Mandibular Condyle Research Articles

Osteoarthritis Disease Severity in the Temporomandibular Joint and the Knee Joint: A Comparative Cadaveric Study.

The objective of this study was to determine the level of disease severity in a pilot cohort of temporomandibular joints (TMJs) and compare them to the pathology findings previously characterized in cadaveric knee joints. Thirty-one intact TMJs from 17 cadaveric donors were harvested and arthritic lesioning seen in the knee joint was investigated on the condyle and the fossa of the TMJ. Prevalence of gross alterations was equated and disease severity was determined for sex- and age-based donor pools using a validated, osteoarthritis (OA) disease severity scale (DSS). Knee joint DSS scores were also compared to the TMJ condyle and fossa DSS scores and a case study was carried out on a male donor that demonstrated severe OA in the both joints. The mandibular fossa demonstrated an increase in disease severity compared to the mandibular condyle in a mixed sex donor pool (P = 0.035). It was discovered that the younger females demonstrated statistically more pathological condyles compared to the older half of the female subgroup (P = 0.02). TMJ fossa and knee joints demonstrated comparable OA severity and similar signs of cartilage disease in a single donor highlighting the systemic nature of OA. This study demonstrates that gross signs of OA in the TMJs of cadavers are comparable to pathology found in the knee. The mandibular fossa appears to be the site of more profound disease, implying translational movements may be more likely to induce biomechanically abnormal movement, loading, and OA.

Using Texture Analysis of Neck Computed Tomography Images to Differentiate Primary Hyperparathyroidism From Normal Controls.

To investigate the utility of texture analysis in detecting osseous changes associated with hyperparathyroidism on neck CT examinations compared with control patients and to explore the best regions in the head and neck to evaluate changes in the trabecular architecture secondary to hyperparathyroidism. Patients with hyperparathyroidism who underwent a 4D CT of the neck with contrast were included in this study. Age-matched control patients with no history of hyperparathyroidism who underwent a contrast-enhanced neck CT were also included. Mandibular condyles, bilateral mandibular bodies, the body of the C4 vertebra, the manubrium of the sternum, and bilateral clavicular heads were selected for analysis, and oval-shaped regions of interest were manually placed. These segmented areas were imported into an in-house developed texture analysis program, and 41 texture analysis features were extracted. A mixed linear regression model was used to compare differences in the texture analysis features contoured at each of the osseous structures between patients with hyperparathyroidism and age-matched control patients. A total of 30 patients with hyperparathyroidism and 30 age-matched control patients were included in this study. Statistically significant differences in texture features between patients with hyperparathyroidism and control patients in all 8 investigated osseous regions. The sternum showed the greatest number of texture features with statistically significant differences between these groups. Some CT texture features demonstrated statistically significant differences between patients with hyperparathyroidism and control patients. The results suggest that texture features may discriminate changes in the osseous architecture of the head and neck in patients with hyperparathyroidism.

Modified Osteotomy for TMJ Ankylosis in Paediatric Patients with Deficient Interpositional Temporalis Muscle Mass and Buccal Fat Pad - A case Series and Literature Review.

Ankylosis of the temporomandibular joint (TMJ) is a bony or fibrous fusion of the articular surfaces of the mandibular condyle and the glenoid fossa. Gap arthroplasty, Interpositional arthroplasty, Condyle reconstruction with autogenic or alloplastic grafts and total joint replacement are some common modalities of management. In this article, we discuss a series of three cases of unilateral TMJ ankylosis in paediatric patients, managed by gap arthroplasty using a modified osteotomy cut. The modification was adapted due to inadequate interpositionable temporalis muscle or buccal fat on the affected side and chances of adaptive remodelling of the CCG (Costochondral graft), if placed were rendered negative.

Correlation between orthodontic treatment and temporomandibular joint disorders

Orthodontic treatment aims to regulate the growth and development of the jaw and teeth. The temporomandibular joint (TMJ) is a hinge joint that connects the upper and lower jaw bones between the temporal bone and the head of the mandibular con-dyle. Orthodontic treatment of patients with a history of restriction of TMJ movement experienced statistically significant re-sults and reduction of TMJ pain. The results of the analysis of 6 journals stated that orthodontic treatment had a significant re-lationship with temporomandibular joint disorders. Orthodontic treatment can cause TMD such as structural disorders of the TMJ and functional disorders. Orthodontic treatment can also help overcome TMD such as reducing pain in the TMJ and pro-viding balance to the occlusion.

Evaluation of mandibular trabecular and cortical bone by fractal analysis and radiomorphometric indices in bruxist and non-bruxist patients

BackgroundThe aim of this study was to evaluate the effect of bruxism on the cortical and trabecular bone of the mandible using the radiomorphometric indexes and fractal analysis (FA) additionally to examine the efficiency of FA as diagnostic test for bruxism.MethodsEvaluation was performed on panoramic radiographs of 94 bruxists and 94 non-bruxist individuals with the ImageJ program. Cortical bone was assessed with mandibular cortical index, mental index, and panoramic mental index. Trabecular bone in the condyle, gonial, and corpus region was evaluated by FA. An independent sample t and Mann-Whitney-U tests and Pearson and Spearman rank correlations were conducted for statistical analysis.ResultsA total of 188 participants, 112 female, and 76 male, were included in the study. The sample age ranged from 18 to 43, with a mean of 27.55 (± 7.022) years. FA values of the angulus were significantly higher than those of the condyle and corpus, and the mean of the sample for the angulus, condyle, and corpus, respectively, were; 1.36 (± 10), 1.10 (± 0.9), 1.13 (± 0.8). There was a positive correlation between FA of the mandibular corpus and age (r = .163, p = .025). Females’ values were smaller than males’ in the FAs of three regions, and significant differences were found in FA of the condyle and angulus of the mandible, MCI, and PMI according to gender. There was no statistically significant difference between bruxist and non-bruxist patients in term of FAs of three regions, MCI, MI, and PMI values (p > .05).ConclusionsFA of the condyle and angulus of the mandible, MCI, and PMI are significantly affected by gender. However bruxism doesn’t cause a significant change in the fractal dimensions of the bone in the mandible and doesn’t change substantially MCI, MI, and PMI.

Effect of occlusion effect by bone-conducted sound on monosyllable articulation.

Bone conduction (BC) technology allows us to hear sounds without having anything blocking our ears and enables hearing even when wearing earplugs. However, optimizing this technology presents challenges, particularly in relation to the occlusion effect (OE), a phenomenon that takes place when the ear canal is occluded, causing low-frequency sounds to seem louder than their original intensity. While some facial regions exhibit greater OE than conventional areas, the impact of OE on speech perception in different facial regions has not been thoroughly investigated. This study explores the relationship between OE and speech perception in various facial regions to inform the functionality of BC technology. We conducted a quantitative analysis of monosyllable articulation in the mastoid process, condylar process, nasal bone, and infraorbital region using both female and male voices to assess OE's impact on speech perception. Our findings reveal that OE improves articulation, facilitating voice communication; however, the extent of articulation enhancement varies depending on the stimulus location and phoneme. By examining OE's role in speech perception, this research report contributes to the development and use of more effective BC technology applications.

Characteristics of Frequency Resolution and Speech Perception Using Bone Conduction on Different Human Facial Parts.

In conventional bone-conduction (BC) devices, a vibrator is typically attached to the mastoid process of the temporal bone or the condyle process of the mandible. However, BC-sound presentations to facial parts such as the nose and cheek have also been investigated recently. As the face is the among the most complex structures of the human body, transmission of sounds using BC on different facial parts are likely to show different perception and propagation characteristics than those presented to conventional parts. However, the characteristics of BC sound presented to different part of the face have not yet been studied in detail. To test the frequency discrimination ability, we measured difference limens for frequency (DLFs). We also conducted monosyllable articulation tests in Japanese to assess the speech-perception characteristics when BC sounds are presented to various facial (nasal, infraorbital region, zygomatic, jaw angle, and chin) and conventional (mastoid and condyle process) parts of a normal-hearing subject. The results suggest that, at least in the parts investigated in the current study, the frequency resolution and intelligibility of the facial parts were about the same as those of the conventional parts. These results indicate that practical frequency information and speech perception are possible with BC devices attached to different facial parts.

Treatment of extracapsular fractures of the mandibular condylar process: A retrospective evaluation of 377 cases.

Mandibular condylar fractures represent 25%-35% of all mandibular fractures. Despite profound research, there is still a controverse debate about treating these fractures conservatively or by open reduction and internal fixation (ORIF). The aim of this study is to analyse the outcome after open and closed treatment of extracapsular mandibular condyle fractures regarding general characteristics, post-treatment malocclusion, facial nerve palsy (FNP), maximum mouth opening (MMO) and parotid complications. A retrospective cohort of 377 fractures (350 open, 27 closed treatment) was reviewed by reference to clinical and radiological pre- and postoperative documentation. Follow-up period was 12 months. Pearsons' chi-square-test, correlations, Kruskal-Wallis test and t-test were carried out for statistical analysis. The dominant type of fracture was type II in Spiessl and Schroll classification (50.1%). In the open treated fractures, the most common approach was retromandibular transparotid (91.7%). Post-treatment malocclusion occurred in 18.0% and was significantly increased in bilateral fractures (p = .039), in luxation fractures (p = .016) and in patients with full dentition (p = .004). After open reduction and internal fixation (ORIF), temporary FNP was documented in 7.1% whereas a permanent paresis occurred in 1.7%. FNP was significantly associated with high fractures (p = .001), comminution (p = .028) and increased duration of surgery (p = .040). Parotid complications were significantly associated with revision surgery (p = .009). Post-treatment reduction of MMO mainly occurred in female patients (p < .001) as well as in patients with bilateral fractures (p < .001), high fractures (p = .030) and concomitant mandibular (p = .001) and midfacial fractures (p = .009). Malocclusion seems to be the most frequent long-term complication after open reduction and osteosynthesis of extracapsular mandibular condyle fractures. We suggest ORIF by a transparotid approach to be an appropriate treatment with a low complication rate regarding especially FNP for extracapsular fractures of the mandibular condyle.

TMJ anterior disc displacement anchorage surgery: a retrospective study based on a suture-free titanium screw strategy.

To evaluate the feasibility and effectiveness of using a suture-free titanium screw in repositioning anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ). A consecutive sample of twelve patients (fifteen joints) was included in this study. All patients were diagnosed with ADDwoR and showed limited mouth opening or temporomandibular joint pain symptoms. Suture-free titanium screw was placed in the condyle directly following the disc repositioning. Pre- and postoperative evaluation parameters include operation time, the visual analogue scale for pain (VAS), lateral excursion movements (LEM), maximum interincisal opening (MIO), and disc length and position on MRI. In addition, the mandibular condyle height was also measured. Statistical significance was considered when p < 0.05. The unilateral operation time was 58.54 ± 5.43min; during the 6-month period after the operation, the VAS values decreased from 87 ± 6.34 to 14.08 ± 6.65. The MIO increased from 30.07 ± 4.73 to 39.89 ± 1.69mm (p = 0.01). The TMJ disc length was prolonged from 8.23 ± 1.12 to 11.51 ± 1.29mm. The condyles showed significant remodeling, and the height of the condyle increased from 18.24 ± 4.12 increase to 19.6 ± 4.31mm. The LEM was increased from 5.27 ± 0.51 to 6.36 ± 0.62mm. The MRI images showed the stability of the disc in position during the opening and closing of the mouth. The TMJ disc position was stable during the follow-up period. Anteriorly displaced articular disc can be repositioned by a suture-free titanium screw strategy. This technique is an alternative method to address ADDwoR.

Mandibular Condyle Shape and Symmetry in 4- to 19-Year-Old Children and Early Adolescents

Background: The prevalence of TMD (temporomandibular disorder) in children and early adolescents varies widely. TMD can cause permanent facial deformities and affect occlusion and speech, which will affect growth, development, and quality of life. For prevention, early detection is needed. However, early detection is often not possible due to a lack of understanding of the normal shape of the condyle. Research on the normal shape of the condyle and symmetry in children and early adolescents has not been much done. Purpose: To evaluate the shape of normal condyles in a population of children and early adolescents aged 4–19 years and determine the most dominant shape and symmetry. Methods: 220 mandibular condyles of 110 children aged 4–19 years (mean 11.4 years) were analyzed retrospectively using an orthopantomograph. Condyle types in primary, mixed, and permanent dentition were categorized according to Yale (convex, rounded, flat, angled) and Chaudhry classification (oval, diamond, bird beak, crooked). Right and left mandibular condyle symmetry was observed according to a previous study by Ribeiro. Results: In primary, mixed, and permanent dentition, the most dominant condyle shapes were (Yale, Chaudhry): 91.6% rounded, 100% oval; 95.8% rounded, 97.9% oval; 98% rounded, 97% oval, respectively. Asymmetry in the right and left mandibular condyles was not found in primary dentition; there were 2 cases in mixed dentition and 3 cases in permanent dentition. Conclusion: In children and early adolescents aged 4–19 years, the normal condyles found are: rounded, convex, angled (Yale), and oval, diamond, or bird beak (Chaudhry). The condyles are dominated by rounded and oval shapes. The incidence of asymmetry in the right and left mandibular condyles probably increases with age.

A Comparison of Clinical Outcomes in Patients of Mandibular Condyles Fractures Treated with Open Versus Close Reduction

Aim: The absence of a widely acknowledged and conclusive therapy for condylar fractures is a matter of contemporary debate and contention, with the issue of whether surgical or conservative approaches are better suitable for managing such fractures being unresolved. This study investigates several methodologies pertaining to the conservative, closed, and open surgical interventions for the treatment of condylar fractures. The standardization of fracture classification systems and treatment techniques is necessary to provide a clear and optimum strategy for individual individuals and their respective fractures. Objectives: The objectives of the study are to compare clinical outcomes in patients of mandibular condyles fractures treated with open versus close reduction. Method: A total of 84 individuals diagnosed with subcondylar fractures of the mandible were assessed. All fractures seen in the study exhibited displacement, with either angulation ranging from 10° to 35° or a reduction in length of the ascending ramus by more than 2 mm. A comprehensive assessment, including both clinical and radiographic examination, was conducted at the 6-month mark after the occurrence of the trauma. The clinical criteria assessed in this study included mouth opening, temporomandibular joint (TMJ) discomfort, mandibular deviation, malocclusion, facial damage, and scar formation. Results: The findings indicated a statistically significant difference between the two groups, with a p-value of less than 0.05. The findings suggest that open reduction was found to be more efficacious than closed reduction in enhancing mouth opening, mandibular deviation, TMJ discomfort, and malocclusion. Conversely, closed reduction was shown to be more beneficial than open reduction. Conclusion: The study findings indicate that the open treatment approach yields superior progress compared to closed techniques, and these differences are statistically significant. Patients who had open reduction demonstrated considerably superior results in all functional measures, with the exception of facial nerve damage and scar formation, when compared to those who underwent closed reduction. Keyword: Mandibular fracture, open reduction, closed reduction, clinical outcome

A Comparison of Quality of life in Patients of Mandibular Condyles Fractures Treated with Open Versus Close Reduction

Aim: The notion of quality of life pertains to the subjective assessment made by people on their overall well-being, taking into account their cultural and value orientations, as well as their goals, expectations, standards, and concerns. The notion of quality of life (QoL) within the medical field is often denoted as Health-Related Quality of Life (HR-QoL) or subjective health status. The primary objective of research on quality of life (QoL) is to evaluate the influence of sickness, disease, and their corresponding therapies on the holistic welfare of individuals. Objectives: The objectives of the study are to compare quality of life in patients of mandibular condylar fractures treated with open versus close reduction. Method: A total of 84 individuals diagnosed with subcondylar fractures of the mandible were subjected to evaluation. All fractures seen in the study exhibited displacement, either in the form of angulation ranging from 10° to 35° or a shortening of the ascending ramus by more than 2 mm. A comprehensive assessment, including both clinical and radiographic examination, was conducted at the 6-month mark after the occurrence of the trauma. The clinical characteristics assessed in this study included oral pain, difficulty in chewing, discomfort, cosmetic deformity, impact on daily routine, and symptoms of sadness. Results: The findings of the study indicate a statistically significant difference between the two groups, with a p-value of less than 0.05. The findings suggest that open reduction had superior outcomes compared to closed reduction in terms of alleviating oral pain, enhancing chewing ability, reducing discomfort, addressing cosmetic deformities, minimising disruptions to daily activities, and mitigating depressive symptoms. Conclusion: The study has determined that open therapy yields a better improvement in quality of life compared to closed treatments, and these differences are statistically significant. Keyword: Mandibular condylar fracture, open reduction, closed reduction, Quality of life

Morphology of Mandibular Condyle in The Population of Sarawak: A Retrospective Cross-sectional Study Using Digital Panoramic Radiograph

Introduction: The morphology of the condyles changes naturally with age, gender, face type, occlusal force, functional load, malocclusion type, and the right and left sides. Although condylar shape and size differ throughout populations, there have been few investigations on condylar morphology, particularly in the Malaysian population. Methods: This retrospective, observational, cross-sectional survey was conducted at the Oral and Maxillofacial Surgery Clinic of Sarawak General Hospital from September 2021 to March 2022, involving radiographic assessment of condylar morphology from 893 panoramic radiographs. Age, gender, ethnicity and dentition status using Eichner index were extracted from the data. Descriptive statistics were used. Pearson’s chi-square test was used to determine the association between the independent variables (age, gender, ethnicity and dentition status) and the shape of the mandibular condyle. A p-value of &lt; 0.05 was considered statistically significant. Results: Only 450 panoramic radiographs were included in this study. The condyles were outlined and grouped into four categories, namely pointed (40.2%), round (32.8), angled (18.8), and flat (8.2%). Condylar morphology was found to be significantly associated with gender (p&lt;0.005) and insignificant with other independent variables. Conclusion: The findings suggest that the most prevalent condylar morphology among the Sarawak population is the pointed shape, in contrast with other previous studies that reported the round shape condylar morphology as the majority shape.

Which of 51 Plate Designs Can Most Stably Fixate the Fragments in a Fracture of the Mandibular Condyle Base?

In the surgical treatment of the most common fracture of the mandible, which is a fracture of the condylar base, a great choice of different plate shapes is observed. The aim of this study was to determine which shape gives the greatest fixation stiffness. To ensure homogeneity in comparison, tests were performed on polyurethane models divided at the level of the condylar base fracture and each were fixed with 51 plates. The plates were cut from a 1 mm thick grade 23 titanium sheet. The models were then loaded and the force required for 1 mm of fracture displacement was recorded. It was noted that in addition to osteosynthesis from two simple plates, there were also two dedicated single plates with similar rigidity. Among the large number of described designs of plates, there is considerable variation in terms of the stability of the fixation performed with them. The proposed Mechanical Excellence Factor allows a pre-evaluation of the expected rigidity of fixation with a given plate shape without the need for a loading experiment. The authors expect this to be helpful for surgeons in the application of relevant plates, as well for inventors of new plates for the osteosynthesis of basal fractures in mandibular condyle.

Scaffold-based tissue engineering strategies for temporomandibular joint disc regeneration and replacement

The temporomandibular joint (TMJ) disc is a fibrocartilage tissue located between the mandibular condyle and the glenoid eminence, which is central to the TMJ functions. The TMJ disc is susceptible to irreparable degenerative changes or post-traumatic injuries, which can lead to the development of a disc-related disease. Scaffold-based tissue engineering offers the potential for regeneration and replacement of the damaged TMJ disc. The present review describes the biomaterials and manufacturing technologies used in scaffold-based TMJ disc engineering strategies and comprehensively evaluates the advantages and disadvantages of each strategy. As an understanding of the extracellular matrix (ECM) is fundamental for succesful TMJ disc tissue engineering, this review defines the key properties and roles of the TMJ disc ECM. Compared with the natural disc, the mechanical properties of the tissue-engineered TMJ disc are not satisfactory. Additionally, the in vivo durability of engineered discs and their long-term impact on the entire TMJ remain to be studied, especially in large-animal preclinical trials.

Efek jumlah kehilangan gigi posterior terhadap bentuk kondilus di rsgm-p fkg usakti melalui radiografi panoramik (Laporan Penelitian)

Background: Effects of tooth loss is the cause of occlusal imbalance that can cause changes in the shape of the condyle, which usually occurs after the age of 30 years. The condyle shapes were classified into 6 types; normal, osteophyte, flattening, erosion, subcortical cyst, and sclerosis. Objective: Determine whether there is an effect of the number of posterior tooth loss on the condyle shape in adult aged 30-45 years using panoramic radiography at Radiology Installation of the RSGM-P FoD, Trisakti University. Research method: Cross-sectional approach to the condyle shape from 80 panoramic radiograph samples with the number of tooth loss &lt;3 and ≥3 posterior teeth at Radiology Installation of the RSGM-P FoD, Trisakti University with subjects aged 30-45 years. Result: In the number of posterior tooth loss &lt;3 teeth and ≥ 3 teeth on the right and left sides, the condyle shapes are generally normal. There are pathological shapes that is most found is flattening and the least found is osteophyte. No subcortical cyst was found. Condylar process which undergoes more changes is on the left side and the prevalence in women is higher. The research data was analysed using Chi-square test with the result p &gt; 0.05. Conclusion: There is no significant effect between the number of posterior tooth loss on the condyle shape in adult subject aged 30-45 years using panoramic radiography at the Radiology Installation of the RSGM-P FoD, Trisakti University.

Unbalanced cartilage calcification during development contributes to the formation of irregular articular surfaces as revealed by micro-CT images

Abstract Introduction The histological features of irregular mandibular condylar surfaces revealed on CT images remain unknown. Aim In order to seek clarification, the aim of the study was to describe the histological features of irregular mandibular condylar surfaces detected on micro-CT images. Materials and methods Due to different modelling requirements, thirty rats were exposed to five experimental occlusal disturbance models at 6- or 8-weeks of age. Another six age-matched rats were used as controls. After 10 or 12 weeks of modelling, the mandibular condyles were sampled for micro-CT scanning and histology, immunohistochemistry and immunofluorescence assessment. The condyles with irregular surface signs were chosen for analysis. Results Based on the micro-CT images, 10 out of the 30 condyles were diagnosed as having irregular articular surfaces which typically appeared as lacunae on histological sections. The lacunae were filled with degraded cartilage, a fibrous mass, or calcified islets. Type II collagen-, type X collagen- and osterix-positive cells were observed at the side walls of the lacunae. Cleaved caspase-3-positive cells, CD90-positive cells and fibronectin-positive areas were observed inside the lacunae. However, in the subchondral bone at the lower margin of the lacunae, TRAP-positive cells were seldom observed. Conclusions Irregular mandibular condylar surfaces revealed by micro-CT images during development appeared to be a result of unbalanced cartilage calcification.

Superolateral dislocation of the intact mandibular condyle: our experience and review of the literature

Superolateral dislocation of the intact mandibular condyle: our experience and review of the literature

Giant Aneurysmal Bone Cyst of the Mandibular Condyle Mimicking Parotid Tumor: A Case Report and 22-Year Follow-Up

Background: Aneurysmal bone cyst (ABC) is a rare benign non-odontogenic cyst that occurs most commonly in the posterior mandible. Occurrence in the mandibular condyle is rare. We present a case that was initially misdiagnosed as a parotid gland tumor and later was found to be an ABC. Case Presentation: A 19-year-old man presents with a painless firm swelling on the right preauricular region. Panoramic imaging revealed a radiolucent lesion in the right condyle and ascending ramus of the mandible with complete erosion of the bony surface losing the condyle configuration. The lesion was excised, and the mandible was curetted. A split-thickness left clavicular joint graft was harvested for reconstruction of the right condyle of the mandible. The pathology report confirmed the diagnosis of aneurysmal bone cyst. The patient was followed for 22 years without any evidence of recurrence. Conclusions: Tumors of the jaws and cystic lesions may mimic benign salivary gland pathology. Appropriate clinical and radiographic examination should be utilized to exclude this from the differential diagnosis. Complete surgical excision of the lesion and reconstruction of the condyle may be utilized to provide patients with good results.

CAD/CAM-assisted total joint replacement for correction of facial asymmetry caused by large osteoma of mandibular condyle

CAD/CAM-assisted total joint replacement for correction of facial asymmetry caused by large osteoma of mandibular condyle