Left Temporomandibular Joint Research Articles

Impact of temporomandibular disorder on food preference behavior in adult male rats

ObjectiveTemporomandibular disorders (TMD) are a group of conditions affecting the jaw, surrounding muscles and associated structures. Researches indicate that TMD has implications for changes in nutritional behavior. This study investigates the impact of TMD on the food preference behavior of rats, examining various food models with differing caloric content, taste, and texture. DesignForty-two male Wistar rats (200–250 g) were divided into six groups, comprising three control and three pain or TMD groups. Induction of TMD by injection of complete Freund adjuvant (CFA) into the left temporomandibular joint (TMJ) of rat serves as a model for studying TMD. Twenty-four hours post-TMD induction, the preference of animals to foods with differences in calories, taste and texture was evaluated with the help of an automatic preference measuring device. ResultsIn terms of caloric preferences, the pain group exhibited a distinct shift towards high-calorie food. Taste preferences were marked by an increased preference for sweet food in the pain group. Texture preferences were altered, with the pain group displaying a preference for low-texture food. ConclusionTMD in rats leads to increased preferences for high-calorie and sweet foods, as well as altered preferences for food textures. These findings highlight the influence of TMJ pain on food preference behavior in rats.

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.

Internal disorder in the temporomandibular joint in young patient : Conservative Treatment vs Surgical Treatment Part 1.

Abstract: The patient presents with algia in the left mandible and in the ocular region, specifically at the base of the orbit. Initially, after clinical examination, the suspicion was migraine associated with bruxism with internal joint disorder. After imaging exams by tomography and magnetic resonance imaging with T1, T2, and DP contrast, it was observed that in the left temporomandibular joint, there is disc displacement without reduction, and in the right temporomandibular joint, the disc shows partial recovery. After one year of using an interocclusal device, the patient shows improvement in pain symptoms; however, the disc has only slightly improved in recovery, suggesting the possibility of future open surgery for disc repositioning through discopexy.

A Case Report of Korean Medicine Treatment for a Patient with Left Facial Paraesthesia, Temporomandibular Joint Pain, and Post-traumatic Neck Pain induced by Cerebral Infarction

Objectives: The aim of this case report is to present the effects of Korean medicine treatment in a patient with left facial paraesthesia, temporomandibular joint (TMJ) pain, and post-traumatic neck pain induced by cerebral infarction.Methods: A 26-year-old male patient was treated with Cheongpa-Jeon H, acupuncture, pharmacopuncture (Shinbaro2), and Chuna Therapy for 24 days of hospitalization. Left facial paraesthesia, TMJ pain, and post-traumatic neck pain were assessed with a Numeric Rating Scale (NRS) and EuroQoL-5 Dimension (EQ-5D). Post-traumatic neck pain was assessed using the Neck Disability Index (NDI).Results: After 24 days of treatment, the patient’s left facial paraesthesia and left arm tingling sensation were relieved from NRS 6 to NRS 2. Left TMJ pain was reduced from NRS 5 to NRS 2. The EQ-5D score increased from 0.138 to 0.73. The NDI score decreased from 71.11 to 37.78.Conclusion: These results show that left facial paraesthesia, TMJ pain, and post-traumatic neck pain can be relieved with Korean medicine treatment. However, further well-designed studies are required to confirm these findings.

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 Dosimetric Predictors of Patient-Reported Quality of Life for Head and Neck Cancer Following Chemoradiation IMRT

This study aims to identify both acute and late patient patient-reported salivary quality of life outcomes in patients with head and neck cancer treated with chemoradiation therapy on a prospective trial. A cohort of 40 patients with head and neck cancers were included in the study. All patients underwent concurrent chemoradiation therapy using IMRT delivery (1 patient on one Linac, 24 patients on a different Linac, and 15 on a helical delivery machine). All patients were asked to complete the University of Washington Quality of Life (UOW-QOL) questionnaire at baseline, immediately after treatment, as well as at 1 month, 3 months, 6 months, 12 month and 18 months post-treatment. For the salivary quality of life (QOL) outcome scores, the possible responses were scored on a discreet scale of 100, 70, 30, and 0, with 100 as normal and 0 as dysfunctional. Dosimetric endpoints achieved based on the treatment plan, such as maximum/mean/minimum doses, V30 (percent volume receiving 30 Gy dose), and Dy (dose received to y percent volume) were collected for the bilateral salivary glands, bilateral temporomandibular joint and bilateral submandibular glands. The associations between these dosimetric parameters and the corresponding salivary QOL scores at each time point were analyzed. A Wilcoxon test was performed to identify any differences in the dosimetry and salivary QOL scores among the four different responses. At short-term follow-up including 1- and 6-month, the distribution of the mean dose received by the right parotid was significantly different between the patients that reported a salivary QOL score of 30 and those that reported 100, with p-values of 0.007 for the 1-month comparison and 0.006 for the 6-month comparison. This was also seen for the V30, with p-values of 0.027 for the 1-month comparison and 0.013 for the 6-month comparison. At 3 months, the maximum dose received by the left temporomandibular joint was significantly different between the patients that reported 30 and those that reported 70, with a p-value of 0.038. At 6 months, the average dose distribution of the right submandibular gland received between the patients that reported a score of 30 and 100 was also significantly different, with a p-value of 0.006. At the long-term follow-up time points of 12 and 18 months, no significant differences were found. The significant differences seen in the data suggest that the dosimetry may have effects on patient reported salivary QOL at short-term follow-up but not long-term. This provides a new perspective into how a patient's QOL over a period of time could be affected by the amount of dose to critical organs. These results also serve as the basis for further investigation into the actual delivered dose, which could differ from the planned dose due to daily anatomic changes over the course of head and neck radiotherapy delivery. These daily volumetric and dosimetric changes may guide early adaptive treatment to improve patient-reported QOL outcomes.

Unilateral Severe Condylar Resorption Following Internal Fixation in Bilateral Mandibular Condylar Fracture

Study Design Case Report Objective: A severe condylar resorption following internal fixation of the mandibular condylar fracture is rarely reported. Methods A 35-year-old female caused bilateral condylar base fracture due to fall. She had no connective tissue autoimmune disease, no temporomandibular joint (TMJ) problems, and no history of the orthodontic treatment. Each fractures of condyles were fixed by 2 none-locking titanium miniplates on ideal lines of the osteosynthesis. Results: 6 months after surgery, although patient showed no malocclusion and no TMJ pain, panoramic X-ray showed left side condylar head resorption. Twelve months after surgery, bilateral plate removal was performed. Twenty-six months after internal fixation, panoramic X-ray showed bone formation at the left side of the condylar head. Magnetic resonance imaging of the TMJ showed left TMJ disc displacement without reduction and severe deformity of the left condylar head. Conclusions The condylar resorption might be caused by increasing functional loading due to new position of the condyle following osteosynthesis. Possible contributors for condylar resorption following osteosynthesis were: (1) internal fixation in bilateral condylar fracture, (2) disc displacement without reduction, and (3) female patient (hormonally-mediated theory, eg estrogen). However, the mechanize of condylar resorption was unclear and the further studies were necessary.

A surgical management of articular disc injury in temporomandibular Joint: A compiled case series of two cases with articular disc tear managed with surgical intervention

Articular disc injury in the temporomandibular joint (TMJ) can lead to significant pain and limited jaw movement. We present two cases in this case series of articular disc injuries in the TMJ and elaborate on their etiology, clinical presentation, diagnostic modalities, and treatment provided with follow-up reviews. Case 1 involved a 50-year-old female with a history of pain and clicking in the left TMJ for 10 years, wherein imaging studies revealed a discal tear. Case 2 involved a patient who presented with trauma and was diagnosed with a displaced disc with a disc tear when the patient was screened for mandibular fractures. The patients underwent surgical intervention, and the disc tear was repaired, following which both showed marked improvement. Our cases highlight the importance of early diagnosis and necessary surgical management of articular disc injury in the TMJ for better clinical outcomes.

Do Case Reports on Total Mandibular, Extended, and Bilateral Total Temporomandibular Joint Reconstruction Prostheses Adhere to the Surgical CAse REport Guidelines?

The Surgical CAse REport (SCARE) guidelines are a standardized format for reporting surgical cases. The aim of this study was to evaluate the completeness of case reports documenting alloplastic reconstruction of large craniomaxillofacial defects involving total mandibular, bilateral, and extended temporomandibular joint in major high-quality craniomaxillofacial journals, based on the SCARE guidelines. An extensive online search was performed according to the Priority Reporting Items for Systematic Reviews and Meta-Analyses statement in PubMed, Embase, Scopus, Google Scholar, and Dimensions databases to identify relevant case reports. Each selected case report was assessed on 16 topics (38 items) of the SCARE guidelines, using a scoring scale of "0" (No/noncompliance), "1" (Yes/compliance), and "2" (unclear). The completeness of reporting (COR) score was calculated as the ratio of "yes" responses to "total" (ie, yes+no+unclear) responses. Adequacy of case reporting was denoted by a COR score of 70% or more. A total of 35 case reports were selected, where the male to female patients ratio was 3:4 cases, mean±standard deviation (SD) age: 34.9±16.7years, mean±SD follow-up duration: 17.0±12.9months, and number of patients with left, right, and bilateral temporomandibular joint reconstruction prostheses were 16, 10, and 09, respectively. The mean±SD COR score for all 35 case reports and the individual item of the SCARE guidelines was 70.2±10.5% and 66.5±31.2%, respectively. The minimum and maximum COR score was found for "Keywords" (0.0%) and "Introduction" (100%) and "Clinical Findings" (100%), respectively. Adequate reporting was found for 20/35 (57%) case reports. This study revealed that case reports in major high-quality craniomaxillofacial journals suffer from insufficient reporting. Widespread adoption of available standards, such as SCARE guidelines, is proposed to improve the quality and robustness of case reporting.

A Case of Internal Carotid Artery Dissection Presenting With Dysgeusia (P12-5.014)

<h3>Objective:</h3> NA <h3>Background:</h3> A 42-year-old man presented to the emergency room (ER) with headache and neck pain associated with dysgeusia for three days. The headache was described as sudden, moderate, with throbbing pain, located in the left frontal region, and radiating to the left temporomandibular joint. The pain was not aggravated by chewing or position. He denied mechanical trauma to the neck including deep tissue massage or chiropractic manipulation. He had also incidentally noticed that orange juice tasted bitter. He denied a change in voice or difficulty swallowing. The exam was notable for left-sided ptosis and altered taste to the posterior 1/3^rd tongue to sugar water. CT angiography showed irregularity of the distal left internal carotid artery (ICA) from the C1 segment into the proximal petrosal segment associated with a 3 mm pseudo-aneurysm, concerning for dissection. <h3>Design/Methods:</h3> NA <h3>Results:</h3> The mean annual incidence of spontaneous ICA dissection is 2.9 per 100,000. The classic triad of symptoms is ipsilateral head or neck pain, partial Horner syndrome, and cerebral or retinal ischemic symptoms. Cranial nerve (CN) palsies may occur in more than 10% of patients with extracranial ICA dissections, most commonly involving CN XII, followed by V, VII, IX and X. We discuss a patient with isolated dysgeusia in the posterior 1/3^rd of the tongue with left-sided Horner syndrome in the setting of distal ICA dissection. Clinical presentation is consistent with an isolated glossopharyngeal nerve palsy and Horner syndrome. At the distal cervical level, the glossopharyngeal nerve and sympathetic tract run closely to the ICA and are susceptible to compression by the pseudoaneurysm. There exist only a few reports on loss of taste sensation caused by dissection of ICA. <h3>Conclusions:</h3> This case highlights that posterior ipsilateral dysgeusia can be a manifestation of cervical internal carotid artery dissection and should prompt appropriate evaluation and neuroimaging. <b>Disclosure:</b> Dr. Joseph has nothing to disclose. Dr. Ariza Hutchinson has nothing to disclose. Dr. Shnawa has nothing to disclose. Dr. Sehgal has nothing to disclose.

E016 Erosive psoriatic arthritis causing deafness

Abstract Background/Aims Hearing loss from systemic psoriatic disease is rare, and cases reported in the literature have been reported with sensorineural deficits. Conductive hearing loss due to psoriatic arthritis has not been specifically reported in the literature, and this is believed to be the first reported case of erosive psoriatic arthritis causing conductive hearing loss. Presented is an illustrated case of a patient complaining of worsening bilateral hearing loss who underwent investigations under otolaryngology and audiology, and subsequent CT imaging which identified erosion of the temporal bone, posterior to the left temporomandibular joint, resulting in subluxation into the external auditory canal leading to complete occlusion of the canal. Methods 58yo female with psoriatic arthritis, psoriasis, and Raynaud’s phenomenon presenting with an 18-month history of hearing loss, worst on the left, but with some improvement on mouth opening. Treatment of her psoriatic arthritis has been with Ixekizumab since July 2021 with good overall disease control. Previous DMARD therapy includes methotrexate, sulfasalazine, and hydroxychloroquine, and previous biologic therapy of adalimumab and secukinumab. She had undergone bilateral reshaping of the mandibular condyle &amp; fossa 20 years ago for presumed degenerative arthropathy that was non-responsive to conservative management; further details of the surgery will be presented. Results Patient was referred to audiology and otolaryngology who noted significant narrowing of both ear canals on examination. Audiological investigations revealed a right sided sensorineural hearing loss, and mixed pattern of hearing loss on the left. The patient proceeded to have skull vault imaging to assess for a structural cause of her left sided hearing loss. The finding of the CT petrous bones revealed soft tissue swelling associated with erosion of the anterior wall of the temporal and mandibular bones, causing subluxation and mass effect into the external auditory canal with no other cause for left-sided hearing loss demonstrated. Interestingly her hearing improved slightly with jaw opening and dynamic MRI may be indicated if surgical intervention is an option. Conclusion Our patient has a mixed hearing loss. The specific cause of the sensorineural component in our patient is not known but sensorineural loss has been reported in patients with psoriatic disease. The pathogenesis of psoriasis associated sensorineural hearing loss remains unclear however emerging evidence may implicate the downregulation of gap junction beta-2 protein encoding connexin 26 an integral cell signalling gap protein. We believe this is the first reported case where conductive hearing loss has resulted from a direct result of psoriatic arthritis from erosive temporomandibular joint disease leading to mass effect on the audio vestibular anatomy. It is a stark reminder of the consequences of erosive disease and the importance of surveillance of temporomandibular joint function in psoriatic arthritis patients given this rare but potential complication. Disclosure A.K. Coulton: None. W.R. Gubbins: None. S. Young-Min: None.

Role of Dynamic 3 Tesla MRI in the Evaluation of Temporomandibular Joint Dysfunction.

The internal derangement of the temporomandibular joint (TMJ) is the most common type of dysfunction. Internal derangement can be divided into anterior and posterior disc displacement. Anterior disc displacement is the most common type, which is further classified into anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR). Temporomandibular joint dysfunction (TMD) symptoms are pain, reduced mouth opening, and joint sound. The main aim of this study was to correlate the clinical findings and magnetic resonance imaging (MRI) diagnosis of TMD in symptomatic and asymptomatic TMJs. This prospective observational study was conducted in a tertiary care hospital on a 3T Philips Achieva MRI machine with 16-array channel coils after obtaining approval from the institutional ethical committee. A total of 60 TMJs of 30 patients were included in the study. After the clinical examination of each patient, an MRI of both right and left TMJs was done. In patients with unilateral TMD, the asymptomatic side was used as the asymptomatic joint, and the affected side as the symptomatic joint. Asymptomatic patients without any symptoms of TMD were used as controls for bilateral TMD cases. MRI with high-resolution specific serial sections was obtained in both open- and closed-mouth positions. A p-value of <0.05 was considered a statistically significant agreement between clinical and MRI diagnoses of internal derangement. Out of a total of 30 clinically asymptomatic TMJs, only 23 were normal on MRI. On MRI, 26 TMJs showed ADDWRand 11 showed ADDWoR. The most common shape of the disc was biconcave and the displacement was anterior in symptomatic joints. The most common type of articular eminence shape was sigmoid in ADDWR and flattened in ADDWoR. Agreement between clinical and MRI diagnosis in this study was 87.5% (p < 0.001). The study concluded substantial agreement between clinical and MRI diagnosis of TMJ internal dysfunction and suggests that the diagnosis of the internal dysfunction can be made clinically but the exact position, shape, and type of disc displacement can be assessed precisely with the help of MRI.

Complicated Relationships between Anterior and Condylar Guidance and Their Clinical Implications-Comparison by Cone Beam Computed Tomography and Electronic Axiography-An Observational Cohort Cross-Sectional Study.

A complex prosthodontic treatment is believed to be more successful when the condylar path is replicated using the articulator. However, there is an ongoing major disagreement between the researchers as the exact relationship between the posterior and anterior determinants has not been clear. The purpose of this study was to investigate whether the protrusive movement of the mandible does correlate with the temporomandibular joint (TMJ) anatomy or with incised features. Subjects (15 males and 15 females) were qualified for this study based on an initial interview including the following criteria: age 21-23 (+/-1), no history of trauma, orthodontic treatment, or temporomandibular disorders (TMD). For each patient, the angle of the condylar path, incisal guidance angle (IGA), interincisal angle, as well as overbite and overjet were measured on cone beam computed tomography (CBCT). This was followed by the examination with the Modjaw® electronic axiograph recording and calculating the functional sagittal condylar guidance angle (SCGA) for the right and left TMJ during the protrusion. The results show that the mean functional axiographic measurement of SCGA in protrusion significantly correlates with the TMJ anatomy presented on CBCT. Moreover, a significant correlation was found between the values of SCGA in the functional and anatomical measurements in all its variants. It turned out that, statistically, the AB measurement was the most accurate. Finally, results showed that incisal relationships of permanent teeth such as overbite, overjet, incisal guidance angle and interincisal angle do not correlate with TMJ anatomy, and therefore, regarding an analyzed study group, do not affect the TMJ formation in young adults.

Temporomandibular joint arthritis increases canonical Wnt pathway expression in the articular cartilage and trigeminal ganglion in rats

The canonical Wnt pathway participates in inflammatory diseases and it is involved in neuropathic pain. This study evaluated the immunoexpression of the canonical Wnt signaling pathway in the articular cartilage of the temporomandibular joint (TMJ) and along the nociceptive trigeminal pathway in arthritic rats. For this, male Wistar rats were divided into Control (C) and Arthritic (RA) groups. Arthritis induction was performed through subcutaneous injection of methylated bovine serum albumin (mBSA) and complete Freund Adjuvant (CFA)/ Incomplete Freund Adjuvant (IFA) on the first 14 days (once a week), followed by 3 weekly intra-articular injections of mBSA (10 μl/joint; left TMJ). The following parameters were evaluated: nociceptive threshold, inflammatory infiltrate, type I and III collagen birefringence, immunohistochemistry for IL-1β, TNF-α, IL-6, Wnt10b, β-catenin, cyclin-D1 in articular cartilage, c-Myc in synovial membrane, and immunofluorescence analysis for c-Fos, Wnt-10b and β-catenin in the trigeminal ganglion and the trigeminal subnucleus caudalis. The RA group showed intense articular cartilage damage with proliferation of type III collagen, increased immunoexpression of proinflammatory cytokines and Wnt-10b, β-catenin and cyclin-D1 in the articular cartilage and c-Myc in the synovial membrane. In the RA group, a reduction in the nociceptive threshold was observed, followed by a significant increase in the expression of Wnt-10b in neurons and β-catenin in satellite cells of the trigeminal ganglion. c-Fos immunoexpression was observed in neurons, peripherally and centrally, in arthritic rats. Our data demonstrated that TMJ arthritis in rats causes articular cartilage damage and nociceptive behavior, with increased immunoexpression of canonical Wnt pathway in the articular cartilage and trigeminal ganglion.

Incidental findings involving the temporomandibular joint on computed tomography and magnetic resonance imaging.

The temporomandibular joint (TMJ) is frequently imaged in head and neck computed tomography (CT) and magnetic resonance imaging (MRI) studies. Depending on the indication for the study, an abnormality of the TMJ may be an incidental finding. These findings encompass both intra- and extra-articular disorders. They may also be related to local, regional or systemic conditions. Familiarity with these findings along with pertinent clinical information helps narrow the list of differential diagnoses. While definitive diagnosis may not be immediately apparent, a systematic approach contributes to improved discussions between clinicians and radiologists and better patient management.

Assessment of Articular Disc with MRI in Patients with Disc Displacement of Temporo-Mandibular Joint – MRI the Game Changer

Background: The temporomandibular joint (TMJ) is considered a complex joint. Temporomandibular disorders (TMDs) are a common cause of musculoskeletal pain. At least one TMD symptom is seen in 33% of the population and 3.6% to 7.0% of the population shows significant severity warranting treatment. Magnetic resonance imaging (MRI) is better for the evaluation of disc and adjacent soft-tissue structures compared to cone beam computed tomography. MRI allows articular disc assessment in open and closed mouth positions. MRI has 95% accuracy in the assessment of disc disorders and 93% accuracy for osseous changes. Materials and Methods: A cross-sectional study was performed with a sample size of 21 patients as per inclusion and exclusion criteria. MRI findings were noted and compared with clinical findings. Results: As per our study, the most common age group is between 20 and 35 years. Of 42 TMJ, 41 joints show disc displacement changes and one TMJ was normal. Disc displacement with reduction is less than disc displacement without reduction. Left TMJ is more affected as disc displacement without reduction, as compared to the right side. Two TMJ were with posterior DD. Four TMJ shows anteromedial and 4 TMJ shows anterolateral DD. Six joints have a subluxation. Conclusion: In our study, we found that MRI in TMDs is more reliable and accurate for the diagnosis of DD.

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.

A Case of Tophaceous Pseudogout with Destruction of the Skull Base at the Temporomandibular Joint.

We report a case of tophaceous pseudogout that occurred in the temporomandibular joint (TMJ) and presented with skull base destruction. The patient was a 73-year-old woman, who complained of an obstructed ear sensation in December 2021. The otolaryngological examination was unremarkeable, and a computed tomography scan revealed a calcified lesion in the left TMJ. Suspected of having osteochondroma, the patient was brought to our hospital. She was performed tumor resection as much as possible under general anesthesia revealed nodular pseudogout. The patient refused to undergo total resection due to the necessary craniotomy and the risk of postoperative complications. Instead, the patient decided to undergo following-up. One year and 4months have passed since the biopsy operation, but there is no tendency to re-increase.

An unusual cause of jaw pain

A 49-year-old woman was referred to the Maxillofacial Surgery Department of our University to evaluate a worsening jaw pain lasting since three-years. She experienced increasing preauricular pain in the area of the left temporomandibular joint (TMJ), during the day and night, and a progressive limitation of mouth opening over the past few years. The patient denied bruxism or jaw clenching. She had been treated by various health professionals, including physiotherapists, osteopaths and orthodontists over the years.

Contribution of magnetic resonance imaging in the biomechanical interpretation of the temporomandibular joint. Clinical case report

X-rays and tomography, in their different modalities, are used as auxiliary diagnostic elements in temporomandibular joint (TMJ) dysfunction, both in static and dynamic situations; however, because they only allow the observation of bone structures, magnetic resonance imaging (MRI) is the ideal method to analyze, among other structures, the articular disc. Among the internal disorders of the TMJ are the abnormal postural relationships between the disc, mandibular head, fossa and articular tubercle, which can even lead to a musculoskeletal condition causing noise, pain and functional limitation. The clinical evaluation of temporomandibular dysfunctions is complex, especially in asymptomatic patients; the Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), place these entities within the AXIS I protocol, considering that the image is not strictly necessary. However, analyzing the disc situation statically and dynamically, with its surroundings, allows considering the loads that generate dysfunction, leading to the correct diagnosis, and selection of the best treatment. A clinical case is presented, an asymptomatic patient, without functional limitation, who reported a history of occasional mouth opening locking upon awakening. MRI was indicated, finding an abnormal position of the disc, in a static and dynamic situation; finding anterior displacement of the disc in the right and left TMJ in closed mouth position, dynamically anterior displacement without recapture in the right TMJ and with recapture in the left TMJ; Treatment was performed with Jaw Functional Orthopedics (JFO), obtaining changes in the dynamic disc-mandibular head relationship, anterior displacement with recapture of the right TMJ and total recapture of the left TMJ.