Evaluation Of Temporomandibular Joint Research Articles

Integration of cone beam computed tomography for interdisciplinary diagnosis and treatment planning

Cone-beam computed tomography (CBCT) has revolutionized dental imaging by providing precise three-dimensional visualization of hard tissue structures with minimal radiation exposure compared to conventional CT. This review explores the integration of CBCT in interdisciplinary diagnosis and treatment planning across various fields of dentistry. CBCT offers versatile applications including assessment of impacted teeth, airway analysis, temporomandibular joint evaluation, detection of jaw pathologies, and precise diagnosis of dento-maxillofacial fractures. Its ability to generate static and rotational 3D images aids in surgical planning and treatment outcome prediction. Furthermore, CBCT plays a crucial role in orthodontics for localization of impacted teeth and evaluation of craniofacial anomalies such as cleft lip and palate. In periodontics and implantology, CBCT facilitates detailed assessment of periodontal structures, bone defects, and precise implant placement. Additionally, CBCT assists in maxillofacial prosthetics by enabling virtual surgical planning and custom prosthetic fabrication. This paper underscores CBCT as an indispensable tool in modern dental practice, enhancing diagnostic accuracy, treatment precision, and patient outcomes across diverse clinical scenarios.

Modern techniques for TMJ evaluation - Modjaw versus Cadiax - a systematic review

The temporomandibular joint (TMJ) plays a crucial role in various functions of the jaw, including chewing, speaking, and swallowing. Disorders of the TMJ can significantly impact a patient's quality of life, causing pain, dysfunction, and other systemic issues. Comprehensive TMJ evaluation is essential for accurately diagnosing and effectively treating these disorders. Two modern techniques for TMJ evaluation, Modjaw and Cadiax, offer advanced tools for detailed assessment. This comparison explores the capabilities, methodologies, and benefits of each system based on the current published studies. The aim is to highlight the novel nature of using digitalized tools for diagnosis and treatment planning, ass well as assessing the reliability of two systems.

The influence of open disc repositioning surgery on the internal derangement of the contralateral temporomandibular joint: a prospective study of 96 patients.

To assess the influence of unilateral open disc repositioning surgery (ODRS) of the temporomandibular joint (TMJ) on the internal derangement (ID) of the contralateral joint. Patients with bilateral ID of TMJ who underwent unilateral ODRS were enrolled and followed-up for one year. They were divided into two groups based on the contralateral disease: the anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR). Postoperative evaluation included clinical and MRI evaluation. Indices measured were unilateral intermaxillary distance (UID), visual analogue scale (VAS), disc length (DL), condylar height (CH), and disc-condyle angle (DCA). Paired t tests were used to compare the clinical and MRI indices between different time points. Ninety-six patients were enrolled, including 47 in the ADDWR group and 49 in the ADDWoR group. One-year post-surgery, ODRS led to significant increases in MMO, DL, and CH, and decrease in VAS and DCA on the operated side (P < 0.05). In ADDWR group, UID, DL, and CH increased significantly, and VAS decreased (P < 0.05), with no significant change in DCA (P > 0.05). In ADDWoR group, clinical and MRI variables worsened slightly, except for UID, which remained unchanged (P > 0.05). ODRS is a promising method for correcting TMJ ID and may improve condition of ADDWR and decrease progress of ADDWoR at the contralateral joint. Preoperative bilateral TMJ evaluation is essential for better outcomes. ODRS can effectively treat TMJ ID and produce adaptive changes in the contralateral ID, for which continuous monitoring of the contralateral joint is essential.

Evaluation of Temporomandibular Joint After Orthognathic Surgery with First Orthognathic Surgery Method: Scoping Review

Evaluation of Temporomandibular Joint After Orthognathic Surgery with First Orthognathic Surgery Method: Scoping Review

Three-dimensional evaluation of temporomandibular joint and dental asymmetries in angle class II division 1 subdivision malocclusion

Abstract Background Management of class II division 1 subdivision malocclusion has consistently offered an important challenge for orthodontic professionals. This problem arises not only from the complexities associated with its treatment but also from the complex nature of its asymmetric characteristics. Understanding the properties of asymmetry in this particular malocclusion has significant importance. Objectives Evaluate the features of temporomandibular joint and dental asymmetries in angle class II division 1 subdivision malocclusion by using cone-beam computed tomography (CBCT). Patients and methods Forty CBCT scans of adult patients were analyzed and divided into two groups: 20 CBCT for each group skeletal and dental measurements were measured and compared among both groups to evaluate the features temporomandibular joint and dental asymmetries in class II division 1 subdivision malocclusion. Results Dental parameters were significantly different (P &lt; 0.01) between right and left sides in maxillary sagittal position (mandibular first), maxillary and mandibular canine. A comparison of condyle and glenoid fossa concerning right, and left sides showed together significant an differences (P &lt; 0.01) in coronal position of GFI, GlS, Poi, and posterior wall angle of the articular tubercle. Conclusion In class II division 1 subdivision malocclusion the mandibular first molar was distal and lingual in position, while the maxillary first molar was mesial in class II side. In class ii subdivision malocclusion, glenoid fossa position and condylar morphology asymmetries caused skeletal asymmetry.

Advancing dental diagnostics: The significance of cone-beam computed tomography (CBCT) in modern dentistry

Dental radiology has historically relied on 2-dimensional (2D) imaging, but recent advancements in Cone-Beam Computed Tomography (CBCT) have revolutionized maxillofacial imaging. This review explores the applications of CBCT, emphasizing its advantages in dental specialties such as implant dentistry, endodontics, orthodontics, and temporomandibular joint evaluation. CBCT offers unparalleled diagnostic accuracy while minimizing radiation exposure, making it a valuable tool in dental practice. The integration of artificial intelligence (AI) and machine learning into CBCT technology presents exciting possibilities for automated image analysis, pathology detection, treatment planning, radiation dose reduction, image enhancement, workflow optimization, predictive analytics, customized treatment plans, teledentistry, and dental education. AI's role in dentistry is poised to enhance diagnostic and treatment capabilities while optimizing CBCT scans, ultimately improving patient care.

Clinical and Instrumental Temporomandibular Joint Evaluation in Children and Adolescents with Juvenile Idiopathic Arthritis: A Medium-Term Follow-Up

(1) Background: The aim of the study was to assess the potential effectiveness of clinical diagnostic examinations, such as muscle palpation, and instrumental examinations, such as electromyography, in the early detection of TMJ involvement in patients with juvenile idiopathic arthritis (JIA), as early diagnosis of these disorders can reduce the risk of developing facial growth anomalies and dento-skeletal malocclusions. (2) Methods: Evaluations were conducted on a cohort of 15 people with juvenile idiopathic arthritis (JIA) and a comparison group of 15 healthy participants at the start of the trial (T0) and after 18 ± 6 months (T1). Data were obtained through clinical examination, involving muscle palpation of the anterior temporalis, masseters, and sternocleidomastoids, and by instrumental analysis using electromyography. The parametric student’s t-test was used to evaluate group comparisons for data that were normally distributed, whereas the nonparametric Mann–Whitney U test was employed for parameters that did not follow a normal distribution. (3) Results: In the JIA group, higher levels of pain were recorded in the sternocleidomastoid muscles on both sides as compared to the control group (p &lt; 0.05) at both T0 and T1. Electromyography revealed no statistically significant variances both in the JIA group and in the control group, except for the IMP index, characterized by a significant improvement over time for the JIA group. (4) Conclusions: According to the methodology employed in this study, all JIA patients had TMD symptoms, mainly muscle disorders. The existence of statistically significant parameters suggests the potential to regard muscle palpation and electromyography as predictive indicators of TMJ involvement in JIA subjects. Additional research is required to validate their reliability.

Three-dimensional Assessment of Temporomandibular Joint Volume, and Condylar and Glenoid-fossa Morphology: A Cone-beam Computed Tomography Study.

The condylar and glenoid fossa morphology can alter in patients with temporomandibular disorders (TMD), which can lead to changes in the temporomandibular joint (TMJ) space volume. Volumetric evaluation of TMJ can represent the entire three-dimensional (3D)-joint space between the condyle and glenoid fossa. To perform 3D assessment of TMJ volume, condylar, and glenoid-fossa morphology using cone-beam computed tomography and evaluate the correlation between these parameters. Thirty-four patients (age: 13.50 years) who had no previous history of TMD were included. The volume of TMJ space was measured and divided into anterior, posterior, medial, and lateral TMJ volume. The antero-posterior (AP) and medio-lateral (ML) condylar width, AP and ML glenoid-fossa width, and glenoid-fossa depth were evaluated. Statistical analyses were performed with R software at a 0.05 significance level. Each parameter was compared between the left and right sides using a paired-t test. The correlations between the parameters were obtained by the Pearson correlation coefficient. There was no significant difference between lateral and medial TMJ volume; however, posterior TMJ volume was significantly greater than anterior TMJ volume. A significant correlation was observed between AP glenoid-fossa width and TMJ volume, glenoid-fossa depth and TMJ volume, AP position of the condyle and anterior TMJ volume, ML position of the condyle and medial TMJ volume, glenoid-fossa width and condyle width in AP and ML dimension, glenoid-fossa depth and AP glenoid-fossa width. In addition to the evaluation of condylar and glenoid-fossa morphology, assessment of TMJ space volume is important for comprehensive evaluation of the joint.

Evaluation of Temporomandibular Joint in Patients with Parkinson's Disease: A Comparative Study.

(1) The aim of this study was to perform an evaluation of the temporomandibular joint (TMJ) in patients with Parkinson's disease (PD) and present the morphological differences of the TMJ between healthy subjects and patients with PD. (2) A total of 102 Caucasian subjects were divided equally into two groups. The study group consisted of patients with PD, while the control group comprised healthy subjects. Ten parameters, including anterior joint space (AJS), superior joint space (SJS), posterior joint space (PJS), condyle head length (CHL), condylar neck width (CNW), minor axis of the condyle (MAC), long axis of the condyle (LAC), condylar axis inclination (CI), medial joint space (MJS), and lateral joint space (LJS), were measured using magnetic resonance images. The data were statistically analyzed using paired samples t-test and Student's t-test, with a significance level set at p < 0.05. (3) In the PD group, all TMJ parameters showed a statistically significant difference between both sides of the face (p < 0.05). However, in the control group, AJS, SJS, PJS, CHL, CNW, MAC, CI, MJS, and LJS did not show a statistically significant difference between both sides of the face (p > 0.05), except for LAC (p < 0.05). The asymmetry index values of AJS, SJS, PJS, CHL, CNW, MAC, CI, MJS, and LJS demonstrated a statistically significant difference between the study and control groups (p < 0.05), except for LAC (p > 0.05). (4) Within the limitations of this retrospective study, the findings suggest that TMJ morphology and asymmetry could be associated with PD.

Temporomandibular joint involvement in patients with Juvenile Idiopathic Arthritis: comparison of ultrasonography and magnetic resonance imaging in assessing the periarticular space width

ObjectivesThis study aimed to compare the performance of Ultrasonography (US) and Magnetic Resonance Imaging (MRI) in assessing the Lateral Periarticular Space (LPAS) of Temporomandibular Joints (TMJs) in patients with Juvenile Idiopathic Arthritis (JIA).MethodsThe LPAS width was evaluated in two different patient groups. In the JIA group, including 29 children (13 ± 2.8 years) with JIA, the LPAS width was measured with both MRI and US. In the healthy group, including 28 healthy children (12.6 ± 2.5 years), the LPAS width was measured only with US. Comparisons of LPAS width based on patient groups and TMJ contrast enhancement in MRI were evaluated by applying the Mann–Whitney U test. Correlation and agreement between MRI and US measurements in JIA group were tested using Spearman rank correlation and Bland–Altman method.ResultsThe LPAS width was significantly greater in the JIA group than in the healthy group. In the JIA group, the LPAS width was significantly greater in TMJs with moderate/severe enhancement than those with mild enhancement. A positive significant correlation between MRI and US measurements of LPAS width was found in the JIA group. In the same group, Bland–Altman method showed a good level of agreement between MRI and US measurements.ConclusionAlthough, US cannot replace MRI in the evaluation of TMJ in patients with JIA, US could be used as a supplementary imaging method to MRI in assessing the TMJ disease.

The effect of myotonic dystrophy type 1 on temporomandibular joint and dentofacial morphology: A CBCT analysis.

Myotonic dystrophy type 1 (DM1) is a neuromuscular multisystem disease. Early involvement of facial muscles may produce an extra load on the temporomandibular joint (TMJ) in DM1. This study aimed to investigate the morphological analyses of the bone components of temporomandibular joint (TMJ), and dentofacial morphology in myotonic dystrophy type 1 (DM1) patients by cone-beam computed tomography (CBCT). Sixty-six individuals (33 DM1, and 33 healthy subjects) age ranging from 20 to 69 were included in the study. Clinical examinations of the patients' TMJ regions and evaluation of dentofacial morphology (maxillary deficiency, open-bite, deep palate and cross-bite) were performed. Dental occlusion was determined based on Angle's classification. CBCT images were evaluated regarding mandibular condyle morphology (convex, angled, flat and round) and osseous changes observed in the condyle (normal, osteophyte, erosion, flattening, sclerosis). DM1-specific morphological and bony TMJ alterations were determined. DM1 patients showed a high prevalence of morphological and osseous TMJ changes, and statistically significant skeletal alterations. The analysis of CBCT scans indicated the prevalent condylar shape among patients with DM1 was flat, the main osseous abnormality was flattening, there was a tendency towards skeletal Class II and a posterior cross-bite was frequently detected in DM1 patients. There was no statistically significant difference between the genders on the parameters evaluated in both groups. Adult patients with DM1 presented a high frequency of crossbite, tendency to skeletal Class II and morphological osseous alterations of TMJ. The analysis of the morphological condylar alterations in patients with DM1 may be beneficial in the diagnosis of TMJ disorders. This study reveals DM1-specific morphological and osseous TMJ alterations to provide an appropriate orthodontic/orthognathic treatment planning to patients.

Does the use of panoramic radiography add information in the temporomandibular joint evaluation in Juvenile Idiopathic Arthritis patients? A case control study

ObjectiveTo determine the frequency of radiographic changes in the temporomandibular joint, in a representative population of patients with Juvenile Idiopathic Arthritis (JIA) and to compare with findings in healthy controls matched by sex and age.Patients and MethodsOne hundred and thirty-seven panoramic radiographies (PR) from JIA patients of a pediatric rheumatology outpatient clinic were prospectively evaluated and compared to 137 PR from healthy individuals.Results102 (74.5%) JIA patients and 47 (34.3%) controls showed at least one radiological alteration (p < 0.001). The following radiographic alterations were more frequently observed in JIA patients than in controls: erosion (p < 0.001), altered condylar morphology (p < 0.001), disproportion between condylar process and the coronoid process (p < 0.001) and accentuated curve in the antegonial notch (p = 0.002). Twenty patients (14.6%) presented the four radiographic alterations simultaneously compared to only two controls (1.5%) (p < 0.001).ConclusionDue to the difference in the frequency of findings in the PR of patients and controls, we concluded that PR has value as a screening tool. In the presence of major changes in the mandible head in the PR of patients with a confirmed diagnosis of JIA, MRI should be considered to detect an active inflammatory process in this joint.

Assessment of influence of facemask treatment with skeletal anchorage on the temporomandibular joint using magnetic resonance imaging: a preliminary study.

The aim of the study was to investigate the influence of facemask treatment with skeletal anchorage on the temporomandibular joint (TMJ) using magnetic resonance imaging (MRI), in patients with Class III malocclusion, accompanied by maxillary retrusion. Fifteen patients with a mean age of 12.1±1.43 years were included in the study. All patients were treated using facemask with skeletal anchorage after eight weeks of Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) protocol. Magnetic resonance imaging was performed before and immediately after facemask treatment for TMJ evaluation. Disc position, condylar translation, degenerative changes of the condyles, and joint effusion were evaluated. To assess whether the alterations associated with the treatment were statistically significant, McNemar and marginal homogeneity tests were used. After facemask treatment, a statistically significant change was observed in the disc position (an anterior disc displacement with/without reduction in five TMJs) (p<0.05). The alteration in the condylar translation was not statistically significant (p>0.05). This treatment did not cause degenerative changes of the condyles or effusion in any of the TMJs. Facemask treatment with skeletal anchorage following the Alt-RAMEC protocol had a minimal influence on the TMJ, only by means of disc position, which was not negligible. Long-term results of such treatment are required for following up the changes observed in the TMJs.

TEMPOROMANDIBULAR JOINT DISLOCATION DUE TO NEAR SELF-EXTUBATION

TEMPOROMANDIBULAR JOINT DISLOCATION DUE TO NEAR SELF-EXTUBATION

Awareness of temporomandibular joint involvement in rheumatoid arthritis patients by physicians dealing with rheumatology

The aim of this study is to evaluate the attitudes and awareness of physicians dealing with rheumatology about temporomandibular joint (TMJ) involvement while evaluating rheumatoid arthritis (RA) patients with the TMJ questionnaire we created. For this purpose, an online TMJ evaluation questionnaire consisting of 10 questions was prepared and completed by the physicians via the Google Forms application. Among those who participated in the survey; the percentage of correct answers to the question of whether the TMJ joint is a synovial joint was 95.5%. While the rate of those who correctly knew that more than half of the RA patients had TMJ involvement remained at 35.5%, the rate of those who correctly identified that RA rarely affected the first TMJ was 75.5%. The rate of those who knew that TMJ involvement is frequently bilateral in RA was 62.7%. The number of participants who answered the question of what the clinical findings are in TMJ involvement correctly was over 60%. When asked about radiological findings in TMJ involvement in RA, more than 75% of the participants expected joint space narrowing, erosion, and mandibular destruction. On the other hand, the number of physicians who expected radiological findings such as ostephitis and sclerosis as radiological findings was below 40%. While the number of physicians who performed TMJ inquiries and examinations in RA patients was only 15.5%, if there was a TMJ complaint, this rate increased to 80%. The number of participants using objective tests for the evaluation of TMJ was below 30%. Also, 85.5% of the participants ignored TMJ involvement in RA. In conclusion, our study showed that physicians dealing with rheumatology have low awareness of TMJ involvement in RA.

An insight into temporo-mandibular joint evaluation using joint vibration analysis: A review.

An insight into temporo-mandibular joint evaluation using joint vibration analysis: A review.

Intra- and inter-examination reproducibility of T2 mapping for temporomandibular joint assessment at 3.0 T

T2 mapping allows quantification of the temporomandibular joint (TMJ) ultrastructural degeneration. The study aimed to assess intra- and inter-examination reproducibility of T2 mapping for TMJ evaluation at 3.0 Tesla (T). Seventeen volunteers, regardless of temporomandibular disorder (TMD) diagnosis, received magnetic resonance (MR) examination at 3.0 T. T2 mapping was performed twice (> 5 min between sessions without repositioning) on 12 volunteers to ensure intra-examination reproducibility. Nine volunteers underwent two examinations (> 6 months) to ensure inter-examination reproducibility. The regions of interest (ROIs) of the articular disc and retrodiscal tissue were manually selected and calculated. The mean T2 values of the articular disc and retrodiscal tissue were 25.3 ± 3.0 and 30.0 ± 4.1 ms, respectively. T2 mapping showed excellent intra-examination intraclass correlation coefficients (ICCs) for both articular disc (0.923) and retrodiscal tissue (0.951). Very strong correlations (r) were observed in both articular disc (0.928) and retrodiscal tissue (0.953) (P < .001). Inter-examination reproducibility also demonstrated that the ICCs were excellent (0.918, 0.935) on both ROIs. T2 values between first and second examinations were strongly correlated (r = 0.921, 0.939) (P < .001). In conclusion, T2 mapping seems to be a promising tool for TMJ assessment, regardless of the TMJ condition.

Calcitonin gene-related peptide: An intra-articular therapeutic target for TMJ disorders.

ObjectivesThe goal of this project was to evaluate the role of calcitonin gene‐related peptide (CGRP) in the development of arthritis.MethodsHerein, we employed somatic mosaic analysis in two different joints by FIV(CGRP) intra‐articular inoculation in the knees or temporomandibular joints (TMJ) of young adult male C57/BL6 mice. FIV(CGRP) is a feline immunodeficiency virus over‐expressing full‐length CGRP. Joint pathology and function were evaluated at the histopathological and behavioral levels. In addition, CGRP signaling was inhibited by intra‐articular inoculation using FIV(CGRP8‐37), such that the inhibitory peptide CGRP(8‐37) was overexpressed 4 weeks after induction of joint inflammation in the TMJ of IL‐1βXAT transgenic mouse model. The mice were evaluated for behavior and killed for evaluation of knee and TMJ pathology.ResultsOverexpression of CGRP in the joints of wild‐type mice induced the development of joint anomalies, including meniscal hypertrophy and articular pathology, associated with nocifensive behavior. Intriguingly, overexpression of the CGRP(8‐37) inhibitory peptide in the knee and TMJ of IL‐1βXAT transgenic mice with joint inflammation resulted in partial amelioration of the attendant joint pathology.ConclusionsThe results of this study suggest that CGRP is sufficient and necessary for the development of joint pathology and may serve as an intra‐articular therapeutic target using gene therapy or monoclonal antibody‐based therapies.

A clinical and MRI retrospective cohort study of patients with juvenile idiopathic arthritis (JIA) to determine if initial temporomandibular joint (TMJ) examination findings are associated with severity of TMJ arthritis

The purpose of the present study was to evaluate the association between initial TMJ examination findings and clinical and MRI severity of TMJ arthritis in a cohort of patients with JIA. The clinical variables were signs and symptoms at the initial TMJ evaluation. Outcome was the severity of TMJ arthritis as evaluated clinically by the Helkimo clinical dysfunction indices and by MRI. Associations of signs and symptoms with clinical and MRI severity were analyzed using a Fisher exact test and linear regression. The sample was composed of 101 patients with a mean age of 12.8 years, 76% of which were girls. Subjective difficulty in opening the mouth wide and objective limited MIO were the only clinical findings associated with both the severity of clinical dysfunction (p = 0.001 and p < 0.001, respectively) and the acute (p = 0.008 and p = 0.001, respectively) and chronic (p = 0.006 and p = 0.001, respectively) MRI severity of the TMJ arthritis. The results of this study suggest that in patients with JIA, limited mouth opening at the initial TMJ assessment may be a valid indicator of clinical severity of TMJ arthritis, which correlates with severity as seen on MRI.

Computed tomographic features of the temporomandibular joint in 10 Jeju horses.

BackgroundThe equine temporomandibular joint (TMJ) has a complex anatomical structure that makes diagnosis of TMJ disorders difficult. Computed tomography (CT) is now available in equine medicine; hence, TMJ evaluation has become more convenient.ObjectivesThe objectives of this study were to describe the CT features of the TMJ in Jeju horses and to compare these features with those of Thoroughbreds.MethodsIn this report, the TMJs of 10 Jeju horses (mean age: 4.5 ± 1.9 yr; mean body weight: 282.6 ± 40.3 kg) and 6 Thoroughbreds (mean age: 7.3 ± 1.6 yr; mean body weight: 479.7 ± 44.0 kg) were examined using CT. After CT scanning, the Hounsfield units (HU) and height to width ratio (H:W) of the mandibular condyle were measured.ResultsThe mean H:W in Jeju horses was significantly lower than that in Thoroughbreds. The mean HU in Jeju horses was lower than that in Thoroughbreds; however, the difference was not significant. The most frequent CT finding was an irregular medial margin of the mandibular condyle in both breeds.ConclusionsIn this study, the shape of the mandibular condyle in Jeju horses was flatter than that in Thoroughbreds. This report could be useful in evaluating the TMJ in Jeju horses. Moreover, CT could be a pragmatic choice for the examination of the TMJ in horses.