Temporomandibular Joint Arthrosis Research Articles

Interpositional arthroplasty using cartilage allografts for treating temporomandibular joint arthrosis: a 3- and 5-year retrospective clinical follow-up study

Objective: To evaluate the effect of arthroplasty using interpositional cartilage allografts in patients with temporomandibular joint (TMJ) arthrosis. Study Design: This retrospective study included patients treated consecutively between 2007 and 2013 using discectomy and interpositional grafting with lyophilised costal cartilage allograft (Tutoplast®) sheets. TMJ pain based on the visual analogue scale (VAS), maximal interincisal opening (MIO), joint tenderness to palpation, crepitus from the affected joint, and postoperative complications were assessed. ResultsArthroplasty was performed on 37 joints among 34 patients (28 women; mean age: 54 years); 24 joints underwent simultaneous condyle shaving. At final follow-up (three [n=37] or five [n = 21] years), we observed reduced mean VAS (from 7.6 to 0.9; P<.001) increased mean MIO (from 32.5 to 41.1 mm; P<.001), number of joints with capsule tenderness (from 30 to 3; P<.001), and percentage of joints with crepitus (from 97% to 75%; P = 0.008). One joint required reoperation because of interposed cartilage fragmentation. No permanent facial nerve injury or malocclusion occurred after treatment. Conclusion: Interpositional arthroplasty is a relatively simple, moderately invasive, and effective surgical treatment for TMJ arthrosis with few complications. However, long-term outcomes of this treatment, specifically beyond three to five years postoperatively, remain unknown.

The role of elastic bands (kinesiotapes) in complex therapy of patients with temporomandibular joint osteoarthrosis

Introduction. Temporomandibular joint (TMJ) arthrosis is a chronic disease, characterized by dystrophic and degenerative changes in TMJ with aseptic inflammatory process. The prevelence of TMJ arthrosis in patients with a history of other TMJ disorders varies between 32-39 % of cases. Complex treatment of TMJ arthrosis includes pharmacotherapy, physiotherapy, exercise therapy for TMJ and massage of the masticatory muscles, manual therapy, prosthodontics, but these treatment methods are not always lead to a desired result.The aim of the study is to improve the traditional treament method of patients suffering from TMJ arthrosis by using elastic tapes (kinesiotapes).Materials and methods. 68 patients were examined at the «Galaxy» Beauty Institute Clinic (St. Petersburg) and FSBEI HE SamSMU MOH Russia (Samara). Comparison group of patients was prescribed pharmacotherapy, exercise therapy for TMJ and massage of masticatory muscles, while for the main group of patients the same therapy was enhanced by elastic bands. The effectiveness of therapy was evaluated using a visual-analog pain scale (VAS), mouth opening width and electromyography of the masticatory muscles.Results. Noticeable positive effect in the main group of patients was observed on the 21th day of treatment. By this time patients noticed significant decrease in pain intensity from 8,77±0,8 to 5,19±0,5 (Z1-4=-5,88; p1-4=0,0015) points as well as increase in mouth opening width from 21-23 to 33-35 mm. Similar changes in the comparison group of patients were achieved only by the beginning of fifth week of treatment (Z1-6=-5,58; p1-6=0,0015). The range of mouth opening width increased from 21-23 to 27-29 mm. Amplitude of masticatory muscles biopotentials in maximum intercuspation in patients of the main group almost approached to the normal results by the beginning of the fourth week. In patients of the comparison group the amplitude of masticatory muscles biopotentials remained reduced even by the end of observations (42 day of the study).Conclusion. Thus, the combination of elastic bands applications with conventional treatment methods of TMJ arthrosis greatly increases the effectiveness of therapy and allows to relief pain and normalize bioelectric activity of masticatory muscles in a relatively short time. Due to the simplicity of elastic bands application it is possible to teach patients the technique of self-applying bands and recommend to use them as a prevention of relapse of TMJ arthrosis.

Sarcoidosis of the mandibular condyle manifesting as a temporomandibular joint arthrosis: A rare case report

AbstractBone sarcoidosis is uncommon, and involvement of the temporomandibular joint is exceptionally rare. We report an unusual case of mandibular condyle sarcoidosis in a 51‐year‐old Japanese woman that manifested as a temporomandibular joint arthritis. The patient was referred for a chief complaint of a painful temporomandibular joint and was initially diagnosed with temporomandibular joint arthritis. However, a more detailed examination revealed bone sarcoidosis in the mandibular condyle and the progression of preexisting cardiac sarcoidosis. Oral steroid treatment (tapered from 50 mg/day to 5 mg/day) appears to have been successful over a 1‐year follow‐up.

Prevalence of tinnitus in patients with different temporomandibular disorders symptoms

To compare the prevalence of tinnitus in temporomandibular disorder (TMD) patients affected by either jaw muscle pain, temporomandibular joint (TMJ) internal derangements, or TMJ arthrosis. The presence of self-reported tinnitus was assessed in 250 consecutive TMD patients and correlation analysis was performed with clinical TMD signs and symptoms. Tinnitus prevalence in the TMD population was 30.4%. Any significant patterns of correlation were shown for the overall study group, despite a higher tinnitus prevalence in patients with (32.8%) than without masseter pain (24.8%; p = 0.176) as well as in those with (33.7%) than without TMJ arthrosis (26.1%; p = 0.082). Age-stratified analysis showed correlations with masseter pain in older patients (48.3% vs 16; p < 0.05), and with arthrosis in younger patients (57.1% vs 22.2%; p < 0.05). Any correlation patterns were shown between tinnitus and TMD. Age-stratified analysis suggested possible hypotheses for a symptom-specific clinical correlation that should be assessed with future research.

Immunohistochemical Evaluation of Neuroreceptors in Healthy and Pathological Temporo-Mandibular Joint

Aim: A study was performed on the articular disk and periarticular tissues of the temporo-mandibular joint (TMJ) with immunohistochemical techniques to give evidence to the presence of neuroreceptors (NRec) in these sites. Methods: The study was carried out on tissue samples obtained from 10 subjects without TMJ disease and from 7 patients with severe TMJ arthritis and arthrosis. We use antibodies directed against following antigens: Gliofibrillary Acidic Protein (GFAP), Leu-7, Myelin Basic Protein (MBP), Neurofilaments 68 kD (NF), Neuron Specific Enolase (NSE), S-100 protein (S-100) and Synaptophysin (SYN). Results: This study revealed that Ruffini's-like, Pacini's-like and Golgi's-like receptors can be demonstrated in TMJ periarticular tissues and that free nervous endings are present in the subsynovial tissues but not within the articular disk. We observed elongated cytoplamic processes of chondrocytes that demonstrated strong S-100 immunoreactivity but they were unreactive with all other antibodies. These cytoplamic processes were more abundant and thicker in the samples obtained from patients with disease TMJ. Conclusion: The results of this study confirm that different Nrec are detectable in TMJ periarticular tissues but they are absent within the articular disk. In the latter site, only condrocytic processes are evident, especially in diseased TMJ, and they might have been confused with nervous endings in previous morphological studies. Nevertheless the absence of immunoreactivity for NF, NSE and SYN proves that they are not of neural origin.

口腔外科領域における顎関節症の治療法

目的：本稿の目的は，顎関節症における各種治療法のうち口腔外科領域が主として担当する薬物療法，理学療法，および手術的治療法について治療成績を文献的に検証し，確証の得られている治療法および治療法の選択基準を明らかにすることである．方法：2012年4月1日の時点における顎関節症ないしtemporomandibular disorders（TMD）の薬物療法，理学療法，および手術的治療法についてのランダム化比較試験（RCT），システマティック・レビュー（SR），コクランライブラリー・レビュー（コクラン・レビュー）およびメタアナリシス（Meta-A）を電子的にMedline，Cochrane Database of Systematic Reviews，医中誌から検索した．次いで抽出された論文の採用しているRCTを研究デザインの均質性と妥当性により再評価した．結果：薬物療法，関節洗浄療法，関節鏡手術についてコクラン・レビューがあり，RCT，SR，Meta-Aともに薬物療法が最も多く，手術的治療法がそれに次いでいた．結論：顎関節症に対する効果が認められたのは自己開口訓練，非ステロイド系鎮痛抗炎症薬の内服および針治療であった．今後，顎関節症における均質なRCTの蓄積が望まれる．

Results of the Treatment of Patients with Temporomandibular Joint Arthrosis under our Department's Guidelines for Masticatory Patterns

Results of the Treatment of Patients with Temporomandibular Joint Arthrosis under our Department's Guidelines for Masticatory Patterns

Temporomandibular joint and 3.0 T pseudodynamic magnetic resonance imaging. Part 1: evaluation of condylar and disc dysfunction

This study describes an improved method for examining and diagnosing temporomandibular joint (TMJ) dynamics by 3.0 T pseudodynamic MRI. Clinical observation and conventional static MRI of volunteers (one without and eight with TMJ arthrosis) were followed by 3.0 T pseudodynamic MRI in positions ranging from the mouth closed to mouth fully opened. Condylar head (Cd), articular disc anterior border (Da) and articular disc posterior border (Dp) were digitized on sagittal images to determine trajectory and velocity patterns. Patients were divided into three groups based on the presence or absence of dysfunction: Group 1, no dysfunction on the right or left side of the TMJ; Group 2, dysfunction on the right or left side of the TMJ; and Group 3, dysfunction on both the right and left sides of the TMJs. In 75% of patients (12 of 16 joints), pseudodynamic TMJ analysis was useful for determining a functional abnormality. Using a points system based on three trajectory and seven velocity patterns, discs with adhesion and perforation had significantly fewer points than discs with anterior displacement (with and without reduction) and discs with no abnormality (P = 0.019 < 0.05). Trajectory and velocity patterns based on 3.0 T pseudodynamic MRI identified the affected side and determined the extent of morbidity in the Cd as well as the Da and Dp. The typical abnormal movement pattern of discs with anterior displacement (with and without reduction) and pathological structural changes of the articular disc (such as adhesion and perforation) could be identified.

顎関節症に対するSI-6601A (ヒアルロン酸ナトリウム関節注入製剤) の臨床的有用性の検討

顎関節症に対するSI-6601A (ヒアルロン酸ナトリウム関節注入製剤) の臨床的有用性の検討

中枢性筋弛緩剤塩酸エペリゾン (ミオナール ® ) の顎関節症に対する効果

中枢性筋弛緩剤塩酸エペリゾン (ミオナール ® ) の顎関節症に対する効果

顎関節症に対するNK-433 (中枢性筋弛緩剤) の臨床的有用性の検討

顎関節症に対するNK-433 (中枢性筋弛緩剤) の臨床的有用性の検討

Incidentally found and unexpected tumors discovered by MRI examination for temporomandibular joint arthrosis

We examined the frequency of incidentally found or unexpected tumors discovered at the time of magnetic resonance imaging (MRI) examinations in the temporomandibular joint (TMJ) region for patients with suspicion of TMJ arthrosis. Five MR images (T1-weighted transverse scout image and proton density and T2-weighted oblique sagittal images at the open and closed mouth) were acquired. In 2776 MRI examinations of TMJ arthrosis, two tumors were discovered. They consisted of an adenoid cystic carcinoma in the deep portion of the parotid gland, and a malignant tumor extending from the infratemporal fossa to the parapharyngeal space. The rate of incidentally founded or unexpected tumors in TMJ examinations was low (0.072%), but the two tumors found were malignant tumors, and therefore, scout image should be carefully examined, not only used for positing the slice.

Relationship between temporomandibular arthralgia and endoscopic findings of synovial tissue in the upper joint cavity of patients with temporomandibular joint arthrosis

Relationship between temporomandibular arthralgia and endoscopic findings of synovial tissue in the upper joint cavity of patients with temporomandibular joint arthrosis

Relationships between upper joint cavity volume and elasticity and mouth opening in temporomandibular joint arthrosis

Relationships between upper joint cavity volume and elasticity and mouth opening in temporomandibular joint arthrosis

Disc preservation surgery for the treatment of internal derangements of the temporomandibular joint

Interest in temporomandibular joint (TMJ) disc preservation surgery has decreased in recent years as the introduction of more conservative surgical procedures such as TMJ arthroscopy 1 Sanders B Arthroscopic surgery of the temporomandibular joint: Treatment of internal derangement with persistent closed lock. Oral Surg. 1986; 62: 361 Abstract Full Text PDF Scopus (215) Google Scholar and arthrocentesis 2 Nitzan DW Dolwick MF Martinez GA Temporomandibular joint arthrocentesis: A simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg. 1991; 49: 1163 Abstract Full Text PDF PubMed Scopus (375) Google Scholar has lessened the role of open surgical procedures. Although the literature supports disc repositioning as being a successful procedure, 3 McCarty WL Farrar WB Surgery for internal derangements of the temporomandibular joint. J Prosthet Dent. 1979; 42: 191 Abstract Full Text PDF PubMed Scopus (203) Google Scholar , 4 Mercuri LG Campbell RL Shamaskin RG Intra-articular meniscus dysfunction surgery. A preliminary report. Oral Surg. 1982; 54: 613 Abstract Full Text PDF Scopus (44) Google Scholar , 5 Hall MB Meniscoplasty of the displaced temporomandibular joint meniscus without violating the inferior joint space. J Oral Maxillofac Surg. 1984; 42: 788 Abstract Full Text PDF PubMed Scopus (47) Google Scholar , 6 Hall MB Kim M-R Dolwick MF Partial thickness plication of the TMJ disc in 149 Joints. J Oral Maxillofac. 1989; 475: 140 Google Scholar , 7 Dolwick MF Sanders B TMJ Internal Derangement and Arthrosis Surgical Atlas. , CV Mosby, St Louis, MO1985 Google Scholar , 8 Walker RV Kalamchi S A surgical technique for management of internal derangement of the temporomandibular joint. J Oral Maxillofac Surg. 1987; 45: 299 Abstract Full Text PDF PubMed Scopus (42) Google Scholar , 9 Kerstens HCJ Tuinzing DB Van Der Kwast WAM Eminectomy and discoplasty for correction of the displaced temporomandibular joint disc. J Oral Maxillofac Surg. 1989; 47: 150 Abstract Full Text PDF PubMed Scopus (41) Google Scholar , 10 Elias AC Weber W Surgical resolution of internal derangements of the temporomandibular joint. J Oral Maxillofac Surg. 1990; 485: 147 Google Scholar , 11 Dolwick MF Nitzan DW TMJ disk surgery: 8-year follow-up evaluation. Fortschr Kiefer Gesichtschir. 1990; 35: 162 PubMed Google Scholar , 12 Dolwick MF Nitzan DW The role of disc-repositioning surgery for internal derangements of the temporomandibular joint. Oral Maxillofac Surg Clin North Am. 1994; 6: 271 Google Scholar , 13 Bays RA Temporomandibular joint disc preservation. Atlas Oral Maxillofac Surg Clin North Am. 1996; 4: 33 PubMed Google Scholar there is a sense among surgeons that the procedure is less successful than reported. After disc repositioning, some patients have been observed to have a return of pain and limited opening, sometimes worse than before surgery. These observations have been discouraging.

Role of panoramic radiographis in differential diagnosis of patients with temporomandibular dysfunction

We reviewed the records for 4 patients with temporomandibular disorders (TMD), in all of whom temporomandibular joint (TMJ) arthrosis was initially suspected because of the clinical symptoms such as limited mouth opening and pain at the TMJ region. However, careful observation of the panoramic radiographs disclosed abnormalities other than TMJ arthrosis, including, obliteration of the posterior maxillary sinus wall (caused by squamous cell carcinoma of the maxillary sinus), resorption around the condylar neck (caused by hemangioma), and radiopaque foci at the anterior area of the right TMJ (synovial chondromatosis). Some of these abnormalities were not observed on the oblique lateral transcranial projection and the transorbital projection.

Dynamic MR imaging of the temporomandibular joint in patients with arthrosis: relationship between contrast enhancement of the posterior disk attachment and joint pain.

The purpose of this study was to determine the relationship between joint pain, disk position, and the degree of contrast enhancement of the posterior disk attachment in patients with temporomandibular joint arthrosis using dynamic contrast-enhanced MR imaging. T1- and T2-weighted spin-echo and spoiled gradient-recalled acquisition in the steady state MR imaging was performed in 36 healthy volunteers and 105 patients who were asymptomatic or who had joint pain, muscular pain, or both. On T1-weighted images, the position of the disk was classified as normal and anteriorly displaced. Next, on sagittal spoiled gradient-recalled acquisition in the steady state MR images, signal intensity from teh posterior disk attachment was measured. Time-intensity curves of the signal-intensity ratio versus the time after contrast administration were obtained in each case. Diagnostic accuracy of enhancement among the clinical symptoms was assessed using receiver operating characteristic curves. Imaging findings of contrast enhancement were correlated with pain and disk position. In quantitative measurement, a rapid enhancement pattern was seen most frequently in patients with joint-pain, whereas relatively gradual enhancement was seen in the healthy subjects and in patients who were asymptomatic or who had muscular pain. The mean peak-signal-intensity ratio of the group with joint pain was significantly higher than that of the other groups (p < .001). In the group with joint pain, anterior disk displacement without reduction was strongly associated with the mean signal-intensity ratio (p < .01). With regard to receiver operating characteristic analysis, the group with joint pain showed significantly greater accuracy than did the other groups (p < .001). Our results suggest that prominent contrast enhancement of the posterior disk attachment on spoiled gradient-recalled acquisition in the steady state MR images may help differentiate intraarticular from extraarticular causes of pain in and around the temporomandibular joint. In the group with joint pain, anterior disk displacement without reduction was closely associated with prominent enhancement.

Clinical evaluation of NK-433 (centrally acting muscle relaxant, lanperisone hydrochloride) on temporomandibular joint arthrosis

Clinical evaluation of NK-433 (centrally acting muscle relaxant, lanperisone hydrochloride) on temporomandibular joint arthrosis

Temporomandibular joint pathosis related to sex, age, and dentition in autopsy material

The purpose of this autopsy study was to test the hypotheses that temporomandibular joint (TMJ) arthrosis is more common in women than in men, increases with age, and is more common in edentulous persons than in those with natural teeth. Two hundred forty-eight TMJs removed at autopsy from 224 fresh cadavers were investigated macroscopically with dissection or cryosectioning. Age was found to be a significant factor in prediction of TMJ arthrosis ( p < 0.001) and of disk perforation ( p < 0.05). No significant association was found between morphologic changes in the TMJ and the factor of sex for the whole group. Disk displacement and disk perforation were, however, more common in the joints of women than men in the group of persons 80 years of age or older ( p < 0.05). There were significant associations ( p < 0.001) between arthrosis, disk displacement, disk deformation, and disk perforation. There were no statistically significant differences in the prevalence of morphologic changes in the joints from persons with 10 or more natural teeth in each jaw compared with those from persons without natural teeth. The results of this study showed that TMJ arthrosis is more frequent in older than in younger persons. TMJ disk displacement generally appears necessary for the development of perforations. The findings of this study indicate that sex and dentition are not major factors for the development of TMJ pathosis in elderly individuals.

Clinical evaluation of the effect of SI-6601A (Intra-articular injective preparation of Sodium Hyaluronate) on temporomandibular joint arthrosis

Clinical evaluation of the effect of SI-6601A (Intra-articular injective preparation of Sodium Hyaluronate) on temporomandibular joint arthrosis