Changes In Temporomandibular Joint Research Articles

Three-dimensional quantitative temporomandibular joint changes in skeletal class I malocclusion treated with extraction and non-extraction protocols: a comparative study of fixed orthodontic appliances and clear aligners

ObjectiveThis study aimed to evaluate the positional and morphological changes in the temporomandibular joint (TMJ) in adult patients with skeletal Class I malocclusion treated with fixed orthodontic appliances (FAs) and clear aligners (CAs), both with and without premolar extractions.MethodsThis retrospective study involved 120 adult patients divided into non-extraction and extraction groups, each further subdivided equally into those treated with FAs and CAs. Cone beam computed tomography (CBCT) was used to assess the TMJ measurements before (T0) and after treatment (T1). Statistical analyses were conducted to compare the mean changes in intra- and inter-groups. A significance level of p ≤ 0.05 was considered.ResultsIn the non-extraction group, specifically in FAs, significant increases were observed in TMJ parameters; anteroposterior condylar position (APCP) and mediolateral condylar inclination (MCI). Conversely, significant decreases were noted in vertical condylar position (VCP) and vertical condylar inclination (VCI). In the extraction group, significant increases were noted in APCP and anterior joint space (AJS), while posterior joint space (PJS) and anteroposterior condylar joint position (APCJP) decreased. For inter-group comparisons, the extraction group showed significant increases in APCP in FAs compared to CAs, and a significant decrease in APCJP in FAs compared to CAs.ConclusionFAs significantly impact condylar positions and joint spaces, especially in extraction cases. Monitoring TMJ parameters during orthodontic treatment is crucial to ensure positive outcomes and prevent TMJ disorders (TMDs). These findings may guide the selection of orthodontic appliances based on individual malocclusion characteristics.

Osteoarthritis-like changes in rat temporomandibular joint induced by unilateral anterior large overjet treatment

Temporomandibular joint osteoarthritis (TMJOA) is a common degenerative disease that causes chronic pain and joint dysfunction. However, the current understanding of TMJOA pathogenesis is limited and necessitates further research. Animal models are crucial for investigating TMJOA due to the scarcity of clinical samples. Class II malocclusion is an occlusal type highly associated with TMJOA, but it currently lacks appropriate animal models for simulating this malocclusion in research. Therefore, this study develops a new malocclusion model using a unilateral anterior large overjet (UALO) dental device to cause Class II malocclusion characteristics and TMJOA-like pathological alterations in rats. By inducing a posteriorly positioned condyle, the UALO device effectively results in cartilage degradation, subchondral bone loss, condylar volume reduction, and mandibular retrusion. Furthermore, RNA sequencing of condylar cartilages revealed that the oxidative stress of chondrocytes was elevated under the UALO-triggered abnormal mechanical stress. Disruption of antioxidant systems and mitochondrial dysfunction are involved in cartilage degeneration. The current study provides a novel and reliable rat model suitable for TMJOA research and offers insights into the disease’s potential mechanistic pathways and molecular targets, contributing to a deeper understanding of TMJOA.

Three-dimensional assessment of temporomandibular joint changes following maxillomandibular advancement surgery: a five-year follow-up study.

This study aimed to evaluate changes of the temporomandibular joint (TMJ) following maxillomandibular advancement surgery (MMA), long-term postoperative skeletal relapse, and progressive condylar resorption (PCR) development. Preoperative and postoperative cone beam computed tomography(2 weeks, 5 years) of 50 patients (33 female, 17 male; mean age 25.6 years) were assessed three-dimensionally. Compared to the preoperative state, the largest long-term changes of the TMJ were observed in the condyles: mean volume decrease of 9.94% for the right condyle and 8.35% for the left. Condylar volume changes contributed most to the changes in condylar height (effect size right/left, η2 = 0.71/0.72) and horizontal postoperative skeletal relapse (η2 = 0.22/0.20). In contrast, glenoid fossa and joint space changes were modest and unassociated with skeletal relapse. Five female patients (10%) showed signs of PCR, with a mean reduction in condylar volume of 32%, a significant loss of condylar height and skeletal relapse. In conclusion, at 5 years following MMA, mainly condylar volume changes were observed, which had the largest effect on long-term postoperative skeletal relapse when compared to glenoid fossa and joint space changes. PCR occurred in 10% of the patients and was related to a significant loss of condylar height and skeletal relapse.

Morphological changes in temporomandibular joint architecture in patients with temporomandibular disorders: systematic review protocol

ObjectiveThe review involves the assessment of morphological variations in the temporomandibular joint (TMJ) and its associated structures in patients with temporomandibular disorder.IntroductionTemporomandibular disorders (TMD) are debilitating conditions that affect the...

Correlation Between Radiological Changes of the Temporomandibular Joint and Upper Cervical Vertebrae in Degenerative Joint Disease: A Cone-Beam Computed Tomography-Based Analytical Study.

Objectives This study was conducted to assess the radiological changes of the temporomandibular joint (TMJ) and cervical vertebrae individually and their correlation in degenerative joint disease (DJD) using a cone-beam computed tomography (CBCT)-based approach. Methodology The study employed a cross-sectional, analytical retrospective design, analyzing one-year data. CBCT scans of 60 patients (120 TMJs) were assessed for degenerative changes using standardized imaging parameters. Eligibility criteria included full field-of-view CBCT scans, excluding those with craniofacial anomalies or prior orthodontic treatment. Radiological assessments of TMJs and cervical vertebrae were conducted by experienced radiologists using the Anjos Pontual method and novel grading system (TMJ Spine Degenerative Severity Index). Results The study included 60 CBCT scans (120 joints), with 31.7% males and 68.3% females. Participants were predominantly aged 31-60 years (58.3%). DJDfindings for the right TMJ showed grade 1 changes in 55.0% and grade 2 in 31.7%, while the left TMJ had 46.7% grade 1 and 35.0% grade 2 changes. A strong positive correlation (0.704) was found between bilateral TMJ and cervical vertebrae changes. Age correlated significantly with TMJ alterations but not with cervical vertebrae changes. Conclusion This study demonstrated that there exists a positive association between the radiological changes of TMJ and cervical vertebrae in DJD with age, which can be detected in mild stage of severity on CBCTand can be of use in clinical correlation and application of optimal interventions ensuring better prognosis.

Improvement of the temporomandibular joint symptoms due to the condylar position change following modified L-shaped intraoral vertico-sagittal ramus osteotomy: a single-center, retrospective study.

Intraoral vertico-sagittal ramus osteotomy (IVSRO) was first reported by Choung in 1992 as a surgical procedure to decrease postoperative condylar dislocation. In 2017, Iwanaga et al. developed modified L-shaped IVSRO (mIVSRO) to reduce postoperative nerve dysfunction and achieved favorable outcomes. This study aimed to clarify the effect of mIVSRO on changes in temporomandibular joint (TMJ) symptoms and three-dimensional condylar position. We conducted a retrospective study of thirty sides in fifteen Japanese adults diagnosed with jaw deformities who underwent mIVSRO and sagittal split ramus osteotomy (SSRO). TMJ symptoms were assessed chronologically, and the condylar long axis and the condylar position were analyzed two- and three-dimensionally using axial cephalograms and cone-beam computed tomography. Postoperative TMJ symptoms improved by 90% (9/10 sides) in the mIVSRO group and by 50% (7/14 sides) in the SSRO group. The mIVSRO group exhibited outward rotation of the condylar long axis, while the SSRO group exhibited inward rotation. Moreover, mIVSRO induced residual anteromedial-inferior deviation of the condyle. The inclination angle of the condylar process was not significantly different between the two procedures pre- and postoperatively. These results clearly demonstrated the effect of mIVSRO on symptomatic TMJ. Residual changes in the position of the condyle following mIVSRO may not affect jaw function.

Positional, morphologic, and volumetric differences in TMJ in unilateral posterior crossbites and controls: A retrospective CBCT study

The objective of this study was to evaluate if there are any morphologic, positional, and volumetric differences in the temporomandibular joint (TMJ) of patients with unilateral posterior crossbite (UPC) compared to controls. Another objective was to analyse the discrepancy in the TMJ between the crossbite versus non-crossbite side in UPC versus right and left sides in controls. Additionally, this study aimed to evaluate the differences in the bone density at the masseteric insertion site at the angle of mandible in the UPC group and control group. One hundred and thirty-two CBCTs were analysed with 66patients in UPC group and 66patients in control group (non-crossbite). Temporomandibular joint spaces-Anterior joint space (AJS), Superior joint space (SJS), Posterior joint space (PJS), Medial joint space (MJS), Middle joint space (MiJS), and Lateral joint space (LJS) were measured. Additionally, bone density at angle of mandible and volume of mandibular condyle were evaluated. The measurements were compared between the groups as well as between the crossbite and non-crossbite sides within the UPC group and between right and left sides within the control group. Furthermore, the associations between UPC and changes in TMJ regarding joint space availability, bone density, condylar head volume, and the effects of sex and age were evaluated using regression analysis. It was observed that UPC group showed a greater condylar volume, than the control group. Additionally, a larger mean discrepancy was observed between the crossbite side and non-crossbite side within the UPC group concerning condylar volume than controls. Concerning age, condylar volume was observed to be larger in adults than children. Adults showed significantly greater bone density and condylar volume than adolescents. Concerning sex, it was observed that males showed a larger SJS (right), MiJS, LJS, and bone density at the mandibular angle than females. There is a difference in the TMJ parameters particularly condylar volume in patients with UPC compared to controls.

The relation between persistent foramen tympanicum and degenerative bone alterations in temporomandibular joint region.

The aim of this study was to evaluate, using cone-beam computed tomography (CBCT), the relationship of persistent foramen tympanicum (PFT) with degenerative changes in the temporomandibular joint (TMJ) and the presence of pneumatized glenoid fossae and articular eminences. Two experienced oral and maxillofacial radiologists evaluated 510 CBCT scans, from which 94 patients were divided into two groups: G1-patients with PFT and G2-control group. The location of the PFT, presence, or absence of degenerative TMJ changes and morphology were evaluated. Similarly, all images were evaluated for the presence of pneumatized articular eminence and glenoid fossa. The Chi-square test and Fisher's Exact test were used for the categorical variables. A multinomial logistic regression model was performed for subgroup analysis. To assess the estimation-chance occurrence of TMJ alterations the Odds Ratio analysis was used. Statistically significant results were found for erosion, planning, and subchondral cyst. Regarding TMJ morphology, significant results were found for: round, flat, and others. Moreover, it was possible to observe that patients who had the PFT were approximately 48 times more likely to manifest TMJ alterations and approximately 3 times more likely to manifest articular eminence pneumatization. Since individuals who have FTP have a greater chance of having TMJ and PEA changes, it is important for the dental radiologist to be aware of these signs in CBCT scans for a correct diagnosis. CAAE: 34328214.3.0000.0104 (11/30/2014).

Radiological Aspects of Temporo-Mandibular Joint Osteoarthritis

This article is about applications of computed tomography (CT) in diagnosis of inflammatory and degenerative disease of temporomandibular joint (TMJ). CT is highly informative method forvisualization of disease of temporomandibular joint. Finally, sections on other aspects of CT research related to the TMJ, clinical decision-making and concluding remarks are added. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bonedestruction/production. Author of this research studied the frequency of radiological signs in different age group. In addition, there were studied frequency of isolated, combination types, and more and less localization sitesof radiological patterns of inflammatory and degenerative changes of temporo-mandibular joint

Correlation between temporomandibular joints and craniocervical posture in patients with bilateral anterial disc displacement

ObjectiveTo study the changes of temporomandibular joints and craniocervical posture in adult patients with bilateral anterior disc displacement, and to explore their correlation, which may provide some clinical value for clinical diagnosis and treatment planning.MethodsNinety-eight adult patients were divided into 3 groups: 29 patients in bilateral disc normal position group (BN), 33 patients in bilateral Anterior Disc Displacement With Reduction group (ADDWR) and 36 patients in bilateral Anterior Disc Displacement Without Reduction group (ADDWoR). Dolphin and Uceph software were used to measure 14 items of temporomandibular joint and 11 items of craniocervical posture for comparison and correlation analysis between groups.ResultsThere were significant differences in bilateral joint space between three groups. Compared with the BN, the anteroposterior diameter of the condyle was significantly reduced, the condyle was significantly displaced posteriorly and superiorly in the ADDWR and ADDWoR, but the joint fossa width and joint fossa depth did not change significantly. Cervical curvature and inclination were greater in patients with anterior disc displacement than BN, indicating that the craniocervical posture of adult patients with anterior disc displacement was extended and protrusive.ConclusionAnterior disc displacement of the temporomandibular joint can displace the condyle upwards and posteriorly and reduce the anteroposterior diameter of condyle, and then make the condyle closer to the wall of articular fossa to induce joint symptoms. Additionally, craniocervical postural position is significantly affected, which may be related to compensate for the effects of airway space.

Comparison of CBCT radiation doses with conventional radiographs in TMJ imaging using Monte Carlo simulations.

Three-dimensional imaging methods are widely used for evaluation of bony changes of temporomandibular joint (TMJ). Besides, lateral and posterio-anterior TMJ projections in both closed- and open-jaw positions for each temporomandibular joint are used as two-dimensional diagnostic tools. The purpose of the present study was to compare effective and mean organ absorbed doses of plain radiography techniques with those of different modalities of cone beam computed tomography (CBCT) scanning of an adult's temporomandibular joint. PCXMC 2.0 software was used to calculate mean organ and effective doses. A NewTom CBCT device (Newtom 5G XL; QR systems; Verona, Italy) was simulated at 360° rotation using a 6 × 6cm2 FOV in standard and high-resolution modes. Lateral and posterio-anterior TMJ plain projections were simulated according to recommendations of the manufacturer of the Planmeca ProMax® 2D S3 device. Doses for both projections were simulated with Monte Carlo methods and the International Commission on radiological protection adult reference computational phantoms. The highest mean organ absorbed doses occurred in bone surfaces, salivary glands, and skull for posterio-anterior TMJ and lateral TMJ, and for CBCT scanning in all examinations. The effective doses of posterio-anterior and lateral TMJ plain radiographs were found to be higher than those of the Standard Mode-Eco Scan CBCT. Therefore, the lowest effective dose was calculated in Standard Mode-Eco Scan CBCT. It is concluded that NewTom 5G XL Standard Mode-Eco Scan CBCT can be used instead of plain radiographs (lateral and posterio-anterior TMJ) in temporomandibular joint imaging as it allows visualizing the three-dimensional structure of the temporomandibular joint as an advantage.

Changes of Trigeminal Ganglion Neurons Innervating the Temporomandibular Joint in Chronic Pain Rat Model.

Background: Phenotype alterations of nociceptive neurons have been shown to be a key step in the pathogenesis of many pain-related diseases. However, it is unclear if the characteristic changes of temporomandibular joint (TMJ) primary afferent neurons are related to the pathogenesis of temporomandibular joint osteoarthritis (TMJOA) chronic pain. This study aimed to determine the morphological and neurochemical changes in trigeminal ganglion (TG) neurons innervating the TMJ in TMJOA chronic pain rats. Materials and Methods: Monosodium iodoacetate (MIA)-induced TMJOA chronic pain rat model was established (n = 6), and saline was injected in rats of the control group (n = 6). TMJ primary afferent neurons were labeled with retrograde tracing (Dil). The spatial distribution and the expression of calcitonin gene-related peptide (CGRP), isolectin B4 (IB4), and neurofilament 200 (NF200) of TMJ primary afferent neurons in TG were investigated using immunofluorescence. Intracellular calcium signaling was recorded by calcium imaging (n = 20). Results: TMJ primary afferent neurons were located only in the V3 region of the TG from both saline- and MIA-injected rats. The number of TG neurons innervating the TMJ was increased in MIA-injected rats. Elevated number and intracellular calcium concentration of small- and medium-sized instead of large-sized Dil+ TG neurons were found in MIA-injected rats. The upregulated expression of CGRP and IB4, but not NF200, in TG neurons innervating the rat TMJs was accompanied by TMJOA chronic pain. Conclusion: This study suggests that sensitization of small- to medium-sized Dil+ TG neurons and CGRP- and IB4-positive Dil+ TG neurons might contribute to the development of TMJOA chronic pain in rats. This will provide valuable information for more efficient control of TMJOA chronic pain.

Age and Gender-related Morphometric Assessment and Degenerative Changes of Temporomandibular Joint in Symptomatic Subjects and Controls using Cone Beam Computed Tomography (CBCT): A Comparative Analysis.

The temporomandibular joint diseases have been associated with various predisposing factors. Joint spaces, articular eminence height and inclination, and the shapes of the condylar and glenoid fossa have all been shown to vary in temporomandibular joint diseases (TMD) patients. Advanced imaging techniques like cone beam computed tomography (CBCT) have been employed to estimate these parameters. The aim of the current study was to investigate the condylar morphology, condylar and glenoid fossa shapes, and assessment of joint spaces, such as anterior, posterior, superior, lateral, and medial spaces, through CBCT slices in coronal and sagittal planes and compare them between the control group and TMD group. A cross-sectional study was planned where 80 joints in 40 patients were assessed for the above parameters; group I consisted of healthy patients, and group II included those with temporomandibular joint diseases (TMDs). The articular eminence height and inclination were assessed on the midsagittal section. The condylar changes and shapes of the glenoid fossa and condyles, as well as the joint spaces, were assessed on the selected coronal and sagittal sections. The condylar fossa had a triangular shape in the TMJ group and an oval shape in the control group. The results were highly significant (P = 0.000**). A highly significant difference in morphological parameters, such as AJS, PJS, SJS, MJS, LJS, articular eminence height, and inclination, was found between the two groups (P = 0.000**). The association of morphological parameters, such as AJS, PJS, SJS, MJS, LJS, and articular eminence height and inclination were compared with condylar and glenoid fossa shapes, where the association of superior joint space and articular eminence inclination was observed. A highly significant difference was noted between the two groups with regard to all the parameters with P=0.00*. The articular eminence inclination, as well as the superior joint space, were found to be associated with the glenoid and condyle fossa shapes in the TMJ group. These observations would, therefore, help in the early diagnosis of temporomandibular joint diseases.

Assessment of bony changes in temporomandibular joint in patients using cone beam computed tomography – a cross sectional study

Background and aimThe aim of this study is to evaluate the changes in the temporomandibular joint (TMJ) in patients with temporomandibular disorder (TMD) and the relationship between age, sex, and types of TMJ change using Cone Beam Computed Tomography (CBCT).Methods and materialCBCT records of 200 patients (123 women and 67 men) were retrieved and assessed. Right and left TMJs were evaluated separately, resulting in a total of 400 TMJs. The images were analyzed using On demand 3D Application The radiographic findings were classified as erosion, proliferative changes mainly, including flattening and osteophytes of the condyle, sclerosis, Ely cyst, hypoplasia and hyperplasia of the condyles, ankylosis, and joint cavity. Data analysis was performed using descriptive statistics, paired T-tests, and repeated measure ANOVA (Analysis of Variance) in SPSS Software.ResultsThe most prevalent types of condylar bony changes observed was osteophyte (63.5%) followed by flattening of the articular surface (42%), erosion (40%), ankylosis (10%) and sclerosis (10%). 7.5% of joints showed hyperplastic condyles but only 2% showed hypoplasia. The least prevalent change observed was Ely Cyst (1%). Osteophyte was the most prevalent change observed in all age groups and both sexes except for men aged 31 ~ 50, where flattening was more frequent. A statistically significant difference was found between sex and prevalence of erosion in the age group of 10 ~ 30 (P = 0.001); as well as between sex and condylar hyperplasia in the same age group.ConclusionBased on the findings of this research, the prevalence of bony changes of TMJ from highest to lowest is as follows: osteophyte, flattening of the articular surface, erosion, ankylosis, sclerosis, hyperplastic condyles, hypoplastic condyles and Ely Cyst. CBCT is an accurate 3 dimensional imaging modality for assessment of TMJ bony structures.

Potential of ultra-high-resolution CT in detecting osseous changes of temporomandibular joint: experiences in temporomandibular disorders

BackgroundOsseous changes of the temporomandibular joint (TMJ) are related to the progression of temporomandibular disorders (TMD), and computed tomography (CT) plays a vital role in disease evaluation.ObjectiveThe aims of this study were to evaluate the image quality and diagnostic value of ultra-high-resolution CT (U-HRCT) in TMD compared to cone-beam CT (CBCT).MethodsTMD patients who underwent both CBCT and U-HRCT between November 2021 and September 2022 were retrospectively included. Image quality scores were assigned for four osseous structures (the cortical and trabecular bones of the condyle, articular eminence, and glenoid fossa) by two independent observers from Score 1 (unacceptable) to Score 5 (excellent). Diagnostic classification of TMD was categorized as follows: Class A (no evident lesion), Class B (indeterminate condition) and Class C (definitive lesion). Image quality scores and diagnostic classifications were compared between CBCT and U-HRCT. The Cohen’s Kappa test, Wilcoxon signed-rank test, Chi-square test and Fisher’s exact test were conducted for statistical analysis.ResultsThirty TMD patients (median age, 30 years; interquartile range, 26–43 years; 25 females) with 60 TMJs were enrolled. Image quality scores were higher for U-HRCT than for CBCT by both observers (all Ps < 0.001). Definitive diagnoses (Class A and C) were achieved in more cases with U-HRCT than with CBCT (93.3% vs. 65.0%, Fisher’s exact value = 7.959, P = 0.012). Among the 21 cases which were ambiguously diagnosed (Class B) by CBCT, definitive diagnosis was achieved for 17 cases (81.0%) using U-HRCT.ConclusionsU-HRCT can identify osseous changes in TMD, providing improved image quality and a more definitive diagnosis, which makes it a feasible diagnostic imaging method for TMD.

Evaluation of Temporomandibular Joint Changes with Functional Appliance—An MRI Study

Evaluation of Temporomandibular Joint Changes with Functional Appliance—An MRI Study

Three-dimensional analysis of the morphological changes of the craniofacial jaw and condyle in patients with idiopathic condylar resorption

In this study we aim to describe the three-dimensional analysis of condylar deformation of the temporomandibular joint (TMJ) and morphological changes of the craniofacial jaw in patients with idiopathic condylar resorption (ICR). We also compare those with a control group that is healthy and matched for age and gender. Cone-beam computed tomography (CBCT) and cephalometric radiograph (X-ray) were conducted and analysis of craniofacial measurement, condylar width, length, height, and condylar axial angle changes were done three-dimensionally using ProPlan CMF™ 3.0 software (Materialise). The craniofacial jaw measurements of the ICR patients were significantly different than the control group and the significant changes in the mandible can be seen in ICR patients according to the results of this study. The results of smaller condylar width and height in the ICR group reflect the smaller size of the condyle compared with an unaffected condyle. Also, both right and left sagittal condylar angles (p = 0.001 and p = 0.003), respectively, and axial condylar angles (p = 0.01 and p = 0.02), respectively, displayed significant differences between the two groups. In conclusion, the vertical development of the condyle decreased along with reduced measurements in the width and height of the condyle in ICR patients, and differences in the morphology of the craniofacial jaw and condylar angles were observed between study groups.

Evaluation of Effects of Bimaxillary Anchored Fixed Functional Appliance on Temporomandibular Joint and Maxillomandibular Complex in Late Adolescents: An MRI Study

Objective To evaluate and assess changes in temporomandibular joint (TMJ), dental, skeletal and soft tissue changes following bimaxillary anchored fixed functional appliance (FFA) treatment of skeletal Class II malocclusion using Magnetic Resonance Imaging. Methods The prospective single-arm clinical trial included 15 patients (8 males, 7 females; mean age 15.71 + 1.81years) with Class II Division 1 malocclusion treated with bimaxillary anchored Forsus FRD. Four miniplates were placed bilaterally in maxilla and mandible. Then Forsus FRD L pin module was attached to miniplates without levelling of the arches. Pre-treatment (T1) and post-functional (T2) lateral cephalograms and MRI of TMJ were recorded. A total of 7 parameters were used to assess TMJ in all the 3 planes using MRI. Student’s t-test was carried out to compare pre- and post-treatment-induced changes. Results The mandible significantly moved forward (SNB, 3.71 + 0.91°; SND, 3.21 + 1.25°; Pg-OLp, 2.61 + 0.66 mm, p &lt; 0.001) and there was distalizing effect on maxilla (SNA, –0.79 + 0.89°; A-OLp, –0.57 + 0.47mm, &amp;lt;0.001). Mean overjet correction of 4.43mm was achieved, of which 71.8% were skeletal changes. 65% of skeletal changes contributed to molar relationship correction. The forward positioning of mandible seems to be because of condylar and glenoid fossa remodelling, with condyle moving in anterior position within glenoid fossa (3.28 + 2.29) and articular disc moved posteriorly relative to condylar head (2.27 + 1.62°). Conclusion Significant skeletal changes and TMJ remodelling were observed with bimaxillary anchored FFA in correcting skeletal Class II malocclusion.

Evaluation of temporomandibular joint changes seen in pre-operative and post-operative patients of oral submucous fibrosis using MRI: A prospective study

To evaluate alterations in temporomandibular joint due to immobilisation and re-mobilisation in oral submucous fibrosis patients. The study population included 2 groups, patients and normal – 22 TMJ’s of 11 individuals respectively. MRI was performed on all patients pre-operatively and 5 month post-operatively and also on controls. Disc thickness (anterior, intermediate and posterior zone), disc length, joint space and structural changes in the glenoid fossa and condylar head were assessed in all the MRI scans. The severity of changes in relation to duration of reduced mouth opening was noted. And, finally regeneration potential of the TMJ after remobilizing the jaw, on 5th month POD was observed. All the measurements were tabulated and subjected to statistical analysis. The study showed that there were significant differences in the pre-op and normal. The post treatment values/dimensions were comparatively the same as that of the normal population (except for joint space on right side and disc length on left side, which is negligible). It proves that the treatment makes the condition comparably similar to that of normal dimension over a time period of 5 months, sighting the potential capacity of the TMJ to regenerate and repair. The study revealed statistically highly significant changes in the components of Temporomandibular joint in OSMF patients with varying degrees of restriction in mouth opening when compared to controls, and return of the joint structurally towards recovery at 5 month POD stresses upon the need for an early intervention.

Prevalence of Temporomandibular Joint Osteoarthritic Changes Using Cone-beam Computed Tomography in South Indian Population

Introduction: Osteoarthritis of temporomandibular joint (TMJ) is a chronic degenerative joint disease characterized by synovitis, cartilage destruction, and subchondral bone remodeling and it is an age-related disorder. Cone-beam computed tomography (CBCT) is used for diagnosis of degenerative changes in TMJ, at the same time ensuring lower radiation dose, a shorter exposure time, and a higher spatial resolution. Aim and Objectives: The aim of the study is to evaluate the prevalence of osteoarthritic changes of TMJ using CBCT. Materials and Methods: One hundred fifty CBCT images were collected from the department database and the condylar morphology and the degenerative changes were evaluated in the coronal and sagittal sections. The CBCT images which had changes were only included in the study. The left and right TMJ were evaluated separately. Results: In our study, the prevalence of osteoarthritic changes of TMJ was higher in females than males. TMJ on the right side was more affected than the left side. Among the study population, 40–49 years age group had extensive changes than other age groups, and severity increases in the older age group. The flattening was the most common change, followed by thinning, erosion, osteophyte, and sclerosis. Conclusion: The study revealed that there is significant gender- and age-related variation in the osteoarthritic changes of TMJ. This study showed that the occurrence of degenerative changes is much higher in females and the prevalence increases with advancement of age and was also seen in younger age groups. The occurrence of osteoarthritic changes was also much prevalent among the population.