Mandibular Condyle Research Articles

Association between psychological stress and mandibular condyle structure: an analytical cross-sectional study

ObjectiveThe potential influence of psychological factors on temporomandibular joint disorders has been clinically documented. To date, all research examining the impact of psychological stress on the temporomandibular joint has been conducted on animals. This study aims to explore the relationship between psychological stress and the structure of the human mandibular condyle.MethodsThis cross-sectional study was performed on individuals, who were referred to the radiology division of 5th Azar Hospital for head and neck Computed Tomography (CT) scans. All participants completed a perceived stress questionnaire to determine their level of stress. Bone density and cortical bone thickness were measured as indicators of mandibular condyle structure. Based on multi-slice CT scan data, bone density was calculated in the anterior, middle, and posterior mandibular condyle. The cortical bone thickness was also measured at the anterior and posterior mandibular condyle. Statistical analysis was performed in R 4.0.2 software.ResultsSeventy individuals, aged 18–59 years, participated in this study. The CT scans revealed a decrease in Hounsfield units (HU) and bone mineral density (BMD) in both the anterior and posterior regions. However, in the high-stress group, there was no significant difference in cortical bone thickness in the anterior and posterior regions of the condyle, nor in HU and BMD in the middle region of the condyle. An inverse correlation was observed between BMD and perceived stress in the anterior, middle, and posterior regions of both condyles.ConclusionThe current findings indicate that recent psychological stress is associated with changes in the structure of the condyle.

Clinical effectiveness of polynucleotide TMJ injection compared with physiotherapy: a 3-month randomised clinical trial

Joint visco-supplementation is an effective therapeutic approach against the degenerative signs and symptoms of osteoarthrosis/osteoarthritis of the mandibular condyle. Supplements of choice are usually delivered inside the temporomandibular joint (TMJ) by intra-articular infiltration. The present study aimed to assess the clinical effectiveness of pericapsular injection of polinucleotides (PN) and hyaluronic acid (HA). Sixty patients suffering from TMJ osteoarthrosis were recruited and divided into two groups (test group: n = 30, pericapsular injection; control group: n = 30, self-delivered physiotherapeutic exercises). For each patient, maximum opening, right and left lateral excursion, and visual analogue scale (VAS) scores were recorded at four different timepoints by a blinded investigator. Paired Student’s t tests were used to compare consecutive measurements of the parameters evaluated within the groups, and unpaired Student’s t tests were used for between-group comparisons. All investigated parameters displayed a progressive clinical improvement in both groups, which was more accentuated in the test group. The decrease in VAS score differed significantly between groups (p < 0.0001). Maximum opening showed a continuous increase from baseline (mean (SD) 37.70 (8.33) mm) to T3 (39.68 (7.64) mm), reflecting a progressive improvement, but it was not statistically significant (p = 0.089 at T3 with respect to T0). PN HA pericapsular injection is a minimally invasive treatment that effectively reduces pain and improves mandibular kinematics.

Volumetric differences in the temporomandibular joint in patients with condylar hyperplasia in active and passive state, SPECT/CT study.

Condylar hyperplasia (CH) is a progressive and deforming disease that modifies anatomy of the temporomandibular joint (TMJ) structures. This study aims to correlate the metabolic bone activity of the condyle measured by SPECT with the volumetry anatomic information from the condyle, fossa and joint space provided by CT images, in patients with CH in active and inactive forms. A cross-sectional comparative study was performed with a set of 116 images from healthy and diagnosed CH patients to compare volumetric measures of the TMJ. Images were acquired through a bone tissue mask using a three-dimensional DICOM reconstruction for SPECT/CT and CBCT images and the Threshold option for segmentation with standardized values for each tissue on the HU scale. there are differences (p<0.01), with greater condylar volume on the affected side in patients with active CH compared to passive CH. The volume of the glenoid cavity shows no differences in either form of CH (p>0.05), however, there were differences for the volume of the joint space on the affected right side of hemimandibular elongation (HE) in the active form. The volume of the mandibular condyle on the affected side in CH cases were larger in HE cases in active and inactive form (p<0.01) compared to healthy patients. Similar results were presented for the glenoid cavity and joint space. Volumetric anatomical evaluation of TMJ structures, as well as information on condylar metabolic activity, can be obtained from SPECT/CT. The study shows a greater condylar volume on the affected side of the CH compared to the contralateral side, but there are more significant differences in the active than in the inactive form.

Assessing the Volume of the Head of the Mandibular Condyle Using 3T-MRI-A Preliminary Trial.

Due to potentially harmful exposure to X-rays, condylar growth in response to orthodontic treatment is poorly studied. To overcome this limitation, here, the authors have proposed high-resolution MRI as a viable alternative to CBCT for clinical 3D assessment of TMJ. A male subject underwent both MRI and CBCT scans. The obtained three-dimensional reconstructions of the TMJ were segmented and superimposed by a semiautomatic algorithm developed in MATLAB R2022a. The condylar geometries were reconstructed using dedicated software for image segmentation. Two geometrical parameters, i.e., the total volume and surface of the single condyle model, were selected to quantify the intraclass and interclass variability from the mean of each DICOM series (CBCT and MRI). The final comparison between the reference standard model of CBCT and 3T MRI showed that the former was more robust in terms of reproducibility, while the latter reached a higher standard deviation compared to CBCT, but these values were similar between the operators and clinically not significant. Within the inherent limitation of image reconstruction on MRI scans due to the current lower resolution of this technique, the method proposed here could be considered as a nucleus for developing future completely automatic AI algorithms, owing to its great potential and satisfactory consistency among different times and operators.

Circadian rhythm disruption upregulating Per1 in mandibular condylar chondrocytes mediating temporomandibular joint osteoarthritis via GSK3β/β-CATENIN pathway

BackgroundTemporomandibular joint osteoarthritis (TMJOA) has a high incidence rate, but its pathogenesis remains unclear. Circadian rhythm is an important oscillation in the human body and influences various biological activities. However, it is still unclear whether circadian rhythm affects the onset and development of TMJOA.MethodsWe disrupted the normal rhythm of rats and examined the expression of core clock genes in the mandibular condylar cartilage of the jaw and histological changes in condyles. After isolating rat mandibular condylar chondrocytes, we upregulated or downregulated the clock gene Per1, examined the expression of cartilage matrix-degrading enzymes, tested the activation of the GSK3β/β-CATENIN pathway and verified it using agonists and inhibitors. Finally, after downregulating the expression of Per1 in the mandibular condylar cartilage of rats with jet lag, we examined the expression of cartilage matrix-degrading enzymes and histological changes in condyles.ResultsJet lag led to TMJOA-like lesions in the rat mandibular condyles, and the expression of the clock gene Per1 and cartilage matrix-degrading enzymes increased in the condylar cartilage of rats. When Per1 was downregulated or upregulated in mandibular condylar chondrocytes, the GSK3β/β-CATENIN pathway was inhibited or activated, and the expression of cartilage matrix-degrading enzymes decreased or increased, which can be rescued by activator and inhibitor of the GSK3β/β-CATENIN pathway. Moreover, after down-regulation of Per1 in mandibular condylar cartilage in vivo, significant alleviation of cartilage degradation, cartilage loss, subchondral bone loss induced by jet lag, and inhibition of the GSK3β/β-CATENIN signaling pathway were observed. Circadian rhythm disruption can lead to TMJOA. The clock gene Per1 can promote the occurrence of TMJOA by activating the GSK3β/β-CATENIN pathway and promoting the expression of cartilage matrix-degrading enzymes. The clock gene Per1 is a target for the prevention and treatment of TMJOA.

Non-Invasive Management of Mandibular Condyle Fracture with Ramus Shortening Using Low Intensity Pulsed Ultrasound and Hypomochlion Splint

Non-Invasive Management of Mandibular Condyle Fracture with Ramus Shortening Using Low Intensity Pulsed Ultrasound and Hypomochlion Splint

Role of Trace Cadmium Exposure on the Development of Occlusal Traumatic Temporomandibular Arthritis.

To investigate whether heavy metal cadmium acts as a risk factor for temporomandibular joint disorder disease and to study its pathogenic mechanism. A total of 57 rats were allocated into 6 distinct groups, distinguished by 2 interventions: occlusal elevation and cadmium water gavage. These groups included a blank control group, occlusal elevation group, occlusal elevation + 0.42mg/mL cadmium water gavage group, occlusal elevation + 4.2mg/mL cadmium water gavage group, no occlusal elevation + 0.42mg/mL cadmium water gavage group, and no occlusal elevation + 4.2mg/mL cadmium water gavage group. The impact of cadmium exposure on cartilage oxidative stress was evaluated through the assessment of SOD, CAT, GST, and GSH-Px enzyme activities. In addition, the influence of cadmium exposure on alterations in the extracellular matrix and inflammatory mediators was examined by analyzing the expression levels of type II collagen, protein aggregation polysaccharide, glycosaminoglycan, IL1β, IL-6, and TNF-α. Histologic examination of the condylar process cartilage of rats in the occlusal elevation + cadmium water gavage group was conducted to ascertain the occurrence of osteoarthritis. The variance in the expression levels of inflammatory factors did not demonstrate statistical significance between the occlusal elevation group and the blank control group; however, statistical significance was observed between the occlusal elevation + cadmium water gavage group and both the control and occlusal elevation groups. The severity of inflammation and condylar lesions correlates directly with the concentration of cadmium.

Evaluation of mandibular condyle position in Class III patients after bimaxillary orthognathic surgery: A cone-beam computed tomography study.

This retrospective study evaluated the mandibular condyle position before and after bimaxillary orthognathic surgery performed with the mandibular condyle positioned manually in patients with mandibular prognathism using cone-beam computed tomography. Overall, 88 mandibular condyles from 44 adult patients (20 female and 24 male) diagnosed with mandibular prognathism due to skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I performed using the manual condyle positioning method were included. Cone-beam computed tomography images obtained 1-2 weeks before (T0) and approximately 6 months after (T1) surgery were analyzed in three planes using 3D Slicer software. Statistical significance was set at P < 0.05 level. Significant inward rotation of the left mandibular condyle and significant outward rotation of the right mandibular condyle were observed in the axial and coronal planes (P < 0.05). The positions of the right and left condyles in the sagittal plane and the distance between the most medial points of the condyles in the coronal plane did not differ significantly (P > 0.05). While the change in the sagittal plane can be maintained as before surgery with manual positioning during the BSSRO procedure, significant inward and outward rotation was observed in the axial and coronal planes, respectively, even in the absence of concomitant temporomandibular joint disorder before or after the operation. Further long-term studies are needed to correlate these findings with possible clinical consequences.

ОСОБЕННОСТИ СТРОЕНИЯ СКЕЛЕТА ГОЛОВЫ АЗИАТСКОГО (БЕЛОХВОСТОГО) ДИКОБРАЗА (HYSTRICIDAE LEVICURA)

The purpose of research is to study the structural features of the head skeleton of the Asian (white-tailed) porcupine. The object of the study is the skeleton of the head of an Asian (white-tailed) porcupine at the age of 12 years. To make the porcupine skeleton, a biological method of processing the material was used. The study of the bones was accompanied by measuring their length and width using an electronic caliper with an accuracy of 0.1 mm, describing and photographing. The head skeleton of the Asian (white-tailed) porcupine is divided into cerebral and facial sections, the size of which is related to the size of the brain and the development of the masticatory apparatus. The brain region is represented by unpaired (occipital, sphenoid, interparietal, ethmoid) and paired (temporal, frontal, parietal, alar) bones. The facial region is represented by the maxillary, incisive, palatine, zygomatic, lacrimal and nasal bones. The rostral edge of the orbit serves as the boundary between the facial and brain regions. The facial section reaches the greatest development, occupying 59.8 % of the length of the brain. The configuration of the skull and the presence of a large number of processes make it possible to attach well-developed masticatory muscles to it. The caudal part of the skull is represented by the occipital bone, and the cranial part by the ethmoid bones. The body of the occipital bone is connected to the sphenoid bone, which participates in the formation of the foramen lacerum. The body of the sphenoid bone is trapezoidal in shape, from which the orbital and temporal wings branch. There are six foramina on the orbital wing: optic, orbital fissure, round, caudal alar, oval and carotid. The temporal wing is involved in the formation of the foramen lacerum with the oval, spinous and carotid notches. On the facial surface of the maxillary bone there is a facial ridge; between its facial and nasal surfaces there is an extensive maxillary sinus. The mandibular bone is paired, represented by two bones connected to each other by a ligament. The massive, triangular-shaped lower jaw has two processes: the condylar and the coronoid. The condylar process is convex, oval-elongated. The coronoid process is low with a bifurcated apex. The pterygoid and chewing fossae are deep and triangular in shape.

Unraveling sauropod diversity in the Portezuelo Formation of Patagonia through a comprehensive analysis of new and existing material

The Portezuelo Formation preserves an outstanding record of the upper Turonian – lower Coniacian. Despite the discovery of a significant quantity of sauropod fossil material from the formation, only two species have been formally described to date: Malarguesaurus florenciae and Futalognkosaurus dukei. Here we present new sauropod material mostly composed of non-articulated caudal vertebrae (MCF-PVPH 916 and 917) that belong to two titanosauriforms on the basis of the following features: anterior caudal vertebrae with procoelous-opisthoplatyan articulations, transverse processes that reach the posterior articular face of the centrum and neural spines with a transverse width of around 50% of their anteroposterior length; anterior and middle caudal vertebrae with the neural arch restricted to the anterior half of the centrum; middle caudal centra with circular cross-section. Phylogenetic analysis recovers the new material in close relation to Malarguesaurus within a monophyletic clade at the base of Somphospondyli. This clade shares large pedicel height with a vertical anterior border on the middle caudal vertebrae, a vertical orientation of the neural spines on the distalmost middle caudal vertebrae and proximalmost posterior caudal vertebrae, and subequal relative lengths of the proximal ulnar condylar processes. The specimens presented here are distinct not only from Futalognkosaurus, but also from other indeterminate titanosaurian remains from the same formation. However, there are no significant differences between the specimen MCF-PVPH 917 and Malarguesaurus, but there are differences between the posterior caudal vertebrae of MCF-PVPH 916 and Malarguesaurus, so they could be considered different species. Whilst we err on the side of caution in not naming new taxa here, the two specimens significantly expand what we know about sauropods in the Turonian–Coniacian ecosystems of Patagonia, which will continue to do so as more material is discovered.

Amyloid-β peptide treatment reverses bone loss in the mandibular condyle via Wnt signalling pathway

ObjectiveTo explore the effect of amyloid-β peptide (Aβ) on mandibular condyle to develop a new treatment for postmenopausal women with Temporomandibular joint osteoarthritis. MethodsA murine bone loss model was established by ovariectomy. Microstructure parameters of the condyle were measured by microcomputed tomography before and after intraperitoneal injection with Aβ. Flow cytometry, Alizarin red staining, RT-qPCR assays, FITC/PI staining, Oil Red O staining and western blotting were used to evaluate the effect of Aβ on the osteogenic differentiation of mouse bone marrow stromal stem cells (mBMSCs). ResultsIn vivo, condylar microstructure parameters increased. Serum osteoprotegerin and procollagen type 1 N propeptide increased in a dose-dependent manner after the injection of Aβ, which were opposite the changes observed in c-terminal telopeptides of type I collagen, tumor necrosis factor-α and the high serum level of leptin. In vitro, Aβ promoted calcium nodule formation in the cells. The expression of ALP, Runx2, osteorix and osteocalcin increased significantly. The expression of mRNAs related to the Wnt signaling pathway was significantly upregulated, which could be blocked by DKK1. ConclusionAβ can reverse bone loss in the mandibular condyle in ovariectomized mice through promoting the osteogenic differentiation of mBMSCs via the Wnt pathway.

The Relationship between Bony Changes of the Mandibular Condyle and Eichner Index

Introduction: The aim of this study was to evaluate whether degenerative bone changes in the mandibular condyle on cone beam computed tomography images are associated with the Eichner index.Methodology: 336 cone beam computed tomography images condyle images of 168 patients were analyzed for degenerative bone changes. These changes were named as condyle flattening, osteophytes, erosions, subchondral sclerosis, generalized sclerosis and subchondral cysts. The edentulous status of the patients was classified as group A-B-C and subtypes according to the Eichner index. Categorical variables were evaluated with chi-square test and p < 0.05 was considered statistically significant.Results: According to the results of the study, the most common degenerative condyle change was flattening of the condyle. Among the Eichner index groups, the most common group was A and the least common group was C. Condyle changes on the right and left sides were most commonly observed in group A patients. The statistically significant majority of patients with right-sided condyle flattening and erosion were in group C. No significant difference was found between all other condyle changes and Eichner index groups. There was no significant relationship between Eichner index and gender.Conclusion: Degenerative bone changes (flattening and erosion of the condyle) in the condyle region were more common in group C patients with more tooth loss. There is a significant relationship between condyle changes and posterior toothlessness.

Therapeutic Effects of Mesenchymal Stem Cells Derived from Bone Marrow and Adipose Tissue in a Rat Model of Temporomandibular Osteoarthritis

ObjectivesTo examine the potential of intra-articular administration of mesenchymal stem cells (MSCs) derived from bone marrow or adipose tissue to mitigate synovial inflammation in a rat model of temporomandibular joint (TMJ) osteoarthritis (OA). MethodsIn this experimental study, 40 rats were divided into 4 groups: (1) Control group; (2) Untreated TMJ-OA group; (3) TMJ-OA group treated with bone marrow-derived MSCs; (4) TMJ-OA group treated with adipose tissue-derived MSCs. The TMJ-OA model was established by inducing synovial inflammation through the intra-articular administration of complete Freund’s adjuvant (CFA). After 8 weeks of TMJ-OA establishment, the animals were sacrificed and each mandibular condyle was extracted for histological evaluation. ResultsThe untreated TMJ-OA group had significantly higher synovial inflammation, as indicated microscopically by higher grades of synovial membrane hyperplasia and adhesion, vascular vasodilation, and fibrin deposition than the control group (p < 0.001). Both TMJ-OA groups treated with MSCs had lower grades of synovial inflammation and less severe synovitis than the untreated TMJ-OA group (p < 0.001). The TMJ-OA group treated with adipose tissue-derived MSCs showed lower grades of synovial membrane hyperplasia and higher grades of fibrin deposition than the that treated with bone marrow-derived MSCs (p < 0.001). Other indicators of synovial inflammation and synovitis severity were comparable between the two treatment groups. ConclusionsAdministration of CFA to the TMJ-OA rat model augmented synovial inflammation. Intra-articular administration of MSCs derived from either bone marrow or adipose tissue attenuated the microscopic manifestations of this inflammation, indicating the therapeutic potential of this treatment for TMJ-OA.

Chondrogenic potential of superficial versus cartilage layer cells of the temporomandibular joint condyle in photopolymerizable gelatin-based hydrogels.

The objectives of this study were to compare the chondrogenic potential of cells derived from different layers of Mandibular condyle cartilage and to gain further understanding of the impact of chondrogenic cues when embedded into a novel hydrogel scaffold (PGH, a polymer blend of poly (ethylene glycol), gelatin, and heparin) compared to a gelatin hydrogel scaffold (GEL). Cartilage layer cells (CLCs) and fibroblastic superficial layer cells (SLCs) were harvested from the mandibular condyle of boer goats obtained from a local abattoir. After expansion, cells were seeded into PGH and GEL hydrogels and cultured in chondrogenic media for 3 weeks. Scaffolds were harvested at 0, 1, and 3 week(s) and processed for gross appearance, histochemical, biochemical, and mechanical assays. In terms of chondrogenesis, major differences were observed between scaffold materials, but not cell types. Glycosaminoglycan (GAG) staining showed GEL scaffolds deposited GAG during the 3 week period, which was also confirmed with the biochemical testing. Moreover, GEL scaffolds had significantly higher compressive modulus and peak stress than PGH scaffolds at all time points with the largest difference seen in week 3. It can be concluded that GEL outperformed PGH in chondrogenesis. It can also be concluded that materials play a more important role in the process of chondrogenesis than the tested cell populations. Fibroblastic SLCs were shown to have similar chondrogenic potential as CLCs cells, suggesting a rich pool of progenitor cells in the superficial fibroblastic layer capable of undergoing chondrogenesis given appropriate physical and chemical cues.

COMPLICATIONS OF CONSERVATIVE AND SURGICAL TREATMENT OF FRACTURES OF THE MANDIBULAR CONDYLAR PROCESS (LITERATURE REVIEW)

One of the most pressing problems in modern maxillofacial surgery is the treatment and rehabilitation of patients with fractures of the condylar process of the mandible. According to various statistical data, the incidence of fractures at this site is 19-37%, and these fractures are the most controversial in terms of diagnosis and treatment. In recent years, there has been an increase in severe forms of mandibular condyle fractures: bilateral, combined, intra-articular, leading to serious complications that affect the functioning of the temporomandibular joint. The data obtained indicated the need for a detailed study of this pathology in order to make a qualitative diagnosis and improve the available treatment methods. The aim of the study – to analyse and summarise current data from the scientific literature on possible complications in the treatment of the condylar process fractures of the mandible. Materials and methods. The bibliosemantic method was used to clarify the state of the problem, to study the analysis of the results of previous scientific research based on the literature sources and electronic resources. Results and discussion. The management of patients with mandibular condylar fractures is widely discussed in the literature due to their high prevalence, but there is still no consensus on the optimal management of patients with this pathology. To date, there are many studies that highlight certain complications of conservative and surgical treatment, but they are not generalised or systematised. Conclusions. Summarizing, we can conclude that complications occur during both conservative and surgical treatment of patients with mandibular condyle fractures. Complications are most often associated with incomplete diagnosis, incorrect choice of treatment method, and depend on the method of access and fixation in surgical treatment.

The effect of gender and site on the condylar head measurements in Diyala

Background: The condylar process of mandible is an ellipsoid hard tissue (bony structure) with a thin neckline that joins to the mandibular ramus. The condylar processes are a critical anatomic component of the mandible that development of mandibular bone is attributed in the sagittal and vertical directions by condylar process. Objective: To radiographical assessment of condylar head measurements according to gender and site by uses cone beam computed tomography. Patients and Methods: The study samples consisted of sixty-five individuals (19 male and 46 female) with age range from (20-50) years old. Width of condylar head, length of condylar head and condylar head height were measured in the study by using cone beam computed tomography from radiology archive in specialist dental center in Diyala. Results: The results show condylar head width, condylar head height and condylar head length in sides (right and left), males have noted higher mean value than females. The results show condylar head width and condylar head length in left side, have recorded higher mean value than right side. While, condylar head height in left side, have recorded lower mean value than right side. Conclusion: Condylar dimensions and sizes may be associated with gender and site. Males have higher condylar dimensions and sizes than females.

The effect of gender and site on the condylar head measurements in Diyala

Background: The condylar process of mandible is an ellipsoid hard tissue (bony structure) with a thin neckline that joins to the mandibular ramus. The condylar processes are a critical anatomic component of the mandible that development of mandibular bone is attributed in the sagittal and vertical directions by condylar process. Objective: To radiographical assessment of condylar head measurements according to gender and site by uses cone beam computed tomography. Patients and Methods: The study samples consisted of sixty-five individuals (19 male and 46 female) with age range from (20-50) years old. Width of condylar head, length of condylar head and condylar head height were measured in the study by using cone beam computed tomography from radiology archive in specialist dental center in Diyala. Results: The results show condylar head width, condylar head height and condylar head length in sides (right and left), males have noted higher mean value than females. The results show condylar head width and condylar head length in left side, have recorded higher mean value than right side. While, condylar head height in left side, have recorded lower mean value than right side. Conclusion: Condylar dimensions and sizes may be associated with gender and site. Males have higher condylar dimensions and sizes than females. Keywords: Condylar head, cone beam computed tomography.

Influence of Method of Treatment of Mandibular Condylar Fractures on Range of Articular Path Measured by Cadiax Device.

Background/Objectives: The aim of this study was to evaluate the function of the treated temporomandibular joint based on the analysis of the image of the articular path using the Cadiax device depending on the choice of treatment method for unilateral condylar fracture of the mandible. Methods: Sixty patients who were treated for condylar fractures of the mandible at the Maxil-lofacial Surgery Department in Katowice were qualified for the analysis of the range of movements of the mandibular heads using the Cadiax device. From the group of patients who suffered fractures of the mandible, including condylar processes, patients were finally qualified for the measurement of the articular path of the injured and healthy joint according to strict criteria. Results: The condylar examination was performed in 20 patients who had conservative condylar fracture treatment and 40 patients who underwent various surgeries in the course of a single condylar fracture. The control group consisted of 20 patients whose mean values for the articular pathway measured for both sides were 12.73 and 12.69 and fell within the standard developed for healthy joints tested with the Cadiax device. Conclusions: We have achieved an almost ideal treatment for condylar fractures. We are also beginning to notice the need for rehabilitation of patients after this type of surgery.

The effect of mentoplate application on the condyle

BackgroundThe aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in the correction of skeletal class III relationship, using fractal analysis (FA).MethodsThe sample consisted of 30 individuals (8–11 years) diagnosed with skeletal Class III malocclusion who underwent MP-RME treatment. Archival records provided cone-beam computed tomography (CBCT) images taken at two intervals: before MP-RME treatment (T0) and after treatment (T1). The CBCT images were obtained using standardized settings to ensure consistency in image quality and resolution. The trabecular structures in the bilateral condyles at both T0 and T1 were analyzed using FA. The FA was performed on these condylar images using the Image J software. The region of interest (ROI) was carefully selected in the condyle to avoid overlapping with cortical bone, and the box-counting method was employed to calculate the fractal dimension (FD). Statistical analysis was conducted to compare the FD values between T0 and T1 and to evaluate gender differences. The statistical significance was determined using paired t-tests for intra-group comparisons and independent t-tests for inter-group comparisons, with a significance level set at p < 0.05.ResultsThe analysis revealed no statistically significant differences in the trabecular structures of the condyles between T0 and T1 (p > 0.05). However, a significant gender difference was observed in FA values, with males exhibiting higher FA values in the left condyle compared to females at both T0 and T1 (p < 0.05). Specifically, the FA values in the left condyle increased from a mean of 1.09 ± 0.09 at T0 to 1.13 ± 0.08 at T1 in males, whereas in females, the FA values remained relatively stable with a mean of 1 ± 0.09 at T0 and 1.03 ± 0.11 at T1.ConclusionThe findings indicate that MP-RME therapy does not induce significant alterations in the trabecular structure of the mandibular condyle. These results suggest the treatment’s safety concerning the structural integrity of the condyle, although the observed gender differences in FA values warrant further investigation.

Characteristics of rehabilitation for patients with severe asymmetric jaw deformities resulting from temporomandibular joint pathology

Relevance. Temporomandibular joint (TMJ) pathology, along with the resultant facial asymmetry, is a common condition within maxillofacial disorders. Addressing the rehabilitation of these patients within specialised medico-social care is a crucial and challenging task.Purpose. To develop a comprehensive rehabilitation protocol for patients with severe asymmetric jaw deformities caused by TMJ pathology.Materials and methods. From 2018 to 2023, ten patients with defects and deformities of the TMJ condylar process, presenting with severe asymmetric jaw deformities, were treated. An assessment of subjective and objective facial aesthetic parameters was conducted based on photographic protocols, as well as 2D and 3D cephalometric facial measurements. Comprehensive preparation for orthognathic surgery with simultaneous endoprosthesis replacement was performed based on the collected data. A regimen of postoperative therapeutic procedures was prescribed following the surgery.Results. All patients achieved the intended statistically significant outcomes: in the sagittal plane, an improvement in facial profile was noted based on the position of the chin (Pog) relative to the true vertical line passing through the subnasale point. In the frontal plane, alignment of the occlusal plane and normalization of the central line of the upper and lower incisors relative to the midline of the face were observed.Conclusion. The algorithm for the comprehensive preparation of patients with asymmetric jaw deformities, developed during growth, prior to performing orthognathic surgery with simultaneous TMJ endoprosthesis replacement should include: orthodontic treatment aimed at aligning teeth position and dental arches, eliminating rotations and pathological inclinations of teeth using a bracket system, fully restoring interocclusal height with temporary implant-supported structures, using occlusal splints and temporary composite restorations, as well as employing separating orthodontic plates. These stages enabled the achievement of good aesthetic results and improved patients' quality of life.