Joint Fossa Research Articles

Effect of Different Treatment Modalities for Condylar Fractures in Childhood on Mandibular Symmetry and Temporomandibular Joint Function: A Retrospective Study.

In a retrospective study of the effects of different treatment modalities of condylar fractures in childhood on mandibular symmetry and temporomandibular function, the cases selected for this article were adult patients who had sustained a condylar fracture in childhood. The aim was to investigate the effects of condylar fractures in children on the development and function of the mandible and their specific manifestations after the completion of mandibular development. According to the different treatment modalities, the patients were divided into the conservative treatment group and the open surgical treatment group, and the effects of the 2 treatment modalities on the patients' condylar healing, the difference in growth ability, and the symmetry of the jaws were evaluated. The effects of different treatment modalities of children's condylar fracture on the growth, development, and function of the mandible were investigated using the Ai and Di, the grading of the imaging results, and the 3-dimensional CT fixation measurements from the aspects of both clinical examination and imaging examination. The 2 groups had condylar malalignment and condylar morphology abnormality, and there was one case of joint ankylosis in the surgical treatment group. There was a statistical difference in the evaluation of condylar reconstruction between the 2 groups, and the condylar reconstruction in the surgical treatment group was better than that in the conservative treatment, and there was a statistical difference between the condylar length, condylar width, condylar height, and depth of TMJ fossa between the healthy side and the affected side in the closed treatment group. There was a statistical difference in the height of the mandibular ascending branch between the healthy side and the affected side, and the unilateral condylar fracture was treated conservatively; the difference in the bony chin point deviation between the 2 groups was not statistically significant. In children, after conservative treatment of condylar fracture, the growth of condylar process is poor, and the condylar shape and position are not as good as surgical repositioning, but through the proliferation of temporomandibular joint fossa, it can make up for the insufficient height of condylar process, which has no effect on the symmetry of the mandible, and the surgical treatment can achieve good anatomical repositioning, which has a greater effect on the symmetry of the mandible than the conservative treatment.

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.

Imaging features of temporomandibular joint synovial chondromatosis with associated osseous degenerative changes

Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign disease associated with the formation of multiple cartilaginous nodules in the synovial tissue of the TMJ. This can result in pain, swelling, clicking, limited mouth opening, and osseous degenerative joint changes. A retrospective cross-sectional study was performed to summarize the clinical features, radiographic findings, and surgical and histopathological findings of TMJ SC patients who underwent open surgery over a 24-year period. A radiographic scoring system was used to evaluate osseous changes and correlate condyle and joint fossa degeneration. The study included 38 patients and focused on 38 joints. All 38 of these joints showed degenerative changes in the condyle, while 37 showed osseous degenerative changes in the articular fossa. The degree of condylar degenerative changes was related to the duration of the chief complaints (r = 0.342, P = 0.036) and the histopathological stage of the TMJ SC (r = 0.440, P = 0.006), while the degree of joint fossa degenerative changes was associated with the radiographic extent of the SC (r = 0.504, P = 0.001), type of calcification (r = 0.365, P = 0.024), and the histopathological stage (r = 0.458, P = 0.004).

Retrospective study of synovial chondromatosis of the temporomandibular joint: clinical and histopathologic analysis and the early-stage imaging features

Herein, we aimed to study the clinical, radiographical, and histopathologic features of synovial chondromatosis in the temporomandibular joint (SC in TMJ) and provide references for early diagnosis and treatment prognosis. The medical records and imaging examinations of patients with SC in TMJ, diagnosed using postoperative histopathologic examination, were reviewed and analyzed. Among them, 18 cases who lacked calcified loose bodies on spiral computed tomography or cone beam computed tomography (SCT/CBCT) were selected for further study. Descriptive statistical methods were used to analyze the clinical characteristics of patients. The study included 100 patients with SC in TMJ, who were predominantly female (male to female: 1:3), and were aged from 21 to 77 years (median, 47). Radiopaque calcified lesions on SCT/CBCT were missing in 18 cases, but cartilaginous nodules were observed during surgery. The cases lacking calcification had a relatively shorter disease course, suggesting they were in the early stages of SC. In the early stage of SC, although calcified loose bodies cannot be detected on SCT/CBCT, attention should be paid to the widening of the posterior superior joint space and sclerosis or slight erosion of the joint fossa. Magnetic resonance imaging would be helpful to detect the early-stage SC in TMJ.

Inter- and Intra-Observer Variations in Radiographic Evaluation of Pelvic Limbs in Yorkshire Terriers with Cranial Cruciate Ligament Rupture and Patellar Luxation.

The main aims of the study were to describe bone alignment differences in Yorkshire Terriers (YT) with cranial cruciate ligament rupture (CCLR), patellar luxation (PL), or with a combination of both (CCLR + PL); to verify the theory of increased strain on cranial cruciate ligament (CrCL) due to PL as a predisposing factor; and to evaluate intra- and inter-observer variability of the protocols developed for measurement of femoral and tibial alignment in Yorkshire Terriers. Fifty-five hindlimbs of YT were divided into four groups: Control, CCLR, PL, and CCLR + PL. Thirty parameters were radiographically evaluated including hip joint, femoral, tibial, and intercondylar fossa (ICF) parameters. Three observers evaluated all parameters on two separate occasions with a twelve-week interval between measurements. Significant differences in conjunction with CCLR and PL theories between groups were noticed in: Norberg angle (NA), quadriceps angle (Qa), anatomic lateral distal femoral angle (aLDFA), femoral varus (FVA), mechanical cranial proximal tibial angle (mCrPTA), mechanical caudal proximal tibial angle (mCdPTA), tibial plateau angle (TPA), distal tibial axis/proximal tibial axis angle (DPA). Some interesting findings are the similarity of values between Control and CCLR vs. CCLR + PL and PL groups in Na, Qa, aLDFA; between CCLR + PL and PL in FVA and a significantly lower age of dogs in CCLR + PL compared to CCLR group. Based on our results, we can conclude that YT with different clinical findings have differing bone morphology. Moreover, these findings may support PL as a predisposing factor for CCLR in small breeds. Measurements in which excellent inter- observer agreement was achieved may be used for surgical planning or for further discussions.

Development and kinesitherapeutic treatment of glenhumeral instability

The upright position of a person frees the upper limb to perform precise activities. As a result, the arm can be placed at any point in an almost complete circle with a diameter determined by the length of the upper limb. This predetermines the development of mobility in the shoulder kinematic complex. However, the large volume of movement causes a compromise with stability, which is a prerequisite for the complex’s fragility. The shoulder joint can be luxated much more often than other joints due to the shallow joint fossa, and low congruence and bone stabilization. The main passive stabilizing structures are the fibrous joint capsule and ligaments, and the main dynamic stabilizer is the rotator cuff of the joint, which surrounds it on all sides. Therefore, the emphasis in kinesiotherapy is on restoring its function (4). The dislocation of the upper limb also has a significant social aspect, associated with job loss, financial difficulties, changes in the lifestyle of the individual and their family, etc. Unfortunately, there are no exact data on the loss of labor, cash benefits and loss in production, both in the world and in Bulgaria. Treatment of traumatic dislocation can be conservative, through adjustment and immobilization. If it fails and the subluxations become chronic, the patient is examined by magnetic resonance imaging and arthroscopy for surgical treatment. Surgical treatment of shoulder instability has been a problem that has attracted the attention of doctors since ancient times. Hippocrates was the first to pay serious attention to recurrent luxation and offer a technique for its treatment. In such patients, he caused burns with white-hot metal rods in several places around the joint in order to obtain coalescence that stabilized it. Restoration of anterior glenohumeral stabilization by the arthroscopic method is one of the most modern methods of treatment (1).

Evaluation of the dimensions, morphology, and position of the mandibular condyles in individuals with neurofibromatosis 1: a case-control study.

The aim of this study was to evaluate the mandibular condyles of neurofibromatosis 1 (NF1) individuals without facial plexiform neurofibroma using cone beam computed tomography images. Eighty cone beam computed tomography scans (160 mandibular condyles) were analyzed: 40 from NF1 individuals (study group) and 40 from individuals without NF1 (control group). The anteroposterior and mediolateral dimensions, height, and volume of the mandibular condyles were measured. The mandibular condyles were classified according to their morphology: healthy (absence of morphological changes), with flattening (loss of rounded contour of at least one of the surfaces), with erosion (loss of continuity of the cortical bone), with osteophyte (exophytic formation of the condyle surface), and with sclerosis (any increase in the cortical thickness in the load-bearing areas). Furthermore, the position of the mandibular condyles in relation to the joint fossa in an anteroposterior view was classified as anterior, concentric, or posterior. The study group had a higher anteroposterior dimension of the mandibular condyles compared with the control group (p < 0.05). There were no differences in condylar morphology and position between both groups (p > 0.05). The morphological alterations were not associated with sex or age in any group evaluated (p > 0.05). For both groups, the concentric position was the most common. For the study group, there was a significant difference in the condylar position between the sides (p < 0.05). NF1 individuals without facial plexiform neurofibroma present a high prevalence of condyles with a large anteroposterior dimension and asymmetric position in the joint fossa. However, no morphological and volumetric changes were observed in the mandibular condyles of them. The knowledge of the TMJ alterations in individuals with NF1 is important to establish an evaluation protocol, which would allow early intervention if indicated.

Maxillary width and hard palate thickness in men and women with different vertical and sagittal skeletal patterns

The objective of this research was to compare maxillary width and hard palate thickness in men and women with different vertical and sagittal skeletal patterns. A total of 241 adults (93 men and 148 women aged from 18 to 25years) were divided into male and female groups. Subjects were then separately divided into 3 sagittal skeletal groups and 3 vertical skeletal groups. A lateral cephalogram and a cone-beam computed tomography were taken for each subject. We measured the parameters to make statistical analyses and compared them between the different groups. Women had smaller craniomaxillofacial bone width and palatal thickness than men. In sagittal groups, maxillary width, maxillary alveolar width, and external temporomandibular joint fossa width in Class II and Class III malocclusion groups were smaller than in the Class I group for both women and men. The internal temporomandibular joint fossa width was the same results in men and women. In vertical groups, palate thickness, maxillary width, and maxillary alveolar width of the high-angle group were smaller than those of the low-angle group, regardless of sex. To an extent, maxillary width is correlated with vertical and sagittal skeletal patterns, and insufficient maxillary width would lead to unfavorable skeletal patterns. Differences exist in the morphology of craniomaxillofacial bone between men and women. Therefore, these findings can provide clinicians with references for differential diagnosis and treatment plans.

A preliminary study on the registration of MRI and cone beam CT images of temporomandibular joint disc

Objective: To evaluate the MRI and cone beam CT (CBCT) image registration methods of the temporomandibular joint (TMJ), and to explore the clinical application of the registered images and clinical diagnostic data for examining the relationship between the articular disc and condyle. Methods: Three patients with TMJ disc disposition were recruited at the Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University from January to March 2018. One patient was male, aged 30, and the others were females, aged 21 and 26 respectively. Three-dimensional (3D) images of CBCT and MRI of the TMJ were reconstructed and registered by using Mimics software. The images were then evaluated after the registration. The evaluation indicators selected were the area and volume of the articular disc, the position of the articular disc or the distance between the highest point of the condyle (point C) to the center point of the articular disc (point D), the distance between the last point of the joint disc (point P) to point C, as well as the angle between line CD and FH plane (∠DCF) at either opened- or closed-mouth condition. Results: The registration images of TMJ, at the closed- and opened-mouth positions of the 3 patients, showed the anatomical structures and interrelationships of the articular disc, articular nodules, joint fossa and condyle. Combined with clinical diagnosis, the difference of CD distances at the normal articular disc position was the minimum (1.94 mm), the difference of CD distances was small at the anterior disc displacement with non-reduction and larger with reduction. When the joint disc was in the opened-mouth position, ∠DCF angle was minimal (3.81°). The patients with anterior disc displacement with non-reduction showed the largest ∠DCF angle (48.03°). Conclusions: The position of the articular disc relative to the condyle and articular nodules, either at closed- or opened-mouth conditionds, could be accurately displayed after the image registration and fusion. The registration image not only could fully show the shape and position of the articular disc in different status from a 3D perspective, but also might provide basis for clinical study of TMJ disc displacement.

EVALUATION BY VOLUMETRIC COMPUTED TOMOGRAPHY IN PATIENTS WITH TEMPOROMANDIBULAR JOINT DEGENERATIVE DISORDER

Objective was to show a clinical case of a patient with degenerative temporomandibular joint (TMJ) disorder by means of volumetric computed tomography (CT) before and after the intervention. A female patient, 65 years old, presented with sudden malocclusion with contact on only 2 teeth, 1 on each side, from a recent open bite, crackling on the left side of TMJ. Magnetic resonance imaging of the TMJ presented a displacement of the disk without recapture. CT of the TMJ presented erosion of the articular surface of the condyle and left fossa, and erosion of the right condyle with osteophyte. She was diagnosed with right side arthralgia, disk displacement without reduction, and degenerative disorder more pronounced on the left side. We performed viscosupplementation of hyaluronic acid, low intensity infrared laser therapy, and use of stabilizing occlusal splint. Comparative CT imaging showed bone remodeling on the left side and a more centered positioning of the condyle on the left side in relation to the joint fossa. Objective was to show a clinical case of a patient with degenerative temporomandibular joint (TMJ) disorder by means of volumetric computed tomography (CT) before and after the intervention. A female patient, 65 years old, presented with sudden malocclusion with contact on only 2 teeth, 1 on each side, from a recent open bite, crackling on the left side of TMJ. Magnetic resonance imaging of the TMJ presented a displacement of the disk without recapture. CT of the TMJ presented erosion of the articular surface of the condyle and left fossa, and erosion of the right condyle with osteophyte. She was diagnosed with right side arthralgia, disk displacement without reduction, and degenerative disorder more pronounced on the left side. We performed viscosupplementation of hyaluronic acid, low intensity infrared laser therapy, and use of stabilizing occlusal splint. Comparative CT imaging showed bone remodeling on the left side and a more centered positioning of the condyle on the left side in relation to the joint fossa.

CBCT Analysis of Changes in Dental Occlusion and Temporomandibular Joints before and after MEAW Orthotherapy in Patients with Nonlow Angle of Skeletal Class III.

This study focus on the changes of the position and morphology of jaw and condyle after MEAW (the multiloop edgewise arch wire) treatment in adults with a nonlow angle (mean angle or high angle SN − MP > 27°) of skeletal class III (mild to moderate skeletal classs III means −5° < ANB < 0°) malocclusions measured by CBCT (cone beam computed tomography). Twenty adult patients (aged 17-26) with a nonlow angle of skeletal class III malocclusions were selected in this study taken orthodontic treatment by MEAW. CBCT was taken before and after the treatment to analyze the changes of the jaw and condyle. After treatment, the angle of L7-MP decreased 12.2°, L6-MP decreased 10.5°, L1-MP decreased 8.8° (P < 0.001 for each) and U1-SN increased (P < 0.05). There was no significant changes between anterior and posterior APDI index and between anterior and posterior spaces of the TMJ (temporomandibular joint) (P > 0.05). The linear ratio of the TMJ was the LR > 12 before treatment, while it was −12 < LR < 12 after treatment; however, there was no statistically significant difference between them (P > 0.05). There was also no significant change in anterior and posterior position and morphology of the condyle within the joint fossa after the treatment by MEAW in this study. MEAW technology in correcting the class III with nonlow angle patients mainly relies on the compensation of distally and posterior mandibular teeth, rather than the mandible and condyle moving backward to establish a neutral occlusal. This study was approved by the institutional ethics committee of the Second Hospital of Tianjin Medical University (No. KYJJ2013002).

Cone-beam CT evaluation of temporomandibular joint in permanent dentition according to Angle's classification.

To compare characteristics of temporomandibular joint (TMJ) and related structures according to Angle class I, II1, II2, and III. 123 Chinese patients (13-36years old, 60 males, and 63 females) were classified in four groups according to Angle's classification: skeletal class I (31 patients), skeletal class II division 1 (30 patients), skeletal class II division 2 (30 patients), and skeletal class III (32 patients). Left and right TMJs of each subject were evaluated independently with cone-beam computed tomography (CBCT). The position of condyle in the joint fossa was analyzed according to Pullinger. There were significant differences between class III subjects and class I, II1, II2 in the superior joint space (p < 0.05). Compared with class II1, II2, and III subjects, the height and diameter of condyle in class I was significantly larger (p < 0.05). The width of joint fossa was significantly larger in Angle class III than in Angle class I, II1, and II2, while the depth was significantly smaller. The condyle position in class III subjects was more anteriorly displaced compared with that in class I subjects. In class II2 patients, the condyle position was mainly concentric and posterior. There are significant differences in condylar morphology, joint space, joint fossa morphology, and condylar position between different Angle classifications.

Effect of Push-Up Position on Wrist Joint Pressures in the Intact Wrist and Following Scapholunate Interosseous Ligament Sectioning.

To determine the contact pressures between the scaphoid and lunate and the distal radius during 2 wrist push-up positions before and following scapholunate interosseous ligament (SLIL) sectioning. Eight fresh cadaveric wrists were tested in a neutral flexion-extension (knuckle) push-up position and in an extended push-up position. Pressure measurements were acquired as each wrist was loaded with the wrist in extension and with the wrist in a neutral position. Data were acquired with the SLIL intact and following sectioning of its dorsal, volar, and proximal components. The wrist was disarticulated and a map drawn on each sensor to identify each joint fossa. A push-up performed with the wrist in extension caused a significantly greater peak pressure in the radioscaphoid fossa but not in the radiolunate fossa. Moving the wrist into extension caused a significant dorsal movement of the pressure centroid an average of 2.9 mm in the radiolunate fossa and an average of 5.7 mm in the radioscaphoid fossa. Sectioning the SLIL caused the centroid of pressure in the radioscaphoid fossa to significantly move an average 1.4 mm radially. A push-up with the wrist in extension causes a significant increase in the pressure in the radioscaphoid fossa but not in the radiolunate. This finding may help explain why degenerative arthritis first develops in the radioscaphoid fossa before involving the radiolunate fossa. As expected, gapping that occurs with SLIL injury was observed here as a radial translation of the scaphoid and not as a movement of the lunate. The new location of scaphoid contact may be an additional reason for the development of radioscaphoid arthritis occurring before radiolunate arthritis. This study provides a possible explanation as to why degenerative arthritis may first occur in the radioscaphoid fossa.

Temporomandibular joint fossa difference according to the skeletal malocclusion

Temporomandibular joint fossa difference according to the skeletal malocclusion

A Comparative evaluation of CBCT outcomes of two closed treatment methods in intracapsular condylar fractures

The cone beam computed tomography (CBCT) images of 2 closed treatments are compared for intracapsular condylar fractures (ICFs) to learn whether splint treatment could promote better radiologic outcomes. Fifty-four patients with 60 sides of ICF were divided into 2 groups. In the control group (C-group), patients had a liquid diet for 1month. In the trial group (T-group), patients wore splints with anterior elastic traction. Local CBCT images of the temporomandibular joint were obtained at T0 (mean 8.8days), T1 (mean 37.4days), and T3 (mean 3.3months) after trauma. Six parameters, including 2 horizontal, 1 sagittal, and 3 vertical distances, were calculated using the coordinates of 10 points marked on CBCT sections. Statistical analysis included intragroup comparison at T0, T1, and T3, and intergroup comparison among subgroups classified by age and ICF types. Compared to C-group, vertical distances were significantly changed in T-group, specifically in adults and patients with ICF type B. Significant changes at stage T1 were also observed in T-group. During the natural healing process, ICF healed in the displaced position and the stump tended to move closer to the joint fossa in the vertical dimension. Splint treatment with elastic traction was helpful to increase joint space and promote better radiologic healing shape.

A cone-beam computerized tomography assessment of the relationship between upper incisors inclination and articular eminence features in orthodontically untreated patients with different facial type

ObjectiveTo compare the features of the glenoid fossa and the upper incisor inclination in orthodontically untreated individuals with different facial types (i.e., short-, normo-, long-faced subjects) and to assess the existence of any correlations between the articular and incisor paramaters by means of cone-beam computed tomography. Materials and MethodsSixty (N = 60) untreated individuals aged 18 to 40 years, subdivided into three groups based on facial type, underwent cone-beam computed tomography assessment of the following measurements: glenoid fossa size, articular eminence angle with respect to the sella nasion plane and inclination of the axis and lingual surface of the upper central incisor with respect to the sella nasion plane. ResultsComparison of the features of temporomandibular joint fossa in the three facial types showed the absence of significant differences. As for the incisor parameters, no significant differences among the three facial types were detected, with a minor exception: the incisal margin/cingulum angle between short- and long-faced subjects (101.86° vs 95.70°; P = 0.024). Correlation analyses shows the absence of any significant relationships between features of the glenoid fossa and incisor inclination both in the overall sample and the different facial morphology groups. ConclusionsThere are no differences between the features of the glenoid fossa and the upper incisor inclination in subjects with different facial types, as well as there is an absence of clinically relevant relationships between the articular shape and incisor inclination.

Accuracy of digital panoramic radiography in the diagnosis of temporal bone pneumatization: A study in vivo using cone-beam-computed tomography

PurposeThe objective of the study was to determine the diagnostic accuracy of panoramic radiographs in the evaluation of pneumatization of the temporal bone, with confirmation of the diagnosis by cone-beam-computed tomography (CBCT) images. MethodsImages of 200 patients' digital panoramic radiographies and CBCT were examined by three evaluators regarding the presence or absence of pneumatization on temporomandibular joint (TMJ) fossa and/or articular eminence. When present, the defect was classified as uni- or multilocular, and as unilateral or bilateral. Areas under the ROC curve were compared to assess the accuracy of panoramic radiograph. ResultsThe values obtained in the comparisons ranged from Az = 0.67 to 0.55 (Az = area under the ROC curve). ConclusionsThe panoramic radiograph, is not the exam of choice for detecting the presence of these air cells based on its medium to low accuracy for diagnosis of pneumatized articular eminence and TMJ fossa when compared to CBCT.

Computed tomography and magnetic resonance imaging findings for primary middle-ear carcinoma

This study aimed to investigate the computed tomography and magnetic resonance imaging findings of primary middle-ear carcinoma. In this retrospective study of 13 patients with primary middle-ear carcinoma, we collected pre- and post-contrast magnetic resonance images for all 13 cases, high-resolution computed tomography scans for 11 cases, and conventional computed tomography scans with contrast for 2 cases. Soft-tissue masses were mainly located in the tympanum, tympanic sinus and deep within the external auditory canal, and involved the jugular fossa (9 of 13 patients), middle cranial fossa (5/13), parotid gland (2/13) and temporomandibular joint fossa (1/13). An irregular, 'moth-eaten' bone destruction pattern was seen on high-resolution computed tomography images, most commonly in the eustachian tube (9/13), jugular foramen (9/13) and facial nerve canal (7/13). On non-contrast magnetic resonances images, masses were isointense or slightly hypointense on T1-weighted images, and isointense or slightly hyperintense on T2-weighted images. On post-contrast images, lesions were moderately and homogeneously enhanced in seven cases and inhomogeneously enhanced in six. High-resolution computed tomography precisely detects regions of bone destruction, whereas MRI can better assess soft-tissue tumour margins, intracranial extension and vessel patency. Eustachian tube erosion is an important characteristic of primary middle-ear carcinoma.

Dental findings and oral health status in patients with mucopolysaccharidosis: a case series

Objective. To present a mucopolysaccharidosis (MPS) case series evaluating oral manifestations (clinical and radiographic), oral health status and discussing its implications. Patients and methods. All patients with MPS attending the Genetics clinic/Brazil were evaluated by means of anamnesis, clinical and radiographic examinations. Results. The final sample consisted of 12 subjects (nine males and three females), with ages ranging from 3–31 years old. Concerning oral health, it was observed high levels of caries and periodontal problems. About oral manifestations, this study clinically observed more cases of delayed tooth eruption, thickness of alveolar process and thick lips. Radiographically, it was observed alterations on condyle, mandibular ramus and joint fossa. Conclusion. The dental changes in MPS population are high and consequently it is important to know them for differential diagnoses, early treatment intervention, prevention and education of both patients and parents/caregivers about oral health.

Magnetic resonance imaging on TMJ disc thickness in TMD patients: A pilot study

Studies of temporomandibular joint (TMJ) discs removed from autopsy specimens and in surgery indicate that they are often thicker in patients with temporomandibular disorders (TMDs). Disc thickness may also change when the condyle moves in and out of the joint fossa during opening and closing. The purpose of this pilot study was to test the hypothesis that the TMJ disc thickness is greater in TMD patients than in healthy subjects and is affected by the degree of jaw opening. Magnetic resonance images (MRI) were made of the TMJs in young volunteers, 9 asymptomatic subjects and 9 TMD subjects, at closed and at 10-, 20-, and 30-mm open positions. The thickness of the anterior and posterior bands of the discs and the intermediate zones was measured and compared between TMD and control groups, and between closed and opened positions, using the repeated-measures method in general linear model (alpha=.05). The hypothesis that the disc was thicker in the TMD than in the control group was supported with respect to the anterior band and intermediate zone (P<.046), but not with respect to the posterior band. The hypothesis that the thickness is affected by the degree of jaw opening was only supported for the posterior band, where it increased during opening in both groups (P<.005). The results indicate that the anterior band and the intermediate zone of the TMJ discs are thicker in TMD patients than in healthy subjects. The posterior band thickness increases with mouth opening in both asymptomatic and TMD subjects.