage, our results suggest that testosterone may mitigate, but estrogen may exacerbate, TMJ damage, particularly in the presence of overt inflammation. Importantly, our results may help explain both the higher prevalence and severity of temporomandibular disorder pain in females than males. PMID:16469833

  5. 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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  8. Estradiol Promotes M1-like Macrophage Activation through Cadherin-11 To Aggravate Temporomandibular Joint Inflammation in Rats.

    PubMed

    Kou, Xiao-Xing; Li, Chen-Shuang; He, Dan-Qing; Wang, Xue-Dong; Hao, Ting; Meng, Zhen; Zhou, Yan-Heng; Gan, Ye-Hua

    2015-03-15

    Macrophages play a major role in joint inflammation. Estrogen is involved in rheumatoid arthritis and temporomandibular disorders. However, the underlying mechanism is still unclear. This study was done to verify and test how estrogen affects M1/M2-like macrophage polarization and then contributes to joint inflammation. Female rats were ovariectomized and treated with increasing doses of 17?-estradiol for 10 d and then intra-articularly injected with CFA to induce temporomandibular joint (TMJ) inflammation. The polarization of macrophages and expression of cadherin-11 was evaluated at 24 h after the induction of TMJ inflammation and after blocking cadherin-11 or estrogen receptors. NR8383 macrophages were treated with estradiol and TNF-?, with or without blocking cadherin-11 or estrogen receptors, to evaluate the expression of the M1/M2-like macrophage-associated genes. We found that estradiol increased the infiltration of macrophages with a proinflammatory M1-like predominant profile in the synovium of inflamed TMJ. In addition, estradiol dose-dependently upregulated the expressions of the M1-associated proinflammatory factor inducible NO synthase (iNOS) but repressed the expressions of the M2-associated genes IL-10 and arginase in NR8383 macrophages. Furthermore, estradiol mainly promoted cadherin-11 expression in M1-like macrophages of inflamed TMJ. By contrast, blockage of cadherin-11 concurrently reversed estradiol-potentiated M1-like macrophage activation and TMJ inflammation, as well as reversed TNF-?-induced induction of inducible NO synthase and NO in NR8383 macrophages. The blocking of estrogen receptors reversed estradiol-potentiated M1-like macrophage activation and cadherin-11 expression. These results suggested that estradiol could promote M1-like macrophage activation through cadherin-11 to aggravate the acute inflammation of TMJs. PMID:25681337

  9. Image-Based Biomimetic Approach to Reconstruction of the Temporomandibular Joint

    Microsoft Academic Search

    Stephen E. Feinberg; Scott J. Hollister; John W. Halloran; T. M. Gabe Chu; Paul H. Krebsbach

    2001-01-01

    This article will present an image-based approach to the designing and manufacturing of biomimetic tissue engineered temporomandibular (TMJ) condylar prosthesis. Our vision of a tissue-engineered TMJ prosthesis utilizes a 3-D designed and manufactured biodegradable scaffold shaped similar to a condylar head and neck, i.e. a condylar-ramus unit (CRU). The fabricated CRU scaffold can be constructed with a specific intra-architectural design

  10. Tenosynovial, diffuse type giant cell tumor of the temporomandibular joint, diagnosis and management of a rare tumor.

    PubMed

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

    2015-04-01

    The purpose of this paper was to describe a rare unusual case of primary mandibular condylar tenosynovial giant cell tumor of diffuse type with predominantly intraosseous growth and its management by resection and functional reconstruction with a vascularized costochondral graft. Clinical presentation was swelling in the right condylar area and limited mouth opening with radiological evidence of central bone destruction and magnetic resonance imaging showed central hemosiderin deposition. Fine needle aspiration did not lead to a diagnosis and an open biopsy had to be performed. Management consisted of tumor resection and reconstruction with a free vascularized costochondral graft. Tenosynovial diffuse type giant cell tumor of the temporomandibular joint is very rare. Complete resection leads to a low recurrence rate and reconstruction with a costochondral free vascularized flap leads to an excellent functional outcome. PMID:25699124

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

    PubMed Central

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

    2015-01-01

    The purpose of this paper was to describe a rare unusual case of primary mandibular condylar tenosynovial giant cell tumor of diffuse type with predominantly intraosseous growth and its management by resection and functional reconstruction with a vascularized costochondral graft. Clinical presentation was swelling in the right condylar area and limited mouth opening with radiological evidence of central bone destruction and magnetic resonance imaging showed central hemosiderin deposition. Fine needle aspiration did not lead to a diagnosis and an open biopsy had to be performed. Management consisted of tumor resection and reconstruction with a free vascularized costochondral graft. Tenosynovial diffuse type giant cell tumor of the temporomandibular joint is very rare. Complete resection leads to a low recurrence rate and reconstruction with a costochondral free vascularized flap leads to an excellent functional outcome. PMID:25699124

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

    PubMed Central

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

    2012-01-01

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

  13. Influence of sociodemographic factors upon pain intensity in patients with temporomandibular joint disorders seen in the primary care setting

    PubMed Central

    Rodríguez-Torronteras, Alejandro; Blanco-Aguilera, Antonio; Biedma-Velázquez, Lourdes; Serrano-del-Rosal, Rafael; Segura-Saint-Gerons, Rafael; de la Torre-de la Torre, Javier; Esparza-Díaz, Federico

    2012-01-01

    Objective: A study is made of the influence of gender, educational level, marital status, income, social support, and perceived general and oral health upon pain intensity in a sample of patients with temporomandibular joint disorders (TMJD) explored in primary care (AP). Design: A review was made of 899 patients from Córdoba Healthcare District (Spain) referred to the primary care TMJD Unit by their primary care physician and/or dentist. Of these subjects, 151 failed to meet the inclusion criteria. The remaining 748 subjects were explored according to the corresponding research diagnostic criteria (RDC/TMJD). A bivariate analysis was made the association of pain intensity to the demographic and psychological characteristics of the patients, and to perceived general and oral health, followed by a multivariate linear regression analysis to explain pain intensity as a function of the rest of the variables. The SPSS version 19.0 statistical package was used. Results: The patient age ranged from 18-86 years, with a mean of 45.8 years (± 15.8), and a female predominance of 5:1. The characteristic pain intensity (CPI) score was almost 15 points higher on average in women than in men (p<0.05). A lower educational level, and separation or divorce, were correlated to an increased intensity of pain. Social support, depression and general and oral health also explained part of pain intensity. The regression model established with these variables accounted for 13.3% of the variability of pain (R2 = 0.133). Conclusions: Women suffer more intense pain than men. Perceived health partially explains the variability of the CPI score. However, it is empirically seen that the variables gender, educational level and marital status exert an important and independent influence upon pain intensity. Key words:Cranial-mandibular disorders, age, gender, educational level, primary care, research diagnostic criteria for temporomandibular joint disorders (RDC/TMD). PMID:22549669

  14. Arthroscopy versus arthrocentesis in the management of internal derangement of the temporomandibular joint: a systematic review and meta-analysis.

    PubMed

    Al-Moraissi, E A

    2015-01-01

    The aim of this study was to assess whether arthroscopy or arthrocentesis is most effective and feasible in the management of internal derangement of the temporomandibular joint (TMJ), specifically in relation to joint movement and pain. A comprehensive electronic search without date or language restrictions was performed in January 2014. Inclusion criteria were the following: study in humans; randomized or quasi-randomized controlled trials (RCTs), controlled clinical trials (CCTs), and retrospective studies; comparison of arthrocentesis and arthroscopy in the treatment of internal derangement. Six publications were included in the review, two RCTs, two CCTs, and two retrospective studies. Two studies showed a low risk of bias and four studies showed a moderate risk of bias. There were statistically significant differences between arthrocentesis and arthroscopy with regard to maximal inter-incisal opening and pain reduction, but no difference between the two groups for postoperative complications. The results of this meta-analysis on the management of internal derangement of the TMJ revealed arthroscopy to have superior efficacy to arthrocentesis in increasing joint movement and decreasing pain. Both arthroscopy and arthrocentesis have comparable postoperative complication rates. However, the current meta-analysis is incomplete due to the paucity of good quality studies in the high-impact, peer-reviewed literature; therefore, further better-designed studies are required to address this important question before final conclusions can be drawn as to the true comparative outcomes of TMJ arthrocentesis versus TMJ arthroscopy. PMID:25123511

  15. Temporomandibular disorders in 19-year-old Korean men

    Microsoft Academic Search

    You-Sung Choi; Pill-Hoon Choung; Hyock-Soo Moon; Seong-Gon Kim

    2002-01-01

    Purpose: The purpose of this study was to determine the prevalence and the nature of the relationships between 3 temporomandibular joint disease (TMD) symptoms and symptoms of associated structures. Materials and Methods: This study was designed to rule out the effect from the uneven composition of the samples on TMD symptoms. The samples were collected from subjects who were of

  16. A longitudinal study on the osteoarthritic change of the temporomandibular joint based on 1-year follow-up computed tomography.

    PubMed

    Lee, Jeong-Yun; Kim, Dae-Jung; Lee, Sang-Goo; Chung, Jin-Woo

    2012-12-01

    This study aims to report the results of a 1-year computed tomographic (CT) follow up of 54 temporomandibular joints (TMJs) affected by osteoarthritis (OA) and to provide longitudinal information on changes in OA and its relationship with clinical signs and symptoms. TMJ OA was diagnosed by history, clinical and CT examinations. The second CT examination was done after about 1 year of conservative treatment. Joints were divided into three groups labeled as no change, improved CT, and worsened CT groups depending on the longitudinal bony change of OA observed in the CT. The sex distribution, mean age, joint noise, subjective pain, joint tenderness, masticatory muscle tenderness, and improvement of subjective symptoms were not different between the groups at the first and second examination, while maximum (p < 0.01) and painless mouth opening range (p < 0.001) at the first examination were both smaller in the worsened CT group. Although the clinical signs and symptoms of OA were improved in 40 joints, 74.1%, at 7.2 ± 4.6 months, the amount if improvement did not differ between the groups. The extent of the destructive change of the condyle was highest in the improved CT group at the first (p < 0.001) and in the worsened CT group at the second examination (p < 0.001). These results imply that the prognosis of OA changes may be independent of the clinical signs and symptoms. More specific longitudinal information as regards OA changes of the TMJ based on a larger sample and a longer follow-up period would be likely to provide a better understanding of TMJ OA. PMID:22075324

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

    Microsoft Academic Search

    Marc Douglas Fries

    2002-01-01

    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

  18. Temporomandibular joint bone tissue resorption in patients with early rheumatoid arthritis can be predicted by joint crepitus and plasma glutamate level.

    PubMed

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

    2010-01-01

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

  19. Articular Cartilage Degeneration in the Contralateral Non-surgical Temporomandibular Joint in Mice with a Unilateral Partial Discectomy

    PubMed Central

    Cohen, Wendy A.; Servais, Jacqueline M.; Polur, Ilona; Li, Yefu; Xu, Lin

    2014-01-01

    Summary Objective The objective was to characterize the contralateral non-surgical temporomandibular joint (TMJ) in mice that had an opposing osteoarthrosis(OA)-like joint induced by unilateral partial discectomy. Methods TMJs on one side in mice were subjected to partial discectomy. Both surgical and contralateral non-surgical TMJs were collected at 4, 8, 12 and 16 weeks post-surgery for histological examination. The morphology of the articular cartilage of the condyle was evaluated using a scoring system. Results A progression of articular cartilage degeneration was seen in the TMJs following unilateral partial discectomy, including increased proteoglycan staining in the extracellular matrix at 4 weeks, the appearance of chondrocyte clusters at 8 weeks, reduced proteoglycan staining and fibrillation at 12 weeks and the loss of articular cartilage at 16 weeks. In the contralateral non-surgical TMJs, increased proteoglycan staining occurred in the articular cartilage of the condyle at 8 weeks and continued to age. Conclusion The result indicated that OA-like changes in one TMJ by partial discectomy could initiate early onset articular cartilage degeneration in the contralateral non-surgical TMJ in mice. PMID:24044578

  20. Correlation between eminence steepness and condyle disc movements in temporomandibular joints with internal derangements on magnetic resonance imaging.

    PubMed

    Gökalp, H; Türkkahraman, H; Bzeizi, N

    2001-10-01

    A steep articular eminence is reported to be a predisposing factor for the development of disc displacement. The purpose of this study was to evaluate the biomechanics of the temporomandibular joint (TMJ) in internal derangements and, additionally, to investigate whether a relationship exists between the steepness of the articular eminence and disc displacement, with (DDR) and without reduction (DDWR). The material consisted of the sagittal TMJ magnetic resonance images (MRIs) of 39 joints (26 DDR and 13 DDWR). Sagittal and coronal TMJ MRIs were obtained at maximum inter-cuspation and in the maximum mouth-opening position. The steepness of the articular eminence, disc, and condyle rotation, and condyle translation were investigated. A Student's t-test was performed and correlation coefficients calculated. The results revealed an increase in disc rotation in the DDR group and in condyle translation in the DDWR group (P < 0.01). Condyle rotation and the steepness of the articular eminence were similar in both groups. Disc rotation was positively correlated with condyle rotation and negatively correlated with condyle translation in the DDR group (P < 0.05, r = 0.44). Condyle translation was positively correlated with steepness of the articular eminence in the DDWR group (P < 0.01, r = 0.74). There was no correlation between movements of the disc-condyle assembly and the steepness of the articular eminence in the DDR group. Nevertheless, a relationship between condyle translation and the steepness of the articular eminence was found in the DDWR subjects. PMID:11668877

  1. Assessing joint space and condylar position in the people with normal function of temporomandibular joint with cone-beam computed tomography

    PubMed Central

    Dalili, Zahra; Khaki, Nasim; Kia, Seyed Javad; Salamat, Fatemeh

    2012-01-01

    Background: The optimal position of the condyle in glenoid fossa is a fundamental question in dentistry. There is no quantitative standard for the optimal position of mandibular condyle in the glenoid fossa in our population. The purpose of this study is to assess the position of the condyle by cone beam computed tomography (CBCT) images in patient with normal function of temporomandibular joint (TMJ). Materials and Methods: In this cross-sectional study, CBCT images of 40 class I skeletal patients (15 males and 25 females) without history of TMJ disorders were selected. Next, the anterior, superior and posterior joint spaces (Ajs, Sjs, Pjs) were measured on the two true central sagittal slices. Then medial (M) and lateral (L) joint spaces on true coronal view were measured in the right and left sides, separately. After that, P/A ratio, S/A ratio and M/L ratio were calculated. Finally, a paired t-test and independent samples t-test were employed for analysis. Results: The centric position of the condyle in glenoid fossa was more common (92.5%) than other positions. Significant differences in Ajs, Sjs, Pjs, Mjs and Ljs values between two sides were observed (P ? 0.05). Additionally, Sjs showed statistically significant differences between the sexes (P = 0.05). P/A ratio and S/A ratio had significant differences between two sides but not between those sexes. Conclusion: The assessment of joint spaces in right and left sides should be done independently. Overall, the measured joint spaces except Sjs are not different in two sexes. The data from this study could be a useful and comparable reference for the clinical assessment of condylar position in patients with normal functional joints. PMID:23559927

  2. Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis?

    PubMed Central

    Assaf, AT; Kahl-Nieke, B; Feddersen, J; Habermann, CR

    2013-01-01

    Objectives: The purpose of this study was to determine the potential of high-resolution ultrasonography for the detection of temporomandibular joint (TMJ) changes in children with juvenile idiopathic arthritis (JIA). Methods: We investigated prospectively 20 children (17 female and 3 male; mean age 11.06 years, standard deviation 3.43 years) with TMJ disorders caused by JIA, over a period of 16 months. Using a 12?MHz array transducer, four images in each TMJ (160 images) were acquired. Each image was analysed with regard to five different aspects (condylar erosion, thickness of the condylar disc, synovial thickness, joint effusion and enlargement of the intra-articular space). Results: Diagnosis of JIA was ensured for every child and involvement of the TMJ was proven by MRI. Overall 287 changes (35.9%) were detected by using high-resolution ultrasonography. On 124 images (77.5%) condylar erosions were diagnosed; on 55 images (34.4%) synovial thickness was abnormal; on 48 images (30%) we could see higher thickness of the condylar disc; on 40 images (25%) irregularities of the bony surface were detected; and on 20 images (12.5%) we found joint effusion. Conclusion: High-resolution ultrasonography could be a sufficient diagnostic method, especially for the detection of condylar involvement in children with JIA, even if not all parts of the TMJ are visible for ultrasonography. High-resolution ultrasonography is a valuable tool in particular situations: (i) when MRI examination is not available; (ii) when children fear MRI examination; (iii) in more advanced stages of JIA; and (iv) for monitoring the progression of TMJ involvement and response of therapy. PMID:23439686

  3. 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

  4. 3T MRI OF THE TEMPOROMANDIBULAR JOINT DISC: FEASIBILITY OF NOVEL QUANTITATIVE MR EVALUATION USING HISTOLOGIC AND BIOMECHANICAL REFERENCE STANDARDS

    PubMed Central

    Sanal, Hatice T.; Bae, Won C.; Pauli, Chantal; Du, Jiang; Statum, Sheronda; Znamirowski, Richard; Sah, Robert L.; Chung, Christine B.

    2014-01-01

    Aims To quantify short T2* properties of a disc from human temporomandibular joint (TMJ) using ultrashort time-to-echo magnetic resonance imaging (UTE MRI) technique, and to corroborate regional T2* values with biomechanical properties and histologic appearance. Methods A cadaveric human TMJ was sliced sagittally and imaged using conventional and UTE MRI techniques. The slices were then subjected to either biomechanical indentation testing or histologic evaluation for comparison to T2* maps obtained from UTE MRI data, using linear regression. Feasibility of in vivo UTE MRI was assessed in two volunteers. Results UTE MRI technique of specimens provided images of TMJ disc with greater signal-to-noise ratio (~3 fold) and contrast against surrounding tissues compared to conventional techniques. Higher T2* values correlated with lower indentation stiffness (softer) and less collagen organization as indicated by polarized light microscopy. T2* values were also obtained from volunteers. Conclusion UTE MRI facilitates quantitative characterization of TMJ discs, which may reflect structural and functional properties related to TMJ dysfunction. PMID:22247930

  5. Temporomandibular joint-evoked responses by spinomedullary neurons and masseter muscle are enhanced after repeated psychophysical stress

    PubMed Central

    Okamoto, Keiichiro; Tashiro, Akimasa; Chang, Zheng; Thompson, Randall; Bereiter, David A.

    2012-01-01

    Psychological stress is a risk factor to develop musculoskeletal pain of the head and neck; however, the basis for this relationship remains uncertain. This study tested the hypothesis that psychophysical stress alone was sufficient to alter the encoding properties of spinomedullary dorsal horn neurons and masseter muscle activity in male rats. Repeated forced swim conditioning increased markedly both the background firing rate and temporomandibular joint (TMJ)-evoked activity of neurons in deep dorsal horn, while neurons in superficial laminae were less affected. Stress also increased the responses to stimulation of facial skin overlying the TMJ of neurons in deep and superficial dorsal horn. TMJ-evoked masseter muscle activity was enhanced significantly in stressed rats, an effect that was reduced by prior blockade of the spinomedullary junction region. These data indicated that repeated psychophysical stress induced widespread effects on the properties of medullary dorsal horn neurons and masseter muscle activity. The effects of stress were seen preferentially on neurons in deep dorsal horn and included enhanced responses to chemosensory input from the TMJ and mechanical input from overlying facial skin. The stress-induced elevation in TMJ-evoked masseter muscle activity matched well the changes seen in dorsal horn neurons. It is concluded that the spinomedullary junction region plays a critical role in the integration of psychophysical stress and sensory information relevant for nociception involving deep craniofacial tissues. PMID:22519876

  6. 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.

  7. 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

  8. Temporomandibular joint disc repositioning using bone anchors: an immediate post surgical evaluation by Magnetic Resonance Imaging

    PubMed Central

    2010-01-01

    Background Open joint procedures using bone anchors have shown clinical and radiograph good success, but post surgical disc position has not been documented with MRI imaging. We have designed a modified technique of using two bone anchors and 2 sutures to reposition the articular discs. This MRI study evaluates the post surgical success of this technique to reposition and stabilize the TMJ articular discs. Methods Consecutive 81 patients with unilateral TMJ internal derangement (ID) (81 TMJs) were treated between December 1, 2003, and December 1, 2006, at the Department of Oral and Maxillofacial Surgery, Ninth Peoples Hospital, Shanghai, Jiao Tong University School of Medicine. All patients were subjected to magnetic resonance imaging before and one to seven days post surgery to determine disc position using the modified bone anchor technique. Results Postoperative MRIs (one to seven days) confirm that 77 of 81 joints were identified as excellent results and one joint was considered good for an overall effective rate of 96.3% (78 of 81 joints). Only 3.7% (3 of 81) of the joints were designated as poor results requiring a second open surgery. Conclusions This procedure has provided successful repositioning of the articular discs in unilateral TMJ ID at one to seven days post surgery. PMID:21073724

  9. 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

  10. Changes in position of the temporomandibular joint disc and condyle after disc repositioning appliance therapy: a functional examination and magnetic resonance imaging study.

    PubMed

    Gökalp, H; Türkkahraman, H

    2000-10-01

    Disc-repositioning splints are routinely used in the treatment of anteriorly displaced discs. The rationale of these appliances is to direct the mandibular condyle anteriorly in the glenoid fossa and to recapture the disc onto the condyle. The stability of disc recapture depends on reestablishment of the occlusion and the adaptive capabilities of the temporomandibular joint. It could therefore be suggested that treatment success is potentially higher in the active growth period. In this case report, partial disc recapture was observed on magnetic resonance images after application of a maxillary disc-repositioning appliance. Orthodontic treatment was applied for the retention of disc recapture. PMID:11037001

  11. Controlled Release of Anti-inflammatory siRNA from Biodegradable Polymeric Microparticles Intended for Intra-articular Delivery to the Temporomandibular Joint

    Microsoft Academic Search

    Paschalia M. Mountziaris; David C. Sing; Sue Anne Chew; Stephanie N. Tzouanas; E. Dennis Lehman; F. Kurtis Kasper; Antonios G. Mikos

    2011-01-01

    Purpose  As the next step in the development of an intra-articular controlled release system to treat painful temporomandibular joint\\u000a (TMJ) inflammation, we developed several biodegradable poly(DL-lactic-co-glycolic acid) (PLGA)-based microparticle (MP) formulations\\u000a encapsulating a model anti-inflammatory small interfering RNA (siRNA) together with branched poly(ethylenimine) (PEI) as a\\u000a transfecting agent. The effect of siRNA loading and N:P ratio on the release kinetics of

  12. Degenerative joint disease: cartilage or vascular disease?

    Microsoft Academic Search

    H. Imhof; M. Breitenseher; F. Kainberger; S. Trattnig

    1997-01-01

    The aetiology of degenerative joint diseases is multifactorial, but one main cause is overloading (mechanical stress). While\\u000a until recently it was well accepted that this represented primarily a disorder of cartilage with reactive subchondral changes,\\u000a there is now some evidence that it might be primarily a subchondral problem with secondary changes in the articular cartilage.\\u000a Early subchondral changes include redistribution

  13. The Effects of Cycling Levels of 17?-Estradiol and Progesterone on the Magnitude of Temporomandibular Joint-Induced Nociception

    PubMed Central

    Kramer, P. R.; Bellinger, L. L.

    2009-01-01

    A greater incidence of temporomandibular joint (TMJ) pain is reported in females, suggesting that gonadal hormones may play a role in this condition. However, the exact roles of 17?-estradiol (E2) and progesterone (P4) in TMJ pain are not completely known. Two experiments were performed to determine the separate roles of E2 and P4 in TMJ nociception at various stages of the estrous cycle. Ovariectomized (OVX) rats were cycled with physiological concentrations of E2 or P4. The E2-cycled rats then received bilateral TMJ injections of saline (SAL) or complete Freund’s adjuvant (CFA) on the morning of diestrus-2 (low E2 condition) or proestrus (high E2 condition). As a control, OVX rats (no ovarian E2 and no replacement) were injected with SAL or CFA. The TMJ nociception was measured using a validated novel method in which an increase in meal duration directly correlated to the intensity of deep TMJ nociception. In the E2 experiment, CFA injection, but not SAL, increased TMJ nociception in the OVX group, but the effect was less pronounced in diestrus-2 and even less in proestrus. In the P4 experiment, the rats receiving TMJ CFA in diestrus-2 (end of minor P4 surge) did not show an increase in TMJ nociception, whereas the rats injected in proestrus (major P4 surge), estrus (low P4), and metestrus (low P4) had similar increases in TMJ nociception. The hormones’ concentration did not affect TMJ IL-1?, IL-6, C-C motif ligand 20, or C-X-C motif ligand 2 or the trigeminal ganglia calcitonin gene-related peptide. The high physiological concentrations of E2 observed at proestrus and the low P4 concentrations observed at diestrus-2 attenuated or eliminated CFA-induced TMJ nociception. The results suggest that the cyclic estrous cycle concentrations of E2 and P4 can influence CFA-induced TMJ nociception in the rat. PMID:19359384

  14. Modulation of temporomandibular joint nociception and inflammation in male rats after administering a physiological concentration of 17?-estradiol

    PubMed Central

    Kramer, P.R.; Bellinger, L.L.

    2012-01-01

    Background Previous studies have shown 17?-estradiol will reduce temporomandibular joint (TMJ) inflammation and hypersensitivity in female rats. Although, male rats contain significant amounts of estradiol it was unknown whether a physiological concentration of 17?-estradiol would attenuate male TMJ inflammation and nociception. Methods Intact and castrated rats were given a physiological concentration of estradiol to examine first, if estradiol will affect male TMJ nociception/inflammation and second, if administration of estradiol would act synergistically with endogenous male hormones to attenuate TMJ nociception. The hormonally treated rats were given TMJ injections of complete Freund’s adjuvant (CFA) and then nociception was measured using a validated method in which a lengthening in meal duration is directly correlated to the intensity of deep TMJ nociception. Inflammation was assayed by quantitating pro-inflammatory gene expression. Results Meal duration was significantly lengthened after TMJ CFA injection and this lengthening was significantly attenuated in the castrated but not intact males after administering a physiological concentration estradiol. A physiological concentration of 17?-estradiol also significantly increased IL-6 expression in the inflamed TMJ of castrated males while 17?-estradiol did not alter IL-1?, CXCL2 and CCL20 expression. Castration increased pro-inflammatory mediators IL-6, IL-1? and CXCL2 suggesting male sex hormones were anti-inflammatory. CGRP in the trigeminal ganglia was unchanged. Conclusions Similar to females, male rats with TMJ inflammation showed a reduced nociceptive response after treatment with a physiological concentration of estradiol suggesting the effects of estradiol treatment were not constrained by organizational processes in the males. PMID:22715057

  15. Estrogen status and psychophysical stress modify temporomandibular joint input to medullary dorsal horn neurons in a lamina-specific manner in female rats

    PubMed Central

    Okamoto, Keiichiro; Thompson, Randall; Katagiri, Ayano; Bereiter, David A.

    2013-01-01

    Estrogen status and psychological stress contribute to the expression of several chronic pain conditions including temporomandibular muscle and joint disorders (TMJD). Sensory neurons that supply the temporomandibular joint (TMJ) region terminate in laminae I and V of the spinal trigeminal nucleus (Vc/C1-2 region); however, little is known about lamina specificity and environmental influences on the encoding properties of TMJ brainstem neurons. To test the hypothesis that Vc/C1-2 neurons integrate both interoceptive and exteroceptive signals relevant for TMJ nociception, we recorded TMJ-evoked activity in superficial and deep laminae of ovariectomized rats under high and low estradiol (E2) and stress conditions. Rats received daily injections of low (LE) or high (HE) dose E2 and were subjected to forced swim (FS) or sham swim conditioning for 3 days. The results revealed marked lamina specificity in that HE rats displayed enhanced TMJ-evoked activity in superficial, but not deep, laminae independent of stress conditioning. By contrast, FS conditioned rats displayed increased background firing and TMJ-evoked activity of neurons in deep, but not superficial, laminae independent of E2 status. FS also enhanced TMJ-evoked masseter muscle activity and suggested the importance of deep dorsal horn neurons in mediating evoked jaw muscle activity. In conclusion, E2 status and psychophysical stress play a significant role in modifying the encoding properties of TMJ-responsive medullary dorsal horn neurons with a marked lamina specificity. PMID:23607965

  16. Estradiol replacement modifies c-fos expression at the spinomedullary junction evoked by temporomandibular joint stimulation in ovariectomized female rats

    PubMed Central

    Okamoto, K.; Bereiter, D.F.; Thompson, R.; Tashiro, A.; Bereiter, D.A.

    2008-01-01

    The influence of estradiol (E2) treatment on temporomandibular joint (TMJ) nociceptive processing in the caudal trigeminal sensory brain stem complex was assessed in ovariectomized female rats by quantitative Fos-immunoreactivity (Fos-LI). After 2 days of daily injections of high (HE2) or low (LE2) dose E2 rats were anesthetized and the small fiber excitant, mustard oil (MO, 0–20%), was injected into the TMJ and after two hours later brains were processed for Fos-LI. TMJ-evoked Fos-LI in laminae I-II at the trigeminal subnucleus caudalis/upper cervical cord (Vc/C1-2) junction and the dorsal paratrigeminal region (dPa5) was significantly greater in HE2 than LE2 rats, while Fos-LI produced at the ventral trigeminal interpolaris/caudalis transition region (Vi/Vcvl) was similar. E2 treatment also modified the influence of N-methyl-D-aspartate (NMDA) and amino-3-hydroxy-5-methyl-4-isoxazoleproprionic acid (AMPA) receptor antagonists on TMJ-evoked Fos-LI. The NMDA antagonist, MK-801, dose-dependently reduced the Fos-LI response at the Vc/C1-2 junction in HE2 rats, while only high dose MK-801 was effective in LE2 rats. MK801 reduced equally the Fos-LI response at the Vi/Vc transition in both groups, while only minor effects were seen at the dPa5 region. The AMPA receptor antagonist, NBQX, reduced Fos-LI at the Vc/C1-2 and Vi/Vcvl regions in HE2 rats, while only high dose NBQX was effective in LE2 rats. NBQX did not reduce Fos-LI at the dPa5 region in either group. These results suggest that estrogen status plays a significant role in TMJ nociceptive processing at the Vc/C1-2 junction mediated, in part, through ionotropic glutamate receptor-dependent mechanisms. PMID:18765271

  17. 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

  18. 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.

  19. Temporomandibular Joint Disorder

    MedlinePLUS

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  20. Analysis by Light, Scanning, and Transmission Microscopy of the Intima Synovial of the Temporomandibular Joint of Human Fetuses during the Development.

    PubMed

    Alvez, Carlos Sabu; Carvalho de Moraes, Luis Otavio; Marques, Sergio R; Tedesco, Roberto C; Harb, Leandro J C; Rodríguez-Vázquez, Jose F; Mérida-Velasco, Jose R; Alonso, Luis Garcia

    2014-01-01

    Objective. To characterize morphologically and ultrastructurally using light microscopy, the scanning electron microscopy and transmission electron microscopy the intima synovial of the temporomandibular joint (TMJ) of human fetuses between the 10th and the 38th week of development. Materials and Methods. The TMJ was dissected bilaterally in 37 human fetuses belonging to the Institute of Embryology of the University Complutense of Madrid and of the Federal University of São Paulo. Results. The outcome by light microscopy showed the morphology of the TMJ and that the formation of inferior joint cavity precedes the superior joint cavity and the presence of blood vessels in the synovial. Conclusion. By scanning and transmission electron microscopy we observed the presence of two well-defined cell types in the intima layer of synovial of the TMJ of human fetuses, macrophage-like type A cell and fibroblast-like type B cell, and the presence of the a third cell type, defined by the name of intermediate lining cell in the intima layer of the synovial. PMID:24527214

  1. Analysis by Light, Scanning, and Transmission Microscopy of the Intima Synovial of the Temporomandibular Joint of Human Fetuses during the Development

    PubMed Central

    Alvez, Carlos Sabu; Carvalho de Moraes, Luis Otavio; Marques, Sergio R.; Tedesco, Roberto C.; Harb, Leandro J. C.; Rodríguez-Vázquez, Jose F.; Mérida-Velasco, Jose R.; Alonso, Luis Garcia

    2014-01-01

    Objective. To characterize morphologically and ultrastructurally using light microscopy, the scanning electron microscopy and transmission electron microscopy the intima synovial of the temporomandibular joint (TMJ) of human fetuses between the 10th and the 38th week of development. Materials and Methods. The TMJ was dissected bilaterally in 37 human fetuses belonging to the Institute of Embryology of the University Complutense of Madrid and of the Federal University of São Paulo. Results. The outcome by light microscopy showed the morphology of the TMJ and that the formation of inferior joint cavity precedes the superior joint cavity and the presence of blood vessels in the synovial. Conclusion. By scanning and transmission electron microscopy we observed the presence of two well-defined cell types in the intima layer of synovial of the TMJ of human fetuses, macrophage-like type A cell and fibroblast-like type B cell, and the presence of the a third cell type, defined by the name of intermediate lining cell in the intima layer of the synovial. PMID:24527214

  2. Joint Involvement Associated with Inflammatory Bowel Disease

    Microsoft Academic Search

    M. De Vos

    2009-01-01

    Joint involvement associated with inflammatory bowel disease (IBD) belongs to the concept of spondyloarthritis (SpA) and includes two types of arthritis: a peripheral arthritis characterized by the presence of pauciarticular asymmetrical arthritis affecting preferentially joints of lower extremities and an axial arthropathy including inflammatory back pain, sacroiliitis and ankylosing spondylitis (AS). Treatment of arthritis includes a short-term use of NSAIDs

  3. Temporomandibular disorders: evaluation and management.

    PubMed

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

    2014-11-01

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

  4. Activation of voltage-gated KCNQ/Kv7 channels by anticonvulsant retigabine attenuates mechanical allodynia of inflammatory temporomandibular joint in rats

    PubMed Central

    2010-01-01

    Background Temporomandibular disorders (TMDs) are characterized by persistent orofacial pain and have diverse etiologic factors that are not well understood. It is thought that central sensitization leads to neuronal hyperexcitability and contributes to hyperalgesia and spontaneous pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are currently the first choice of drug to relieve TMD pain. NSAIDS were shown to exhibit anticonvulsant properties and suppress cortical neuron activities by enhancing neuronal voltage-gated potassium KCNQ/Kv7 channels (M-current), suggesting that specific activation of M-current might be beneficial for TMD pain. Results In this study, we selected a new anticonvulsant drug retigabine that specifically activates M-current, and investigated the effect of retigabine on inflammation of the temporomandibular joint (TMJ) induced by complete Freund's adjuvant (CFA) in rats. The results show that the head withdrawal threshold for escape from mechanical stimulation applied to facial skin over the TMJ in inflamed rats was significantly lower than that in control rats. Administration of centrally acting M-channel opener retigabine (2.5 and 7.5 mg/kg) can dose-dependently raise the head withdrawal threshold of mechanical allodynia, and this analgesic effect can be reversed by the specific KCNQ channel blocker XE991 (3 mg/kg). Food intake is known to be negatively associated with TMJ inflammation. Food intake was increased significantly by the administration of retigabine (2.5 and 7.5 mg/kg), and this effect was reversed by XE991 (3 mg/kg). Furthermore, intracerebralventricular injection of retigabine further confirmed the analgesic effect of central retigabine on inflammatory TMJ. Conclusions Our findings indicate that central sensitization is involved in inflammatory TMJ pain and pharmacological intervention for controlling central hyperexcitability by activation of neuronal KCNQ/M-channels may have therapeutic potential for TMDs. PMID:20796319

  5. Activation of NK1 receptor of trigeminal root ganglion via substance P paracrine mechanism contributes to the mechanical allodynia in the temporomandibular joint inflammation in rats.

    PubMed

    Takeda, Mamoru; Tanimoto, Takeshi; Nasu, Masanori; Ikeda, Mizuho; Kadoi, Jun; Matsumoto, Shigeji

    2005-08-01

    The aim of this study was to investigate whether under in vivo conditions, temporomandibular joint (TMJ) inflammation alters the excitability of Abeta-trigeminal root ganglion (TRG) neuronal activity innervating the facial skin by using extracellular electrophysiological recording with multibarrel-electrodes. Complete Freund's adjuvant (CFA) was injected into the rat TMJ. Threshold for escape from mechanical stimulation applied to the whisker pad area in inflamed rats (2 days) was significantly lower than that in control rats. A total of 36 Abeta-TRG neurons responding to electrical stimulation of the whisker pad was recorded in pentobarbital-anesthetized rats. The number of Abeta-TRG neurons with spontaneous firings and their firing rate in TMJ inflamed rats were significantly larger than those in control rats. The firing rates of their spontaneous activity in the Abeta-TRG neurons were current-dependently decreased by local iontophoretic application of an NK1 receptor antagonist (L-703,606) in inflamed, but not non-inflamed rats. Their spontaneous activities were current-dependently increased by local iontophoretic application of substance P (SP) in control and inflamed rats. The mechanical response threshold of Abeta-TRG neurons in inflamed rats was significantly lower than that in control rats. The mechanical response threshold in inflamed rats after iontophoretic application of L-703,606 was not different from that in control rats. These results suggest that TMJ inflammation modulate the excitability of Abeta-TRG neurons innervating the facial skin via paracrine mechanism due to SP released from TRG neuronal cell body. Such a SP release may play an important role in determining the trigeminal inflammatory allodynia concerning the temporomandibular disorder. PMID:15985331

  6. 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

  7. Effect of Interleukin-1beta and Dehydroepiandrosterone on the Expression of Lumican and Fibromodulin in Fibroblast-Like Synovial Cells of the Human Temporomandibular Joint

    PubMed Central

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

    2015-01-01

    Several epidemiological studies have reported that temporomandibular disorders (TMDs) are more prevalent in women than in men. It has recently been proposed that sex hormones such as estrogen, testosterone and dehydroepiandrosterone (DHEA) are involved with the pathogenesis of TMDs. Although studies have investigated the relationship between estrogen and testosterone and the restoration of TMDs, the relationship between DHEA and TMDs is unknown. The synovial tissue of the temporomandibular joint (TMJ) is made up of connective tissue with an extracellular matrix (ECM) composed of collagen and proteoglycan. One proteoglycan family, comprised of small leucine-rich repeat proteoglycans (SLRPs), was found to be involved in collagen fibril formation and interaction. In recent years, the participation of SLRPs such as lumican and fibromodulin in the internal derangement of TMJ has been suggested. Although these SLRPs may contribute to the restoration of the synovium, their effect is still unclear. The purpose of this study was to investigate the effect of DHEA, a sex hormone, on the expression of lumican and fibromodulin in human temporomandibular specimens and in cultured human TMJ fibroblast-like synovial cells in the presence or absence of the pro-inflammatory cytokine interleukin-1beta (IL-1beta). In the in vivo study, both normal and osteoarthritic (OA) human temporomandibular synovial tissues were immunohistochemically examined. In the in vitro study, five fibroblast-like synoviocyte (FLS) cell lines were established from human TMJ synovial tissue of patients with osteoarthritis. The subcultured cells were then incubated for 3, 6, 12 or 24 h with/without IL-1beta (1 ng/mL) in the presence or absence of DHEA (10 ?M). The gene expression of lumican and fibromodulin was examined using the real-time polymerase chain reaction (PCR) and their protein expression was examined using immunofluorescent staining. We demonstrated that the expression of lumican differs from that of fibromodulin in synovial tissue and furthermore, that IL-1beta induced a significant increase in lumican mRNA and immunofluorescent staining in FLS compared to cells without IL-1beta. DHEA plus IL-1beta induced a significant increase in fibromodulin, but not in lumican mRNA, compared to DHEA alone, IL-1beta alone and in the absence of DHEA and IL-1beta. In immunofluorescent staining, weaker fibromodulin staining of FLS cells was observed in cells cultured in the absence of both DHEA and IL-1beta compared to fibromodulin staining of cells cultured with DHEA alone, with DHEA plus IL-1beta, or with IL-1beta alone. These results indicate that DHEA may have a protective effect on synovial tissue in TMJ by enhancing fibromodulin formation after IL-1beta induced inflammation. DHEA enhancement of fibromodulin expression may also exert a protective effect against the hyperplasia of fibrous tissue that TGF-beta1 induces. In addition lumican and fibromodulin are differentially expressed under different cell stimulation conditions and lumican and fibromodulin may promote regeneration of the TMJ after degeneration and deformation induced by IL-1beta. PMID:25820556

  8. 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

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

    2013-03-01

    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

  9. DISEASE IN WILDLIFE OR EXOTIC SPECIES Characterization of Degenerative Changes in the

    E-print Network

    Athanasiou, Kyriacos

    DISEASE IN WILDLIFE OR EXOTIC SPECIES Characterization of Degenerative Changes of the functional demands on the joint. Degenerative joint disease was observed in both cases and this was more of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally

  10. Dental disease and periprosthetic joint infection.

    PubMed

    Young, Heather; Hirsh, Joel; Hammerberg, E Mark; Price, Connie S

    2014-01-15

    ? The number of patients with end-stage osteoarthritis is increasing, and treatment with hip and knee arthroplasty is expected to increase over the next several decades. ? Dental disease has long been anecdotally associated with increased periprosthetic joint infections, although case-control studies do not support this relationship. ? While most recent guidelines for the prevention of endocarditis have favored treatment of fewer patients, the most recent recommendations for prevention of periprosthetic joint infection have increased the number of patients who would receive antibiotics before a dental procedure. ? Antibiotics given before a dental procedure decrease the risk of bacteremia from the oral cavity, but this is of uncertain clinical importance. ? The number of patients who would require antibiotics before dental procedures to prevent one periprosthetic joint infection greatly outnumbers the number of patients who would experience an adverse event associated with antibiotics given before a dental procedure. PMID:24430417

  11. 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.

  12. Is running associated with degenerative joint disease

    Microsoft Academic Search

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

    1986-01-01

    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

  13. Estrogen in cycling rats alters gene expression in the temporomandibular joint, trigeminal ganglia and trigeminal subnucleus caudalis/upper cervical cord junction.

    PubMed

    Puri, Jyoti; Bellinger, Larry L; Kramer, Phillip R

    2011-12-01

    Females report temporomandibular joint (TMJ) pain more than men and studies suggest estrogen modulates this pain response. Our goal in this study was to determine genes that are modulated by physiological levels of 17?-estradiol that could have a role in TMJ pain. To complete this goal, saline or complete Freund's adjuvant was injected in the TMJ when plasma 17?-estradiol was low or when it was at a high proestrus level. TMJ, trigeminal ganglion, and trigeminal subnucleus caudalis/upper cervical cord junction (Vc/C(1-2) ) tissues were isolated from the treated rats and expression of 184 genes was quantitated in each tissue using real-time PCR. Significant changes in the amount of specific transcripts were observed in the TMJ tissues, trigeminal ganglia, and Vc/C(1-2) region when comparing rats with high and low estrogen. GABA A receptor subunit ?6 (Gabra6) and the glycine receptor ?2 (Glra2) were two genes of interest because of their direct function in neuronal activity and a >29-fold increase in the trigeminal ganglia was observed in proestrus rats with TMJ inflammation. Immunohistochemical studies showed that Gabr?6 and Glr?2 neuronal and not glial expression increased when comparing rats with high and low estrogen. Estrogen receptors ? and ? are present in neurons of the trigeminal ganglia, whereby 17?-estradiol can alter expression of Gabr?6 and Glr?2. Also, estrogen receptor ? (ER?) but not ER? was observed in satellite glial cells of the trigeminal ganglia. These results demonstrate that genes associated with neurogenic inflammation or neuronal excitability were altered by changes in the concentration of 17?-estradiol. PMID:21321935

  14. Differential ascending projections of temporomandibular joint-responsive brainstem neurons to periaqueductal gray and posterior thalamus of male and female rats

    PubMed Central

    Chang, Z.; Okamoto, K.; Bereiter, D.A.

    2011-01-01

    Several craniofacial pain conditions including temporomandibular joint disorders (TMJD) are more prevalent in women than men. The basis for sex differences in deep craniofacial pain is not known. The present study compared the magnitude of ascending projections from TMJ-responsive neurons in trigeminal brainstem to the ventrolateral periaqueductal gray (vlPAG) or posterior nucleus of the thalamus (Po) in males and female rats. Fluorogold (FG) was injected into vlPAG or Po and TMJ-responsive neurons were identified by Fos-like immunoreactivity (Fos-LI) after mustard oil injection. TMJ-evoked Fos-LI was similar in males and females; however, significant differences in cell counts were seen for FG single-labeled and Fos/FG double-labeled neurons in trigeminal brainstem. After vlPAG injections, the number of FG-labeled neurons in trigeminal subnucleus interpolaris (Vi), ventral interpolaris/caudalis transition (vl-Vi/Vc) and dorsal paratrigeminal region (dPa5) was greater in females than males. The percentage of Fos/FG double-labeled neurons in vl-Vi/Vc and dPa5 after vlPAG injection also were greater in females than males. By contrast after Po injections, males displayed a greater number of FG-labeled neurons in superficial laminae of Vc and C1–2 and deeper laminae at C1–2 than females. The percentage of Fos/FG double-labeled neurons in superficial laminae of Vc after Po injection also was greater in males than females. These data revealed significant sex differences in ascending projections from TMJ-responsive neurons in trigeminal brainstem. Such differences may influence the ability of males and females to recruit autonomic reflexes and endogenous pain control circuits relevant for TMJ nociception. PMID:22155654

  15. Estrogen in cycling rats alters gene expression in the temporomandibular joint, trigeminal ganglia and trigeminal subnucleus caudalis/upper cervical cord junction

    PubMed Central

    Puri, Jyoti; Bellinger, Larry L.; Kramer, Phillip R.

    2011-01-01

    Females report temporomandibular joint (TMJ) pain more than men and studies suggest estrogen modulates this pain response. Our goal in this study was to determine genes that are modulated by physiological levels of 17?-estradiol that could have a role in TMJ pain. To complete this goal, saline or complete Freund’s adjuvant was injected in the TMJ when plasma 17?-estradiol was low or when it was at a high proestrus level. TMJ, trigeminal ganglion and trigeminal subnucleus caudalis/upper cervical cord junction (Vc/C1–2) tissues were isolated from the treated rats and expression of 184 genes was quantitated in each tissue using real time PCR. Significant changes in the amount of specific transcripts were observed in the TMJ tissues, trigeminal ganglia and Vc/C1–2 region when comparing rats with high and low estrogen. GABA A receptor subunit ?6 (Gabra6) and the glycine receptor ?2 (Glra2) were two genes of interest because of their direct function in neuronal activity and a greater than 29 fold increase in the trigeminal ganglia was observed in proestrus rats with TMJ inflammation. Immunohistochemical studies showed that Gabr?6 and Glr?2 neuronal and not glial expression increased when comparing rats with high and low estrogen. Estrogen receptors ? and ? are present in neurons of the trigeminal ganglia, whereby 17?-estradiol can alter expression of Gabr?6 and Glr?2. Also, estrogen receptor ? (ER?) but not ER? was observed in satellite glial cells of the trigeminal ganglia. These results demonstrate that genes associated with neurogenic inflammation or neuronal excitability were altered by changes in the concentration of 17?-estradiol. PMID:21321935

  16. Gonadal hormones decrease temporomandibular joint kappa-mediated antinociception through a down-regulation in the expression of kappa opioid receptors in the trigeminal ganglia.

    PubMed

    Clemente-Napimoga, Juliana T; Pellegrini-da-Silva, Adriana; Ferreira, Vinícius H A; Napimoga, Marcelo H; Parada, Carlos A; Tambeli, Cláudia H

    2009-09-01

    We have previously demonstrated that activation of kappa-opioid receptor located in the temporomandibular joint (TMJ) of rats induces a significantly greater TMJ antinociception in diestrus females than in proestrus females (higher estradiol serum levels than diestrus) and males. These findings indicate that gonadal hormones decrease TMJ kappa-mediated antinociception. The aim of this study was to investigate some of the mechanisms by which gonadal hormones decrease TMJ kappa-mediated antinociception. Western blot analysis demonstrated a significantly lower kappa-opioid receptor expression in the trigeminal ganglia of intact males than in intact and ovariechtomized (OVX) females and orchidectomized (ORX) males. In females, kappa-opioid receptor expression in the trigeminal ganglia was significantly lower in proestrus than in diestrus and OVX females. Taken together these findings suggest that gonadal hormones, especially male gonadal hormones, down-regulate kappa-opioid receptor expression. Co-application of the NOS inhibitor L-NMMA or the NO-sensitive guanylyl cyclase inhibitor ODQ with the kappa-opioid receptor agonist U50,488 blocked TMJ kappa-mediated antinociception in males and females. These findings suggest that antinociception induced by activation of kappa opioid receptors in the TMJ region is mediated by the L-arginine/NO/cGMP pathway in both sexes. Despite the involvement of the L-arginine/NO/cGMP pathway in TMJ kappa-mediated antinociception in both sexes, gonadal hormones do not diminish the activity of this pathway to decrease TMJ kappa-mediated antinociception. Alternatively, they significantly reduce kappa-opioid receptor expression in the trigeminal ganglia. PMID:19567249

  17. 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

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

    PubMed Central

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

    2014-01-01

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

  19. Use of Oral Mucoperiosteal and Pterygo-Masseteric Muscle Flaps as Interposition Material in Surgery of Temporomandibular Joint Ankylosis: A Comparative Study

    PubMed Central

    Anyanechi, CE; Osunde, OD; Bassey, GO

    2015-01-01

    Background: The most common complication of surgery for the release of temporomandibular joint (TMJ) ankylosis is relapse of the ankylosis. To prevent re-ankylosis, a variety of interpositional materials have been used. Aim: The aim was to compare the surgical outcome of oral mucoperiosteal flap, not hitherto used as interpositional material, with pterygo-masseteric muscles flap after surgical release of TMJ ankylosis. Subjects and Methods: This was a prospective randomized study of all consecutive patients treated for the release of complete TMJ bony ankylosis, from January 2003 to December 2012, at the Oral and Maxillofacial unit of our institution. The patients were randomized into two groups: The pterygo-masseteric group comprises 22 patients while the oral mucoperiosteal group had 23 patients. Information on demographics, clinical characteristics, and postoperative complications over a 5 year follow-up period were obtained, and analyzed using the statistical package for social sciences (Statistical Package for the Social Sciences version 13, Chicago, IL, USA). A P < 0.05 was considered significant. Results: The age of the patients ranged from 15 to 28 mean 20.3 (3.35) years while the duration of ankylosis ranged from 2 to 16 mean 5.1 (3.4) years. The baseline demographic (gender; P = 0.92; side; P = 0.58) and clinical characteristics in terms of etiology (P = 0.60) and age (P = 0.52) were comparable in both treatment groups. All the patients presented with complete bony TMJ ankylosis with a preoperative inter-incisal distance of <0.5 cm. The intraoperative mouth opening achieved ranged from 4 cm to 5 cm, mean 4.6 (0.27) cm and this was not different for either group (P = 0.51). The patients were followed up postoperatively for a period ranging from 3 to 5 years, mean 3.4 (0.62) years. The mouth opening decreased, over the period of postoperative review, from the initial range of 4–5 cm to 2.9–3.6 cm, and this was not different in both groups (P = 0.18). Conclusion: This study suggests that oral mucoperiosteal flap could be an option in the choice of interpositional materials in surgery of TMJ ankylosis.

  20. 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

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

    PubMed

    Wu, Yang; 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

  2. Psycho-education programme for temporomandibular disorders: a pilot study

    Microsoft Academic Search

    Waseem Jerjes; Geir Madland; Charlotte Feinmann; Mohammed El Maaytah; Mahesh Kumar; Colin Hopper; Tahwinder Upile; Stanton Newman

    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

  3. 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

  4. Degenerative joint disease of the acromioclavicular joint: a review.

    PubMed

    Mall, Nathan A; Foley, Emily; Chalmers, Peter N; Cole, Brian J; Romeo, Anthony A; Bach, Bernard R

    2013-11-01

    Osteoarthritis of the acromioclavicular (AC) joint is a common condition causing anterior or superior shoulder pain, especially with overhead and cross-body activities. This most commonly occurs in middle-aged individuals because of degeneration to the fibrocartilaginous disk that cushions the articulations. Diagnosis relies on history, physical examination, imaging, and diagnostic local anesthetic injection. Diagnosis can be challenging given the lack of specificity with positive physical examination findings and the variable nature of AC joint pain. Of note, symptomatic AC osteoarthritis must be differentiated from instability and subtle instability, which may have similar symptoms. Although plain radiographs can reveal degeneration, diagnosis cannot be based on this alone because similar radiographic findings can be seen in asymptomatic individuals. Nonoperative therapy can provide symptomatic relief, whereas patients with persistent symptoms can be considered for resection arthroplasty by open or arthroscopic technique. Both techniques have proven to provide predictable pain relief; however, each has its own unique set of potential complications that may be minimized with an improved understanding of the anatomical and biomechanical characteristics of the joint along with meticulous surgical technique. PMID:23649008

  5. Chiropractic care of a patient with temporomandibular disorder and atlas subluxation

    Microsoft Academic Search

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

    2002-01-01

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

  6. Class III malocclusion with severe facial asymmetry, unilateral posterior crossbite, and temporomandibular disorders

    Microsoft Academic Search

    Eri Miyatake; Shouichi Miyawaki; Yasuko Morishige; Akiyoshi Nishiyama; Akira Sasaki; Teruko Takano-Yamamoto

    2003-01-01

    A 22-year-old woman had a Class III malocclusion with severe facial asymmetry, unilateral posterior crossbite, and temporomandibular disorders. A clicking sound was noted in the temporomandibular joint on the posterior crossbite side during jaw opening, and she complained of pain in the masticatory muscles on both sides. The articular disc on the crossbite side was displaced anteriorly without reduction. The

  7. Hemophilic joint disease - current perspective and potential future strategies.

    PubMed

    Acharya, Suchitra S

    2008-02-01

    Recurrent hemarthroses can lead to hemophilic joint disease (HJD), which is one of the most disabling complications of these X-linked recessive disorders characterized by a deficiency of clotting factors VIII/IX. The pathogenesis of HJD is not well understood and there is evidence to suggest that iron may play a central role in the pathogenetic process causing changes at the molecular level and through the release of cytokines and perpetuation of a chronic inflammatory state. Also, there may be a role for angiogenesis in accelerating the joint damage begun by recurrent hemarthroses. Hemophilic joint disease can be diagnosed by MRI which provides information about the pathology of the synovium, articular cartilage and bone. However, it is expensive, and maybe cumbersome in young children who require sedation. Newer, cost-effective imaging tools such as ultrasonography need to be explored to facilitate diagnosis and monitoring of joint disease. Repeated bleeds into the joint could be prevented by reducing the number of bleeds by the prophylactic infusion of factor concentrates on a bi-weekly to alternate day schedule depending on the activity level and bleeding phenotype. However, the dose, schedule and timing of prophylaxis still remain unresolved despite some multi-center clinical studies proving its benefit in preserving joint function. Prohibitive costs and the need for venous access devices in delivering factor concentrates in younger children continue to complicate universal recommendations of prophylaxis. In those patients who fail or refuse prophylaxis, procedures such as isotopic synovectomy can provide relief from repeated joint bleeds, again the timing of which is not well-defined. Newer strategies to identify early joint disease through the use of serological markers are needed. Also, cost-effective imaging modalities are needed so that treatment strategies such as prophylaxis and isotopic synovectomy can be appropriately timed to reap maximum benefits. A combination of serological and imaging evidence of early joint disease might ultimately impact on the optimal management of hemophilic joint disease. PMID:18304874

  8. 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

  9. Treatment of nongout joint deposition diseases: an update.

    PubMed

    Pascart, Tristan; 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

  10. Temporomandibular disorders and hormones in women.

    PubMed

    Warren, M P; Fried, J L

    2001-01-01

    Temporomandibular disorders (TMD) are loosely defined as an assorted set of clinical conditions, characterized by pain and dysfunction of the masticatory system. Pain in the masticatory muscles, in the temporomandibular joint (TMJ), and in associated hard and soft tissues, limitation in jaw function, and sounds in the TMJ are common symptoms. That women make up the majority of patients treated for TMD is extensively hypothesized and documented in numerous epidemiological studies. Certain contradictory studies exist which propose that there are no statistically significant gender differences in the actual incidence of changes in joint morphology. Nonetheless, extensive literature suggests the disorder is 1.5-2 times more prevalent in women than in men, and that 80% of patients treated for TMD are women. The severity of symptoms is also related to the age of the patients. Pain onset tends to occur after puberty, and peaks in the reproductive years, with the highest prevalence occurring in women aged 20-40, and the lowest among children, adolescents, and the elderly. The gender and age distribution of TMD suggests a possible link between its pathogenesis and the female hormonal axis. In this review, we will use the hypothesis that the overwhelming majority of patients treated for temporomandibular disorders are women and use the available literature to examine the role of hormones in TMD. PMID:11455113

  11. Cartilage tissue engineering for degenerative joint disease

    Microsoft Academic Search

    Dobrila Nesic; Robert Whiteside; Mats Brittberg; David Wendt; Ivan Martin; Pierre Mainil-Varlet

    2006-01-01

    Pain in the joint is often due to cartilage degeneration and represents a serious medical problem affecting people of all ages. Although many, mostly surgical techniques, are currently employed to treat cartilage lesions, none has given satisfactory results in the long term. Recent advances in biology and material science have brought tissue engineering to the forefront of new cartilage repair

  12. Hydroxyapatite deposition disease of the joint

    Microsoft Academic Search

    Eamonn S. Molloy; Geraldine M. McCarthy

    2003-01-01

    Basic calcium phosphate (BCP) crystals include partially carbonate-substituted hydroxyapatite, octacalcium phosphate, and\\u000a tricalcium phosphate. They may form deposits, which are frequently asymptomatic but may give rise to a number of clinical\\u000a syndromes including calcific periarthritis, Milwaukee shoulder syndrome, and osteoarthritis, in and around joints. Recent\\u000a data suggest that magnesium whitlockite, another form of BCP, may play a pathologic role in

  13. 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.

  14. Role of interleukin-7 in degenerative and inflammatory joint diseases

    Microsoft Academic Search

    Joel AG van Roon; Floris PJG Lafeber

    2008-01-01

    IL-7 is known foremost for its immunostimulatory capacities, including potent T cell-dependent catabolic effects on bone. In joint diseases like rheumatoid arthritis and osteoarthritis, IL-7, via immune activation, can induce joint destruction. Now it has been demonstrated that increased IL-7 levels are produced by human articular chondrocytes of older individuals and osteoarthritis patients. IL-7 stimulates production of proteases by IL-7

  15. Diagnóstico y tratamiento de la patología de la articulación temporomandibular

    Microsoft Academic Search

    Eduardo Valmaseda; Cosme Gay Escoda

    Summary We present a brief description of the pathology that most often affects the temporomandibular joint (TMJ), with its clinical features and the therapeutic principles for each one. Thereafter, we comment the diagnostic techniques in TMJ pathology, its indication, interpretation and limitations. Finally, we discuss the different general therapeutic options, that can be either conservative (psychological treatment, drugs, oclusal treatment

  16. Diamond fraise technique for dermal grafts in temporomandibular disk reconstruction

    Microsoft Academic Search

    Faisal A Quereshy; Michael S Hauser

    1998-01-01

    Dermal grafts have been described for a variety of applications, including preprosthetic surgery, reconstructive surgery, and temporomandibular joint surgery. Several reports have described the procedural techniques for acquiring a dermal graft. The surgical technique for harvesting a dermal graft with the use of the dermabrading diamond fraise bur is described. The use of the diamond fraise bur offers many unique

  17. Targeted disruption of Mig6 in the mouse genome leads to early onset degenerative joint disease

    Microsoft Academic Search

    Yu-Wen Zhang; Yanli Su; Nathan Lanning; Pamela J. Swiatek; Roderick T. Bronson; Robert Sigler; Richard W. Martin; George F. Vande Woude

    2005-01-01

    Degenerative joint disease, also known as osteoarthritis, is the most common joint disorder in human beings. The molecular mechanism underlying this disease is not fully understood. Here, we report that disruption of mitogen-inducible gene 6 (Mig-6) in mice by homologous recombination leads to early onset degenerative joint disease, which is revealed by simultaneous enlargement and deformity of multiple joints, degradation

  18. Cartilage tissue engineering for degenerative joint disease.

    PubMed

    Nesic, Dobrila; Whiteside, Robert; Brittberg, Mats; Wendt, David; Martin, Ivan; Mainil-Varlet, Pierre

    2006-05-20

    Pain in the joint is often due to cartilage degeneration and represents a serious medical problem affecting people of all ages. Although many, mostly surgical techniques, are currently employed to treat cartilage lesions, none has given satisfactory results in the long term. Recent advances in biology and material science have brought tissue engineering to the forefront of new cartilage repair techniques. The combination of autologous cells, specifically designed scaffolds, bioreactors, mechanical stimulations and growth factors together with the knowledge that underlies the principles of cell biology offers promising avenues for cartilage tissue regeneration. The present review explores basic biology mechanisms for cartilage reconstruction and summarizes the advances in the tissue engineering approaches. Furthermore, the limits of the new methods and their potential application in the osteoarthritic conditions are discussed. PMID:16574268

  19. [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

  20. Bone and joint complications related to Gaucher disease

    Microsoft Academic Search

    Gregory M. Pastores; Manan J. Patel; Hossien Firooznia

    2000-01-01

    There is a broad spectrum of Gaucher disease-related skeletal complications, ranging from asymptomatic osteopenia to osteonecrosis\\u000a (of the shoulders and hips) with secondary degenerative joint disease. Characterization of the pattern and severity of bone\\u000a involvement in the individual patient requires the application of conventional and advanced radiographic techniques. The introduction\\u000a of enzyme replacement therapy (ERT) for this inborn error of

  1. Reactive oxygen species and superoxide dismutases: Role in joint diseases

    Microsoft Academic Search

    Valéry Afonso; Romuald Champy; Dragoslav Mitrovic; Pascal Collin; Abderrahim Lomri

    2007-01-01

    Reactive oxygen species (ROS) are produced in many normal and abnormal processes in humans, including atheroma, asthma, joint diseases, aging, and cancer. The superoxide anion O2? is the main ROS. Increased ROS production leads to tissue damage associated with inflammation. Superoxide dismutases (SODs) convert superoxide to hydrogen peroxide, which is then removed by glutathione peroxidase or catalase. Thus, SODs prevent

  2. Hemophilic joint disease – current perspective and potential future strategies

    Microsoft Academic Search

    Suchitra S. Acharya

    2008-01-01

    Recurrent hemarthroses can lead to hemophilic joint disease (HJD), which is one of the most disabling complications of these X-linked recessive disorders characterized by a deficiency of clotting factors VIII\\/IX. The pathogenesis of HJD is not well understood and there is evidence to suggest that iron may play a central role in the pathogenetic process causing changes at the molecular

  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. Reactive oxygen species and superoxide dismutases: role in joint diseases.

    PubMed

    Afonso, Valéry; Champy, Romuald; Mitrovic, Dragoslav; Collin, Pascal; Lomri, Abderrahim

    2007-07-01

    Reactive oxygen species (ROS) are produced in many normal and abnormal processes in humans, including atheroma, asthma, joint diseases, aging, and cancer. The superoxide anion O(2)(-) is the main ROS. Increased ROS production leads to tissue damage associated with inflammation. Superoxide dismutases (SODs) convert superoxide to hydrogen peroxide, which is then removed by glutathione peroxidase or catalase. Thus, SODs prevent the formation of highly aggressive ROS, such as peroxynitrite or the hydroxyl radical. Experimental models involving SOD knockout or overexpression are beginning to shed light on the pathophysiological role of SOD in humans. Although the antiinflammatory effects of exogenous native SOD (orgotein) are modest, synthetic SOD mimetics hold considerable promise for modulating the inflammatory response. In this review, we discuss new knowledge about the role of the superoxide anion and its derivates as mediators of inflammation and the role of SODs and SOD mimetics as antioxidant treatments in joint diseases such as rheumatoid arthritis, osteoarthritis, and crystal-induced arthropathies. PMID:17590367

  5. Feline degenerative joint disease: a genomic and proteomic approach.

    PubMed

    Gao, Xiangming; Lee, Junyu; Malladi, Sukhaswami; Melendez, Lynda; Lascelles, B Duncan X; Al-Murrani, Samer

    2013-06-01

    The underlying disease mechanisms for feline degenerative joint disease (DJD) are mostly unidentified. Today, most of what is published on mammalian arthritis is based on human clinical findings or on mammalian models of human arthritis. However, DJD is a common occurrence in the millions of domestic felines worldwide. To get a better understanding of the changes in biological pathways that are associated with feline DJD, this study employed a custom-designed feline GeneChip, and the institution's unique access to large sample populations to investigate genes and proteins from whole blood and serum that may be up- or down-regulated in DJD cats. The GeneChip results centered around three main pathways that were affected in DJD cats: immune function, apoptosis and oxidative phosphorylation. By identifying these key disease-associated pathways it will then be possible to better understand disease pathogenesis and diagnose it more easily, and to better target it with pharmaceutical and nutritional intervention. PMID:23295270

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

    PubMed Central

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

    2014-01-01

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

  7. Temporomandibular dysfunction and headache disorder.

    PubMed

    Speciali, José G; Dach, Fabíola

    2015-02-01

    It has been well established that primary headaches (especially migraine, chronic migraine, and tension-type headache) and temporomandibular dysfunction (TMD) are comorbid diseases, with the presence of one of them in a patient increasing the prevalence of the others. The relationship between the 2 diseases may involve the sharing of common physiopathological aspects. Studies about the treatment of this disease association have shown that a simultaneous therapeutic approach to the 2 diseases is more effective than the separate treatment of each. As a consequence, specialists in orofacial pain are now required to know the criteria for the diagnosis of headaches, and headache physicians are required to know the semiologic aspects of orofacial pain. Nevertheless, a headache may be attributed to TMD, instead be an association of 2 problems - TMD and primary headaches - in these cases a secondary headache, described in item 11.7 of the International Classification of Headache Disorders, is still a controversial topic. Attempts to determine the existence of this secondary headache with a specific or suggestive phenotype have been frustrated. The conclusion that can be reached based on the few studies published thus far is that this headache has a preferential unilateral or bilateral temporal location and migraine-like or tension-type headache-like clinical characteristics. In the present review, we will consider the main aspects of the TMD-headache relationship, that is, comorbidity of primary headaches and TMD and clinical aspects of the headaches attributed to TMD from the viewpoint of the International Headache Society and of a group of specialists in orofacial pain. This paper aims to explore our understanding of the association between TMD and headaches in general and migraine in particular. PMID:25644695

  8. Regenerative Therapies for Equine Degenerative Joint Disease: A Preliminary Study

    PubMed Central

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

    2014-01-01

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

  9. Joint Modeling of Transitional Patterns of Alzheimer's Disease

    PubMed Central

    Liu, Wei; Zhang, Bo; Zhang, Zhiwei; Zhou, Xiao-Hua

    2013-01-01

    While the experimental Alzheimer's drugs recently developed by pharmaceutical companies failed to stop the progression of Alzheimer's disease, clinicians strive to seek clues on how the patients would be when they visit back next year, based upon the patients' current clinical and neuropathologic diagnosis results. This is related to how to precisely identify the transitional patterns of Alzheimer's disease. Due to the complexities of the diagnosis of Alzheimer's disease, the condition of the disease is usually characterized by multiple clinical and neuropathologic measurements, including Clinical Dementia Rating (CDRGLOB), Mini-Mental State Examination (MMSE), a score derived from the clinician judgement on neuropsychological tests (COGSTAT), and Functional Activities Questionnaire (FAQ). In this research article, we investigate a class of novel joint random-effects transition models that are used to simultaneously analyze the transitional patterns of multiple primary measurements of Alzheimer's disease and, at the same time, account for the association between the measurements. The proposed methodology can avoid the bias introduced by ignoring the correlation between primary measurements and can predict subject-specific transitional patterns. PMID:24073268

  10. Abstract--Osteoarthritis is a degenerative joint disease, which causes the degradation of articular cartilage and

    E-print Network

    Zhao, Xiaopeng

    Abstract--Osteoarthritis is a degenerative joint disease, which causes the degradation of articular cartilage and subchondral bone. The disease may result in mechanical abnormalities of the joints, including STEOARTHRITIS (OA) is a debilitating disease with a high prevalence in elderly individuals. OA affects nearly 27

  11. Locking of the Metacarpophalangeal Joints in Degenerative Disease

    Microsoft Academic Search

    G. J. STEWART; E. A. WILLIAMS

    1981-01-01

    Nine cases of locking of the metacarpo-phalangeal joint are described. The previously asymptomatic middle finger joint in an elderly person was most likely to be affected. Radiology of the joint has shown degenerative changes in all cases. In two patients, spontaneous unlocking of the joint occurred and in a further six operative release was undertaken. The important anatomical features of

  12. Joints

    NSDL National Science Digital Library

    Olivia Worland (Purdue University; Biological Sciences)

    2008-06-06

    Hinge joints move only in one direction, ball-and-socket joints are free to rotate in all directions, and gliding joints are able to move forward, backward, and side to side, but do not rotate freely.

  13. Arthroscopy for treating temporomandibular joint disorders

    Microsoft Academic Search

    Roger Currie

    2011-01-01

    Data sourcesThe Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline Embase, Lilacs, Allied and Complementary Medicine Database (AMED) and CINAHL databases were searched. In addition the reference lists of the included articles were checked and 14 journals hand searched.Study selectionRandomised controlled clinical trials (RCT) of arthroscopy for treating TMDs were included. There were

  14. 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

  15. Temporomandibular joint involvement in familial mediterranean fever

    Microsoft Academic Search

    M. Mukamel; M. Mimouni

    1993-01-01

    Case 2. A 15-year-old girl of Jewish Sephardi origin had a history of recurrent cellulitis on the medial aspect of the ankles since 7 years of age. At age 12, she had recurrent episodes of chest pain and\\/or abdominal pain with fever. At age 14 years she underwent laparotomy and appendectomy because of signs of peritonitis. Histologically her appendix was

  16. Antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease: a cost effectiveness analysis

    Microsoft Academic Search

    P. Krijnen; C J E Kaandorp; E. W. Steyerberg; D van Schaardenburg; H J Bernelot Moens; J. D. F. Habbema

    2001-01-01

    OBJECTIVETo assess the cost effectiveness of antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease.METHODSIn a decision analysis, data from a prospective study on bacterial arthritis in 4907 patients with joint disease were combined with literature data to assess risks and benefits of antibiotic prophylaxis. Effectiveness and cost effectiveness calculations were performed on antibiotic prophylaxis for various patient

  17. Stress radiographs in the evaluation of degenerative femorotibial joint disease

    Microsoft Academic Search

    Kai Tallroth; T. Sam Lindholm

    1987-01-01

    Thirty-eight osteoarthrotic knees were examined to assess the widths of the femorotibial joint spaces. Radiographs were exposed with the patient lying, in a standing position, and with an adduction and abduction force. Forced compression of the osteoarthrotic joint compartment caused, on average, 18% greater narrowing than when loading it in the standing position. Compared to the joint space at rest,

  18. British Journal of Oral and Maxillofacial Surgery 44 (2006) 124128 Biochemical analysis of the porcine temporomandibular

    E-print Network

    Athanasiou, Kyriacos

    2006-01-01

    of the porcine temporomandibular joint disc A.J. Almarzaa, A.C. Beana, L.S. Baggettb, K.A. Athanasioua Surgeons. Published by Elsevier Ltd. All rights reserved. Keywords: Porcine; TMJ disc; DNA and porcine models.6,7 Other investigators have reported that the periphery of the human TMJ disc contains

  19. Reconstrucción de la articulación temporomandibular postraumática con prótesis a medida. Planificación quirúrgica virtual

    Microsoft Academic Search

    Aitor García Sánchez; Miguel Ángel Morey Mas; Mikel Ramos Murguialday; Sergi Janeiro Barrera; Iñaki Molina Barraguer; José Ignacio Iriarte Ortabe

    2011-01-01

    IntroductionNew virtual surgery planning techniques like CAD\\/CAM and advances in biomaterials have made it possible to undertake increasingly complex cases of temporomandibular joint reconstruction. The planning and preparation of custom alloplastic devices makes it possible to accurately accommodate anatomic structures. Dental and facial deformities often coexist with articular pathology. Using computerized planning methods, orthognathic surgery procedures can be combined with

  20. Temporomandibular disorders in headache patients

    PubMed Central

    Mello, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Siqueira Quintans, Jullyana-de Souza; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues

    2012-01-01

    Objective: To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its seve-rity in individuals with headache. Study Design: 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic questionnaire. The severity of TMD was defined by the temporomandibular index (TMI). Results: The TMD signs and symptoms were always more frequent in individuals with headache, especially report of pain in TMJ area (CDH, n=16; EH, n=12; WH, n=6), pain to palpation on masseter (CDH, n=19; EH, n=16; WH, n=11) which are significantly more frequent in episodic and chronic daily headache. The mean values of temporomandibular and articular index (CDH patients) and muscular index (CDH and EH patients) were statistically higher than in patients of the control group, notably the articular (CDH=0.38; EH=0.25;WH=0.19) and muscular (CDH=0.46; EH=0.51; WH=0.26) indices. Conclusions: These findings allow us to speculate that masticatory and TMJ pain are more common in headache subjects. Besides, it seems that the TMD is more severe in headache patients. Key words:Temporomandibular dysfunction, headache disorders. PMID:22926473

  1. Treatment of Temporomandibular Disorders

    MedlinePLUS

    ... one or more of the following: Transcutaneous electrical nerve stimulation (TENS) — This therapy uses low-level electrical currents to relax the jaw joint and facial muscles. For some people, this relieves pain. This ...

  2. The Diagnostic Value of Pressure Algometry for Temporomandibular Disorders

    PubMed Central

    Wi?ckiewicz, W?odzimierz; Wo?niak, Krzysztof; Lipski, Mariusz

    2015-01-01

    The aim of this study is to determine the diagnostic value of pressure algometry in temporomandibular disorders. Two hundred volunteers aged 19.3 to 27.8 (mean 21.50, SD 0.97) participated in this study. An analogue pressure algometer was used for the evaluation of muscle tenderness of the following masticatory muscles: superficial and deep parts of the masseter muscle; anterior and posterior parts of the temporal muscle; and the tissues adjacent to the lateral and dorsal part of the temporomandibular joint capsule. Each patient described the algometry result for the individual components of the masticatory motor system, by selecting each time the intensity of pain on a 100?mm Visual Analogue Scale (VAS) ruler. The area under the receiver operating characteristic (ROC) curve, indicating the discriminatory efficiency for asymptomatic subjects and patients with temporomandibular dysfunction according to the dysfunction Di index, was the largest for the mean pain value (AUC?=?0.8572; SEM?=?0.0531). The 7.4 VAS cut-off point marked 95.3% specificity for this variable in identifying healthy subjects and 58.4% sensitivity in identifying patients with symptoms of dysfunctions (accuracy 68.1%). Assuming comparable sensitivity (74.9%) and specificity (74.2%) for a diagnostic test, there was test accuracy of 74.5% at the 4.2 VAS cut-off point.

  3. Host and parasite diversity jointly control disease risk in complex communities

    E-print Network

    Johnson, Pieter

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

  4. [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

  5. 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 ...

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

    E-print Network

    Zhou, Xianghong Jasmine

    Joint Genome-Wide Profiling of miRNA and mRNA Expression in Alzheimer's Disease Cortex Reveals in Alzheimer's disease (AD). In this study, we used microarrays for the first joint profiling and analysis TE, Finch CE, Zhou XJ (2010) Joint Genome-Wide Profiling of miRNA and mRNA Expression in Alzheimer

  7. Assessment of pain in temporomandibular disorders: the bio-psychosocial complexity.

    PubMed

    Kafas, P; Leeson, R

    2006-02-01

    Temporomandibular joint disorders (TMD) affect the joint, the masticatory muscles, or are expressed as a clinical combination of these two factors. The aims of this study were to: (i) identify the clinical and psychosocial factors that aid in the diagnosis and classification of acute and chronic TMD, (ii) determine specific initiating and perpetuating factors which may act as a guide to differentiate between acute and chronic TMD, (iii) identify factors which might predispose to conversion from acute to chronic TMD. Twenty-two patients were examined in the pain clinics at the Eastman Dental Institute. The assessment technique incorporated questionnaires, clinical history and examination including dental panoramic tomography. The results of this pilot study show a significant correlation between mood and enjoyment of life in both groups, mood and relationships in the chronic group, average pain and sleep in the chronic group, average pain and eating-chewing in the chronic group, and phobia for physical disease with trust in clinicians in the chronic group. The bio-psychosocial model of pain is an important appraisal tool. The newly designed TMD Pain Assessment is described with good results. PMID:15975765

  8. Nutraceutical Therapies for Degenerative Joint Diseases: A Critical Review

    Microsoft Academic Search

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

    2005-01-01

    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

  9. Degenerative Joint Disease Activated Osteoarthrosis Deformans: Hip, Knee, Shoulder and Other Joints

    Microsoft Academic Search

    Guido Hildebrandt; Friedrich-Hugo Kamprad

    Osteoarthritis is a chronic, degenerative disorder of unknown cause characterized by the gradual loss of articular cartilage.\\u000a It is the most prevalent disease in the western societies, with a worldwide distribution. As a cause of disability (such as\\u000a walking and stair climbing) in the elderly in the west, osteoarthritis is second only to vascular diseases. Altogether 10%-15%\\u000a of adults over

  10. Degenerative joint disease: An example of calcium paradox

    Microsoft Academic Search

    Takuo Fujita

    1998-01-01

    :   Osteoporosis and degenerative arthropathy such as osteoarthritis and spondylosis deformans represent the two most common\\u000a diseases seen in later life, sharing some common clinical features such as pain, deformity, and restriction of motion. Augmented\\u000a bone resorption, possibly mediated by cytokines such as interleukin 1, and favorable therapeutic response to estrogen also\\u000a characterize both diseases. Both osteoarthritis of the knee

  11. 205Oral & Craniofacial Tissue Engineering Temporomandibular Disorders

    E-print Network

    Athanasiou, Kyriacos

    characteristics of each patient's disease. In the mechanically demanding and biochemically active environment, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically of degenerative musculoskeletal conditions associated with morphologic and functional deformities that affect up

  12. Intraarticular Application of Unsealed Beta-Emitting Radionuclides in the Treatment Course of Inflammatory Joint Diseases

    Microsoft Academic Search

    W. U. Kampen; W. Brenner; N. Czech; E. Henze

    2002-01-01

    Intraarticular injection of ?-emitting radionuclides, called radiation synovectomy or radiosynoviorthesis, is an effective treatment in patients suffering from inflammatory-rheumatoid and degenerative joint diseases. Since the first description of intraarticular radionuclide therapy in 1952, several gamma- and beta-emitting radionuclides have been used in both experimental and clinical studies. Today, mainly three substances are in clinical use, each of them for special

  13. Causes of pain in degenerative bone and joint disease: a lesson from vertebroplasty

    Microsoft Academic Search

    David Niv; Michael Gofeld; Marshall Devor

    2003-01-01

    Pain in degenerative bone and joint disease is usually attributed to sensitized nociceptors in inflamed periarticular soft tissues. Here we draw attention to the potential contribution of intrinsic bone innervation. The structure and innervation of articular bone ends is analogous to that of teeth. Although some dental pain derives from inflamed periodontal soft tissue, a more important source is the

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

    Microsoft Academic Search

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

    1983-01-01

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

  15. Therapy Insight: how the gut talks to the joints—inflammatory bowel disease and the spondyloarthropathies

    Microsoft Academic Search

    Carmen Meier; Scott Plevy

    2007-01-01

    Axial and peripheral arthritis can occur in up to 30% of patients with inflammatory bowel disease. Likewise, the presence of gut inflammation in primary spondyloarthropathies is underappreciated, with subclinical gut inflammation documented in up to two-thirds of patients with this group of inflammatory disorders. Common genetic and immunologic mechanisms underlie the coincidence of inflammation in the joints and the intestine.

  16. Lumbar degenerative disc disease and tibiotalar joint arthritis: a 710-specimen postmortem study.

    PubMed

    Boiwka, Alex V; Bajwa, Navkirat S; Toy, Jason O; Eubanks, Jason; Ahn, Nicholas U

    2015-04-01

    Research has associated lumbar spinal disease with lower extremity arthrosis. These studies focused solely on the lumbar spine's connection with hip or knee pathology, failing to investigate potential ankle relationships. We specifically explored the interplay between lumbar disc degeneration and tibiotalar joint arthritis. Lumbar disc degeneration and tibiotalar joint arthritis was graded 0 to 4, according to osteophytosis of the vertebral rim and talar surface in 710 randomly selected cadaveric specimens. We corrected for confounding factors of age, sex, race, and height. A significant association was found between lumbar disc degeneration and tibiotalar joint arthritis (P < .01). Lumbar disc degeneration encompassing 3 intervetebral discs demonstrated the highest odds for development of severe tibiotalar joint arthritis. Severe lumbar degenerative disc disease was more prevalent than severe tibiotalar joint arthritis in individuals age 20 years and older. Furthermore, the presence of severe lumbar degeneration significantly predisposes individuals to the development of severe ankle arthritis (P < .05). Gait changes resulting from disc degeneration or neural compression in the lumbar spine may play a role in ankle osteoarthritis development. This association must be considered when treating patients with lumbar disc degeneration and leg pain. PMID:25844591

  17. Anti-Tumor Necrosis Factor Ameliorates Joint Disease in Murine Collagen- Induced Arthritis

    NASA Astrophysics Data System (ADS)

    Williams, Richard O.; Feldmann, Marc; Maini, Ravinder N.

    1992-10-01

    There is considerable evidence implicating tumor necrosis factor ? (TNF-?) in the pathogenesis of rheumatoid arthritis. This evidence is based not only on the universal presence of TNF-? in arthritic joints accompanied by the upregulation of TNF-? receptors but also on the effects of neutralizing TNF-? in joint cell cultures. Thus, neutralization of TNF-? in vitro results in inhibition of the production of interleukin 1, which like TNF-?, is believed to contribute to joint inflammation and erosion. To determine the validity of this concept in vivo, the effect of administering TNF-neutralizing antibodies to mice with collagen-induced arthritis has been studied. This disease model was chosen because of its many immunological and pathological similarities to human rheumatoid arthritis. TN3-19.12, a hamster IgG1 monoclonal antibody to murine TNF-?/?, was injected i.p. into mice either before the onset of arthritis or after the establishment of clinical disease. Anti-TNF administered prior to disease onset significantly reduced paw swelling and histological severity of arthritis without reducing the incidence of arthritis or the level of circulating anti-type II collagen IgG. More relevant to human disease was the capacity of the antibody to reduce the clinical score, paw swelling, and the histological severity of disease even when injected after the onset of clinical arthritis. These results have implications for possible modes of therapy of human arthritis.

  18. 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

  19. Hip joint replacement

    MedlinePLUS

    ... made joint. The artificial joint is called a prosthesis . ... thromboembolic disease in patients undergoing elective hip and ... joint arthroplasties: current concepts of patient outcomes after ...

  20. Influence of degenerative joint disease on spinal bone mineral measurements in postmenopausal women

    Microsoft Academic Search

    W. Yu; C.-C. Glüer; T. Fuerst; S. Grampp; J. Li; Y. Lu; H. K. Genant

    1995-01-01

    We assessed the impact of various forms of spinal degenerative joint disease (DJD) on bone mineral density (BMD) measured by quantitative computed tomography (QCT) and dual X-ray absorptiometry (DXA) in a group of postmenopausal women. Lateral (T4-L4) and AP (L1-L4) spinal radiographs were reviewed for fracture and DJD in 209 women (mean age 62.6±6.7). The severity of DJD findings was

  1. 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

  2. Host and parasite diversity jointly control disease risk in complex communities.

    PubMed

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

    2013-10-15

    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. CAPSULAR TISSUES OF THE PROXIMAL INTERPHALANGEAL JOINT: NORMAL COMPOSITION AND EFFECTS OF DUPUYTREN'S DISEASE AND RHEUMATOID ARTHRITIS

    Microsoft Academic Search

    M. BENJAMIN; J. R. RALPHS; M. SHIBU; M. IRWIN

    1993-01-01

    Three fibrocartilages associated with the proximal interphalangeal joint are described—at the attachment of the central slip to bone, within the slip where it passes over the joint, and the volar plate. Material was obtained at surgery following trauma, Dupuytren's disease and rheumatoid arthritis. The fibrocartilages were structurally distinct and immunolabelled differently with monoclonal antibodies to extracellular matrix components. All fibrocartilages

  4. EFFECTIVENESS OF THE TREATMENT OF DEGENERATIVE JOINT DISEASE WITH PERIARTICULAR, INTRAARTICULAR, AND INTRAMUSCULAR INJECTIONS OF ZEEL T

    Microsoft Academic Search

    Andrzej Lesiak; Rainer Gottwald; Michael Weiser

    Summary Effectiveness of the treatment of degenerative joint disease by Zeel injections was assessed on the basis of published work and our own experience, including the results of a study carried out in a group of 523 patients. The solution was injected into the affected joints, periarticularly and intramuscularly. We also assessed the product's tolerability. Women were predominant (71%) in

  5. Intra-articular vs. systemic administration of etanercept in antigen-induced arthritis in the temporomandibular point. Part I: histological effects

    Microsoft Academic Search

    Kasper D Kristensen; Peter Stoustrup; Annelise Küseler; Thomas K Pedersen; Jens R Nyengaard; Ellen Hauge; Troels Herlin

    2009-01-01

    BACKGROUND: Temporomandibular joint (TMJ) arthritis in children causes alterations in craniomandibular growth. This abnormal growth may be prevented by an early anti-inflammatory intervention. We have previously shown that intra-articular (IA) corticosteroid reduces TMJ inflammation, but causes concurrent mandibular growth inhibition in young rabbits. Blockage of TNF-? has already proven its efficacy in children with juvenile idiopathic arthritis not responding to

  6. Joint Effects of Smoking and Silicosis on Diseases to the Lungs

    PubMed Central

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

    2014-01-01

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

  7. Regenerative Injection Therapy with Whole Bone Marrow Aspirate for Degenerative Joint Disease: A Case Series

    PubMed Central

    Hauser, Ross A.; Orlofsky, Amos

    2013-01-01

    Regenerative therapeutic strategies for joint diseases usually employ either enriched concentrates of bone marrow-derived stem cells, chondrogenic preparations such as platelet-rich plasma, or irritant solutions such as hyperosmotic dextrose. In this case series, we describe our experience with a simple, cost-effective regenerative treatment using direct injection of unfractionated whole bone marrow (WBM) into osteoarthritic joints in combination with hyperosmotic dextrose. Seven patients with hip, knee or ankle osteoarthritis (OA) received two to seven treatments over a period of two to twelve months. Patient-reported assessments were collected in interviews and by questionnaire. All patients reported improvements with respect to pain, as well as gains in functionality and quality of life. Three patients, including two whose progress under other therapy had plateaued or reversed, achieved complete or near-complete symptomatic relief, and two additional patients achieved resumption of vigorous exercise. These preliminary findings suggest that OA treatment with WBM injection merits further investigation. PMID:24046512

  8. Correlation between signs of temporomandibular (TMD) and cervical spine (CSD) disorders in asthmatic children.

    PubMed

    Chaves, Thaís Cristina; Grossi, Débora Bevilaqua; de Oliveira, Anamaria Siriani; Bertolli, Fabiana; Holtz, Amanda; Costa, Dirceu

    2005-01-01

    Neck accessory respiratory muscles and mouth breathing suggest a direct relationship among asthma, Temporomandibular (TMD) and Cervical Spine (CSD) Disorders. This study was performed to evaluate and correlate TMD, CSD in asthmatic and non-asthmatic. Thirty asthmatic children (7.1 +/- 2.6 years old), 30 non-asthmatic predominantly mouth breathing children (Mouth Breathing Group - MBG) (8.80 +/- 1.61 years) and 30 non-asthmatic predominantly nasal breathing children (Nasal breathing Group - NBG) (9.00 +/- 1.64 years) participated in this study and they were submitted to clinical index to evaluate stomatognathic and cervical systems. Spearman correlation test and Chi-square were used. The level of significance was set at p < 0. 05. Significant frequency of palpatory tenderness of temporomandibular joint (TMJ), TMJ sounds, pain during cervical extension and rotation, palpatory tenderness of sternocleidomastoids and paravertabrae muscles and a severe reduction in cervical range of motion were observed in AG. Both AG and MBG groups demonstrated palpatory tenderness of posterior TMJ, medial and lateral pterygoid, and trapezius muscles when compared to NBG. Results showed a positive correlation between the severity of TMD and CSD signs in asthmatic children (r = 0.48). No child was considered normal to CSD and cervical mobility. The possible shortening of neck accessory muscles of respiration and mouth breathing could explain the relationship observed between TMD, CSD signs in asthmatic children and emphasize the importance of the assessment of temporomandibular and cervical spine regions in asthmatic children. PMID:16161392

  9. 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

  10. The role of leukocyte-stromal interactions in chronic inflammatory joint disease

    PubMed Central

    Burman, Angela; Haworth, Oliver; Bradfield, Paul; Parsonage, Greg; Filer, Andrew; Thomas, Andrew M.C.; Amft, Nicole; Salmon, Mike; Buckley, Christopher D.

    2011-01-01

    Rheumatoid arthritis (RA) is a debilitating, chronic, persistent inflammatory disease that is characterised by painful and swollen joints. The aetiology of RA is unknown, however whereas past research has concentrated on the role of immune or inflammatory infiltrating cells in inflammation, it is becoming clear that stromal cells play a critical part in regulating the quality and duration of an inflammatory response. In this review we assess the role of fibroblasts within the inflamed synovium in modulating immune responses; in particular we examine the role of stromal cells in the switch from resolving to persistent inflammation as is found in the rheumatoid synovium. PMID:15681242

  11. Nuclear medicine in diagnosis and therapy of bone and joint diseases.

    PubMed

    Riccabona, G

    1999-01-01

    Concerning bone and joint diseases therapy of rheumatic synovitis (= radiosynoviorthesis) was introduced in 1952 before clinically relevant diagnostic procedures were developed. Radionuclides of Sr and later on 99mTc phosphonates then started the wide use of bone scintigraphy since > 30 years. The diagnostic methods have an excellent sensitivity for detection of local abnormalities of bone metabolism, the specificity of such studies, however, is low. Modifications of the technique (3-phase-bone-scintigraphy, pinhole collimators, ROI-technique), increasing knowledge of pathological scan patterns and introduction of other radionuclide studies (67Ga, 201Tl, inflammation scans with 99mTc-leukocytes or 99mTc-HIG) as well as 18FDG-PET have increased the specificity significantly in recent years and improvements of imaging systems (SPECT) also increased the accuracy of diagnostic methods in diseases of bone and joints. Therapy of such diseases has made considerable progress: inflamed, swollen joints can effectively be treated with 90Y-, 186Re, 169Er-colloids or with 165Dy-particles by radiosynoviorthesis. Severe pain due to disseminated bone metastases of cancer or polyarthritis can be controlled by radionuclide therapy with 89Sr, 153Sm-EDTMP, 186Re- or 188Re-HEDP and possibly 117mSn-DTPA with an acceptable risk of myelodepression. Possibilities, technical details and limitations of radionuclide applications for diagnostic and therapeutic purposes must be considered if optimal benefit for individual patients should be achieved. Overall Nuclear Medicine can become an essential element in management of bone and joint diseases. The relationship of Nuclear Medicine to bone and joint pathology is peculiar: In 1952 treatment of rheumatic synovitis by radiosynoviorthesis with 198Au Colloid was started by Fellinger and Schmid before diagnostic approaches to bone pathology existed. Bone scintigraphy was introduced only in 1961 using 85Sr but obviously the unfavourable radiation characteristics of this radionuclide limited it's broad application and 87mSr did not improve this situation. Only when 99mTc phosphonates were developed by Subramanian the importance of bone scintigraphy became apparent: The excellent imaging properties of these radiotracers showed, that abnormal bone metabolism could be visualized even before morphological alterations in the skeleton become visible on radiographies or even CT-scans. Moreover, proposals made earlier to use 32P or 89Sr for palliation of pain in patients with disseminated skeletal metastases were picked up again and led also to other radiopharmaceuticals (186Re-HEDP, 153Sm-EDTMP, 117mSn-DTPA) which are applied today for the same purpose with very good success. Therefore Nuclear Medicine today has a broad program for diagnostic and therapeutic approaches to diseases of bone and joints. In bone scanning the high sensitivity led to inclusion of this method for routine staging and re-staging programs in a variety of cancer forms which have a trend to develop bone metastases (e.g. breast, lung, prostate, melanoma) but the low specificity of abnormal patterns on such scans can impair the diagnostic value of the technique. To increase specificity and to define inflammatory lesions, radiotracers used for "inflammation scanning" were introduced such as labeled granulocytes, 99mTc Human Immunoglobulin and others but also a simple modification of bone scanning--triple phase bone scintigraphy--was used. Recently the excellent properties of 18F for PET of the skeleton were rediscovered again and emission CT scanning--possibly with overlay with transmission CT or MRT pictures--can enhance the diagnostic impact of radionuclide bone studies. PMID:14601000

  12. 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

  13. [Limb and joint pain in Lyme disease. An important differential neurologic diagnosis].

    PubMed

    von Albert, H H

    1989-08-10

    On the basis of 4 cases, attention is drawn to the problem of early detection of Lyme disease. The occurrence of joint pain with fluctuating spread and unresponsive to the usual antiinflammatory therapy should prompt the physician to consider lyme disease, which can be confirmed or excluded only by lumbar puncture. The CSF shows a cell count of between 300/3 and 2,000/3 cells (90% lymphocytes) and usually moderately elevated protein. A demonstration of elevated antibody titers confirms the diagnosis. The condition can be cured with antibiotics (penicillins or cephalosporins) and also cerebral nerve involvement (usual the facial nerve) with or without impairment of taste also clears up completely. PMID:2767602

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

    PubMed

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

    2014-09-01

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

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

    PubMed Central

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

    2008-01-01

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

  16. Three-dimensional osteogenic and chondrogenic systems to model osteochondral physiology and degenerative joint diseases.

    PubMed

    Alexander, Peter G; Gottardi, Riccardo; Lin, Hang; Lozito, Thomas P; Tuan, Rocky S

    2014-09-01

    Tissue engineered constructs have the potential to function as in vitro pre-clinical models of normal tissue function and disease pathogenesis for drug screening and toxicity assessment. Effective high throughput assays demand minimal systems with clearly defined performance parameters. These systems must accurately model the structure and function of the human organs and their physiological response to different stimuli. Musculoskeletal tissues present unique challenges in this respect, as they are load-bearing, matrix-rich tissues whose functionality is intimately connected to the extracellular matrix and its organization. Of particular clinical importance is the osteochondral junction, the target tissue affected in degenerative joint diseases, such as osteoarthritis (OA), which consists of hyaline articular cartilage in close interaction with subchondral bone. In this review, we present an overview of currently available in vitro three-dimensional systems for bone and cartilage tissue engineering that mimic native physiology, and the utility and limitations of these systems. Specifically, we address the need to combine bone, cartilage and other tissues to form an interactive microphysiological system (MPS) to fully capture the biological complexity and mechanical functions of the osteochondral junction of the articular joint. The potential applications of three-dimensional MPSs for musculoskeletal biology and medicine are highlighted. PMID:24994814

  17. 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.

  18. 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

  19. Segment-specific association between cervical pillar hyperplasia (CPH) and degenerative joint disease (DJD)

    PubMed Central

    Stupar, Maja; Peterson, Cynthia K

    2006-01-01

    Background Cervical pillar hyperplasia (CPH) is a recently described phenomenon of unknown etiology and clinical significance. Global assessment of pillar hyperplasia of the cervical spine as a unit has not shown a relationship with degenerative joint disease, but a more sensible explanation of the architectural influence of CPH on cervical spine biomechanics may be segment-specific. Objective The objective of this study was to determine the level of association between degenerative joint disease (DJD) and cervical pillar hyperplasia (CPH) in an age- and gender-matched sample on a [cervical spine] by-level basis. Research Methods Two-hundred and forty radiographs were collected from subjects ranging in age between 40 and 69 years. The two primary outcome measures used in the study were the segmental presence/absence of cervical pillar hyperplasia from C3 to C6, and segment-specific presence/absence of degenerative joint disease from C1 to C7. Contingency Coefficients, at the 5% level of significance, at each level, were used to determine the strength of the association between CPH and DJD. Odds Ratios (OR) with their 95% Confidence Intervals (95% CI) were also calculated at each level to assess the strength of the association. Results Our study suggests that an approximately two-to-one odds, or a weak-to-moderate correlation, exists at C4 and C5 CPH and adjacent level degenerative disc disease (DDD); with the strongest (overall) associations demonstrated between C4 CPH and C4–5 DDD and between C5 CPH and C5–6 DDD. Age-stratified results demonstrated a similar pattern of association, even reaching the initially hypothesized OR ? 5.0 (95% CI > 1.0) or "moderately-strong correlation of C ? .4 (p ? .05)" in some age categories, including the 40–44, 50–59, and 60–64 years of age subgroups; these ORs were as follows: OR = 5.5 (95% CI 1.39–21.59); OR = 6.7 (95% CI 1.65–27.34); and OR = 5.3 (95% CI 1.35–21.14), respectively. Conclusion Our results suggest that CPH has around two-to-one odds, that is, only a weak-to-moderate association with the presence of DJD (DDD component) at specific cervical spine levels; therefore, CPH may be but one of several factors that contributes (to a clinically important degree) to the development of DJD at specific levels in the cervical spine. PMID:16970812

  20. A Collaborative Approach Between Chiropractic and Dentistry to Address Temporomandibular Dysfunction: A Case Report

    PubMed Central

    Rubis, Lisa M.; Rubis, David; Winchester, Brett

    2014-01-01

    Objective The purpose of this case report is to describe the chiropractic and dental comanagement of a patient with temporomandibular dysfunction, headaches, and myalgia. Clinical features A 38-year-old black female patient presented for chiropractic care with a chief concern of jaw pain, tinnitus, headaches, and neck and shoulder soreness of 8 months’ duration. The patient rated the pain a 6/10. The patient had a maximum mouth opening of 42 mm, graphed evidence of disk displacement, loss of translation on opening of the right temporomandibular joint viewed on the lateral radiograph, and numerous areas of point tenderness on the Kinnie-Funt Chief Complaint Visual Index. She had decreased lateral cervical flexion. Intervention and outcome Dental treatment consisted of an anterior repositioning splint. Chiropractic care consisted of Activator treatment to the pelvis and the thoracic and cervical spine. Manual manipulation of the temporomandibular joint was performed along with a soft tissue technique intraorally on the lateral pterygoid. Postisometric relaxation in the head and neck region was also done. The patient was treated 6 times over 3 weeks. At the end of treatment, the patient had a pain rating of 0/10, maximum mouth opening of 49 mm, no tender points on the follow-up Kinnie-Funt, and increased cervical range of motion. Conclusion The patient demonstrated increased mouth opening, decreased pain rating, improved Kinnie-Funt visual index, and an increased cervical lateral flexion range of motion after 3 weeks of a combination of chiropractic and dental care. PMID:24711786

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

    PubMed Central

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

    2013-01-01

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

  2. 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

  3. Proximal interphalangeal joint release in Dupuytren's disease of the little finger.

    PubMed

    Ritchie, J F S; Venu, K M; Pillai, K; Yanni, D H

    2004-02-01

    We present a prospective study, with 3-year follow-up, of the role and outcome of fasciectomy plus sequential surgical release of structures of the proximal interphalangeal joint in Dupuytren's contracture of the little finger. Our treatment programme involves fasciectomy for all patients followed by sequential release of the accessory collateral ligament and volar plate as necessary. Of the 19 fingers in the study, eight achieved a full correction by fasciectomy alone, and in these cases there was a fixed flexion deformity of 6 degrees at 3 months and 8 degrees at 3 years. The remaining 11 fingers (initial mean deformity 70 degrees flexion) were left with a fixed flexion deformity of 42 degrees after fasciectomy which reduced to 7 degrees with capsulo-ligamentous release. This increased to 26 degrees at 3 months but then remained relatively stable, increasing only to 29 degrees at 3 years. In our experience sequential proximal interphalangeal joint release has led to consistently good results with few complications in the correction of severe Dupuytren's disease of the little finger. PMID:14734062

  4. Latent class models for joint analysis of disease prevalence and high-dimensional semicontinuous biomarker data.

    PubMed

    Zhang, Bo; Chen, Zhen; Albert, Paul S

    2012-01-01

    High-dimensional biomarker data are often collected in epidemiological studies when assessing the association between biomarkers and human disease is of interest. We develop a latent class modeling approach for joint analysis of high-dimensional semicontinuous biomarker data and a binary disease outcome. To model the relationship between complex biomarker expression patterns and disease risk, we use latent risk classes to link the 2 modeling components. We characterize complex biomarker-specific differences through biomarker-specific random effects, so that different biomarkers can have different baseline (low-risk) values as well as different between-class differences. The proposed approach also accommodates data features that are common in environmental toxicology and other biomarker exposure data, including a large number of biomarkers, numerous zero values, and complex mean-variance relationship in the biomarkers levels. A Monte Carlo EM (MCEM) algorithm is proposed for parameter estimation. Both the MCEM algorithm and model selection procedures are shown to work well in simulations and applications. In applying the proposed approach to an epidemiological study that examined the relationship between environmental polychlorinated biphenyl (PCB) exposure and the risk of endometriosis, we identified a highly significant overall effect of PCB concentrations on the risk of endometriosis. PMID:21908867

  5. Gastrointestinal peptides in serum and synovial fluid from patients with inflammatory joint disease.

    PubMed Central

    Lygren, I; Ostensen, M; Burhol, P G; Husby, G

    1986-01-01

    The concentrations of immunoreactive vasoactive intestinal polypeptide (ir-VIP), immunoreactive pancreatic polypeptide (ir-PP), ir-somatostatin, and ir-secretin were measured in serum and synovial fluid from patients suffering from various inflammatory joint diseases. One group of patients were not taking any medication, while another group received anti-inflammatory treatment at the time of sampling. High levels of ir-VIP in the synovial fluid were observed in the untreated group of patients, and the concentration of ir-VIP in the synovial fluid was significantly higher than in parallel serum samples. On the other hand, no significant differences in the concentrations of the other peptides were observed either between serum and synovial fluid or between the two groups of patients. It is suggested that VIP is released locally at the inflammatory site and that VIP may be of significance in inflammatory disorders. PMID:2874778

  6. A protocol for magnetic resonance imaging of the temporomandibular joints.

    PubMed

    Gibbs, S J; Simmons, H C

    1998-10-01

    The complex concepts and procedures of magnetic resonance imaging (MRI) are unfamiliar to many dentists. Similarly, many radiologists lack understanding of the clinical requirements of the dentist for accurate assessment of TMJ abnormalities. Thus, TMJ imaging procedures may be inadequate or incomplete, may vary from facility to facility, and sometimes from patient to patient in a given facility. A protocol for TMJ imaging is presented which meets dental requirements and is rapidly performed in the MRI facility. The protocol may be copied and attached to the prescription to the imaging center. It may be modified or expanded to accommodate specific patient requirements or equipment performance. PMID:10029751

  7. Temporomandibular joint function and its effect on concepts of occlusion.

    PubMed

    Weinberg, L A

    1976-05-01

    Many of the premises of dentistry that have evolved empirically have been re-evaluated in the light of newly-developed concepts of TMJ function. Centric relation, although duplicable, may not necessarily be correct. A "functional" centric relation exists when the TMJ radiographs can be correlated with the occlusal findings, in which case, the retruded classical centric relation should be used. When a "dysfunctional" centric relation is present (no correlation between the TMJ radiographs and occlusal findings), the most retruded position should not be used and a therapeutic centric occlusion should be created by the dentist. Subclinical TMJ dysfunction occurs more frequently than commonly thought, because TMJ radiographs are not routinely used. Retruded condylar displacements can be easily overlooked, because the lateral pterygoid muscle has relatively few stretch receptors compared to the elevator muscles of the mandible. Condylar retrusion, therefore, would not necessarily cause lateral pterygoid spasm as might be expected. The exact mechanism of the TMJ suspension system is unknown, although experimental evidence has shown that the condyle can be displaced superiorly with posterior unsupported muscle force. This indicates that the immutability of the condylar path under varying clinical conditions is questionable. Due to the superior displacement characteristics of the TMJ, the condyle does not act as the fulcrum in mandibular kinetics. The fulcrum, therefore, shifts to the teeth and/or bolus, depending on the specific situation. In either instance, whether considering bruxism or mastication, for most patients, an occlusion based on group function is preferable to a canine-protected occlusion to insure TMJ health. Scientifically, no one scheme of occlusion or articulation has been proven to be superior to any other scheme; therefore, the choice is a matter of the personal preference of the dentist. PMID:1063872

  8. Temporomandibular joint dysfunction and orthognathic surgery: a retrospective study

    Microsoft Academic Search

    Jean-Pascal Dujoncquoy; Joël Ferri; Gwénael Raoul; Johannes Kleinheinz

    2010-01-01

    BACKGROUND: Relations between maxillo-mandibular deformities and TMJ disorders have been the object of different studies in medical literature and there are various opinions concerning the alteration of TMJ dysfunction after orthognathic surgery. The purpose of the present study was to evaluate TMJ disorders changes before and after orthognathic surgery, and to assess the risk of creating new TMJ symptoms on

  9. Temporomandibular disorders and facial pain: a psychophysiological perspective.

    PubMed

    Glaros, Alan G

    2008-09-01

    This article presents a psychophysiological perspective on temporomandibular muscle and joint disorders (TMJD) and facial pain. After a brief introduction to TMJD, the article presents data, largely derived from work carried out in my laboratory, that address four questions: (1) What are the consequences of parafunctional activities? (2) Do TMJD patients engage in parafunctional activities? (3) Why are TMJD patients unaware of these activities? and (4) What are the implications of these findings for treatment? The findings suggest that low-level parafunctions increase pain in otherwise pain-free individuals and can produce symptoms sufficiently severe to meet the diagnostic criteria for TMJD diagnoses of myofascial pain and/or arthralgia. Patients with certain forms of TMJD report very high levels of parafunctional tooth contact. Their lack of awareness of these behaviors may arise from uncertain definitions of the term "clenching", from proprioceptive deficits, or from the presence of adjunctive behaviors. Preliminary work shows that reduction in tooth contact via habit reversal techniques may be a promising mechanism for reducing pain in these patients. PMID:18726689

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

    PubMed

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

    2015-02-01

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

  11. Poor results of drilling in early stages of juxta-articular osteonecrosis in 12 joints affected by Gaucher disease

    PubMed Central

    Lebel, Ehud; Phillips, Mici; Zimran, Ari; Itzchaki, Menachem

    2009-01-01

    Background and purpose Gaucher disease is heterogeneous. One of the most devastating complications is bone involvement, ranging from mild osteopenia to osteonecrosis, but no markers have been discovered to predict onset and/or progression. We describe our experience in a large referral center using drilling for juxta-articular osteonecrosis in young patients with Gaucher disease. Patients and methods We retrospectively reviewed medical data from all patients who were recommended to undergo drilling for osteonecrosis of juxta-articular bone of the femoral head, the humeral head, or upper tibia for acute osteonecrosis at a pre-collapse stage. Results 11 patients (mean age 34 years) underwent drilling of 12 joints with juxta-articular osteonecrosis; 3 (mean age 51 years) refused intervention. 9 joints that were drilled showed advancing joint degeneration within 0.5 to 4 years. 3 joints have undergone replacement. Of the 3 joints that did not undergo drilling, 2 have undergone replacement and 1 has collapsed with osteoarthritis. Interpretation We found equally poor outcome with and without drilling. Effective intervention can only be achieved by improving our understanding of bone physiology and pathophysiology in Gaucher disease. PMID:19404804

  12. Osteoarthritis (OA), a degenerative joint disease associ-ated with the degradation of articular cartilage, is a leading

    E-print Network

    Firestone, Jeremy

    Osteoarthritis (OA), a degenerative joint disease associ- ated with the degradation of articular and progres- sion processes are poorly understood. Cartilage mechanics are highly sensitive to the poroelastic one cylindrical bo- vine cartilage plug ( 10mm x 10mm, 1mm cartilage 9mm subchondral bone). One sample

  13. Pharmacoeconomic study of patients with chronic inflammatory joint disease before and during infliximab treatment

    PubMed Central

    Laas, K; Peltomaa, R; Kautiainen, H; Puolakka, K; Leirisalo?Repo, M

    2006-01-01

    Objective To evaluate medical and work disability costs for patients with chronic inflammatory joint disease during one year before and one year after institution of infliximab treatment in routine clinical practice. Methods Starting from 1999, clinical and laboratory variables for patients treated with biological agents for inflammatory rheumatic diseases were systematically recorded at Helsinki University Central Hospital. From this database clinical information was collected on 96 patients in whom infliximab was started during the period 1999 to 2001. Economic analyses were based on costs incurred because of outpatient and inpatient visits, orthopaedic operations, drugs used, and days on sickness or rehabilitation allowance. Medical and work disability costs were calculated separately for the one year period before (period I) and the one year period after institution of infliximab (period II). Results Of the study group of 96 patients (arthritis duration 16 years (range 3 to 43)), 74 completed one year of infliximab treatment. Their clinical and laboratory variables improved significantly. The mean increase in medical costs during period II was €12?015 (95% confidence interval, 6496 to 18?076). A minimal decrease in work disability costs occurred—mean decrease €130 (?1268 to 1072). Conclusions One year treatment with infliximab in patients with longstanding aggressive arthritis showed a good clinical effect but raised medical costs significantly. Work disability costs failed to show a substantial decrease. Starting infliximab in the earlier stages of chronic arthritis could in the long term prevent work disability and thus decrease the total cost to society. PMID:16339293

  14. Lipoproteins and their subfractions in psoriatic arthritis: identification of an atherogenic profile with active joint disease

    PubMed Central

    Jones, S; Harris, C; Lloyd, J; Stirling, C; Reckless, J; McHugh, N

    2000-01-01

    OBJECTIVES—(a) To characterise the lipid profile in psoriatic arthritis and investigate whether there are similarities to the dyslipoproteinaemia reported in rheumatoid arthritis and other inflammatory forms of joint disease; (b) to investigate whether there is an atherogenic lipid profile in psoriatic arthritis, which may have a bearing on mortality.?METHODS—Fasting lipids, lipoproteins, and their subfractions were measured in 50 patients with psoriatic arthritis and their age and sex matched controls.?RESULTS—High density lipoprotein cholesterol (HDL cholesterol) and its third subfraction, HDL3 cholesterol, were significantly reduced and the most dense subfraction of low density lipoprotein (LDL), LDL3, was significantly increased in the patients with psoriatic arthritis. Twenty patients with active synovitis had significantly lower total cholesterol, LDL cholesterol, and HDL3 cholesterol than their controls. 25% of the patients with psoriatic arthritis had raised Lp(a) lipoprotein levels (>300 mg/l) compared with 19% of controls, but this was not statistically significant.?CONCLUSION—Raised levels of LDL3 and low levels of HDL cholesterol are associated with coronary artery disease. Such an atherogenic profile in a chronic inflammatory form of arthritis is reported, which may be associated with accelerated mortality.?? PMID:11053070

  15. A joint model for multistate disease processes and random informative observation times, with applications to electronic medical records data.

    PubMed

    Lange, Jane M; Hubbard, Rebecca A; Inoue, Lurdes Y T; Minin, Vladimir N

    2015-03-01

    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

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

    PubMed Central

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

    2014-01-01

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

  17. Targeted mutation of NOV/CCN3 in mice disrupts joint homeostasis and causes osteoarthritis-like disease

    PubMed Central

    Roddy, K.A.; Boulter, C.A.

    2015-01-01

    Summary Objective The matricellular protein NOV/CCN3, is implicated in osteoarthritis (OA) and targeted mutation of NOV in mice (Novdel3) leads to joint abnormalities. This investigation tested whether NOV is required for joint homeostasis and if its disruption causes joint degeneration. Method NOV expression in the adult mouse joint was characterized by immunohistochemistry. A detailed comparison of the joints of Novdel3?/? and Novdel3+/+ (wild-type) males and females at 2, 6 and 12 months of age was determined by X-ray, histology and immunohistochemistry. Results NOV protein was found in specific cells in articular cartilage, meniscus, synovium and ligament attachment sites in adult knees. Novdel3?/? males exhibited severe OA-like pathology at 12 months (OARSI score 5.0 ± 0.5, P < 0.001), affecting all tissues of the joint: erosion of the articular cartilage, meniscal enlargement, osteophytic outgrowths, ligament degeneration and expansion of fibrocartilage. Subchondral sclerosis and changes in extracellular matrix composition consistent with OA, were also seen. The density of articular cartilage cells in Novdel3+/+ knee joints is maintained at a constant level from 2 to 12 months of age whereas this is not the case in Novdel3?/? mice. Compared with age and sex-matched Novdel3+/+ mice, a significant increase in articular cartilage density was seen in Novdel3?/? males at 2 months, whereas a significant decrease was seen at 6 and 12 months in both Novdel3?/? males and females. Conclusion NOV is required for the maintenance of articular cartilage and for joint homeostasis, with disruption of NOV in ageing Novdel3?/? male mice causing OA-like disease. PMID:25541297

  18. Reduced joint distance during TMJ movement in the posterior condylar position.

    PubMed

    Yang, Hoon Joo; Kim, Dae Seung; Yi, Won-Jin; Hwang, Soon Jung

    2013-10-01

    Biomechanical loading reduces joint distance and has a causative relationship with disc displacement in temporomandibular joint and/or osteoarthritis. Condylar movement and pathways during mouth opening and closing are different depending on the condylar position in the glenoid fossa. Therefore, physical loading on the articular disc or condylar head would also be different in different condylar positions. The aim of this study was to evaluate the 3-dimensional changes of joint distance in different anterior-posterior condylar positions. We divided 52 temporomandibular joints into anterior, concentric, and posterior condylar positions using transcranial radiographs. We traced the condylar movements by simulating mandibular movement with 3-dimensional computed tomography data and a position-tracking camera. The joint distance during temporomandibular joint movement was significantly narrower, and the length of condylar pathways with narrower joint distance was longer in the posterior condylar position than in the concentric (p < 0.05) or anterior condylar positions (p < 0.01). Our study suggests that the posterior condylar position experiences more physical loading than other positions. Therefore, the position may have an accelerating or worsening effect on biomechanical loading-related temporomandibular joint disorder in cases of harmful parafunctional activities such as excessive mouth opening, clenching, and bruxism. PMID:23465637

  19. Improved Flow Cytometric Assessment Reveals Distinct Microvesicle (Cell-Derived Microparticle) Signatures in Joint Diseases

    PubMed Central

    György, Bence; Szabó, Tamás G.; Turiák, Lilla; Wright, Matthew; Herczeg, Petra; Lédeczi, Zsigmond; Kittel, Ágnes; Polgár, Anna; Tóth, Kálmán; Dérfalvi, Beáta; Zelenák, Gerg?; Böröcz, István; Carr, Bob; Nagy, György; Vékey, Károly; Gay, Steffen; Falus, András; Buzás, Edit I.

    2012-01-01

    Introduction Microvesicles (MVs), earlier referred to as microparticles, represent a major type of extracellular vesicles currently considered as novel biomarkers in various clinical settings such as autoimmune disorders. However, the analysis of MVs in body fluids has not been fully standardized yet, and there are numerous pitfalls that hinder the correct assessment of these structures. Methods In this study, we analyzed synovial fluid (SF) samples of patients with osteoarthritis (OA), rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA). To assess factors that may confound MV detection in joint diseases, we used electron microscopy (EM), Nanoparticle Tracking Analysis (NTA) and mass spectrometry (MS). For flow cytometry, a method commonly used for phenotyping and enumeration of MVs, we combined recent advances in the field, and used a novel approach of differential detergent lysis for the exclusion of MV-mimicking non-vesicular signals. Results EM and NTA showed that substantial amounts of particles other than MVs were present in SF samples. Beyond known MV-associated proteins, MS analysis also revealed abundant plasma- and immune complex-related proteins in MV preparations. Applying improved flow cytometric analysis, we demonstrate for the first time that CD3+ and CD8+ T-cell derived SF MVs are highly elevated in patients with RA compared to OA patients (p?=?0.027 and p?=?0.009, respectively, after Bonferroni corrections). In JIA, we identified reduced numbers of B cell-derived MVs (p?=?0.009, after Bonferroni correction). Conclusions Our results suggest that improved flow cytometric assessment of MVs facilitates the detection of previously unrecognized disease-associated vesicular signatures. PMID:23185418

  20. 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

  1. Articular Chondrocytes from Animals with a Dermatan Sulfate Storage Disease Undergo a High Rate of Apoptosis and Release Nitric Oxide and Inflammatory Cytokines: A Possible Mechanism Underlying Degenerative Joint Disease in the Mucopolysaccharidoses

    Microsoft Academic Search

    Calogera M. Simonaro; Mark E. Haskins; Edward H. Schuchman

    2001-01-01

    Mucopolysaccharidosis (MPS) Type VI (Maroteaux-Lamy Disease) is the lysosomal storage disease characterized by deficient arylsulfatase B activity and the resultant accumulation of dermatan sulfate-containing glycosaminoglycans (GAGs). A major feature of this and other MPS disorders is abnormal cartilage and bone development leading to short stature, dysostosis multiplex, and degenerative joint disease. To investigate the underlying cause(s) of degenerative joint disease

  2. 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

  3. Partial Antiviral Activities Detection of Chicken Mx Jointing with Neuraminidase Gene (NA) against Newcastle Disease Virus

    PubMed Central

    Zhang, Yani; Fu, Dezhi; Chen, Hao; Zhang, Zhentao; Shi, Qingqing; Elsayed, Ahmed Kamel; Li, Bichun

    2013-01-01

    As an attempt to increase the resistance to Newcastle Disease Virus (NDV) and so further reduction of its risk on the poultry industry. This work aimed to build the eukaryotic gene co-expression plasmid of neuraminidase (NA) gene and myxo-virus resistance (Mx) and detect the gene expression in transfected mouse fibroblasts (NIH-3T3) cells, it is most important to investigate the influence of the recombinant plasmid on the chicken embryonic fibroblasts (CEF) cells. cDNA fragment of NA and mutant Mx gene were derived from pcDNA3.0-NA and pcDNA3.0-Mx plasmid via PCR, respectively, then NA and Mx cDNA fragment were inserted into the multiple cloning sites of pVITRO2 to generate the eukaryotic co-expression plasmid pVITRO2-Mx-NA. The recombinant plasmid was confirmed by restriction endonuclease treatment and sequencing, and it was transfected into the mouse fibroblasts (NIH-3T3) cells. The expression of genes in pVITRO2-Mx-NA were measured by RT-PCR and indirect immunofluorescence assay (IFA). The recombinant plasmid was transfected into CEF cells then RT-PCR and the micro-cell inhibition tests were used to test the antiviral activity for NDV. Our results showed that co-expression vector pVITRO2-Mx-NA was constructed successfully; the expression of Mx and NA could be detected in both NIH-3T3 and CEF cells. The recombinant proteins of Mx and NA protect CEF cells from NDV infection until after 72 h of incubation but the individually mutagenic Mx protein or NA protein protects CEF cells from NDV infection till 48 h post-infection, and co-transfection group decreased significantly NDV infection compared with single-gene transfection group (P<0. 05), indicating that Mx-NA jointing contributed to delaying the infection of NDV in single-cell level and the co-transfection of the jointed genes was more powerful than single one due to their synergistic effects. PMID:23977111

  4. Metal ions and oxygen radical reactions in human inflammatory joint disease.

    PubMed

    Halliwell, B; Gutteridge, J M; Blake, D

    1985-12-17

    Activated phagocytic cells produce superoxide (O2-) and hydrogen peroxide (H2O2); their production is important in bacterial killing by neutrophils and has been implicated in tissue damage by activated phagocytes. H2O2 and O2- are poorly reactive in aqueous solution and their damaging actions may be related to formation of more reactive species from them. One such species is hydroxyl radical (OH.), formed from H2O2 in the presence of iron- or copper-ion catalysts. A major determinant of the cytotoxicity of O2- and H2O2 is thus the availability and location of metal-ion catalysts of OH. formation. Hydroxyl radical is an initiator of lipid peroxidation. Iron promoters of OH. production present in vivo include ferritin, and loosely bound iron complexes detectable by the 'bleomycin assay'. The chelating agent Desferal (desferrioxamine B methanesulphonate) prevents iron-dependent formation of OH. and protects against phagocyte-dependent tissue injury in several animal models of human disease. The use of Desferal for human treatment should be approached with caution, because preliminary results upon human rheumatoid patients have revealed side effects. It is proposed that OH. radical is a major damaging agent in the inflamed rheumatoid joint and that its formation is facilitated by the release of iron from transferrin, which can be achieved at the low pH present in the micro-environment created by adherent activated phagocytic cells. It is further proposed that one function of lactoferrin is to protect against iron-dependent radical reactions rather than to act as a catalyst of OH. production. PMID:2419931

  5. Comparative degenerative joint disease of the vertebral column in the medieval monastic cemetery of the Gilbertine Priory of St. Andrew, Fishergate, York, England

    Microsoft Academic Search

    Christopher J. Knüsel; Sonia Göggel; David Lucy

    1997-01-01

    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

  6. Chondrosarcoma of the Temporomandibular Disc: Behavior Over a 28-Year Observation Period.

    PubMed

    MacIntosh, Robert B; Khan, Faisal; Waligora, Bret M

    2015-03-01

    Chondrosarcoma of the head and neck occurs infrequently, with a recorded prevalence of only 5 to 12% of all such tumors; this in total represents only 17 to 22% of all monostotic bone malignancies. Chondrosarcomas arising in the region of the temporomandibular joint are especially rare, with only 28-including subsets-recorded in the 6 decades since the first report in 1954. The lesion described in the present report would appear to be the first arising solely from the disc itself, and the postoperative period of observation is the longest on record. The patient's course over 27 years shows the need for ongoing vigilance in the management of this tumor. PMID:25577455

  7. Joint chondrolysis.

    PubMed

    Provencher, Matthew T; Navaie, Maryam; Solomon, Daniel J; Smith, Jessica C; Romeo, Anthony A; Cole, Brian J

    2011-11-01

    Although the disease was first described in the hip, reports of chondrolysis in nearly all diarthrodial joints have since emerged with considerable variations in the literature.Despite speculation among clinicians and researchers about the implicit causal pathways and etiologic contributors associated with chondrolysis, definitive answers remain elusive.The term chondrolysis has been applied to varied levels of joint cartilage destruction from focal chondral defects to diffuse cartilage loss, revealing a lack of consistency in the application of diagnostic criteria to guide differential disease classification.Differentiating between the various potential etiologies associated with chondrolysis provides opportunities for the prevention of the disease. PMID:22048100

  8. Excision of Femoral Head and Neck for Treatment of Coxofemoral Degenerative Joint Disease in a Rhesus Macaque (Macaca mulatta)

    PubMed Central

    Dufour, Jason P; Phillippi-Falkenstein, Kathrine; Bohm, Rudolf P; Veazey, Ronald S; Carnal, Jean

    2012-01-01

    Nonhuman primates are a valuable model for osteoarthritis. Osteoarthritis has been extensively studied in nonhuman primates in both naturally occurring and induced disease states. However, little published information describes naturally occurring osteoarthritis of the coxofemoral joints of nonhuman primates. We report a case of naturally occurring coxofemoral joint osteoarthritis in a rhesus macaque. This case radiographically resembled hip dysplasia reported in other species and demonstrated a rapid progression in severity of lameness, with accompanying loss of muscle mass in the affected limb. We excised the femoral head and neck to alleviate the pain that accompanied the osteoarthritis. Physical therapy was initiated, and dual-energy X-ray absorptiometry and video recordings were performed to evaluate the macaque's response to surgical intervention. By 3 mo postoperatively, the macaque had regained full use of the affected limb. PMID:23561889

  9. Proprioception and joint stability

    Microsoft Academic Search

    J. Jerosch; M. Prymka

    1996-01-01

    In the present paper the current clinical knowledge about proprioception is given for the shoulder, knee, ankle, elbow and the radiocarpal joint. Proprioceptive capabilities are decreased after joint injuries such as ACL or meniscus tears, shoulder dislocation, ankle sprain and in joints with degenerative joint disease. Some surgical procedures seem to restore the proprioceptive abilities; others do not. Elastic knee

  10. Tooth contact in patients with temporomandibular disorders.

    PubMed

    Glaros, Alan G; Williams, Karen; Lausten, Leonard; Friesen, Lynn R

    2005-07-01

    Both experimental and retrospective studies suggest a link between parafunctions and pain in temporomandibular disorder (TMD) patients. To investigate the role of parafunctions in TMD, experience sampling methodology was used as a prospective test of the hypothesis that patients with TMD have higher levels of tooth contact and tension than non-TMD controls. Three groups of TMD patients and a group of normal controls carried pagers for one week, were contacted approximately every two hours by an automated calling system, and completed questionnaires assessing tooth contact, tension, and pain at each contact. Results showed that tooth contact was much more frequent among normal controls than is commonly presumed. Patients with myofascial pain with/without arthralgia reported more frequent contact, higher intensity contact, and more tension than patients with disk displacement or normal controls. Increased masticatory muscle activity responsible for tooth contact and tension may be an important mechanism in the etiology and maintenance of the myofascial pain and arthralgia of TMD. PMID:16128353

  11. 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

  12. High Spatial Resolution MRI of Cystic Adventitial Disease of the Iliofemoral Vein Communicating with the Hip Joint

    SciTech Connect

    Michaelides, Michael, E-mail: mihalismihailidis@gmail.com [Ygia Polyclinic Hospital, MRI/CT Department (Cyprus); Papas, Stylianos, E-mail: vascular@drpapas.com [Ygia Polyclinic Hospital, Vascular Surgery Department (Cyprus); Pantziara, Maria, E-mail: mgpantziara@gmail.com; Ioannidis, Kleanthis, E-mail: aktinodiagnostis@gmail.com [Ygia Polyclinic Hospital, MRI/CT Department (Cyprus)

    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. Network-based SNP meta-analysis identifies joint and disjoint genetic features across common human diseases

    PubMed Central

    2012-01-01

    Background Genome-wide association studies (GWAS) have provided a large set of genetic loci influencing the risk for many common diseases. Association studies typically analyze one specific trait in single populations in an isolated fashion without taking into account the potential phenotypic and genetic correlation between traits. However, GWA data can be efficiently used to identify overlapping loci with analogous or contrasting effects on different diseases. Results Here, we describe a new approach to systematically prioritize and interpret available GWA data. We focus on the analysis of joint and disjoint genetic determinants across diseases. Using network analysis, we show that variant-based approaches are superior to locus-based analyses. In addition, we provide a prioritization of disease loci based on network properties and discuss the roles of hub loci across several diseases. We demonstrate that, in general, agonistic associations appear to reflect current disease classifications, and present the potential use of effect sizes in refining and revising these agonistic signals. We further identify potential branching points in disease etiologies based on antagonistic variants and describe plausible small-scale models of the underlying molecular switches. Conclusions The observation that a surprisingly high fraction (>15%) of the SNPs considered in our study are associated both agonistically and antagonistically with related as well as unrelated disorders indicates that the molecular mechanisms influencing causes and progress of human diseases are in part interrelated. Genetic overlaps between two diseases also suggest the importance of the affected entities in the specific pathogenic pathways and should be investigated further. PMID:22988944

  14. Selenium deficiency and fulvic acid supplementation induces fibrosis of cartilage and disturbs subchondral ossification in knee joints of mice: An animal model study of Kashin-Beck disease

    Microsoft Academic Search

    Chunlin Yang; Eduard Wolf; Kerstin Röser; Günter Delling; Peter K. Müller

    1993-01-01

    Kashin-Beck disease is an acquired, chronic and degenerative osteoarticular disorder. Selenium deficiency and fulvic acid in drinking water have been implicated in the cause of this disease. Pathologically, chondronecrosis of the growth plate and articular cartilage and subconsequent disturbance of ossification were observed in the joints. In this animal model study, mice were fed with a selenium deficient diet and

  15. Parafunctional Clenching, Pain, and Effort in Temporomandibular Disorders

    Microsoft Academic Search

    Alan G. Glaros; Eric Burton

    2004-01-01

    This study tested the hypotheses that (1) parafunctional clenching increases pain and can lead to a diagnosis of temporomandibular disorder (TMD) pain and (2) electromyographic (EMG) activity during parafunctional clenching is significantly and positively correlated with reports of pain. Fourteen individuals without TMD participated in 5 consecutive days of 20-min long EMG biofeedback training sessions of the left and right

  16. Multisystem Dysregulation in Painful Temporomandibular Disorders

    PubMed Central

    Chen, Hong; Nackley, Andrea; Miller, Vanessa; Diatchenko, Luda; Maixner, William

    2013-01-01

    Multiple physiological and psychological regulatory domains may contribute to the pathophysiology of pain in temporomandibular disorder (TMD) and other bodily pain conditions. The purpose of this study was to evaluate the relationship between multisystem dysregulation and the presence of TMD pain, as well as the presence of different numbers of comorbid pain conditions in TMD. Secondary data analysis was conducted in 131 non-TMD (without comorbid pain) controls, 14 TMD subjects without comorbid pain, 78 TMD subjects with 1 comorbid pain, and 67 TMD subjects with multiple comorbid pain conditions who participated in a TMD genetic study. Twenty markers from sensory, autonomic, inflammatory, and psychological domains were evaluated. The results revealed that 1) overall dysregulation in multiple system domains (OR [odds ratio] = 1.6, 95% confidence interval [CI] = 1.4–1.8), particularly in the sensory (OR = 1.9, 95% CI = 1.3–2.9) and the psychological (OR = 2.1, 95% CI = 2.1–2.7) domains, were associated with increased likelihood of being a painful TMD case; and 2) dysregulations in individual system domains were selectively associated with the increased odds of being a TMD case with different levels of comorbid persistent pain conditions. These outcomes indicate that heterogeneous multisystem dysregulations may exist in painful TMD subgroups, and multidimensional physiological and psychological assessments can provide important information regarding pathophysiology, diagnosis, and management of pain in TMD patients. Perspective The concurrent assessment of multiple physiological and psychological systems is critical to our understanding of the pathophysiological processes that contribute to painful TMD and associated comorbid conditions, which will ultimately guide and inform appropriate treatment strategies that address the multisystem dysregulation associated with complex and common persistent pain conditions. PMID:23721875

  17. Prophylaxis versus Episodic Treatment to Prevent Joint Disease in Boys with Severe Hemophilia

    Microsoft Academic Search

    Marilyn J. Manco-Johnson; Thomas C. Abshire; Amy D. Shapiro; Brenda Riske; Michele R. Hacker; Ray Kilcoyne; J. David Ingram; Michael L. Manco-Johnson; Sharon Funk; Linda Jacobson; Leonard A. Valentino; W. Keith Hoots; George R. Buchanan; Donna DiMichele; Michael Recht; Deborah Brown; Cindy Leissinger; Shirley Bleak; Alan Cohen; Prasad Mathew; Alison Matsunaga; Desiree Medeiros; Diane Nugent; Gregory A. Thomas; Alexis A. Thompson; Kevin McRedmond; J. Michael Soucie; Harlan Austin; Bruce L. Evatt

    2007-01-01

    Sixty-five boys younger than 30 months of age were randomly assigned to prophylaxis (32 boys) or enhanced episodic therapy (33 boys). When the boys reached 6 years of age, 93% of those in the prophylaxis group and 55% of those in the episodic-ther- apy group were considered to have normal index-joint structure on MRI (P = 0.006). The relative risk

  18. 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

  19. Objective and subjective assessment of masticatory function for patients with temporomandibular disorder in Korea.

    PubMed

    Ahn, H J; Lee, Y S; Jeong, S H; Kang, S M; Byun, Y S; Kim, B I

    2011-07-01

    This study examined the differences in the masticatory function of patients with temporomandibular disorder (TMD) in Korea. The experimental groups were as follows: 23 patients with painful arthralgia classified as pain group according to the research diagnostic criteria for temporomandibular disorder (RDC/TMC) and 28 patients with pain-free disc displacement and reduction classified as clicking group. The subjects were obtained from those who had visited Yonsei University Dental Hospital from 2007 to 2008. Twenty dental students without TMD symptoms were enroled as the normal control group. The Mixing Ability Index (MAI) was used as the objective index, and the Food Intake Ability (FIA) Index, Visual Analogue Scale (VAS) and oral health impact profile (OHIP) were used as the subjective indices. The MAI, FIA and VAS were significantly lower in the pain group than in the normal and clicking groups (P<0·05). The pain group showed a MAI, FIA and VAS of 16%, 81% and 67%, respectively, compared to that of the normal group. However, there were no significant differences in the MAI, FIA and VAS between the clicking and normal groups. The pain and clicking groups showed a 1·7 and 1·4 times higher OHIP value than the normal group (P<0·05). The MAI and subjective indices, such as the FIA (r=0·40) and VAS (r=0·48), showed a moderate correlation (P<0·01). In conclusion, pain is the main factor for the reduced masticatory function in patients with TMD in Korea, and the joint sound, not the masticatory function, affects the declining OHIP. PMID:21118290

  20. 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

  1. Is there an association between anxiety/depression and temporomandibular disorders in college students?

    PubMed Central

    CALIXTRE, Letícia Bojikian; GRÜNINGER, Bruno Leonardo da Silva; CHAVES, Thais Cristina; de OLIVEIRA, Ana Beatriz

    2014-01-01

    Objective Considering the high incidence of Temporomandibular Disorders (TMD) in the population aged 15-30 years and the fact that students are exposed to stressful psychosocial factors, the purposes of this study were: to verify clinical symptoms and jaw functionality in college students with TMD according to the anxiety/depression (A/D) level and to evaluate the correlation between A/D and functionality, maximum mouth opening (MMO) and pain and muscle activity. Material and Methods Nineteen students with TMD diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders underwent two assessments during an academic semester. The evaluations were based on questionnaires (MFIQ - Mandibular Function Impairment Questionnaire; HADS - Hospital Anxiety and Depression Scale), clinical measurements (MMO without pain, MMO and assisted MMO; palpation of joint and masticatory muscles), and electromyography. The HADS scores obtained in the two assessments were used to classify all data as either "high" or "low" A/D. Data normality, differences and correlations were tested with the Shapiro-Wilk test, Student's t-test (or the Wilcoxon test), and Spearman test, respectively. The alpha level was set at 0.05. Results None of the clinical variables were significantly different when comparing low and high A/D data. In low A/D there was a significant correlation between HADS score and: MFIQ (P=0.005, r=0.61), and MMO without pain (P=0.01, r=-0.55). Conclusions Variation in A/D level did not change clinical symptoms or jaw functionality in college students with TMD. Apparently, there is a correlation between TMJ functionality and A/D level, which should be further investigated, taking into account the source of the TMD and including subjects with greater functional limitation. PMID:24626244

  2. Avaliação anamnésica de sintomas de disfunção temporomandibular em crianças asmáticas Anamnestic evaluation of temporomandibular dysfunction symptoms in asthmatic children

    Microsoft Academic Search

    Thaís Cristina Chaves; Dirceu Costa; Débora Bevilaqua Grossi; Fabiana Bertolli

    Mechanical respiratory dysfunction in asthmatic children, contributing to overuse the secondary respiratory muscles related to cervical spine and allergic sinunasal alterations, leading to development of mouth breathing (MB), might induce craniocervical disorders and predispose asthmatic patients to Temporomandibular Disorders (TMD). The purpose of this study was to assess the presence and features of TMD symptoms in asthmatic children by using

  3. 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

  4. Drug therapies for peripheral joint disease in psoriatic arthritis: a systematic review.

    PubMed

    Acosta Felquer, Maria Laura; Coates, Laura C; Soriano, Enrique R; Ranza, Roberto; Espinoza, Luis R; Helliwell, Philip S; FitzGerald, Oliver; McHugh, Neil; Roussou, Euthalia; Mease, Philip J

    2014-11-01

    In 2009, GRAPPA published their first evidence-based recommendations for the treatment of psoriasis and psoriatic arthritis (PsA). Since then, new information has been published and drugs developed. We summarize evidence for the efficacy of available treatments for peripheral joint involvement in PsA. We performed a systematic review of current literature on the efficacy of different therapies, management, and therapeutic strategies for peripheral arthritis involvement in PsA, in order to provide information for the development of the new GRAPPA treatment recommendations. PMID:25362711

  5. Evidence from Raman Spectroscopy of a Putative Link Between Inherent Bone Matrix Chemistry and Degenerative Joint Disease

    PubMed Central

    Kerns, Jemma G; Gikas, Panagiotis D; Buckley, Kevin; Shepperd, Adam; Birch, Helen L; McCarthy, Ian; Miles, Jonathan; Briggs, Timothy W R; Keen, Richard; Parker, Anthony W; Matousek, Pavel; Goodship, Allen E

    2014-01-01

    Objective Osteoarthritis (OA) is a common debilitating disease that results in degeneration of cartilage and bone in the synovial joints. Subtle changes in the molecular structure of the subchondral bone matrix occur and may be associated with cartilage changes. The aim of this study was to explore whether the abnormal molecular changes observed in the matrix of OA subchondral bone can be identified with Raman spectroscopy. Methods Tibial plateaus from patients undergoing total knee replacement for OA (n = 10) were compared with healthy joints from patients undergoing leg amputation (n = 5; sex- and laterality-matched) and with non-OA cadaveric knee specimens (n = 5; age-matched). The samples were analyzed with Raman spectroscopy, peripheral quantitative computed tomography, and chemical analysis to compare changes in defined load-bearing sites in both the medial and lateral compartments. Results OA subchondral bone matrix changes were detected by Raman spectroscopy. Within each cohort, there was no spectral difference in bone matrix chemistry between the medial and lateral compartments, whereas a significant spectral difference (P < 0.001) was observed between the non-OA and OA specimens. Type I collagen chain ratios were normal in the non-OA specimens but were significantly elevated in the OA specimens. Conclusion In comparing the results of Raman spectroscopy with those obtained by other standard techniques, these findings show, for the first time, that subchondral bone changes, or inherent differences, exist in both the medial and lateral (beneath intact cartilage) compartments of OA knees. The development of Raman spectroscopy as a screening tool, based on molecular-specific modifications in bone, would facilitate the identification of clinical disease, including early molecular changes. PMID:24470432

  6. VESTIBULAR SCHWANNOMA (ACOUSTIC NEUROMA) MIMICKING TEMPOROMANDIBULAR DISORDERS: A CASE REPORT

    PubMed Central

    Bisi, Maurício A.; Selaimen, Caio M. P.; Chaves, Karen D.; Bisi, Melissa C.; Grossi, Márcio L.

    2006-01-01

    Approximately 6 to 16% of patients with trigeminal neuralgia symptoms present intracranial tumors, the most common being the vestibular schwannoma (acoustic neuroma). Some symptoms reported by patients include hearing loss, tinnitus, headaches, vertigo and trigeminal disturbances. An increased muscle response in the surrounding head and neck musculature may also be observed, which mimics signs and symptoms of temporomandibular disorders. In these cases, magnetic resonance imaging (MRI) has proved to be a useful tool in tumor diagnosis. The differential diagnosis between myofascial and neuralgic pain is important, as both may present similar characteristics, while being of different origin, and demanding special treatment approaches. The purpose of this paper is to demonstrate the relationship among trigeminal neuralgia symptoms, intracranial tumors and temporomandibular dysfunction by presenting a clinical case. PMID:19089251

  7. Morbid anatomy of ‘erosive osteoarthritis’ of the interphalangeal finger joints: an optimised scoring system to monitor disease progression in affected joints

    PubMed Central

    Verbruggen, Gust; Wittoek, Ruth; Cruyssen, Bert Vander; Elewaut, Dirk

    2010-01-01

    Objectives To develop and validate a quantitative radiographic scoring system, the Ghent University Scoring System (GUSS), with better ability to detect progression over a shorter period of time in erosive osteoarthritis (OA) of the interphalangeal (IP) finger joints compared with the existing anatomic phase scoring system. Methods Thirty IP finger joints showing erosive features at baseline or follow-up were selected from 18 patients with erosive hand OA. Posteroanterior radiographs of these joints obtained at baseline, 6 and 12 months—totalling 90 images—were used for the study. All joints were first scored according to the original anatomic phase scoring system. Erosive progression and signs of repair or remodelling were then scored by indicating the proportion of normal subchondral bone, subchondral plate and joint space on an 11-point rating scale (range 0–100 with 10 unit increases). Inter- and intrareader reproducibility was studied using intraclass correlation coefficients (ICCs). Based on the within-variance of two readers, the smallest detectable change (SDC) was calculated and allowed identification of joints with changes above the SDC as ‘progressors’. Results Longitudinal inter-reader ICC scores rated well for all variables and the total score (ICC 0.86–0.93). To identify ‘real’ change over background noise, a change of at least 40 units on the total score (range 0–300) over 12 months (SDC 0–12:36.0), and 50 units over 6 months (SDC 0–6:47.6) had to be present. 60% of the 30 joints were identified as ‘progressors’ over 6 months compared with 33.3% with the classical anatomical scoring system, and 70% versus 56.6%, respectively, over 12 months. Conclusion GUSS, is a reliable method to score radiographic change over time in erosive IP OA and detects more progression over a shorter period of time than the classical scoring system. PMID:19948521

  8. Efficacy of Biofeedback-Based Treatments for Temporomandibular Disorders

    Microsoft Academic Search

    Andrew Crider; Alan G. Glaros; Richard N. Gevirtz

    2005-01-01

    Bibliographic searches identified 14 controlled and uncontrolled outcome evaluations of biofeedback-based treatments for temporomandibular\\u000a disorders published since 1978. This literature includes two randomized controlled trials (RCTs) of each of three types of\\u000a biofeedback treatment: (1) surface electromyographic (SEMG) training of the masticatory muscles, (2) SEMG training combined\\u000a with adjunctive cognitive-behavioral therapy (CBT) techniques, and (3) biofeedback-assisted relaxation training (BART). A

  9. Joint Committee on Aviation Pathology: XIV. Ischaemic heart disease: a problem in aircraft accident reconstruction.

    PubMed

    Ground, K E

    1977-10-01

    A twin-engine light aircraft crashed at night on the third ILS approach. Runway Visual Range was 300 m. All four occupants were killed. The owner, aged 61, one of the two crew members, occupied the left-hand seat and was found to have an old, extensive antero-lateral infarct and severe coronary artery disease. There was no evidence of recent pathological change. A large number of drugs was found in the personal effects of the owner, including Allopurinol, Indomethacin, and Flurazepam. Subsequent investigation revealed that the owner had his PPL withdrawn 12 months prior to the accident on account of myocardial infarction. The problem of pilot control and the significance of cardiovascular disease as a possible cause for the accident are discussed. PMID:921659

  10. 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

  11. 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

  12. A joint frailty model to estimate the recurrence process and the disease-specific mortality process without needing the cause of death.

    PubMed

    Belot, Aurélien; Rondeau, Virginie; Remontet, Laurent; Giorgi, Roch

    2014-08-15

    In chronic diseases, such as cancer, recurrent events (such as relapses) are commonly observed; these could be interrupted by death. With such data, a joint analysis of recurrence and mortality processes is usually conducted with a frailty parameter shared by both processes. We examined a joint modeling of these processes considering death under two aspects: 'death due to the disease under study' and 'death due to other causes', which enables estimating the disease-specific mortality hazard. The excess hazard model was used to overcome the difficulties in determining the causes of deaths (unavailability or unreliability); this model allows estimating the disease-specific mortality hazard without needing the cause of death but using the mortality hazards observed in the general population. We propose an approach to model jointly recurrence and disease-specific mortality processes within a parametric framework. A correlation between the two processes is taken into account through a shared frailty parameter. This approach allows estimating unbiased covariate effects on the hazards of recurrence and disease-specific mortality. The performance of the approach was evaluated by simulations with different scenarios. The method is illustrated by an analysis of a population-based dataset on colon cancer with observations of colon cancer recurrences and deaths. The benefits of the new approach are highlighted by comparison with the 'classical' joint model of recurrence and overall mortality. Moreover, we assessed the goodness of fit of the proposed model. Comparisons between the conditional hazard and the marginal hazard of the disease-specific mortality are shown, and differences in interpretation are discussed. PMID:24639014

  13. Biomechanical adaptation of the bone-periodontal ligament (PDL)-tooth fibrous joint as a consequence of disease.

    PubMed

    Lin, Jeremy D; Lee, Jihyun; Ozcoban, Hüseyin; Schneider, Gerold A; Ho, Sunita P

    2014-06-27

    In this study, an in vivo ligature-induced periodontitis rat model was used to investigate temporal changes to the solid and fluid phases of the joint by correlating shifts in joint biomechanics to adaptive changes in soft and hard tissue morphology and functional space. After 6 and 12 weeks of ligation, coronal regions showed a significant decrease in alveolar crest height, increased expression of TNF-?, and degradation of attachment fibers as indicated by decreased collagen birefringence. Cyclical compression to peak loads of 5-15N at speeds of 0.2-2.0mm/min followed by load relaxation tests showed decreased stiffness and reactionary load rate values, load relaxation, and load recoverability, of ligated joints. Shifts in joint stiffness and reactionary load rate increased with time while shifts in joint relaxation and recoverability decreased between control and ligated groups, complementing measurements of increased tooth displacement as evaluated through digital image correlation. Shifts in functional space between control and ligated joints were significantly increased at the interradicular (?10-25?m) and distal coronal (?20-45?m) regions. Histology revealed time-dependent increases in nuclei elongation within PDL cells and collagen fiber alignment, uncrimping, and directionality, in 12-week ligated joints compared to random orientation in 6-week ligated joints and to controls. We propose that altered strains from tooth hypermobility could cause varying degrees of solid-to-fluid compaction, alter dampening characteristics of the joint, and potentiate increased adaptation at the risk of joint failure. PMID:24332618

  14. Contrast-enhanced microCT (EPIC-µCT) ex vivo applied to the mouse and human jaw joint

    PubMed Central

    Mulder, L; Lin, A S; Langenbach, G E J; Koolstra, J H; Guldberg, R E; Everts, V

    2014-01-01

    Objectives: The temporomandibular joint (TMJ) is susceptive to the development of osteoarthritis (OA). More detailed knowledge of its development is essential to improve our insight into TMJ-OA. It is imperative to have a standardized reliable three-dimensional (3D) imaging method that allows for detailed assessment of both bone and cartilage in healthy and diseased joints. We aimed to determine the applicability of a contrast-enhanced microCT (µCT) technique for ex vivo research of mouse and human TMJs. Methods: Equilibrium partitioning of an ionic contrast agent via µCT (EPIC-µCT) was previously applied for cartilage assessment in the knee joint. The method was ex vivo, applied to the mouse TMJ and adapted for the human TMJ. Results: EPIC-µCT (30-min immersion time) was applied to mouse mandibular condyles, and 3D imaging revealed an average cartilage thickness of 110?±?16?µm. These measurements via EPIC-µCT were similar to the histomorphometric measures (113?±?19?µm). For human healthy OA-affected TMJ samples, the protocol was adjusted to an immersion time of 1?h. 3D imaging revealed a significant thicker cartilage layer in joints with early signs of OA compared with healthy joints (414.2?±?122.6 and 239.7?±?50.5?µm, respectively). A subsequent significant thinner layer was found in human joints with late signs of OA (197.4?±?159.7?µm). Conclusions: The EPIC-µCT technique is effective for the ex vivo assessment of 3D cartilage morphology in the mouse as well as human TMJ and allows bone–cartilage interaction research in TMJ-OA. PMID:24353248

  15. 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%.

  16. ASSESSMENT OF TEMPOROMANDIBULAR DISORDER AND OCCLUSION IN TREATED CLASS III MALOCCLUSION PATIENTS

    PubMed Central

    Valle-Corotti, Karyna; Pinzan, Arnaldo; do Valle, Caio Vinícius Martins; Nahás, Ana Carla Raphaelli; Corotti, Mauro Vinícius

    2007-01-01

    Objective: The aims of this study were to compare the prevalence of temporomandibular disorders (TMD) in individuals submitted to either orthodontic or ortho-surgical Class III malocclusion treatment and to assess the influence of occlusal aspects on TMD severity. Material and methods: The sample consisted of 50 individuals divided into two groups, according to the type of treatment (orthodontic or orthodontic with orthognathic surgery). The presence of signs and symptoms of TMD was evaluated by an anamnestic questionnaire and a clinical examination, including TMJ and muscle palpation, active mandibular range of motion, joint noises and occlusal examination. Results: Based on the anamnestic questionnaire, 48% had no TMD, 42% had mild TMD and 10% had moderate TMD. The presence and severity of TMD did not show any relationship with the type of orthodontic treatment (p>0.05). The chi-square test showed a positive association (p<0.05) between TMD and non-working side occlusal interferences. Conclusion: Based on the methodology used and the results obtained, it may be concluded that Class III orthodontic treatment was not associated with the presence of TMD signs and symptoms and the non-working side contacts can be occlusal factors of risk. There was no significant difference in TMD prevalence between the studied groups (orthodontically treated patients and patients treated with orthodontics followed by orthognathic surgery). PMID:19089112

  17. A randomized double blind comparison of short-term duodenally administrated whale and seal blubber oils in patients with inflammatory bowel disease and joint pain.

    PubMed

    Bjørkkjaer, Tormod; Araujo, Pedro; Madland, Tor Magne; Berstad, Arnold; Frøyland, Livar

    2009-01-01

    Compared with soy oil, 10 days treatment with seal oil (SO), 10mLx3 daily, self-administrated through a nasoduodenal feeding tube, relieves joint pain in patients with inflammatory bowel disease (IBD). This randomized, controlled, double blind pilot trial compares SO and whale oil (WO) administered similarly by duodenal tube, for 10 days in 18 patients with IBD-related joint pain (n=9 per group). Other long chain n-3 polyunsaturated fatty acids were prohibited 7-days prior to and during study. Significant changes from baseline to study end were observed in both groups: reduced plasma arachidonic acid to eicosapentaenoic acid ratio and prostaglandin E(2) (PGE(2)) levels (tendency in WO group), decreased IBD-related joint pain and IBD-disease activity, and improved quality of life. These changes were not significantly different between SO and WO groups. Inhibition of cyclooxygenase is consistent with amelioration of IBD-related joint pain, but, as active control was used, effects need confirmation. PMID:19713092

  18. Prosthetic joint infection after total hip or knee arthroplasty in rheumatoid arthritis patients treated with nonbiologic and biologic disease-modifying antirheumatic drugs

    Microsoft Academic Search

    Shigeki MomoharaKosei; Kosei Kawakami; Takuji Iwamoto; Koichiro Yano; Yu Sakuma; Ryo Hiroshima; Hitoshi Imamura; Ikuko Masuda; Asami Tokita; Katsunori Ikari

    The aim of this study was to identify risk factors for acute surgical-site infection (SSI) after total joint arthroplasty\\u000a in rheumatoid arthritis (RA) patients treated with nonbiologic and biologic disease-modifying antirheumatic drugs (DMARDs).\\u000a We performed a retrospective study of all consecutive total hip (THA) and total knee (TKA) arthroplasties performed during\\u000a a 5-year period (THA 81; TKA 339). Multivariate logistic

  19. Clinical efficacy and tolerance of an extract of green-lipped mussel (Perna canaliculus) in dogs presumptively diagnosed with degenerative joint disease

    Microsoft Academic Search

    B Pollard; WG Guilford; KL Ankenbauer-Perkins; D Hedderley

    2006-01-01

    AIM: To evaluate the efficacy and tolerance of an extract of green-lipped mussel (GLME) in the management of mild-to-moderate degenerative joint disease (DJD) in dogs.METHODS: Eighty-one dogs presumptively diagnosed with DJD were treated orally daily with either GLME or a placebo for 56 days, in a double-blind, placebo-controlled study. In an uncontrolled open-label extension to the study, all dogs were

  20. Evaluation of pain, jaw movements, and psychosocial factors in elderly individuals with temporomandibular disorder under laser phototherapy.

    PubMed

    Rodrigues, Jeniffer Holley; Marques, Márcia Martins; Biasotto-Gonzalez, Daniela Aparecida; Moreira, Maria Stella Nunes Araújo; Bussadori, Sandra Kalil; Mesquita-Ferrari, Raquel Agnelli; Martins, Manoela Domingues

    2015-04-01

    Few studies have been carried out on the application of laser phototherapy (LPT) for treating painful temporomandibular disorder (TMD) in elderly population that is growing worldwide. The aim of the present study was to evaluate the pain, jaw movements, and psychosocial factors in ten elderly patients with painful TMD before and after LPT. All patients were evaluated before and after LPT by using the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) axes I and II. For pain assessment, a visual analogue scale (VAS) was used. The LPT was carried out with an GaAlAs diode laser (780 nm; spot size 0.04 cm(2)) in punctual and contact mode. Two settings of irradiations were applied as follows: in patients presenting myofascial pain, 10 mW, 5 J/cm(2), 20 s, 0.2 J per application point; and in patients with joint TMD, 70 mW, 105 J/cm(2), 60 s on five points, 4.2 J per point. Two sessions of LPT were carried out per week over four consecutive weeks, in the total of eight sessions. Data was statistically analyzed (p?

  1. SINAIS E SINTOMAS DE DISFUNÇÃO TEMPOROMANDIBULAR EM CRIANÇAS PORTADORAS DE PARALISIA CEREBRAL

    Microsoft Academic Search

    Lílian Gerdi; Kittel Ries; Bairro Campeche

    Signs and symptoms of temporomandibular dysfunction in children with cerebral palsy Objective: To analyze the signs and symptoms of temporomandibular dysfunction in children with cerebral palsy. Method: Twenty- two children aged 5 to 13 years were evaluated, of whom ten had spastic cerebral palsy (9.1 ± 2.64 years) and twelve were nor- mal (7.91 ± 0.99 years). Information on mastication,

  2. Effect of adalimumab on joint disease: features of patients with psoriatic arthritis detected by magnetic resonance imaging

    Microsoft Academic Search

    A P Anandarajah; P Ory; D Salonen; C Feng; R L Wong; C T Ritchlin

    2010-01-01

    Background:Bone marrow oedema (BMO), synovitis, effusion and joint erosion on magnetic resonance imaging (MRI) may be used as outcome measures in psoriatic arthritis (PsA).Objective:To assess the impact of adalimumab on BMO, synovitis, effusion and erosions in PsA, as measured by MRI.Methods:Fifteen patients with active PsA (?3 tender and ?3 swollen joints) were enrolled in an open-label pilot study. Each received

  3. Oral Health, Temporomandibular Disorder, and Masticatory Performance in Patients with Charcot-Marie-Tooth Type 2

    PubMed Central

    Rezende, Rejane L. S.; Bonjardim, Leonardo R.; Neves, Eduardo L. A.; Santos, Lidiane C. L.; Nunes, Paula S.; Garcez, Catarina A.; Souza, Cynthia C.; Araújo, Adriano A. S.

    2013-01-01

    Background. The aim of this study was to evaluate the oral health status of temporomandibular disorders (TMD) and bruxism, as well as to measure masticatory performance of subjects with Charcot-Marie-Tooth type 2 (CMT2). Methods and Results. The average number of decayed, missing, and filled teeth (DMFT) for both groups, control (CG) and CMT2, was considered low (CG = 2.46; CMT2 = 1.85, P = 0.227). The OHIP-14 score was considered low (CG = 2.86, CMT2 = 5.83, P = 0.899). The prevalence of self-reported TMD was 33.3% and 38.9% (P = 0.718) in CG and CMT2 respectively and for self-reported bruxism was 4.8% (CG) and 22.2% (CMT2), without significant difference between groups (P = 0.162). The most common clinical sign of TMD was masseter (CG = 38.1%; CMT2 = 66.7%) and temporalis (CG = 19.0%; GCMT2 = 33.3%) muscle pain. The geometric mean diameter (GMD) was not significantly different between groups (CG = 4369; CMT2 = 4627, P = 0.157). Conclusion. We conclude that the CMT2 disease did not negatively have influence either on oral health status in the presence and severity of TMD and bruxism or on masticatory performance. PMID:24391462

  4. The use of biosimilars in immune-mediated disease: A joint Italian Society of Rheumatology (SIR), Italian Society of Dermatology (SIDeMaST), and Italian Group of Inflammatory Bowel Disease (IG-IBD) position paper.

    PubMed

    Fiorino, Gionata; Girolomoni, Giampiero; Lapadula, Giovanni; Orlando, Ambrogio; Danese, Silvio; Olivieri, Ignazio

    2014-07-01

    Biological agents are widely used in rheumatology, dermatology and inflammatory bowel disease. Evidence about their efficacy and safety has been strengthened for all those therapeutic indications over the last decade. Biosimilar agents are monoclonal antibodies similar to previously approved biologics. In the European Union, they have been approved for all the indications in the management of immune-mediated inflammatory diseases (IMIDs), although data only in rheumatoid arthritis and ankylosing spondylitis are currently available. Direct evidence on efficacy, safety, and immunogenicity of biosimilars is mandatory in psoriasis, psoriatic arthritis, and inflammatory bowel disease, as well as in children. Based on the current evidence in the literature, we present the joint official position of the Italian Societies of Rheumatology, Dermatology and Inflammatory Bowel Disease on the use of biosimilars in IMIDs. PMID:24657898

  5. Evidenzbasierte Therapie degenerativer Gelenkerkrankungen: Teil 1: Allgemeine und operative Therapieverfahren Evidence Based Therapy of Degenerative Joint Diseases - Surgical Treatment Options

    Microsoft Academic Search

    T. Rosemann

    Osteoarthritis is the most common joint affec- tion in humans. Women are twice as often af- fected as men. Incidence and prevalence are expected to notably rise further within the next years. In therapy, all common methods should be used fi rst. To those methods belong appropriate or modifi ed shoes, walking sticks as well as other orthopaedic-technical methods. The

  6. Interchangeability of 28-joint disease activity scores using the erythrocyte sedimentation rate or the C-reactive protein as inflammatory marker.

    PubMed

    Siemons, Liseth; Vonkeman, Harald E; ten Klooster, Peter M; van Riel, Piet L C M; van de Laar, Mart A F J

    2014-06-01

    This paper aims to examine the interchangeability of the disease activity score in 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) and DAS28-CRP scores in a diverse sample of rheumatoid arthritis (RA) patients and to evaluate generalizability over gender, age, and disease duration. A sample of 682 patients was drawn from the DREAM registry. Agreement between the two DAS28 scores was analyzed using the intraclass correlation coefficient (ICC), Bland Altman plots, and a matrix of classification agreement over DAS28 disease activity categories. Despite a strong linear correlation between the DAS28 scores and a high ICC value of 0.931, a considerable lack of individual agreement could be observed, with Bland-Altman 95% limits of agreement ranging between -0.85 and +1.25 points. On average, DAS28-CRP scores were 0.20 points lower than DAS28-ESR scores, and data stratification on age and gender showed that this systematic bias was most severe in older women (0.39 points). The overall classification agreement across DAS28 categories was 76.69%, with the agreement being lowest (35.37%) in the low disease activity group. Patients were more easily classified as being in remission when using the DAS28-CRP measure. DAS28-ESR and DAS28-CRP scores are not interchangeable within individuals. The DAS28-CRP tends to yield lower values of disease activity than the DAS28-ESR, resulting in substantial classification differences. PMID:24562719

  7. Hip joints

    NSDL National Science Digital Library

    Connie Raab (National Institutes of Health; )

    2006-05-17

    The human hips are an example of a ball-and-socket joint. Ball-and-socket joints have the ability to rotate in a circular motion. The joint where the arm connects to the shoulder is also a type of ball-and-socket joint.

  8. 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 ?l of synovial fluid from several animal species, including human. The mAbs were specific for lubricin since they did not cross-react with other synovial fluid constituents from patients with camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP), who genetically lack this protein. The competition ELISA detected lubricin in blood samples from healthy individuals but not from patients with CACP, indicating blood can be used in a diagnostic test for patients suspected of having CACP. Lubricin epitopes in blood do not represent degradation fragments from synovial fluid. Therefore, although blood lubricin levels did not differentiate patients with inflammatory joint disease from healthy controls, epitope-specific anti-lubricin mAbs could be useful for monitoring disease activity in synovial fluid. PMID:25642942

  9. Validity and Agreement between the 28-Joint Disease Activity Score Based on C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis

    PubMed Central

    Nielung, Louise; Christensen, Robin; Danneskiold-Samsøe, Bente; Bliddal, Henning; Holm, Christian Cato; Ellegaard, Karen; Slott Jensen, Hanne; Bartels, Else Marie

    2015-01-01

    Objective. To validate the agreement between the 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) and the 28-joint disease activity score based on C-reactive protein (DAS28-CRP) in a group of Danish patients with rheumatoid arthritis (RA). Methods. Data from 109 Danish RA patients initiating biologic treatment were analysed at baseline and following one year of treatment. Participants were retrospectively enrolled from a previous cohort study and were considered eligible for this project if CRP and ESR were measured at baseline and at the follow-up visit. To assess the extent of agreement between the two DAS28 definitions, the “European League Against Rheumatism” (EULAR) response criteria based on each definition were calculated with cross-classification. Weighted Kappa (?) coefficients were calculated, and Bland-Altman plots were used to illustrate degree of agreement between DAS28 definitions. Results. The 75 eligible patients were classified as EULAR good, moderate, and nonresponders with good agreement (61/75; 81%) between DAS28-CRP and DAS28-ESR (? = 0.75 (95% CI: 0.63 to 0.88)). Conclusions. According to our findings, DAS28-CRP and DAS28-ESR are interchangeable when assessing RA patients and the two versions of DAS28 are comparable between studies. PMID:25632353

  10. Modulation of orphan nuclear receptor NURR1 expression by methotrexate in human inflammatory joint disease involves adenosine A2A receptor-mediated responses.

    PubMed

    Ralph, Jennifer A; McEvoy, Alice N; Kane, David; Bresnihan, Barry; FitzGerald, Oliver; Murphy, Evelyn P

    2005-07-01

    Modulation by proinflammatory mediators indicate that NURR1 induction represents a point of convergence of distinct signaling pathways, suggesting an important common role for this transcription factor in mediating multiple inflammatory signals. The present study identifies NURR1 as a molecular target of methotrexate (MTX) action in human inflammatory joint disease and examines the mechanism through which MTX modulates NURR1 expression. MTX significantly suppresses expression of NURR1 in vivo in patients with active psoriatic arthritis (n = 10; p < 0.002) who were prescribed low-dose MTX for management of peripheral arthritis. Importantly, reduction in NURR1 levels correlate (n = 10; r = 0.57; p = 0.009) with changes in disease activity score (both clinical and laboratory parameters). MTX selectively modulates NURR1 levels induced by inflammatory stimuli and growth factors in resident cell populations of synovial tissue. In primary human synoviocytes and microvascular endothelial cells, we observe dose-dependent differential effects of MTX on steady-state and inducible NURR1 levels. Our data confirms that adenosine, and its stable analog 5'-N-ethylcarboxamideadenosine, can mimic the differential effects of MTX on NURR1 transcription. In addition, we verify that the inhibitory effect of low-dose MTX on NURR1 activation is mediated through the adenosine receptor A2. More specifically, our data distinguishes the selective involvement of the A2A receptor subtype in these responses. In summary, these findings establish the nuclear orphan receptor NURR1 as a molecular target of MTX action in human inflammatory joint disease and demonstrate that the immunomodulatory actions of MTX on NURR1 expression are mediated through adenosine release. PMID:15972692

  11. What is the TMJ? The temporomandibular joint is located in front of the ear

    E-print Network

    Virginia Tech

    minutes. A heating pad may help. Avoid chewy or hard foods. Avoid chewing gum or cracking ice. Eat soft Headaches Limited ability to open the mouth Pain when chewing CAUSES: Grinding the teeth at night

  12. 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

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

    E-print Network

    Alberta, University of

    (mandibular resection) in the case of Journal of Otolaryngology-Head & Neck Surgery JOT_2012_120040.3d 2 of Otolaryngology-Head & Neck Surgery Journal of Otolaryngology-Head & Neck Surgery, Vol 41, No 0 (month),

  14. 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.

  15. 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

  16. Condylar hyperplasia of the temporomandibular joint: types, treatment, and surgical implications.

    PubMed

    Rodrigues, Daniel B; Castro, Vanessa

    2015-02-01

    Condylar hyperplasia (CH) is a progressive and pathologic overgrowth of either or both mandibular condyles, which can affect the neck, ramus, or body of the mandible. It may lead to facial asymmetry, malocclusion, speech, and masticatory problems. Identifying the specific type of condylar hyperplasia is crucial. Serial radiographs, dental models, clinical evaluations, and bone scan techniques are usually the best diagnostic methods to determine the type of CH and if the growth process is still active. The protocol of surgical procedures recommended in this article for CH has been proven to treat the condylar pathology and correct the jaw deformity. PMID:25483450

  17. Analysis of laser therapy and assessment methods in the rehabilitation of temporomandibular disorder: a systematic review of the literature

    PubMed Central

    Herpich, Carolina Marciela; Amaral, Ana Paula; Leal-Junior, Ernesto Cesar Pinto; Tosato, Juliana de Paiva; Gomes, Cid Andre Fidelis de Paula; Arruda, Éric Edmur Camargo; Glória, Igor Phillip dos Santos; Garcia, Marilia Barbosa Santos; Barbosa, Bruno Roberto Borges; Rodrigues, Monique Sampaio; Silva, Katiane Lima; El Hage, Yasmin; Politti, Fabiano; Gonzalez, Tabajara de Oliveira; Bussadori, Sandra Kalil; Biasotto-Gonzalez, Daniela Aparecida

    2015-01-01

    The aim of the present study was to perform a systematic review of the literature on the effects of low-level laser therapy in the treatment of TMD, and to analyze the use of different assessment tools. [Subjects and Methods] Searches were carried out of the BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for papers published in English and Portuguese using the terms: “temporomandibular joint laser therapy” and “TMJ laser treatment”. [Results] Following the application of the eligibility criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited considerable methodological differences, especially with regard to the number of sessions, anatomic site and duration of low-level laser therapy irradiation, as well as irradiation parameters, diagnostic criteria and assessment tools. [Conclusion] Further studies are needed, especially randomized clinical trials, to establish the exact dose and ideal parameters for low-level laser therapy and define the best assessment tools in this promising field of research that may benefit individuals with signs and symptoms of TMD. PMID:25642095

  18. Is the masticatory function changed in patients with temporomandibular disorder?

    PubMed

    Rodrigues, Carolina Almeida; Melchior, Melissa de Oliveira; Magri, Laís Valencise; Mestriner, Wilson; Mazzetto, Marcelo Oliveira

    2015-01-01

    Patients with temporomandibular disorders (TMD) often complain and have limitation in masticatory function, which can be affected by a complex interaction of factors. The aim of this study was analyze the masticatory function in patients with TMD using surface electromyography (EMG) and masticatory efficiency (ME). Twenty-seven patients with TMD and 25 considered control (n), aged between 18 and 60 years, paired by age and gender, were evaluated according to RDC/TMD. In both groups were performed: EMG with chewing gum, clinical evaluation of habitual chewing with stuffed cookie (CE) (number of chewing strokes and time) and analysis of ME with fuchsin beads. Nonparametric statistical analyses were used (Mann-Whitney) for comparisons between groups, with 5% significance level. For all variables, the TMD group showed higher values than the control, with statistical significance for ME (p<0.0001), number of chewing strokes (p=0.04), chewing time (p=0.009), right masseter EMG activity (p=0.05), left masseter (p=0.005), right anterior temporal (p=0.05) and left anterior temporal (p=0.001). The conclusion is that patients with TMD showed changed chewing pattern, but without impairment of masticatory function. PMID:25831111

  19. An association between temporomandibular disorder and gum chewing.

    PubMed

    Correia, Diana; Real Dias, Maria Carlos; Castanho Moacho, Antonio; Crispim, Pedro; Luis, Henrique; Oliveira, Miguel; Carames, Joao

    2014-01-01

    This single center, randomized, small study sought to investigate the prevalence and frequency of chewing gum consumption, and whether there is a relationship between these factors and the presence of symptoms associated with temporomandibular disorder (TMD). Subjects were divided into 7 groups based on their parafunctional oral habits. Of these, subjects who chewed gum were divided into 5 subgroups (A-E) based on their gum chewing habits. Group A chewed gum <1 hour/day (n = 12), Group B chewed gum 1-2 hours/day (n = 11), Group C chewed gum 3 hours/day (n = 6), and Group D chewed gum >3 hours at a time (n = 8); the frequency of gum chewing in Groups A-D was once a week. Group E subjects chewed gum 1-3 times/week for at least 1 hour each occurrence (n = 2). Sixty-three percent of the subjects in Group D reported TMD symptoms of arthralgia and myofascial pain. Thirty-three percent of the subjects in Group C showed symptoms of arthralgia. Eighty-three percent of the subjects in Group A and 27% in Group B reported myofascial pain. All subjects in Group E reported masseter hypertrophy. The remaining 2 groups were Group F, subjects that didn't chew gum but had other parafunctional oral habits (n = 2), and Group G, subjects who didn't have parafunctional oral habits (n = 12). PMID:25369399

  20. Temporomandibular disorder modifies cortical response to tactile stimulation

    PubMed Central

    Nebel, Mary Beth; Folger, Stephen; Tommerdahl, Mark; Hollins, Mark; McGlone, Francis; Essick, Gregory

    2010-01-01

    Individuals with temporomandibular disorder (TMD) suffer from persistent facial pain and exhibit abnormal sensitivity to tactile stimulation. To better understand the pathophysiological mechanisms underlying TMD, we investigated cortical correlates of this abnormal sensitivity to touch. Using functional magnetic resonance imaging (fMRI), we recorded cortical responses evoked by low frequency vibration of the index finger in subjects with TMD and in healthy controls (HC). Distinct subregions of contralateral SI, SII, and insular cortex responded maximally for each group. Although the stimulus was inaudible, primary auditory cortex was activated in TMDs. TMDs also showed greater activation bilaterally in anterior cingulate cortex and contralaterally in the amygdala. Differences between TMDs and HCs in responses evoked by innocuous vibrotactile stimulation within SI, SII, and the insula paralleled previously reported differences in responses evoked by noxious and innocuous stimulation, respectively, in healthy individuals. This unexpected result may reflect a disruption of the normal balance between central resources dedicated to processing innocuous and noxious input, manifesting itself as increased readiness of the pain matrix for activation by even innocuous input. Activation of the amygdala in our TMD group could reflect the establishment of aversive associations with tactile stimulation due to the persistence of pain. Perspective This article presents evidence that central processing of innocuous tactile stimulation is abnormal in TMD. Understanding the complexity of sensory disruption in chronic pain could lead to improved methods for assessing cerebral cortical function in these patients. PMID:20462805

  1. Factors associated with temporomandibular disorders pain in adolescents.

    PubMed

    Fernandes, G; van Selms, M K A; Gonçalves, D A G; Lobbezoo, F; Camparis, C M

    2015-02-01

    To gain a better understanding of temporomandibular disorders (TMD) pain in adolescents, it is important to study the factors associated with its presence. Therefore, the aim of this study was to investigate potential predictors for TMD pain in adolescents, thereby including a diversity of factors from the biopsychosocial model to determine the strongest predictors. The sample of this cross-sectional study consisted of 1094 adolescents. The presence of TMD pain was assessed using the RDC/TMD, Axis I. Apart from demographical characteristics, the roles of parafunctional habits, psychosocial aspects, menarche and other bodily pain complaints were evaluated. Single and multiple logistic regression models were used to identify associations between the predictor variables and TMD pain. Painful TMD had a prevalence of 25·5%. Logistic regression analyses showed that TMD pain was associated with sleep bruxism (OR = 1·8 95% CI = 1·34-2·34), awake bruxism (OR = 2·1 95% CI = 1·56-2·83), other parafunctional habits (OR = 2·2 95% CI = 1·17-4·08) and bodily pain complaints (OR = 5·0 95% CI = 3·48-7·28). Parafunctional habits and other bodily pain complaints may play an important role in the presence of TMD pain in adolescents. Of course, it remains unclear whether the observed associations between the investigated factors and the adolescent's TMD pain have a true causal linkage. PMID:25244610

  2. Headache and temporomandibular disorders: evidence for diagnostic and behavioural overlap.

    PubMed

    Glaros, A G; Urban, D; Locke, J

    2007-06-01

    To assess the diagnostic and behavioural overlap of headache patients with temporomandibular disorders (TMD), individuals recruited from the general population with self-described headaches were compared with non-headache controls. The examination and diagnostic procedures in the Research Diagnostic Criteria (RDC) for TMD were applied to both sets of subjects by a blinded examiner. Following their examination, subjects used experience sampling methods to obtain data on pain, tooth contact, masticatory muscle tension, emotional states and stress. Results showed that a significantly higher proportion of the headache patients received an RDC/TMD diagnosis of myofascial pain than non-headache controls. Headache patients also reported significantly more frequent and intense tooth contact, more masticatory muscle tension, more stress and more pain in the face/head and other parts of the body than non-headache controls. These results are similar to those reported for TMD patients and they suggest that headache patients and TMD patients overlap considerably in diagnosis and oral parafunctional behaviours. PMID:17441972

  3. Orthodontic Treatment, Genetic Factors and Risk of Temporomandibular Disorder

    PubMed Central

    Slade, Gary D.; Diatchenko, Luda; Ohrbach, Richard; Maixner, William

    2008-01-01

    Traditionally, four groups of factors have been identified in the etiology of temporomandibular disorder (TMD): anatomical variation in the masticatory system; psychosocial characteristics; pain in other body regions; and demographics. Orthodontic treatment has been variously cited both as a protective and harmful factor in TMD etiology. Recently, a search has begun for a genetic influence on TMD etiology. Genetic markers can be of additional value in identifying gene-environment interactions, that is, isolating population sub-groups, defined by genotype in which environmental influences play a relatively greater or lesser etiological role. This paper reviews concepts and study design requirements for epidemiological investigations into TMD etiology. Findings are presented from a prospective cohort study of 186 females that illustrate an example of gene-environment interaction in TMD onset. Among people with a variant of the gene encoding catechol-O-methyl-transferase, an enzyme associated with pain responsiveness, risk of developing TMD was significantly greater for subjects who reported a history of orthodontic treatment compared with subjects who did not (P=0.04). While further studies are needed to investigate TMD etiology, this genetic variant potentially could help to identify patients whose risk of developing TMD is heightened following orthodontic treatment, hence serving as a risk marker useful in planning orthodontic care. PMID:18663384

  4. Mobilization with movement, thoracic spine manipulation, and dry needling for the management of temporomandibular disorder: a prospective case series.

    PubMed

    González-Iglesias, Javier; Cleland, Joshua A; Neto, Francisco; Hall, Toby; Fernández-de-las-Peñas, César

    2013-11-01

    The purpose of this case series was to describe the outcomes of patients with temporomandibular disorder (TMD) treated with mobilization with movement (MWM) directed at the temporomandibular joint (TMJ) and the cervical spine, thoracic manipulation, and trigger point (TrP) dry needling. Fifteen patients with TMD completed the Steigerwald/Maher TMD disability questionnaire, the Visual Analog Scale (VAS), and maximal mouth opening (MMO) at baseline. The VAS and MMO were also collected at 15 days posttreatment and at a 2-month follow-up, and the Steigerwald/Maher TMD disability questionnaire was completed at the 2-month follow-up. Repeated measure ANOVAs were used to determine the effects of the intervention on each outcome. Within-group effect sizes were calculated in order to assess clinical effectiveness. Fifteen patients participated in this case series. The ANOVA revealed significant decreases (all, p ?? 1.0) for all outcomes at both follow-up periods. Patients with TMD treated with a multimodal treatment exhibited significant and clinical improvements in pain intensity, disability, and MMO. PMID:23687913

  5. Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

    PubMed Central

    2014-01-01

    Background The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community. Methods A random sampling of living quarters (households) in the selected areas was done. 586 adults over 19 years old living in these households were clinically examined using World Health Organization (WHO) Oral Health Survey criteria 4th edition (1997). Results The overall prevalence of dental caries, periodontal disease, denture wearers and temporomandibular joint problems were 70.5%, 97.1%, 16.7% and 26%, respectively. The majority (80.5%) needed some form of dental treatment. The highest treatment needs were found in the oldest age group while the lowest were in the youngest group (19-29 years) (p = 0.000). The most prevalent periodontal problem was calculus; regardless of gender, ethnicity and age. Significantly more females (20.5%) wore prosthesis than males (11.1%) (p = 0.003). Prosthetic status and need significantly increased with age (p = 0.000). About one in four adults had Temporo-Mandibular Joint (TMJ) problems. Overall, it was surprising to note that the oral disease burden related to caries, prosthetic status and treatment need were lower in this population as compared to the national average (NOHSA, 2010). However, their periodontal disease status and treatment needs were higher compared to the national average indicating a poor oral hygiene standard. Conclusions The evidence does not show that the overall oral disease burden and treatment needs in this urban disadvantaged adult population as higher than the national average, except for periodontal disease. The older age groups and elderly were identified as the most in need for oral health intervention and promotion. An integrated health intervention programme through a multisectoral common risk factor approach in collaboration with the Faculties of Medicine, Dentistry and other agencies is needed for the identified target group. PMID:25438162

  6. Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi arabian adolescents: a research report

    PubMed Central

    Feteih, Rabab M

    2006-01-01

    Background The aim of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) and oral parafunction habits among Saudi adolescents in the permanent dentition stage. Methods A total of 385 (230 females and 155 males) school children age 12–16, completed a questionnaire and were examined clinically. A stratified selection technique was used for schools allocation. Results The results showed that 21.3% of the subjects exhibited at least one sign of TMD and females were generally more affected than males. Joint sounds were the most prevalent sign (13.5%) followed by restricted opening (4.7%) and opening deviation (3.9%). The amplitude of mouth opening, overbite taken into consideration, was 46.5 mm and 50.2 mm in females and males respectively. TMJ pain and muscle tenderness were rare (0.5%). Reported symptoms were 33%, headache being the most frequent symptom 22%, followed by pain during chewing 14% and hearing TMJ noises 8.7%. Difficulty during jaw opening and jaw locking were rare. Lip/cheek biting was the most common parafunction habit (41%) with females significantly more than males, followed by nail biting (29%). Bruxism and thumb sucking were only 7.4% and 7.8% respectively. Conclusion The prevalence of TMD signs were 21.3% with joint sounds being the most prevalent sign. While TMD symptoms were found to be 33% as, with headache being the most prevalent. Among the oral parafunctions, lip/cheek biting was the most prevalent 41% followed by nail biting 29%. PMID:16914032

  7. An evidence-based assessment of occlusal adjustment as a treatment for temporomandibular disorders

    Microsoft Academic Search

    Yoshihiro Tsukiyama; Kazuyoshi Baba; Glenn T. Clark

    2001-01-01

    Statement of problem. Occlusal adjustment therapy has been advocated as a treatment modality for temporomandibular disorders. In contrast to this position, a panel at the 1996 National Institute of Health technology assessment conference on TMD indicated that no clinical trials demonstrate that occlusal adjustment is superior to noninvasive therapies. Purpose. This article summarizes the published experimental studies on occlusal adjustments

  8. Prevalence of temporomandibular disorder signs in patients with complete versus partial dentures

    Microsoft Academic Search

    Osama A. Al-Jabrah; Yousef R. Al-Shumailan

    2006-01-01

    Objectives: To determine the prevalence of signs of a temporomandibular disorder (TMD) in completely edentulous patients wearing upper and lower complete dentures (CD) and to compare this to the prevalence of signs in partially edentulous patients wearing upper and lower clasp-retained acrylic removable partial dentures (RPD). Materials and methods: A questionnaire and a clinical examination were used to assess 200

  9. Overlapping Conditions Among Patients With Chronic Fatigue Syndrome, Fibromyalgia, and Temporomandibular Disorder

    Microsoft Academic Search

    Leslie A. Aaron; Mary M. Burke; Dedra Buchwald

    2000-01-01

    Background: Patients with chronic fatigue syndrome (CFS), fibromyalgia (FM), and temporomandibular dis- order (TMD) share many clinical illness features such as myalgia, fatigue, sleep disturbances, and impairment in abil- ity to perform activities of daily living as a consequence of these symptoms. A growing literature suggests that a variety of comorbid illnesses also may commonly coexist in these patients, including

  10. Awareness of physiological responding under stress and nonstress conditions in temporomandibular disorders

    Microsoft Academic Search

    Alan G. Glaros

    1996-01-01

    To test the hypothesis that individuals with temporomandibular disorders (TMD) have deficits in proprioceptive awareness, 20 TMD patients were compared with 20 nonpain individuals matched to the TMD patients on age and gender. Left and right frontalis, masseter, and temporalis were monitored, as were forearm extensor, heart rate, and skin conductance while the participants viewed a nonstressful film segment. Following

  11. Occlusal treatments in temporomandibular disorders: a qualitative systematic review of randomized controlled trials

    Microsoft Academic Search

    Heli Forssell; Eija Kalso; Pirkko Koskela; Raili Vehmanen; Pauli Puukka; Pentti Alanen

    1999-01-01

    Occlusal treatments (occlusal splints and occlusal adjustment) are controversial but widely used treatment methods for temporomandibular disorders (TMD). To investigate whether studies are in agreement with current clinical practices, a systematic review of randomized controlled trials (RCTs) of occlusal treatment studies from the period 1966 to March 1999 was undertaken. Eighteen studies met the inclusion criteria, 14 on splint therapy,

  12. Quantification and validation of predictive values of occlusal variables in temporomandibular disorders using a multifactorial analysis

    Microsoft Academic Search

    Andrew G. Pullinger; Donald A. Seligman

    2000-01-01

    Statement Of Problem. A consensus is lacking on the association between occlusal variables and temporomandibular disorders (TMDs). Purpose. This study estimated the maximum potential power of occlusal variables to differentiate patients with TMD from asymptomatic normal adult subjects. Material And Methods. The occlusal characteristics in 2 sets of female patients with intracapsular TMD (1993, n = 257, and 1998, n

  13. Muscle Fatigue in the Temporal and Masseter Muscles in Patients with Temporomandibular Dysfunction

    PubMed Central

    Wo?niak, Krzysztof; Lipski, Mariusz; Lichota, Damian

    2015-01-01

    The aim of this study is to evaluate muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction (TMD). Two hundred volunteers aged 19.3 to 27.8 years (mean 21.50, SD 0.97) participated in this study. Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany). Muscle fatigue was evaluated on the basis of a maximum effort test. The test was performed during a 10-second maximum isometric contraction (MVC) of the jaws. An analysis of changes in the mean power frequency of the two pairs of temporal and masseter muscles (MPF%) revealed significant differences in the groups of patients with varying degrees of temporomandibular disorders according to Di (P < 0.0000). The study showed an increase in the muscle fatigue of the temporal and masseter muscles correlated with the intensity of temporomandibular dysfunction symptoms in patients. The use of surface electromyography in assessing muscle fatigue is an excellent diagnostic tool for identifying patients with temporomandibular dysfunction.

  14. Neonatal retroviral vector-mediated hepatic gene therapy reduces bone, joint, and cartilage disease in mucopolysaccharidosis VII mice and dogs

    Microsoft Academic Search

    Robert L. Mango; Lingfei Xu; Mark S. Sands; Carole Vogler; Gabriela Seiler; Tobias Schwarz; Mark E. Haskins; Katherine Parker Pondera

    2004-01-01

    Mucopolysaccharidosis VII (MPS VII) is a lysosomal storage disease caused by deficient ?-glucuronidase (GUSB) activity. Accumulation of glycosaminoglycans (GAGs) in bone, cartilage, and synovium likely contributes to reduced mobility in untreated MPS VII individuals. We previously reported that neonatal intravenous injection of a retroviral vector (RV) expressing canine GUSB resulted in hepatocyte transduction in mice and dogs, and secreted GUSB

  15. The effects of mechanical strain on synovial fibroblasts

    Microsoft Academic Search

    Voltaire V. Sambajon; Joseph E. Cillo; Robert J. Gassner; Michael J. Buckley

    2003-01-01

    Purpose: Arthritic diseases of the temporomandibular joint, such as rheumatoid arthritis and osteoarthritis, suggest that inflammatory mediators and metalloproteinases may play a role in their pathogenesis. Recent clinical evidence from physical therapy and other modalities has shown a significant decrease in temporomandibular joint symptoms in patients with early disease. This project examines the effect of mechanical strain on synovial fibroblasts[apos

  16. Streptococcus pneumoniae serotype 6C presenting as recurrent prosthetic knee joint infection in a patient with a history of congenital asplenia and underlying autoimmune disease: a case report and literature review.

    PubMed

    Roberts, Amity L; Hewlett, Angela L; Yu, Jigui; Nahm, Moon H; Fey, Paul D; Iwen, Peter C

    2013-12-01

    This report describes a case of primary Streptococcus pneumoniae bacteremia with prosthetic joint infection caused by serotype 6C with recurrent infection in a patient with a history of congenital asplenia and underlying autoimmune disease. Isolates from the primary and recurrent infections were determined to be indistinguishable by pulsed-field gel electrophoresis. This study expands the conditions associated with recurrent invasive pneumococcal disease caused by serotype 6C. PMID:24139971

  17. HIV and Rheumatic Disease

    MedlinePLUS

    ... Patient Resources > Diseases & Conditions Back to Diseases & Conditions HIV and Rheumatic Disease PRINT Download PDF HIV infection ... treatment and HIV infection all overlap. What are HIV-associated rheumatic diseases? Some diseases of the joints ...

  18. Time to face the challenge of multimorbidity. A European perspective from the joint action on chronic diseases and promoting healthy ageing across the life cycle (JA-CHRODIS).

    PubMed

    Onder, Graziano; Palmer, Katie; Navickas, Rokas; Jurevi?ien?, Elena; Mammarella, Federica; Strandzheva, Mirela; Mannucci, Piermannuccio; Pecorelli, Sergio; Marengoni, Alessandra

    2015-04-01

    Research on multimorbidity has rapidly increased in the last decade, but evidence on the effectiveness of interventions to improve outcomes in patients with multimorbidity is limited. The European Commission is co-funding a large collaborative project named Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS) in the context of the 2nd EU Health Programme 2008-2013. The present manuscript summarizes first results of the JA-CHRODIS, focuses on the identification of a population with multimorbidity who has a high or very high care demand. Identification of characteristics of multimorbid patients associated with a high rate of resource consumption and negative health outcomes is necessary to define a target population who can benefit from interventions. Indeed, multimorbidity alone cannot explain the complexity of care needs and further, stratification of the general population based on care needs is necessary for allocating resources and developing personalized, cost-efficient, and patient-centered care plans. Based on analyses of large databases from European countries a profile of the most care-demanding patients with multimorbidity is defined. Several factors associated with adverse health outcomes and resource consumption among patients with multimorbidity were identified in these analyses, including disease patterns, physical function, mental health, and socioeconomic status. These results underline that a global assessment is needed to identify patients with multimorbidity who are at risk of negative health outcomes and that a comprehensive approach, targeting not only diseases, but also social, cognitive, and functional problems should be adopted for these patients. PMID:25797840

  19. Effects of joint capsule tissue on cartilage degradation in an in vitro joint injury model

    E-print Network

    Lin, Stephanie Norris, 1980-

    2004-01-01

    Osteoarthritis is a degenerative disease of the whole joint that affects an estimated 20.7 million Americans. Traumatic joint injury causes an increase in risk for the development of osteoarthritis. A previously developed ...

  20. Lyme Disease

    MedlinePLUS

    Lyme disease is a bacterial infection you get from the bite of an infected tick. The first symptom ... Muscle and joint aches A stiff neck Fatigue Lyme disease can be hard to diagnose because you may ...

  1. [Epidemiology of bone and joint disease - the present and future - . Epidemiology of osteoporosis and osteoporotic fracture in Japan].

    PubMed

    Iki, Masayuki

    2014-05-01

    Osteoporosis is a major burden on modern society because of its high prevalence and tragic consequences due to fractures. According to population-based epidemiologic studies, number of people with osteoporosis in Japan was estimated to be 13 million in 2005, and only 20% of them were under treatment. Osteoporosis is a highly undertreated disease. Number of hip fractures occurred in Japan in 2007 was approximately 130 thousands which were 2.8-fold greater than those in 1987. This increase can be explained by an increase in the elderly population. Prevalence rate of vertebral fracture was reported to be approximately 30% in women aged 70s and 40% in those aged 80s. Fracture risk assessment in individuals is essential for osteoporosis management. To improve prediction accuracy for major osteoporotic fractures, FRAX(®) model including clinical risk factors was developed. Predicted risk of major osteoporotic fractures for Japanese women by FRAX(®) were not significantly different from observed risk in the Japanese Population-based Osteoporosis (JPOS) Cohort Study, and FRAX(®) model without bone mineral density (BMD) showed a similar validity to FRAX(®) model with BMD. This suggests that FRAX(®) without BMD may be used as a screening tool for people at increased risk of fractures in community. However, FRAX(®) should be improved further in combination with new bone strength indices. Epidemiology should play a great role in developing and evaluating such improvement in fracture risk assessment. PMID:24769675

  2. Is serum procalcitonin measurement a useful addition to a rheumatologist's repertoire? A review of its diagnostic role in systemic inflammatory diseases and joint infections.

    PubMed

    Shaikh, Muddassir Muhammad; Hermans, Lucas Etienne; van Laar, Jacob M

    2015-02-01

    Early differentiation between infection and aseptic inflammation is difficult and is a challenge often faced in the rheumatology practice. Procalcitonin (PCT) is a biomarker that is preferentially induced in patients with bacterial infections, and a growing body of evidence supports its use for improving diagnosis of bacterial infections and guiding antibiotic therapy. In this article, we review the evidence for the use of PCT measurement in rheumatology practice. Several studies have examined the use of PCT to assist in the differentiation between septic and non-septic arthritis in patients with an inflamed joint and found it to be a sensitive and specific marker of infection. A number of studies in patients with diverse inflammatory rheumatic diseases have provided useful information regarding the usefulness of PCT in these patients. In summary, PCT when used in the appropriate clinical setting can be a useful adjunct to currently available laboratory infection markers, though further studies are warranted. Furthermore, PCT results should be interpreted in parallel with the clinical assessment. PMID:25349443

  3. Female Gender and Acne Disease Are Jointly and Independently Associated with the Risk of Major Depression and Suicide: A National Population-Based Study

    PubMed Central

    Yang, Yi-Chien; Tu, Hung-Pin; Chang, Wei-Chao; Fu, Hung-Chun; Ho, Ji-Chen; Chang, Wei-Pin; Chuang, Hung-Yi; Lee, Chih-Hung

    2014-01-01

    Acne is a common disease in adolescence with female preponderance. It could cause poor self-esteem and social phobia. Previous studies based on questionnaires from several thousands of adolescents showed that acne is associated with major depression and suicide. However, the gender- and age-specific risk of depression and suicide in patients with acne remain largely unknown. Using a database from the National Health Insurance, which included 98% of the population of Taiwan in 2006, we identified patients of acne, major depression, and suicide based on ICD-9-CM codes. Totally 47111 patients with acne were identified (16568 males and 30543 females) from 1 million subjects. The youths of 7–12 years had the highest prevalence of acne (14.39%). Major depression was more common in those with acne (0.77%) than controls (0.56% , P < 0.0001) regardless of gender. Multiple logistic regression showed an increased risk of major depression in women without acne (OR = 1.85, 95% CI 1.75–1.96). The risk is additive in women with acne (OR = 2.78, 95% CI 2.43–3.17). Similar additive risk of suicide was noticed in women with acne. In conclusion, acne and gender, independently and jointly, are associated with major depression and suicide. Special medical support should be warranted in females with acne for the risk of major depression and suicide. PMID:24678508

  4. Reliability and discriminatory testing of a client-based metrology instrument, feline musculoskeletal pain index (FMPI) for the evaluation of degenerative joint disease-associated pain in cats.

    PubMed

    Benito, J; Depuy, V; Hardie, E; Zamprogno, H; Thomson, A; Simpson, W; Roe, S; Hansen, B; Lascelles, B D X

    2013-06-01

    The objective of this study was to test the readability, reliability, repeatability and discriminatory ability of an owner-completed instrument to assess feline degenerative joint disease (DJD)-associated pain (feline musculoskeletal pain index, FMPI). Readability was explored using four different formulas (Flesch, Fry, SMOG and FOG) and the final FMPI instrument was produced. To assess the instrument, client-owned cats that were defined as normal (normal group) or as having DJD-associated pain and mobility impairment (pain-DJD group) were recruited. A total of 32 client-owned cats were enrolled in the study (normal, n=13; pain-DJD, n=19). Owners completed the FMPI on two occasions, 14days apart. Internal consistency (reliability) and repeatability (test-retest) were explored using Cronbach's ? and weighted ? statistic, respectively. Data from the two groups were compared using analysis of covariance (controlling for age) to evaluate discriminatory ability. The FMPI was constructed with 21 questions covering activity, pain intensity and overall quality of life. It had a 6th grade readability score. Reliability of the FMPI was excellent (Cronbach's ?>0.8 for all groupings of questions in normal and pain-DJD cats) and repeatability was good (weighted ? statistic >0.74) for normal and pain-DJD cats. All components of the FMPI were able to distinguish between normal cats and cats with DJD (P<0.001 for all components). This initial evaluation of the FMPI suggests that this instrument is worthy of continued investigation. PMID:23369382

  5. Interference of Different Types of Mastication on Static Balance in Individuals without Temporomandibular Disorder

    PubMed Central

    Politti, Fabiano; El Hage, Yasmin; de Sousa, Dowglas Fernando Magalhães; Amorin, Cesar Ferreira; Gonzalez, Tabajara de Oliveira; Biasotto-Gonzalez, Daniela Aparecida

    2014-01-01

    Purpose: This study was to determine whether non-habitual (isotonic) bilateral and unilateral mastication with eyes open and eyes closed exerts an influence on static balance in individuals without temporomandibular disorder (TMD). Method: An observational, cross-sectional study was conducted involving 20 volunteers aged 20 to 40 years without temporomandibular disorder. Static balance was assessed with the individuals in a quiet standing position on a force plate performing different types of mastication under six separate conditions. Results: Significant differences (p < .05) were found in the area of oscillation during bilateral mastication (eyes open) and the right unilateral mastication, significant differences were only found for oscillation area with eyes open and mediolateral center of pressure with eyes closed (p < .05). Conclusions: The findings of the present study reveal that the stomatognathic system (bilateral and unilateral mastication) promote changes in some variables of static balance.

  6. Inter-examiner reliability of the diagnosis of cervical pillar hyperplasia (CPH) and the correlation between CPH and spinal degenerative joint disease (DJD)

    PubMed Central

    Stupar, Maja; Mauron, Damien; Peterson, Cynthia K

    2003-01-01

    Background Cervical pillar hyperplasia (CPH) is a recently described phenomenon of unknown aetiology. Its clinical importance is poorly understood at the present time; therefore, the objective of this study was to determine (1) the inter-examiner reliability of detecting CPH and (2) if there is a clinically important correlation (r > 0.4) between the number of cervical spine levels showing signs of degenerative joint disease (DJD) and CPH. Methods The sample consisted of 320 radiographs of human male and female subjects who ranged from 40 to 79 years of age. The inter-examiner reliability of assessing the presence/absence of pillar hyperplasia was evaluated on 50 neutral lateral radiographs by two examiners using line drawings and it was quantified using the kappa coefficient of concordance. To determine the presence/absence of hyperplastic pillars as well as the presence/absence of DJD at each intervertebral disc and zygapophysial joint, 320 AP open mouth, AP lower cervical and neutral lateral radiographs were then examined. The unpaired t-test at the 5% level of significance was performed to test for a statistically significant difference between the number of levels affected by DJD in patients with and without hyperplasia. The Spearman's rho at the 5% level of significance was performed to quantify the correlation between DJD and age. Results The inter-examiner reliability of detecting cervical pillar hyperplasia was moderate with a kappa coefficient of 0.51. The unpaired t-test indicated that there was no statistically significant difference (p > 0.05) between the presence/absence of cervical pillar hyperplasia and the number of levels affected by DJD in an age-matched population, regardless of whether all elements were considered together, or the discs and facets were analyzed separately. A Spearman correlation rank of 0.67 (p < 0.05) suggested a moderately strong correlation between the number of elements (i.e. discs/facets) affected, and the age of the individual. Conclusion Cervical pillar hyperplasia is a reasonable concept that requires further research. Its evaluation is easy to learn and acceptably reliable. Previous research has suggested that CPH may affect the cervical lordosis, and therefore, alter biomechanics which may result in premature DJD. This current study, however, indicates that, globally, CPH does not appear to be related to the development of DJD. PMID:14678560

  7. Compliant joint

    NASA Technical Reports Server (NTRS)

    Eklund, Wayne D. (inventor); Kerley, James J. (inventor)

    1990-01-01

    A compliant joint is provided for prosthetic and robotic devices which permits rotation in three different planes. The joint provides for the controlled use of cable under motion. Perpendicular outer mounting frames are joined by swaged cables that interlock at a center block. Ball bearings allow for the free rotation of the second mounting frame relative to the first mounting frame within a predetermined angular rotation that is controlled by two stop devices. The cables allow for compliance at the stops and the cables allow for compliance in six degrees of freedom enabling the duplication or simulation of the rotational movement and flexibility of a natural hip or knee joint, as well as the simulation of a joint designed for a specific robotic component for predetermined design parameters.

  8. Mouse models of osteoarthritis and joint injury

    E-print Network

    Avedillo, Jose Enrique

    2012-01-01

    Nearly 21 million Americans are affected by osteoarthritis, a complex disease characterized by degenerative lesions to the articular cartilage and subchondral bone in the joints. The complexity of the disease makes the use ...

  9. Molecular monitoring of equine joint homeostasis

    Microsoft Academic Search

    Janny C. de Grauw

    2011-01-01

    Diseases affecting synovial joints are a major cause of chronic disability both in humans and in companion animal species, most notably dogs and horses. As progressive deterioration of the articular cartilage is the hallmark of degenerative joint disease or osteoarthritis, research efforts traditionally tended to focus primarily on cartilage pathology. However, in recent years it has become clear that synovial

  10. Muscle Organization in Individuals with and without Pain and Joint Dysfunction

    PubMed Central

    Nickel, J.C.; Gonzalez, Y.M.; McCall, W.D.; Ohrbach, R.; Marx, D.B.; Liu, H.; Iwasaki, L.R.

    2012-01-01

    Central nervous system organization of masticatory muscles determines the magnitude of joint and muscle forces. Validated computer-assisted models of neuromuscular organization during biting were used to determine organization in individuals with and without temporomandibular disorders (TMD). Ninety-one individuals (47 women, 44 men) were assigned to one of four diagnostic groups based on the presence (+) or absence (-) of pain (P) and bilateral temporomandibular joint disc displacement (DD). Electromyography and bite-forces were measured during right and left incisor and molar biting. Two three-dimensional models employing neuromuscular objectives of minimization of joint loads (MJL) or muscle effort (MME) simulated biting tasks. Evaluations of diagnostic group and gender effects on choice of best-fit model were by analysis of variance (ANOVA) and Tukey-Kramer post hoc tests, evaluations of right-left symmetry were by Chi-square and Fisher’s exact statistics, and evaluations of model accuracy were by within-subject linear regressions. MME was the best-fit during left molar biting in +DD individuals and incisor biting in men (all p < 0.03). Incisor biting symmetry in muscle organization was significantly higher (p < 0.03) in healthy individuals compared with those with TMD. Within-subject regressions showed that best-fit model errors were similar among groups: 8 to 15% (0.68 ? R2 ? 0.74). These computer-assisted models predicted muscle organization during static biting in humans with and without TMDs. PMID:22522774

  11. Joint Association of Dietary Pattern and Physical Activity Level with Cardiovascular Disease Risk Factors among Chinese Men: A Cross-Sectional Study

    PubMed Central

    Li, Yanping; Luan, Dechun; Zhai, Fengying; Yang, Xiaoguang; Ma, Guansheng

    2013-01-01

    The purpose of this cross-sectional study was to investigate the joint associations of physical activity level (PAL) and dietary patterns in relation to cardiovascular disease (CVD) risk factors among Chinese men. The study population consisted of 13 511 Chinese males aged 18–59 years from the 2002 China National Nutrition and Health Survey. Based on dietary data collected by a food frequency questionnaire, four dietary patterns were identified and labeled as “Green Water” (high consumption of rice, vegetables, seafood, pork, and poultry), “Yellow Earth” (high consumption of wheat flour products and starchy tubers), “New Affluent” (high consumption of animal sourced foods and soybean products), and “Western Adopter” (high consumption of animal sourced foods, cakes, and soft drinks). From the information collected by a 1-year physical activity questionnaire, PAL was calculated and classified into 4 categories: sedentary, low active, active, and very active. As compared with their counterparts from the New Affluent pattern, participants who followed the Green Water pattern had a lower likelihood of abdominal obesity (AO; 50.2%), hypertension (HT; 37.9%), hyperglycemia (HG; 41.5%), elevated triglyceride (ETG; 14.5%), low HDL (LHDL; 39.8%), and metabolic syndrome (MS; 51.9%). When compared to sedentary participants, the odds ratio of participants with very active PAL was 0.62 for AO, 0.85 for HT, 0.71 for HG, 0.76 for ETG, 0.74 for LHDL, and 0.58 for MS. Individuals who followed both very active PAL and the Green Water pattern had a lower likelihood of CVD risk factors (AO: 65.8%, HT: 39.1%, HG: 57.4%, ETG: 35.4%, LHDL: 56.1%, and MS: 75.0%), compared to their counterparts who followed both sedentary PAL and the New Affluent pattern. In addition, adherence to both healthy dietary pattern and very active PAL presented a remarkable potential for CVD risk factor prevention. PMID:23840426

  12. Compliant Prosthetic Or Robotic Joint

    NASA Technical Reports Server (NTRS)

    Kerley, James J.; Eklund, Wayne D.

    1989-01-01

    Rotation partly free and partly restrained by resilience and damping. Joint includes U-shaped x- and y-axis frames joined by cables that cross in at center piece. The y-axis frame rotates about y-axis on roller bearing within predetermined angular range. The y-axis frame rotates slightly farther when arm strikes stop, because cables can twist. This mimics compliant resistance of knee joint reaching limit of its forward or backward motion. Used in prosthetic device to replace diseased or damage human joint, or in robot linkage to limit movement and cushion overloads.

  13. Dickkopf-1 is a master regulator of joint remodeling

    Microsoft Academic Search

    Danielle Diarra; Marina Stolina; Karin Polzer; Jochen Zwerina; Michael S Ominsky; Denise Dwyer; Adelheid Korb; Josef Smolen; Markus Hoffmann; Clemens Scheinecker; Desiree van der Heide; Robert Landewe; Dave Lacey; William G Richards; Georg Schett

    2007-01-01

    Degenerative and inflammatory joint diseases lead to a destruction of the joint architecture. Whereas degenerative osteoarthritis results in the formation of new bone, rheumatoid arthritis leads to bone resorption. The molecular basis of these different patterns of joint disease is unknown. By inhibiting Dickkopf-1 (DKK-1), a regulatory molecule of the Wnt pathway, we were able to reverse the bone-destructive pattern

  14. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    PubMed Central

    DeVocht, James W.; Goertz, Christine M.; Hondras, Maria A.; Long, Cynthia R.; Schaeffer, Wally; Thomann, Lauren; Spector, Michael; Stanford, Clark M.

    2014-01-01

    Background Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). Methods The authors assigned 80 participants randomly into one of the following four groups, all of which included a comprehensive self-care program: reversible interocclusal splint therapy (RIST), Activator Method Chiropractic Technique (AMCT) (Activator Methods International, Phoenix), sham AMCT and self-care only. They made assessments at baseline and at month 2 and month 6, including use of the Research Diagnostic Criteria for Temporomandibular Disorders. Results The authors screened 721 potential participants and enrolled 80 people; 52 participants completed the six-month assessment. The adjusted mean change in current pain over six months, as assessed on the 11-point numerical rating scale, was 2.0 (95 percent confidence interval, 1.1-3.0) for RIST, 1.7 (0.9-2.5) for self-care only, 1.5 (0.7-2.4) for AMCT and 1.6 (0.7-2.5) for sham AMCT. The authors also assessed bothersomeness and functionality. Conclusions The authors found the study design and methodology to be manageable. They gained substantial knowledge to aid in conducting a larger study. AMCT, RIST and self-care should be evaluated in a future comparative effectiveness study. Practical Implications. This pilot study was a necessary step to prepare for a larger study that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD. PMID:24080932

  15. Articular Cartilage Deformation Determined in an Intact Tibiofemoral Joint by Displacement-Encoded Imaging

    E-print Network

    Hull, Maury

    information regarding degenerative joint diseases. Comparison of deformations from degenerated and healthyArticular Cartilage Deformation Determined in an Intact Tibiofemoral Joint by Displacement displacement and strain of articular cartilage in a cyclically-compressed and intact joint using displacement

  16. Molecular monitoring of equine joint homeostasis.

    PubMed

    de Grauw, Janny C

    2011-06-01

    Diseases affecting synovial joints are a major cause of chronic disability both in humans and in companion animal species, most notably dogs and horses. As progressive deterioration of the articular cartilage is the hallmark of degenerative joint disease or osteoarthritis, research efforts traditionally tended to focus primarily on cartilage pathology. However, in recent years it has become clear that synovial joints should be considered intricate organs in their own right, with each of the constituent tissues (cartilage, bone, and synovial membrane) interacting with each other both in health and disease. Moreover, with the advent of modern molecular biology techniques, the importance of synovial inflammation in disease development and progression has become increasingly recognized. These realizations have spurred the need for tools that allow a more comprehensive, integral study of synovial joint homeostasis. This review provides a brief overview of synovial joint biology and the concept of joint homeostasis, followed by a discussion of methods that may be used to study joint homeostasis (varying from in vitro tissue culture to in vivo imaging) including specific advantages and limitations of each approach. It then zooms in on one such approach, synovial fluid biomarker analysis, as a promising avenue in synovial joint research, highlighting some results from equine studies performed in the author's own laboratory that illustrate how such studies may help shed light on in vivo joint homeostasis and therapeutic modulation thereof. The review concludes with some future perspectives and promising developments in the field. PMID:22029852

  17. Joint assembly

    NASA Technical Reports Server (NTRS)

    Wilson, Andrew (Inventor); Punnoose, Andrew (Inventor); Strausser, Katherine (Inventor); Parikh, Neil (Inventor)

    2010-01-01

    A joint assembly is provided which includes a drive assembly and a swivel mechanism. The drive assembly features a motor operatively associated with a plurality of drive shafts for driving auxiliary elements, and a plurality of swivel shafts for pivoting the drive assembly. The swivel mechanism engages the swivel shafts and has a fixable element that may be attached to a foundation. The swivel mechanism is adapted to cooperate with the swivel shafts to pivot the drive assembly with at least two degrees of freedom relative to the foundation. The joint assembly allows for all components to remain encased in a tight, compact, and sealed package, making it ideal for space, exploratory, and commercial applications.

  18. Muscle and joint forces under variable equilibrium states of the mandible.

    PubMed

    Rues, Stefan; Lenz, Jürgen; Türp, Jens C; Schweizerhof, Karl; Schindler, Hans J

    2011-10-01

    It is well established that subjects without molars have reduced ability to comminute foods. However, epidemiological studies have indicated that the masticatory system is able to functionally adapt to the absence of posterior teeth. This supports the shortened dental arch concept which, as a prosthetic option, recommends no replacement of missing molars. Biomechanical modeling, however, indicates that using more anterior teeth will result in a larger temporomandibular joint load per unit of bite force. In contrast, changing bite from incisor to molar position increases the maximum possible bite force and reduces joint loads. There have been few attempts, however, to determine realistic joint loads and corresponding muscular effort during generation of occlusal forces similar to those used during chewing with intact or shortened dental arches. Therefore, joint and cumulative muscle loads generated by vertical bite forces of submaximum magnitude moving from canine to molar region, were calculated. Calculations were based on intraoral measurement of the feedback-controlled resultant bite force, simultaneous electromyograms, individual geometrical data of the skull, lines of action, and physiological cross-sectional areas of all jaw muscles. Compared to premolar and canine biting, bilateral and unilateral molar bites reduced cumulative muscle and joint loads in a range from 14% to 33% and 25% to 53%, respectively. During unilateral molar bites, the ipsilateral joints and contralateral muscles were about 20% less loaded than the opposing ones. In conclusion, unilateral or bilateral molar biting at chewing-like force ranges caused the least muscle and joint loading. PMID:20585815

  19. Efficacy of Physical Therapy Treatment on Patients with Temporomandibular Disorder at 6, 12, 18, and 24 Months Post-discharge

    Microsoft Academic Search

    Erin Calhoun; Makindra Winters

    2005-01-01

    Background and purpose. This study was intended to assess the efficacy of physical therapy treatment on patients with various temporomandibular disorders at 6, 12, 18, and 24 months after their discharge from physical therapy. These patients were all treated at Therapeutic Associates - Cedar Hills Physical Therapy in Portland, Oregon. Methods. Objective measures (Therapeutic Associates Outcomes System Functional Index (TAOS),

  20. Analysis of occlusal variables, dental attrition, and age for distinguishing healthy controls from female patients with intracapsular temporomandibular disorders

    Microsoft Academic Search

    Donald A. Seligman; Andrew G. Pullinger

    2000-01-01

    Statement Of Problem. Confusion about the relationship of occlusion to temporomandibular disorders (TMD) persists. Purpose. This study attempted to identify occlusal and attrition factors plus age that would characterize asymptomatic normal female subjects. Methods And Material. A total of 124 female patients with intracapsular TMD were compared with 47 asymptomatic female controls for associations to 9 occlusal factors, 3 attrition

  1. Patellofemoral Joint Biomechanics and Tissue Engineering

    Microsoft Academic Search

    Gerard A. Ateshian; Clark T. Hung

    2005-01-01

    Recent advances in the study of patellofemoral joint biome-chanics have provided promising diagnosis and treatment modalities for patellofemoral joint disorders, such as quan-titative assessment of cartilage lesions from noninvasive im-aging, computer simulations of surgical procedures for opti-mizing surgical parameters and potentially predicting out-comes, and cartilage tissue engineering for the treatment of advanced degenerative joint disease. These technologies are still in

  2. Occlusion and temporomandibular disorders: a malpractice case with medical legal considerations.

    PubMed

    Bucci, M B; Aversa, M; Guarda-Nardini, L; Manfredini, D

    2011-01-01

    Occlusion and temporomandibular The issue of temporomandibular disorders (TMD) diagnosis and treatment has become a matter of increasing interest in the medical legal field in recent years. The old-fashioned theories based on the occlusal paradigm was proven to be erroneous, and clinicians who still provide irreversible treatments to TMD patients have to be conscious of the potential legal consequences of their behavior. The present paper described an illustrative case report of a patient to whom extensive and irreversible occlusal therapies were performed with the unique aim to provide relief from TMD symptoms. The treatment was unsuccessful and the dental practitioner was called into cause for a professional liability claim. The clinician was judged guilty of malpractice on the basis of the lack of scientific evidence of the irreversible occlusal approaches to TMD, which were erroneously used and did not give the patient any benefit, thus forcing him to a non necessary financial and biological cost. The failure to satisfy the contract with the patient, which is usually not covered by any insurance company, forced the practitioner to give the money back to the patient. The ethical and legal implications of such case were discussed, with particular focus on the concept that medical legal advices need to satisfy the highest standards of evidence and have to be strictly based on scientific knowledge. PMID:21252850

  3. ELECTROMYOGRAPHIC ACTIVITY ASSESSMENT OF INDIVIDUALS WITH AND WITHOUT TEMPOROMANDIBULAR DISORDER SYMPTOMS

    PubMed Central

    Tosato, Juliana de Paiva; Caria, Paulo Henrique Ferreira

    2007-01-01

    Introduction: Temporomandibular disorders (TMD) present several signs and symptoms that hinder their correct diagnosis, which is imperative on the elaboration of a treatment plan. Over the past years, several studies have been conducted to characterize and classify TMD to better understand these disorders. Therefore, the purpose of this study was to assess the electromyographic behavior of the masseter and temporal muscles in individuals with and without myogenic, arthrogenic and mixed TMD. Method: Forty volunteers of both genders responded to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) Questionnaire, were submitted to clinical exam and underwent bilateral electromyographic exam of the masseter and temporal muscles. Results: No statistically significant difference (p>0.05) was observed during the assessment of isotonic contraction. Regarding isometric contraction, pairing between the mixed TMD group and the asymptomatic subjects did not present significant difference (p>0.05). Comparison between the myogenic and arthrogenic TMD groups and the asymptomatic group showed statistically significant difference (p<0.05). The findings of the present study demonstrated alteration on the muscle contraction pattern of TMD individuals compared to that of asymptomatic patients. PMID:19089121

  4. POSTURAL EVALUATION OF PATIENTS WITH TEMPOROMANDIBULAR DISORDERS UNDER USE OF OCCLUSAL SPLINTS

    PubMed Central

    Strini, Paulinne Junqueira Silva Andresen; Machado, Naila Aparecida de Godoi; Gorreri, Marília Cavalheri; Ferreira, Amanda de Freitas; Sousa, Gilmar da Cunha; Fernandes, Alfredo Júlio

    2009-01-01

    Objectives: Alterations in the temporomandibular complex can reflect in adaptations of the individual's entire muscular system, intervening with the head position and scapular waist, developing postural alterations and modifying all corporal biomechanics. The aim of this study was to evaluate the head position (HP) and head postural alterations before and after installation of occlusal splints. Material and Methods: Twenty patients with temporomandibular disorders (TMD) underwent clinical and postural examination, before the installation of an occlusal splint, and after 1 week and 1 month of use. Results: There were statistically differences for HP, between the initial values and after 1 week of use of the occlusal device (p= 0.048) and also between 1 week and 1 month of evaluation (p= 0.001). Decrease of the painful symptomatology and maintenance of the rectification were also observed. Conclusions: The individual's postural position can suffer biomechanical alterations due to stomatognathic alterations, causing clinically visible changes in dysfunctional individuals and affecting the performance of the involved structures. PMID:19936539

  5. Estrogen replacement therapy among postmenopausal women and its effects on signs and symptoms of temporomandibular disorders.

    PubMed

    Nekora-Azak, Aysen; Evlioglu, Gulumser; Ceyhan, Arzu; Keskin, Haluk; Berkman, Sinan; Issever, Halim

    2008-07-01

    The prevalence of temporomandibular disorders (TMD) is about two to five times higher in females than in males. Data for the higher prevalence of TMD in women and prevalence rates peak during the reproductive years and decrease after menopause. This indicated that female sex hormones may play a role in the etiology or maintenance of TMD. The aim of this study was to investigate the relationship between postmenopausal hormone use and TMD in Turkish postmenopausal women. One hundred-eighty (180), postmenopausal women, aged 42-72 years, were examined both clinically and by questionnaire with regard to the signs and symptoms of temporomandibular disorders, general health status and use of postmenopausal hormone replacement therapy in the preceding year. Ninety-one (91) postmenopausal women (50.6%) were on hormone replacement therapy (HRT). The remaining 89 (49.4%) postmenopausal women were not on hormone replacement therapy. There was no significant difference found in the signs and symptoms of TMD between postmenopausal women using hormone therapy and those not using postmenopausal hormones. There was no association between the use of postmenopausal hormones and the signs and symptoms of TMD in this study. PMID:18686498

  6. Temporomandibular joint inflammation activates glial and immune cells in both the trigeminal ganglia and in the spinal trigeminal nucleus

    Microsoft Academic Search

    Giovanni Villa; Stefania Ceruti; Matteo Zanardelli; Giulia Magni; Luc Jasmin; Peter T Ohara; Maria P Abbracchio

    2010-01-01

    BACKGROUND: Glial cells have been shown to directly participate to the genesis and maintenance of chronic pain in both the sensory ganglia and the central nervous system (CNS). Indeed, glial cell activation has been reported in both the dorsal root ganglia and the spinal cord following injury or inflammation of the sciatic nerve, but no data are currently available in

  7. 5.517. Tissue Engineering of the Temporomandibular Joint V P Willard, Rice University, Houston, TX, USA

    E-print Network

    Athanasiou, Kyriacos

    .517.3.1.3. Glycosaminoglycans and proteoglycans 224 5.517.3.1.4. Tissue mechanics 225 5.517.3.2. Condylar and Fossa Cartilages 225 5.517.3.2.1. Cells 225 5.517.3.2.2. Extracellular matrix 226 5.517.3.2.3. Tissue mechanics 226 5.517.6.1.3. Bioactive agents 230 5.517.6.1.4. Mechanical stimulation 230 5.517.6.2. Condylar Cartilage 231 5

  8. Frey's Syndrome Consequent to an Unusual Pattern of Temporomandibular Joint Dislocation: Case Report with Review of Its Incidence and Etiology

    PubMed Central

    Kamath, Rajay A. D.; Bharani, Shiva; Prabhakar, Suhas

    2013-01-01

    Frey's syndrome was first described in the 18th century. Recognizing it as a nonspecific condition, the symptom of gustatory sweating in patients with parotid gland inflammation was described by Duphenix and Baillarger. However, as a specific diagnostic entity, gustatory sweating, following trauma to parotid glands, was first described by Polish neurologist Lucie Frey, in 1923, and hence he proposed the term auriculotemporal syndrome. The condition is characterized by sweating, flushing, a sense of warmth, and occasional pain in the preauricular and temporal areas, following the production of a strong salivary stimulus. Several etiologies of Frey's syndrome have been mentioned in the literature; however, none attribute dislocation of the “intact” mandibular condyle as a cause of the syndrome. Reviewing its pathophysiology, etiology, and incidence in detail, we describe a case of Frey's syndrome subsequent to superolateral dislocation of the intact mandibular condyle following fracture of the anterior mandible. Its management and prevention are also discussed in brief. PMID:24436729

  9. Joint Instability and Osteoarthritis

    PubMed Central

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  10. Rothia prosthetic knee joint infection.

    PubMed

    Trivedi, Manish N; Malhotra, Prashant

    2013-01-25

    Rothia species - Gram-positive pleomorphic bacteria that are part of the normal oral and respiratory flora - are commonly associated with dental cavities and periodontal disease although systemic infections have been described. We describe a 53-year-old female with rheumatoid arthritis complicated by prosthetic knee joint infection due to Rothia species, which was successfully treated by surgical removal of prosthesis and prolonged antimicrobial therapy. The issue of antibiotic prophylaxis before dental procedures among patients with prosthetic joint replacements is discussed. PMID:23357608

  11. Challenges and opportunities in drug and biomarker development for nonalcoholic steatohepatitis: Findings and recommendations from an American Association for the Study of Liver Diseases-U.S. Food and Drug Administration Joint Workshop.

    PubMed

    Sanyal, Arun J; Friedman, Scott L; McCullough, Arthur J; Dimick-Santos, Lara

    2015-04-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease (CLD) in North America. It is a growing contributor to the burden of CDL requiring liver transplantation. Cirrhosis is also associated with an increased risk of hepatocellular cancer, which may occur even in the absence of cirrhosis in subjects with nonalcoholic steatohepatitis (NASH), the histological form of NAFLD associated with increased liver-related mortality. The diagnosis of NASH currently requires a liver biopsy. There are also no U.S. Food and Drug Administration (FDA)-approved therapies for NASH. Therefore, there is a need to develop better diagnostic and therapeutic strategies for patients with NASH, targeting both those with early-stage disease as well as those with advanced liver fibrosis. There are unique challenges in the design of studies for these target populations. The long relatively asymptomatic time interval in the progression of NAFLD and NASH to cirrhosis and ultimately liver failure, along with gaps in knowledge regarding disease modifiers, combine to present significant challenges in trial design. Therefore, there is an urgent need to develop methods to identify the populations at particular risk of disease progression and validate endpoints that reflect meaningful changes in health status in this population. This article summarizes the discussion at a joint workshop held September 5 and 6, 2013 in Silver Spring, Maryland, sponsored by the FDA and the American Association for the Study of Liver Diseases to develop guidance on diagnostic and therapeutic modalities for NASH. (Hepatology 2015;61:1392-1405). PMID:25557690

  12. The study of temporomandibular disorders and orofacial pain from the perspective of the predoctoral dental curriculum.

    PubMed

    Attanasio, Ron

    2002-01-01

    This paper addresses questions 2 to 6 posed in the charge to the conference to discuss the study of temporomandibular disorders (TMD) and orofacial pain from the perspective of the predoctoral dental curriculum. This paper lends itself to an additional query: how much diagnostic and therapeutic skill relative to TMD and orofacial pain should a new graduate possess and demonstrate to be deemed competent in accordance with the definition of competence of the American Dental Association's Commission on Dental Accreditation? Although much of the content of this and the accompanying articles from the conference pertain to the TMD and orofacial pain curricula of dental schools in North America, most of what is presented here is universal to the teaching of the subject matter; therefore, it could be applied to educational institutions in other parts of the world. Indeed, an international survey relative to the teaching of TMD and orofacial pain would be of interest and value to dental schools worldwide. PMID:12221732

  13. Temporomandibular disorders among Brazilian adolescents: reliability and validity of a screening questionnaire

    PubMed Central

    FRANCO-MICHELONI, Ana Lucia; FERNANDES, Giovana; GONÇALVES, Daniela Aparecida de Godoi; CAMPARIS, Cinara Maria

    2014-01-01

    Temporomandibular disorders (TMD) screeners assume significant item overlap with the screening questionnaire proposed by the American Academy of Orofacial Pain (AAOP). Objective To test the reliability and validity of the Portuguese version of AAOP questions for TMD screening among adolescents. Material and Methods Diagnoses from Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were used as reference standard. Reliability was evaluated by internal consistency (KR-20) and inter-item correlation. Validity was tested by sensitivity, specificity, predictive values, accuracy and receiver operating characteristic (ROC) curves, the relationship between the true-positive rate (sensitivity) and the false-positive rate (specificity). Test-retest reliability of AAOP questions and intra-examiner reproducibility of RDC/TMD Axis I were tested with kappa statistics. Results The sample consisted of 1307 Brazilian adolescents (56.8% girls; n=742), with mean age of 12.72 years (12.69 F/12.75 M). According to RDC/TMD, 397 [30.4% (32.7% F/27.3% M)] of adolescents presented TMD, of which 330 [25.2% (27.6% F/22.2% M)] were painful TMD. Because of low consistency, items #8 and #10 of the AAOP questionnaire were excluded. Remaining items (of the long questionnaire version) showed good consistency and validity for three positive responses or more. After logistic regression, items #4, #6, #7 and #9 also showed satisfactory consistency and validity for two or more positive responses (short questionnaire version). Both versions demonstrated excellent specificity (about 90%), but higher sensitivity for detecting painful TMD (78.2%). Better reproducibility was obtained for the short version (k=0.840). Conclusions The Portuguese version of AAOP questions showed both good reliability and validity for the screening of TMD among adolescents, especially painful TMD, according to RDC/TMD. PMID:25141204

  14. Assessment of joint symmetry in arthritis.

    PubMed

    Cresswell, Lynne; Farewell, Vern

    2011-04-30

    We evaluate three methods for the assessment of symmetry in the joints affected by an arthritic disease. The first two methods, based on published methodology, are limited by their assumptions. We introduce a third method that enables a more comprehensive investigation. In common with previous methods, this method examines tabulations of observed data for evidence of symmetry. Expected values for the table cells are simulated under an assumption of independent joint disease, whilst allowing for differences between patients, and joint locations, in terms of their susceptibility to disease symptoms. Departures of observed from expected values are assessed via a Pearson-type goodness-of-fit test and are examined for consistency with symmetry. We illustrate the three methods using data on the damage accrued in the hand joints of patients registered at the University of Toronto Psoriatic Arthritis clinic. PMID:21284011

  15. CONTAGIOUS DISEASE MODULE FOR THE JOINT EFFECTS MODEL Mr. Jason Rodriguez, Ms. Karen E. Cheng, Dr. Gene E. McClellan, Dr. David J. Crary, and Dr.

    E-print Network

    Ray, Jaideep

    smallpox and plague. Smallpox and plague are contagious diseases that lead to an additional load on medical at risk. In order to properly defend against an attack involving smallpox or plague, medical planners must

  16. Joint Infection (Beyond the Basics)

    MedlinePLUS

    ... Infection of an artificial joint is known as prosthetic joint infection. GONOCOCCAL JOINT INFECTION Gonococcal joint infection ... cases, it is not possible to replace the prosthetic joint, and surgery to fuse the bones is ...

  17. Guidelines for diagnosis and management of chronic obstructive pulmonary disease: joint recommendations of Indian Chest Society and National College of Chest Physicians (India).

    PubMed

    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; Jindal, S K

    2014-01-01

    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 and the National College of Chest Physicians (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 analysed to arrive at simple and practical recommendations. The evidence is presented under these five headings: (a) definition, epidemiology and disease burden, (b) disease assessment and diagnosis, (c) pharmacologic management of stable COPD, (d) management of acute exacerbations; and (e) non-pharmacologic and preventive measures. PMID:24974625

  18. Photoacoustic tomography of small-animal and human peripheral joints

    NASA Astrophysics Data System (ADS)

    Wang, Xueding; Chamberland, David L.; Fowlkes, J. Brian; Carson, Paul L.; Jamadar, David A.

    2008-02-01

    As an emerging imaging technology that combines the merits of both light and ultrasound, photoacoustic tomography (PAT) holds promise for screening and diagnosis of inflammatory joint diseases such as rheumatoid arthritis. In this study, the feasibility of PAT in imaging small-animal joints and human peripheral joints in a noninvasive manner was explored. Ex vivo rat tail and fresh cadaveric human finger joints were imaged. Based on the intrinsic optical contrast, intra- and extra-articular tissue structures in the joints were visualized successfully. Using light in the near-infrared region, the imaging depth of PAT is sufficient for cross-sectional imaging of a human peripheral joint as a whole organ. PAT, as a novel imaging modality with unique advantages, may contribute significantly to the early diagnosis of inflammatory joint disorders and accurate monitoring of disease progression and response to therapy.

  19. Butt Joint Tool Commissioning

    SciTech Connect

    Martovetsky, N N

    2007-12-06

    ITER Central Solenoid uses butt joints for connecting the pancakes in the CS module. The principles of the butt joining of the CICC were developed by the JAPT during CSMC project. The difference between the CSMC butt joint and the CS butt joint is that the CS butt joint is an in-line joint, while the CSMC is a double joint through a hairpin jumper. The CS butt joint has to carry the hoop load. The straight length of the joint is only 320 mm, and the vacuum chamber around the joint has to have a split in the clamp shell. These requirements are challenging. Fig.1 presents a CSMC joint, and Fig.2 shows a CS butt joint. The butt joint procedure was verified and demonstrated. The tool is capable of achieving all specified parameters. The vacuum in the end was a little higher than the target, which is not critical and readily correctable. We consider, tentatively that the procedure is established. Unexpectedly, we discover significant temperature nonuniformity in the joint cross section, which is not formally a violation of the specs, but is a point of concern. All testing parameters are recorded for QA purposes. We plan to modify the butt joining tool to improve its convenience of operation and provide all features necessary for production of butt joints by qualified personnel.

  20. Genetic polymorphisms in folate pathway enzymes, DRD4 and GSTM1 are related to temporomandibular disorder

    PubMed Central

    2011-01-01

    Background Temporomandibular disorder (TMD) is a multifactorial syndrome related to a critical period of human life. TMD has been associated with psychological dysfunctions, oxidative state and sexual dimorphism with coincidental occurrence along the pubertal development. In this work we study the association between TMD and genetic polymorphisms of folate metabolism, neurotransmission, oxidative and hormonal metabolism. Folate metabolism, which depends on genes variations and diet, is directly involved in genetic and epigenetic variations that can influence the changes of last growing period of development in human and the appearance of the TMD. Methods A case-control study was designed to evaluate the impact of genetic polymorphisms above described on TMD. A total of 229 individuals (69% women) were included at the study; 86 were patients with TMD and 143 were healthy control subjects. Subjects underwent to a clinical examination following the guidelines by the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Genotyping of 20 Single Nucleotide Polymorphisms (SNPs), divided in two groups, was performed by multiplex minisequencing preceded by multiplex PCR. Other seven genetic polymorphisms different from SNPs (deletions, insertions, tandem repeat, null genotype) were achieved by a multiplex-PCR. A chi-square test was performed to determine the differences in genotype and allelic frequencies between TMD patients and healthy subjects. To estimate TMD risk, in those polymorphisms that shown significant differences, odds ratio (OR) with a 95% of confidence interval were calculated. Results Six of the polymorphisms showed statistical associations with TMD. Four of them are related to enzymes of folates metabolism: Allele G of Serine Hydoxymethyltransferase 1 (SHMT1) rs1979277 (OR = 3.99; 95%CI 1.72, 9.25; p = 0.002), allele G of SHMT1 rs638416 (OR = 2.80; 95%CI 1.51, 5.21; p = 0.013), allele T of Methylentetrahydrofolate Dehydrogenase (MTHFD) rs2236225 (OR = 3.09; 95%CI 1.27, 7.50; p = 0.016) and allele A of Methionine Synthase Reductase (MTRR) rs1801394 (OR = 2.35; 95CI 1.10, 5.00; p = 0.037). An inflammatory oxidative stress enzyme, Gluthatione S-Tranferase Mu-1(GSTM1), null allele (OR = 2.21; 95%CI 1.24, 4.36; p = 0.030) and a neurotransmission receptor, Dopamine Receptor D4 (DRD4), long allele of 48 bp-repeat (OR = 3.62; 95%CI 0.76, 17.26; p = 0.161). Conclusions Some genetic polymorphisms related to folates metabolism, inflammatory oxidative stress, and neurotransmission responses to pain, has been significantly associated to TMD syndrome PMID:21615938

  1. How does joint remodeling work?: new insights in the molecular regulation of the architecture of joints.

    PubMed

    Schett, Georg

    2007-01-01

    Remodeling of joints is a key feature of inflammatory and degenerative joint disease. Bone erosion, cartilage degeneration and growth of bony spurs termed osteophytes are key features of structural joint pathology in the course of arthritis, which lead to impairment of joint function. Understanding their molecular mechanisms is essential to tailor targeted therapeutic approaches to protect joint architecture from inflammatory and mechanical stress. This addendum summarizes the new insights in the molecular regulation of bone formation in the joint and its relation to bone resorption. It describes how inflammatory cytokines impair bone formation and block the repair response of joints towards inflammatory stimuli. It particularly points out the key role of Dickkopf-1 protein, a regulator of the Wingless signaling and inhibitor of bone formation. This new link between inflammation and bone formation is also crucial for explaining the generation of osteophytes, bony spurs along joints, which are characterized by new bone and cartilage formation. This mechanism is largely dependent on an activation of wingless protein signaling and can lead to complete joint fusion. This addendum summarized the current concepts of joint remodeling in the limelight of these new findings. PMID:19262161

  2. Interventional radiology in bone and joint

    SciTech Connect

    Bard, M.; Laredo, J.D.

    1988-01-01

    Recent radiologic procedures in bone and joints, some of which eliminate the need for surgery are exposed, including: trephine biopsies of the thoracic and lumbar spine, sacro-iliac joints, peripheral bones synovial membrane and soft tissues, using either fluoroscopic echographic or CT guidance - chemonucleolysis - vascular embolization of skeletal tumors and management of vertebral hemangiomas - selective steroid injection in a broad spectrum of diseases including vertebral facet syndrome, cervicobrachial nerve root pain, rotator cuff calcium deposit, bone cysts.

  3. Patellofemoral Joint Biomechanics and Tissue Engineering

    PubMed Central

    Ateshian, Gerard A.; Hung, Clark T.

    2013-01-01

    Recent advances in the study of patellofemoral joint biomechanics have provided promising diagnosis and treatment modalities for patellofemoral joint disorders, such as quantitative assessment of cartilage lesions from noninvasive imaging, computer simulations of surgical procedures for optimizing surgical parameters and potentially predicting outcomes, and cartilage tissue engineering for the treatment of advanced degenerative joint disease. These technologies are still in development and their clinical potentials remain an ongoing topic of investigation. We review some of our progress in addressing these issues, and the important role of cartilage mechanics and lubrication in understanding the challenges regarding patellofemoral surgery and cartilage tissue engineering. PMID:15995425

  4. Risk Management Institute Joint Seminar Joint Seminar -

    E-print Network

    Chaudhuri, Sanjay

    around their use of leverage. Research on optimal leverage in the money management industry, howeverRisk Management Institute Joint Seminar Joint Seminar - Risk Management Institute And Department A (S14, #03-10) Speaker Prof. Wang Hefei University of Illinois, Chicago Title Leverage Management

  5. TLR5; a novel and unidentified inflammatory mediator in Rheumatoid Arthritis that correlates with disease activity score and joint TNF-? levels

    PubMed Central

    Chamberlain, Nathan D.; Vila, Olga M.; Volin, Michael V.; Volkov, Suncica; Pope, Richard M.; Swedler, William; Mandelin, Arthur M.; Shahrara, Shiva

    2012-01-01

    The innate immune system plays an important role in rheumatoid arthritis (RA) pathogenesis. Previous studies support the role of TLR2 and 4 in RA and experimental arthritis models however the regulation and pathogenic effect of TLR5 is undefined in RA. In this study we show that TLR5 is elevated in RA and osteoarthritis (OA) synovial tissue lining and sublining macrophages and endothelial cells compared to normal individuals. Further, expression of TLR5 is elevated in RA synovial fluid macrophages and RA peripheral blood (PB) monocytes compared to RA and normal PB in vitro differentiated macrophages. We also found that TLR5 on RA monocytes is an important modulator of TNF-? in RA synovial fluid and that TLR5 expression on these cells strongly correlates with RA disease activity and TNF-? levels. Interestingly, TNF-? has a feed back regulation with TLR5 expression in RA monocytes, while expression of this receptor is regulated by IL-17 and IL-8 in RA macrophages and fibroblasts. We show that RA monocytes and macrophages are more responsive to TLR5 ligation compared to fibroblasts despite the proinflammatory response being mediated through the same signaling pathways in macrophages and fibroblasts. In conclusion we document the potential role of TLR5 ligation in modulating transcription of TNF-? from RA synovial fluid and the strong correlation of TLR5 and TNF-? with each other and with disease activity score in RA monocytes. Our results suggest that expression of TLR5 may be a predictor for RA disease progression and that targeting TLR5 may suppress RA. PMID:22661088

  6. Is there an association between temporomandibular disorders and playing a musical instrument? A review of literature.

    PubMed

    Attallah, M M; Visscher, C M; van Selms, M K A; Lobbezoo, F

    2014-07-01

    Temporomandibular disorders (TMDs) have a multifactorial etiology. Among others, parafunctions and oral habits have been suggested as important initiating and perpetuating factors. Playing a musical instrument that loads the masticatory system, like wind instruments and the violin or viola, has been suggested to be part of this group of etiological factors. However, the evidence base for this suggestion is lacking. Therefore, the aim of this study was to review the literature on the possible association between playing a musical instrument and developing and/or having a TMD. A PubMed search, using the query ['Music'(Mesh) AND 'Craniomandibular Disorders'(Mesh)], yielded 19 articles, 14 of which were included in this review. Six of 14 papers had a case-control or pre-test-post-test design; the remaining eight papers were case reports of expert opinions. The former papers were analysed and tabulated according to the PICO (Patient/population-Intervention-Control/comparison-Outcome/results) system; the latter ones were only summarised and tabulated. All articles with a case-control or pre-test-post-test design suggested a possible association between TMD and playing a musical instrument, especially the violin and viola. However, no clear-cut conclusion could be drawn as to whether playing a musical instrument is directly associated with TMD, or only in combination with other factors. More and better research on this topic is needed, as to enable a better counselling and possibly even a better treatment of the suffering musician. PMID:24702514

  7. Prevalence of Temporomandibular Disorder in Children and Adolescents from Public Schools in Southern Portugal

    PubMed Central

    Minghelli, Beatriz; Cardoso, Iara; Porfírio, Melani; Gonçalves, Roberta; Cascalheiro, Sabina; Barreto, Vera; Soeiro, Andreia; Almeida, Leandro

    2014-01-01

    Background: The prevalence of temporomandibular disorder (TMD) in children and adolescents is in the range of 6-68% and can be triggered or aggravated by emotional stress. Aim: The study was to investigate the prevalence of TMD in Portuguese children and adolescents and its association with emotional stress. Materials and Methods: The sample comprised 3,260 students aged 5-19 years. The questionnaire was used to assess the presence of TMD, and was applied in a single moment. Results: TMD was observed in 821 (25.2%) students. The most common symptoms of TMD were: if considered tense or nervous (52%), have headaches (36.8%), and habit of clenching or grinding teeth (27.3%). The girls had a 1.36 higher probability of developing TMD than boys (95% CI: 1.14-1.63; p < 0.001); moreover, students from the older age group had a 2.31 higher probability of developing the disorder (95% CI: 1.85-2.89; p < 0.001). Students who considered themselves tense or nervous presented 8.74 higher probability (95% CI: 7.03-10.86; p < 0.001) of developing TMD. Conclusion: This study showed a high prevalence of TMD in children and adolescents in southern Portugal, and revealed a significant association between this dysfunction and the levels of emotional stress. Female students, older students, and those considered tense or nervous have a higher probability of developing TMD. PMID:24741551

  8. Association of temporomandibular disorder symptoms with anxiety and depression in Portuguese college students.

    PubMed

    Minghelli, Beatriz; Morgado, Marcos; Caro, Tatiana

    2014-01-01

    We investigated the prevalence of temporomandibular disorder (TMD) and its association with anxiety and depression among 1,493 Portuguese college students (age 17-69 years) at Piaget Institute. The assessment instruments were the Fonseca Anamnestic Questionnaire and the Hospital Anxiety and Depression Scale. TMD was present in 633 (42.4%) students, and anxiety or depression was present in 456 (30.5%) students. Regarding the association of TMD with anxiety and depression, 280 of the 633 students (61.4%) with TMD symptoms also had signs of anxiety or depression (P < 0.001). As compared with men, women had an odds ratio of 1.9 (95% confidence interval: 1.53-2.46; P < 0.001) for TMD. As compared with students without signs of anxiety or depression, students with such signs had an odds ratio of 3.1 (95% confidence interval: 2.42-3.84; P < 0.001) for TMD. College students from various fields of study and regions of Portugal had a high prevalence of TMD, which was significantly associated with anxiety and depression. PMID:24930749

  9. TENS AND LOW-LEVEL LASER THERAPY IN THE MANAGEMENT OF TEMPOROMANDIBULAR DISORDERS

    PubMed Central

    Kato, Melissa Thiemi; Kogawa, Evelyn Mikaela; Santos, Carlos Neanes; Conti, Paulo César Rodrigues

    2006-01-01

    Pain relief and reestablishment of normal jaw function are the main goals of conservative management of Temporomandibular Disorders (TMD). Transcutaneous electrical nerve stimulation (TENS) and laser therapy are part of these modalities, although little is known about their real efficacy in controlled studies. This research compared these two treatments in a sample of 18 patients with chronic TMD of muscular origin, divided into two groups (LASER and TENS). Treatment consisted of ten sessions, in a period of 30 days. Active range of motion (AROM), visual analogue scale (VAS) of pain and muscle (masseter and anterior temporalis) palpation were used for follow-up analysis. Data were analyzed by Friedman test and ANOVA for repeated measurements. Results showed decrease in pain and increase in AROM for both groups (p<0.05), and improvement in muscle tenderness for the LASER group. Authors concluded that both therapies are effective as part of TMD management and a cumulative effect may be responsible for the improvement. Caution is suggested when analyzing these results because of the self-limiting feature of musculoskeletal conditions like TMD. PMID:19089044

  10. Histamine and substance P in synovial fluid of patients with temporomandibular disorders.

    PubMed

    Li, W; Long, X; Jiang, S; Li, Y; Fang, W

    2015-05-01

    Although psychosocial factors and malocclusion are regarded as potential causes of temporomandibular disorders (TMD), the underlying pathogenesis is poorly understood. Recent studies suggest that substance P (SP), which has been associated with both psychosocial factors and malocclusion, and histamine, whose release can be induced by SP, may be implicated in the pathogenetic process. This study was designed to measure the concentration of histamine and SP in synovial fluid (SF) of both 38 patients with TMD and 11 healthy controls, and analyse the correlation between histamine and SP. Patients with TMD were divided into three subgroups: displaced disc with reduction (DDR), displaced disc without reduction (DDNR) and osteoarthritis (OA), with 10, 13, 15 subjects in every subgroup, respectively. After collecting SF samples, histamine and SP levels were measured by enzyme-linked immunosorbent assay analysis (ELISA) and calibrated by bicinchoninic acid (BCA)-quantified protein level in the samples. The results suggest that OA group presented a significantly higher level of both histamine and SP than DDNR, DDR and healthy control groups. Histamine or SP in DDR and DDNR groups tend to be higher than control group, but no significance was found. Painful TMJs show higher histamine and SP than painless TMJs. Correlation analysis reveals a significant correlation between histamine and SP concentrations. Collectively, this study showed the changes of histamine and SP in the SF from different stages of TMD and found a significant correlation between the two substances, suggesting their potential implication in the pathogenesis of TMD. PMID:25545415

  11. Relationship between Temporomandibular Disorders, Widespread Palpation Tenderness and Multiple Pain Conditions: A Case - Control Study

    PubMed Central

    Chen, Hong; Slade, Gary; Lim, Pei Feng; Miller, Vanessa; Maixner, William; Diatchenko, Luda

    2012-01-01

    The multiple bodily pain conditions in temporomandibular disorders (TMD) have been associated with generalized alterations in pain processing. The purpose of this study was to examine the relationship between the presence of widespread body palpation tenderness (WPT) and the likelihood of multiple comorbid pain conditions in TMD patients and controls. This case-control study was conducted in 76 TMD subjects with WPT, 83 TMD subjects without WPT, and 181 non-TMD matched control subjects. The study population was also characterized for clinical pain, experimental pain sensitivity, and related psychological phenotypes. Results showed that (1) TMD subjects reported an average of 1.7 comorbid pain conditions compared to 0.3 reported by the control subjects (p<0.001); (2) Compared to control subjects, the odds ratio (OR) for multiple comorbid pain conditions is higher for TMD subjects with WPT [OR 8.4 (95% CI 3.1–22.8) for TMD with WPT versus OR 3.3 (95% CI 1.3–8.4) for TMD without WPT]; (3) TMD subjects with WPT presented with reduced pressure pain thresholds (PPTs) in both cranial and extra-cranial regions compared to TMD subjects without WPT; and (4) TMD subjects with WPT reported increased somatic symptoms. These findings suggest that pain assessment outside of the orofacial region may prove valuable for the classification, diagnosis, and management of TMD patients. PMID:23031401

  12. Age-related associations between psychological characteristics and pain intensity among Japanese patients with temporomandibular disorder.

    PubMed

    Komiyama, Osamu; Obara, Ryoko; Iida, Takashi; Nishimura, Hitoshi; Okubo, Masakazu; Uchida, Takashi; Shimosaka, Michiharu; Narita, Noriyuki; Niwa, Hideo; Kubo, Hideyuki; De Laat, Antoon; Kawara, Misao; Makiyama, Yasuhide

    2014-09-01

    We investigated the relationship between pain intensity and psychosocial characteristics in patients with temporomandibular disorder (TMD). Participants with painful TMD, according to the Research Diagnostic Criteria for TMD (RDC/TMD), were recruited from our clinic and classified into six age groups: 15 to 24, 25 to 34, 35 to 44, 45 to 54, 55 to 64, and 65 to 85 years (Groups A through F, respectively). Self-reported present pain intensity and worst pain intensity during the past 6 months were ascertained using a numeric rating scale (0 to 10). Depression and somatization scores were evaluated using the RDC/TMD axis II questionnaire. Among women, worst pain intensity was significantly lower in Groups E and F than in Groups B and C (P < 0.05). In Groups A, C, and D, depression scores were significantly higher in women than in men (P < 0.05). Among women, depression score was significantly lower in Group F than in Groups A through C (P < 0.05). In Groups A through D, somatization scores were significantly higher for women than for men (P < 0.05). Depression score and TMD symptom severity appear to decrease with age in women. PMID:25231149

  13. The role of occlusal factors on the occurrence of temporomandibular disorders.

    PubMed

    Sousa, Stéphanie Trajano de; Mello, Victor Villaça Cardoso de; Magalhães, Bruno Gama; Morais, Mariana Pacheco Lima de Assis; Vasconcelos, Marcia Maria Vendiciano Barbosa; Junior, Arnaldo de França Caldas; Gomes, Simone Guimarães Farias

    2014-07-16

    Aims: The aim of this study was to investigate the relationship between occlusal factors and temporomandibular disorders (TMD). Methodology: One hundred patients were selected among those who sought medical or dental care in public practice in Recife, Brazil. The presence of malocclusions and absence of five or more posterior teeth were evaluated by the clinical exam. TMD diagnosis was given using Research Diagnostic Criteria (RDC/TMD). Statistics were carried out using Fisher and Mann-Whitney methods with 5% significance level, as well as multiple logistic regression analysis. Results: The sample was mainly comprised of women (83%), individuals over 30 years old (57%) and singles (53%). The percentage of TMD and malocclusion in total sample was 42% and 50%, respectively, while in TMD subjects, malocclusion was present in 38·1%. There was no association between TMD and the occlusal factors studied. Conclusion: It can be concluded that malocclusion and loss of five or more posterior teeth does not contribute to TMD. PMID:25027731

  14. Differential brain activity in subjects with painful trigeminal neuropathy and painful temporomandibular disorder.

    PubMed

    Youssef, Andrew M; Gustin, Sylvia M; Nash, Paul G; Reeves, Jenna M; Petersen, Esben T; Peck, Chris C; Murray, Greg M; Henderson, Luke A

    2014-03-01

    Human brain imaging investigations have revealed that acute pain is associated with coactivation of numerous brain regions, including the thalamus, somatosensory, insular, and cingulate cortices. Surprisingly, a similar set of brain structures is not activated in all chronic pain conditions, particularly chronic neuropathic pain, which is associated with almost exclusively decreased thalamic activity. These inconsistencies may reflect technical issues or fundamental differences in the processing of acute compared with chronic pain. The appreciation of any differences is important because better treatment development will depend on understanding the underlying mechanisms of different forms of pain. In this investigation, we used quantitative arterial spin labeling to compare and contrast regional cerebral blood flow (CBF) patterns in individuals with chronic neuropathic orofacial pain (painful trigeminal neuropathy) and chronic nonneuropathic orofacial pain (painful temporomandibular disorder). Neuropathic pain was associated with CBF decreases in a number of regions, including the thalamus and primary somatosensory and cerebellar cortices. In contrast, chronic nonneuropathic pain was associated with significant CBF increases in regions commonly associated with higher-order cognitive and emotional functions, such as the anterior cingulate and dorsolateral prefrontal cortices and the precuneus. Furthermore, in subjects with nonneuropathic pain, blood flow increased in motor-related regions as well as within the spinal trigeminal nucleus. PMID:24269492

  15. General health status and incidence of first-onset temporomandibular disorder: OPPERA prospective cohort study

    PubMed Central

    Sanders, Anne E.; Slade, Gary D.; Bair, Eric; Fillingim, Roger B.; Knott, Charles; Dubner, Ronald; Greenspan, Joel D.; Maixner, William; Ohrbach, Richard

    2013-01-01

    Temporomandibular disorders (TMD) overlap with other health conditions but no study has examined which of these conditions increase the risk of developing first-onset TMD. The authors prospectively evaluated the relationship between health status at enrollment and subsequent incidence of TMD in 2,722 men and women. Participants aged 18–44 years had no history of TMD and were clinically free of TMD when enrolled in 2006–08 at four U.S. study sites in the OPPERA prospective cohort study. First-onset examiner-classified TMD developed in 260 people over a median 2.8 years of follow-up. Cox regression estimated the association between health conditions and TMD incidence while accounting for potential confounders. Incidence of first-onset TMD was 50% higher for people with lower back pain (adjusted hazard ratio [AHR] = 1.50, 95% confidence limits [95% CL]: 1.08, 2.10) and 75% higher for people with genital pain symptoms (AHR = 1.75 [95% CL: 1.04, 2.93]) than people without a history of these pain disorders. Digit ratio, a marker of intra-uterine exposure to sex hormones, was significantly associated with TMD incidence. Other independent predictors of first-onset TMD were sleep disturbance and cigarette smoking. These findings reveal multiple-influences of health status on incidence of first-onset TMD. PMID:24275223

  16. Pain Catastrophizing and Salivary Cortisol Responses to Laboratory Pain Testing in Temporomandibular Disorder and Healthy Participants

    PubMed Central

    Quartana, Phillip J.; Buenaver, Luis F.; Edwards, Robert R.; Klick, Brendan; Haythornthwaite, Jennifer A.; Smith, Michael T.

    2009-01-01

    Pain catastrophizing is an important variable in the context of acute and chronic pain. The neurophysiological correlates of pain catastrophizing, however, have not been rigorously evaluated. We examined the relationship between trait pain catastrophizing and morning salivary cortisol levels before and following a 45-minute laboratory pain testing session in healthy, pain-free (n=22) and temporomandibular disorder (TMD) participants (n=39). We also examined whether TMD patients evidenced generalized hyperalgesia and hypercortisolism. Pain catastrophizing was associated with a flattened morning salivary cortisol profile in the context of pain testing, irrespective of pain status. Cortisol profiles did not differ between healthy and TMD participants. TMD was associated with mechanical hyperalgesia only at the masseter. These data are the first to show an association between pain catastrophizing and elevated salivary cortisol profiles in the context of standardized experimental pain testing. These findings in both healthy individuals and those with chronic orofacial pain suggest that aberrant adrenocortical responses to pain may serve as a neurophysiologic pathway by which pain catastrophizing enhances vulnerability for development of chronic pain and maintains and/or exaggerates existing pain and associated morbidity. Perspective Neurophysiological mechanisms by which pain catastrophizing is related to acute and chronic pain recently have come under empirical study. Understanding of these mechanisms has the unique potential to shed light on key central nervous system factors that mediate catastrophizing-pain relations and therapeutic benefits associated with changes in catastrophizing and related cognitive processes. PMID:19853521

  17. Self-reported aural symptoms, headache and temporomandibular disorders in Japanese young adults

    PubMed Central

    2013-01-01

    Background To investigate the associations of aural symptoms, headache and depression with the presence of temporomandibular disorder (TMD) symptoms in a young adult population in Japan. Methods A personal interview survey was conducted on first-year university students (n?=?1,930) regarding symptoms of TMD, aural problems, headache, shoulder pain and depression. Logistic regression was applied to assess the associations of these problems with the presence of TMD symptoms after controlling for age and gender. Results Among the 1,930 students, 543 students exhibited TMD symptoms and were classified into 7 groups: clicking only (Group I, n?=?319), pain in the TMJ only (Group II, n?=?21), difficulty in mouth opening only (Group III, n?=?18), clicking and pain (Group IV, n?=?29), clicking and difficulty in mouth opening (Group V, n?=?48), difficulty in mouth opening and pain (Group VI, n?=?11), and combination of three symptoms (Group VII, n?=?97). The control group (n?=?1,387) were subjects without any TMD symptoms. After adjusting for age and gender, a strong association was observed between TMD symptoms (Group II and IV) and tinnitus (OR?=?12.1 and 13.2, respectively). TMD symptoms (Group I, II and III) were also associated with vertigo and headache. Otalgia and depression were significantly associated with the presence of clicking only. Conclusions TMD symptoms were significantly correlated to aural symptoms and headache. A functional evaluation of the stomatognathic system should be considered in subjects with unexplained aural symptoms and headache. PMID:23384362

  18. Joint and distinct risk factors associated with micro- and macrovascular complications in a cohort of type 2 diabetic patients cared through disease management

    Microsoft Academic Search

    Anna V. CiardulloM; M. Monica Daghio; Massimo Bevini; Gaetano Feltri; Doriano Novi; Giuseppe Fattori; Silvana Borsari; Carlo Di Donato

    2010-01-01

    We analysed the risk factors associated with diabetic complications in the cohort of patients assisted by a type 2 diabetes\\u000a mellitus (T2DM) shared-care program. We analysed registry data from 16,136 T2DM patients. Of them, 4,781 had microangiopathy,\\u000a 3,469 CV events. They were 70.5 ± 17.1 years old, 50% were male, disease duration 13.3 ± 7.8 years, BMI 28.7 ± 4.9 kg\\/m2, HbA1c 7.08 ± 1.23%, FBG 134.7 ± 35.7 mg\\/dl, 2hPPBG 163.9 ± 47.8 mg\\/dl, 12.5% smokers.

  19. Mandibular Condyle Reconstruction with Free Costochondral Grafting

    Microsoft Academic Search

    Christian Lindqvist

    Reconstruction of the temporomandibular articulation is one of the most demanding challenges in maxillofacial surgery. The\\u000a goals include not only rehabilitation of the complex mechanism of the normal joint, but restoration of facial symmetry, occlusion,\\u000a and mastication. As advanced temporomandibular joint (TMJ) disease can lead to disturbances in these features and functions,\\u000a this often constitutes major indications for arthroplastic procedures.

  20. Temporomandibular disorders with skeletal open bite treated with stabilization splint and zygomatic miniplate anchorage: A case report.

    PubMed

    Song, Fang; He, Shushu; Chen, Song

    2015-03-01

    This case report describes the treatment of a patient with temporomandibular disorder (TMD) and skeletal open bite. First, the patient was treated with a stabilization splint to stabilize the condyles in centric relation and to alleviate TMD signs and symptoms. After making a definitive diagnosis from postsplint records, orthodontic treatment was initiated. Titanium miniplates were placed at bilateral zygomatic buttresses and used as orthodontic anchorage for molar intrusion and distalization. The treatment was completed after 30 months. Satisfactory appearance and function were achieved for this patient. PMID:24773222

  1. The Flavin-Containing Monooxygenase 3 Gene and Essential Hypertension: The Joint Effect of Polymorphism E158K and Cigarette Smoking on Disease Susceptibility

    PubMed Central

    Bushueva, Olga; Solodilova, Maria; Churnosov, Mikhail; Ivanov, Vladimir; Polonikov, Alexey

    2014-01-01

    Gene encoding flavin-containing monooxygenase 3 (FMO3), a microsomal antioxidant defense enzyme, has been suggested to contribute to essential hypertension (EH). The present study was designed to investigate whether common functional polymorphism E158K (rs2266782) of the FMO3 gene is associated with EH susceptibility in a Russian population. A total of 2?995 unrelated subjects from Kursk (1?362 EH patients and 843 healthy controls) and Belgorod (357 EH patients and 422 population controls) regions of Central Russia were recruited for this study. DNA samples from all study participants were genotyped for the FMO3 gene polymorphism through PCR followed by RFLP analysis. We found that the polymorphism E158K is associated with increased risk of essential hypertension in both discovery population from Kursk region (OR 1.36?95% CI 1.09–1.69, P = 0.01) and replication population from Belgorod region (OR 1.54 95% CI 1.07–1.89, P = 0.02) after adjustment for gender and age using logistic regression analysis. Further analysis showed that the increased hypertension risk in carriers of genotype 158KK gene occurred in cigarette smokers, whereas nonsmoker carriers of this genotype did not show the disease risk. This is the first study reporting the association of the FMO3 gene polymorphism and the risk of essential hypertension. PMID:25243081

  2. European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fungal Infection Study Group (EFISG) and European Confederation of Medical Mycology (ECMM) 2013 joint guidelines on diagnosis and management of rare and emerging fungal diseases.

    PubMed

    Cornely, O A; Cuenca-Estrella, M; Meis, J F; Ullmann, A J

    2014-04-01

    This guideline is the second in the line of three for fungal diseases by ESCMID and other societies. The guideline tried to follow the AGREE criteria for the development of clinical guidelines. This guideline serves as a European and potentially world-wide recommendation for the diagnosis and management of rare and emerging fungi. They include mucormycosis, hyalohyphomycosis (Fusarium, Paecilomyces, Scedosporium, etc.), phaeohyphomycosis (Alternaria, Bipolaris, Cladosporium, Rhinocladiella, etc.), and emerging yeasts (Saccharomyces, Trichosporon, Rhodotorula, etc.). PMID:24606200

  3. Comparison of TMJ vibration frequencies under different joint conditions.

    PubMed

    Radke, John C; Kull, Robert S

    2014-07-31

    Objective: To compare 10 Hz wide segments of the 0 to 1000 Hz frequency distributions of vibrations recorded from five stages of internally deranged and asymptomatic temporomandibular joints (TMJs). Methods: TMJ vibrations were recorded from 236 patients with five stages of TMJ dysfunction: (1) reducing partial disc displacement (PDDR, n?=?39); (2) acute reducing complete disc displacement (A-DDR, n?=?39); (3) chronic reducing complete disc displacement (C-DDR, n?=?55); (4) un-adapted, non-reducing, complete disc displacement (DDUA, n?=?57); and (5) well adapted, non-reducing, complete disc displacement (DDWA, n?=?46). A totally asymptomatic control group with quiet TMJs (AQ, n?=?43) and a group with vibrating TMJs (AWV, n?=?93), but otherwise asymptomatic were also recorded. Frequency distributions were calculated for each group using discrete Fourier transform methods in 10 Hz increments (0-10 Hz, 10-20 Hz,…, 990-1000 Hz). The 10 Hz segments were compared between the seven groups using Student's t test with Bonferroni adjustment. Results: There were significant differences (P<0·05) in all 21 comparisons for the three segments between 80 Hz and 110 Hz, in 20 of 21 comparisons between 180 and 200 Hz, in 19 of 21 comparisons between 110 and 180 Hz and between 50 and 80 Hz. Discussion: The segments of the frequency distributions from 80 to 110 Hz provided the best differentiation between all seven groups. PMID:25079855

  4. Conventional diagnostic challenges in periprosthetic joint infection.

    PubMed

    Nodzo, Scott R; Bauer, Thomas; Pottinger, Paul S; Garrigues, Grant E; Bedair, Hany; Deirmengian, Carl A; Segreti, John; Blount, Kevin J; Omar, Imran M; Parvizi, Javad

    2015-04-01

    Periprosthetic joint infection remains a clinical challenge with no benchmark for diagnosis. The diagnosis is based on many different clinical variables that may be difficult to interpret, especially in the setting of chronic systemic disease. Synovial fluid aspiration, diagnostic imaging, traditional culture, peripheral serum inflammatory markers, and intraoperative frozen sections each have their limitations but continue to be the mainstay for diagnosis of periprosthetic joint infection. As molecular- and biomarker-based technologies improve, the way we interpret and diagnose periprosthetic joint infection will ultimately change and may even improve diagnostic accuracy and turnaround time. Future research on this topic should be focused on improving diagnostic criteria for low-virulence organisms, improving interpretation of intraoperative frozen sections, and establishing improved synovial fluid and peripheral serum biomarker profiles for periprosthetic joint infection. PMID:25808966

  5. Chronic myofascial temporomandibular pain is associated with neural abnormalities in the trigeminal and limbic systems

    PubMed Central

    Shen, Yoshi F.; Goddard, Greg; Mackey, Sean C.

    2010-01-01

    Myofascial pain of the temporomandibular region (M-TMD) is a common, but poorly understood chronic disorder. It is unknown whether the condition is a peripheral problem, or a disorder of the central nervous system (CNS). To investigate possible CNS substrates of M-TMD, we compared the brain morphology of 15 women with M-TMD to 15 age- and gender-matched healthy controls. High-resolution structural brain and brainstem scans were carried out using magnetic resonance imaging (MRI), and data were analyzed using a voxel-based morphometry approach. The M-TMD group evidenced decreased or increased gray matter volume compared to controls in several areas of the trigeminothalamocortical pathway, including brainstem trigeminal sensory nuclei, the thalamus, and the primary somatosensory cortex. In addition, M-TMD individuals showed increased gray matter volume compared to controls in limbic regions such as the posterior putamen, globus pallidus, and anterior insula. Within the M-TMD group, jaw pain, pain tolerance, and pain duration were differentially associated with brain and brainstem gray matter volume. Self-reported pain severity was associated with increased gray matter in the rostral anterior cingulate cortex and posterior cingulate. Sensitivity to pressure algometry was associated with decreased gray matter in the pons, corresponding to the trigeminal sensory nuclei. Longer pain duration was associated with greater gray matter in the posterior cingulate, hippocampus, midbrain, and cerebellum. The pattern of gray matter abnormality found in M-TMD individuals suggests the involvement of trigeminal and limbic system dysregulation, as well as potential somatotopic reorganization in the putamen, thalamus, and somatosensory cortex. PMID:20236763

  6. Effect of Occlusal Splints on the Temporomandibular Disorders, Dental Wear and Anxiety of Bruxist Children

    PubMed Central

    Restrepo, Claudia C.; Medina, Isabel; Patiño, Isabel

    2011-01-01

    Objectives: To evaluate the effectiveness of occlusal splints to reduce the signs and symptoms of temporomandibular disorders (TMD), dental wear and anxiety in a group of bruxist children. Methods: All of the subjects were 3 to 6 years old, had complete primary dentition, class I occlusion and were classified as bruxist according to the minimal criteria of the ICSD for bruxism. For each child, anxiety was evaluated with the Conners’ Parent Rating Scales (CPRS). The TMD were evaluated using the RDC/TMD. The dental wear was processed in digital format with Mat Lab® and Lab view® software to determine its size and form. The children were randomized into an experimental (n=19) and a control (n=17) group. The children in the experimental group used rigid bite plates for a two-year period, until mixed dentition. Afterwards, the CPRS and the RDC/TMD were applied again and dental casts were taken. Comparisons of the variables regarding dental wear, signs and symptoms of TMD and anxiety before and after treatment among the groups were analyzed using the t-test, the Wilcoxon rank sum test and the Mann-Whitney test. Results: The subjects in the experimental group showed no statistically significant difference regarding anxiety levels and dental wear when compared with the control group. The signs and symptoms of TMD were not reduced except for the deviation in mouth opening. Conclusions: The use of rigid occlusal bite plates was not efficient in reducing the signs of bruxism as a whole but did reduce the deviation in mouth opening. PMID:21912500

  7. Effect of hypnotic pain modulation on brain activity in patients with temporomandibular disorder pain.

    PubMed

    Abrahamsen, Randi; Dietz, Martin; Lodahl, Sanne; Roepstorff, Andreas; Zachariae, Robert; Østergaard, Leif; Svensson, Peter

    2010-12-01

    Hypnosis modulates pain perception but the associated brain mechanisms in chronic pain conditions are poorly understood. Brain activity evoked by painful repetitive pin-prick stimulation of the left mental nerve region was investigated with use of fMRI in 19 patients with painful temporomandibular disorders (TMD) during hypnotic hypoalgesia and hyperalgesia and a control condition. Pain intensity and unpleasantness of the painful stimulation was scored on a 0-10 Numerical Rating Scale (NRS). NRS pain and unpleasantness scores during hypnotic hypoalgesia were significantly lower than in the control condition and significantly higher in the hypnotic hyperalgesia condition. In the control condition, painful stimulation caused significant activation of right posterior insula, primary somatosensory cortex (SI), BA21, and BA6, and left BA40 and BA4. Painful stimulation during hypnotic hyperalgesia was associated with increased activity in right posterior insula and BA6 and left BA40 whereas hypnotic hypoalgesia only was associated with activity in right posterior insula. Unexpectedly, direct contrasts between control and hypnotic hyperalgesia conditions revealed significant decreases in S1 during hyperalgesia. Direct contrasts between control and hypnotic hypoalgesia conditions demonstrated significant decreases in right posterior insula and BA21, as well as left BA40 during hypoalgesia. These findings are the first to describe hypnotic modulation of brain activity associated with nociceptive processing in chronic TMD pain patients and demonstrate that hypnotic hypoalgesia is associated with a pronounced suppression of cortical activity and a disconnection between patient-based scores and cortical activity in S1 during hypnotic hyperalgesia. PMID:20933331

  8. Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

    PubMed Central

    Lopes, Sérgio Lúcio Pereira de Castro; Costa, André Luiz Ferreira; Gamba, Thiago de Oliveira; Cruz, Adriana Dibo; Min, Li Li

    2015-01-01

    Purpose Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Materials and Methods Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Results Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. Conclusion In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

  9. Sensitivity of the jaw-jerk reflex in patients with myogenous temporomandibular disorder.

    PubMed

    Lobbezoo, F; van der Glas, H W; van der Bilt, A; Buchner, R; Bosman, F

    1996-06-01

    Changes in the activity of human jaw-elevator muscles related to the mandibular stretch (jaw-jerk) reflex could be involved in the aetiology of temporomandibular disorders (TMD). In order to investigate whether there are differences in the sensitivity of the jaw-jerk reflex between myogenous TMD patients (n = 10) and gender- and age-matched controls (n = 10), jaw-jerk reflexes were elicited under standardized conditions. By measuring the reflex with bipolar surface electromyography (EMG), reflex sensitivity was determined from relations between reflex amplitude and jaw displacement from the masseter and the anterior temporalis muscles. Reflex amplitude and background EMG activity were normalized with respect to the maximal voluntary contraction (MVC) to correct for differences in the thickness of soft tissues overlying the muscle or in electrode placement. In addition to normalization with respect to MVC, for the patients, normalization was also applied with respect to a MVC that was scaled by multiplying values by the ratio of the mean MVC of controls to the mean MVC of patients. At a constant level of background EMG activity, the reflex sensitivity can be determined from the slope (reflex gain) and x-intercept (reflex threshold) of the reflex amplitude-jaw displacement relation. No significant differences between patients and controls were found for the gain or threshold values of either the masseter or the anterior temporalis muscles with a univariate analysis of variance. It is concluded that jaw-jerk reflex sensitivity is not significantly changed in myogenous TMD patients. Therefore, the fusimotor system probably does not play a part in the perpetuating myogenous TMD. PMID:8937646

  10. Multiple postnatal craniofacial anomalies are characterized by conditional loss of polycystic kidney disease 2 (Pkd2).

    PubMed

    Khonsari, Roman H; Ohazama, Atsushi; Raouf, Ramin; Kawasaki, Maiko; Kawasaki, Katsushige; Porntaveetus, Thantrira; Ghafoor, Sarah; Hammond, Peter; Suttie, Michael; Odri, Guillaume A; Sandford, Richard N; Wood, John N; Sharpe, Paul T

    2013-05-01

    Polycystin 2 (Pkd2), which belongs to the transient receptor potential family, plays a critical role in development. Pkd2 is mainly localized in the primary cilia, which also function as mechanoreceptors in many cells that influence multiple biological processes including Ca(2+) influx, chemical activity and signalling pathways. Mutations in many cilia proteins result in craniofacial abnormalities. Orofacial tissues constantly receive mechanical forces and are known to develop and grow through intricate signalling pathways. Here we investigate the role of Pkd2, whose role remains unclear in craniofacial development and growth. In order to determine the role of Pkd2 in craniofacial development, we located expression in craniofacial tissues and analysed mice with conditional deletion of Pkd2 in neural crest-derived cells, using Wnt1Cre mice. Pkd2 mutants showed many signs of mechanical trauma such as fractured molar roots, distorted incisors, alveolar bone loss and compressed temporomandibular joints, in addition to abnormal skull shapes. Significantly, mutants showed no indication of any of these phenotypes at embryonic stages when heads perceive no significant mechanical stress in utero. The results suggest that Pkd2 is likely to play a critical role in craniofacial growth as a mechanoreceptor. Pkd2 is also identified as one of the genes responsible for autosomal dominant polycystic kidney disease (ADPKD). Since facial anomalies have never been identified in ADPKD patients, we carried out three-dimensional photography of patient faces and analysed these using dense surface modelling. This analysis revealed specific characteristics of ADPKD patient faces, some of which correlated with those of the mutant mice. PMID:23390131

  11. Evaluation of functional and esthetic outcome after correction of mandibular hypoplasia secondary to temporomandibular ankylosis treated by distraction osteogenesis.

    PubMed

    Gupta, Gaurav Mahesh; Gupta, Pranjali; Sharma, Ashish; Patel, Nehal; Singh, Abhishek

    2014-06-01

    Patient with TMJ ankylosis are affected with mandibular hypoplasia which in turn causes functional and esthetic problems. Restoration of normal function and esthetics is the prime goal in treatment of such patients with distraction becoming an important treatment option. The present study also was conducted on patients with mandibular hypoplasia secondarily to TMJ ankylosis treated with distraction. Since function and esthetics improvement was the prime aim behind the treatment with distraction, evaluation of functional and esthetics outcome becomes an important aspect. Thus the study was indigenously designed and aimed at qualitative evaluation of the functional and esthetic outcome after correction of mandibular hypoplasia secondary to temporomandibular ankylosis with Distraction osteogenesis. Patients treated with distraction were evaluated on the basis of parameters for function and esthetics. Parameters for function were occlusion, airway, mouth opening and chewing-biting perception of patient pre and post distraction. Parameters for esthetics used were patient and panel perception. All parameters for function and occlusion improved with distraction in all the patients except one in whom occlusion and chewing- biting pattern worsened. It is concluded that distraction is a good option for improving patients functional and esthetic outcome in cases of mandibular hypoplasia secondary to temporomandibular ankylosis as the results achieved are stable with negligible chances of relapse. PMID:24822007

  12. ARTHRITIS AND NATURE'S JOINTS NEIL E. WILLIAMS (University at Buffalo)

    E-print Network

    Williams, Neil E.

    ARTHRITIS AND NATURE'S JOINTS NEIL E. WILLIAMS (University at Buffalo) forthcoming: MIT Press Carving Nature at its Joints ­ Topics in Contemporary Philosophy V. 8. Abstract The thought that diseases form natural kinds tends not to sit well with the essentialist treatment of natural kinds

  13. Ecology of Infectious Diseases

    NSDL National Science Digital Library

    A joint National Science Foundation (NSF) and National Institutes of Health program, Ecology of Infectious Diseases (EID), allows scientists to study how large-scale environmental events—such as habitat destruction, invasions of non-native species and pollution—alter the risks of emergence of viral, parasitic and bacterial diseases in humans and animals. Specific infectious diseases being studied include hantavirus, Lyme Disease, and Chronic Wasting Disease (CWD).

  14. Rothia prosthetic knee joint infection: report and mini-review

    PubMed Central

    Mahobia, N; Chaudhary, P; Kamat, Y

    2013-01-01

    Rothia spp. are gram-positive pleomorphic bacteria that are part of the normal oral microflora. They are associated with dental and periodontal disease, although systemic infections have also been reported. We describe the case of a 75-year-old lady with rheumatoid arthritis who presented with prosthetic knee joint infection due to Rothia aeria. We discuss its identification and the evidence regarding association of dental disease with Rothia spp. joint infections based on available literature. PMID:25356316

  15. Rothia prosthetic knee joint infection: report and mini-review.

    PubMed

    Mahobia, N; Chaudhary, P; Kamat, Y

    2013-10-01

    Rothia spp. are gram-positive pleomorphic bacteria that are part of the normal oral microflora. They are associated with dental and periodontal disease, although systemic infections have also been reported. We describe the case of a 75-year-old lady with rheumatoid arthritis who presented with prosthetic knee joint infection due to Rothia aeria. We discuss its identification and the evidence regarding association of dental disease with Rothia spp. joint infections based on available literature. PMID:25356316

  16. Hyaluronan and synovial joint: function, distribution and healing

    PubMed Central

    2013-01-01

    Synovial fluid is a viscous solution found in the cavities of synovial joints. The principal role of synovial fluid is to reduce friction between the articular cartilages of synovial joints during movement. The presence of high molar mass hyaluronan (HA) in this fluid gives it the required viscosity for its function as lubricant solution. Inflammation oxidation stress enhances normal degradation of hyaluronan causing several diseases related to joints. This review describes hyaluronan properties and distribution, applications and its function in synovial joints, with short review for using thiol compounds as antioxidants preventing HA degradations under inflammation conditions. PMID:24678248

  17. Campylobacter Prosthetic Joint Infection

    PubMed Central

    Vasoo, Shawn; Schwab, Jeramy J.; Cunningham, Scott A.; Robinson, Trisha J.; Cass, Joseph R.; Berbari, Elie F.; Walker, Randall C.; Osmon, Douglas R.

    2014-01-01

    A 75-year-old man was diagnosed with probable Campylobacter jejuni prosthetic knee infection after a diarrheal illness. Joint aspirate and operative cultures were negative, but PCR of prosthesis sonicate fluid was positive, as was stool culture. Nineteen additional cases of Campylobacter prosthetic joint infection reported in the literature are reviewed. PMID:24523462

  18. Behavior of jointed pipelines

    Microsoft Academic Search

    Singhal

    1984-01-01

    Experimental data on the axial, bending and torsional behavior of ductile cast iron pipes with rubber gasket joints is presented. Analytical expressions are provided which predict the resistance mechanisms and behavior of the joints. The bending mechanism is found to be quite different from the axial and torsional mechanism. By repeating the tests in a specially designed soil box, the

  19. Wedge Joints for Trusses

    NASA Technical Reports Server (NTRS)

    Wood, Kenneth E.

    1987-01-01

    Structure assembled rapidly with simple hand tools. Proposed locking wedge joints enable rapid assembly of lightweight beams, towers, scaffolds, and other truss-type structures. Lightweight structure assembled from tubular struts joined at nodes by wedge pins fitting into mating slots. Joint assembled rapidly by seating wedge pin in V-shaped slots and deforming end of strut until primary pawl engages it.

  20. Strategies for joint appointments.

    PubMed

    Royle, J; Crooks, D L

    1985-01-01

    The structure and policies governing joint appointments discussed above, are developed primarily through cooperation and collaboration between nursing service and education institutions. The joint appointee participates in the process of negotiation of salary, benefits and role responsibilities and exploration of the implications of the appointment for personal career development. Implementation and maintenance of the appointment requires the collaborative efforts of the joint appointee with both contracting agencies. Factors influencing the functioning of joint appointees have been identified and strategies to facilitate functioning presented. The joint appointee must be independent in thought and action yet adaptable to work within the boundaries of two social systems with differing values and expectations. Nursing management, peers and students can provide the support needed to overcome the frustrations and to achieve the rewards inherent in successful implementation of an exciting and innovative role. PMID:3852805