Changes In Temporomandibular Joint Research Articles

The relation between persistent foramen tympanicum and degenerative bone alterations in temporomandibular joint region.

The aim of this study was to evaluate, using cone-beam computed tomography (CBCT), the relationship of persistent foramen tympanicum (PFT) with degenerative changes in the temporomandibular joint (TMJ) and the presence of pneumatized glenoid fossae and articular eminences. Two experienced oral and maxillofacial radiologists evaluated 510 CBCT scans, from which 94 patients were divided into two groups: G1-patients with PFT and G2-control group. The location of the PFT, presence, or absence of degenerative TMJ changes and morphology were evaluated. Similarly, all images were evaluated for the presence of pneumatized articular eminence and glenoid fossa. The Chi-square test and Fisher's Exact test were used for the categorical variables. A multinomial logistic regression model was performed for subgroup analysis. To assess the estimation-chance occurrence of TMJ alterations the Odds Ratio analysis was used. Statistically significant results were found for erosion, planning, and subchondral cyst. Regarding TMJ morphology, significant results were found for: round, flat, and others. Moreover, it was possible to observe that patients who had the PFT were approximately 48 times more likely to manifest TMJ alterations and approximately 3 times more likely to manifest articular eminence pneumatization. Since individuals who have FTP have a greater chance of having TMJ and PEA changes, it is important for the dental radiologist to be aware of these signs in CBCT scans for a correct diagnosis. CAAE: 34328214.3.0000.0104 (11/30/2014).

Radiological Aspects of Temporo-Mandibular Joint Osteoarthritis

This article is about applications of computed tomography (CT) in diagnosis of inflammatory and degenerative disease of temporomandibular joint (TMJ). CT is highly informative method forvisualization of disease of temporomandibular joint. Finally, sections on other aspects of CT research related to the TMJ, clinical decision-making and concluding remarks are added. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bonedestruction/production. Author of this research studied the frequency of radiological signs in different age group. In addition, there were studied frequency of isolated, combination types, and more and less localization sitesof radiological patterns of inflammatory and degenerative changes of temporo-mandibular joint

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.

Comparison of CBCT radiation doses with conventional radiographs in TMJ imaging using Monte Carlo simulations.

Three-dimensional imaging methods are widely used for evaluation of bony changes of temporomandibular joint (TMJ). Besides, lateral and posterio-anterior TMJ projections in both closed- and open-jaw positions for each temporomandibular joint are used as two-dimensional diagnostic tools. The purpose of the present study was to compare effective and mean organ absorbed doses of plain radiography techniques with those of different modalities of cone beam computed tomography (CBCT) scanning of an adult's temporomandibular joint. PCXMC 2.0 software was used to calculate mean organ and effective doses. A NewTom CBCT device (Newtom 5G XL; QR systems; Verona, Italy) was simulated at 360° rotation using a 6 × 6cm2 FOV in standard and high-resolution modes. Lateral and posterio-anterior TMJ plain projections were simulated according to recommendations of the manufacturer of the Planmeca ProMax® 2D S3 device. Doses for both projections were simulated with Monte Carlo methods and the International Commission on radiological protection adult reference computational phantoms. The highest mean organ absorbed doses occurred in bone surfaces, salivary glands, and skull for posterio-anterior TMJ and lateral TMJ, and for CBCT scanning in all examinations. The effective doses of posterio-anterior and lateral TMJ plain radiographs were found to be higher than those of the Standard Mode-Eco Scan CBCT. Therefore, the lowest effective dose was calculated in Standard Mode-Eco Scan CBCT. It is concluded that NewTom 5G XL Standard Mode-Eco Scan CBCT can be used instead of plain radiographs (lateral and posterio-anterior TMJ) in temporomandibular joint imaging as it allows visualizing the three-dimensional structure of the temporomandibular joint as an advantage.

Age and Gender-related Morphometric Assessment and Degenerative Changes of Temporomandibular Joint in Symptomatic Subjects and Controls using Cone Beam Computed Tomography (CBCT): A Comparative Analysis.

The temporomandibular joint diseases have been associated with various predisposing factors. Joint spaces, articular eminence height and inclination, and the shapes of the condylar and glenoid fossa have all been shown to vary in temporomandibular joint diseases (TMD) patients. Advanced imaging techniques like cone beam computed tomography (CBCT) have been employed to estimate these parameters. The aim of the current study was to investigate the condylar morphology, condylar and glenoid fossa shapes, and assessment of joint spaces, such as anterior, posterior, superior, lateral, and medial spaces, through CBCT slices in coronal and sagittal planes and compare them between the control group and TMD group. A cross-sectional study was planned where 80 joints in 40 patients were assessed for the above parameters; group I consisted of healthy patients, and group II included those with temporomandibular joint diseases (TMDs). The articular eminence height and inclination were assessed on the midsagittal section. The condylar changes and shapes of the glenoid fossa and condyles, as well as the joint spaces, were assessed on the selected coronal and sagittal sections. The condylar fossa had a triangular shape in the TMJ group and an oval shape in the control group. The results were highly significant (P = 0.000**). A highly significant difference in morphological parameters, such as AJS, PJS, SJS, MJS, LJS, articular eminence height, and inclination, was found between the two groups (P = 0.000**). The association of morphological parameters, such as AJS, PJS, SJS, MJS, LJS, and articular eminence height and inclination were compared with condylar and glenoid fossa shapes, where the association of superior joint space and articular eminence inclination was observed. A highly significant difference was noted between the two groups with regard to all the parameters with P=0.00*. The articular eminence inclination, as well as the superior joint space, were found to be associated with the glenoid and condyle fossa shapes in the TMJ group. These observations would, therefore, help in the early diagnosis of temporomandibular joint diseases.

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 of ultra-high-resolution CT in detecting osseous changes of temporomandibular joint: experiences in temporomandibular disorders

BackgroundOsseous changes of the temporomandibular joint (TMJ) are related to the progression of temporomandibular disorders (TMD), and computed tomography (CT) plays a vital role in disease evaluation.ObjectiveThe aims of this study were to evaluate the image quality and diagnostic value of ultra-high-resolution CT (U-HRCT) in TMD compared to cone-beam CT (CBCT).MethodsTMD patients who underwent both CBCT and U-HRCT between November 2021 and September 2022 were retrospectively included. Image quality scores were assigned for four osseous structures (the cortical and trabecular bones of the condyle, articular eminence, and glenoid fossa) by two independent observers from Score 1 (unacceptable) to Score 5 (excellent). Diagnostic classification of TMD was categorized as follows: Class A (no evident lesion), Class B (indeterminate condition) and Class C (definitive lesion). Image quality scores and diagnostic classifications were compared between CBCT and U-HRCT. The Cohen’s Kappa test, Wilcoxon signed-rank test, Chi-square test and Fisher’s exact test were conducted for statistical analysis.ResultsThirty TMD patients (median age, 30 years; interquartile range, 26–43 years; 25 females) with 60 TMJs were enrolled. Image quality scores were higher for U-HRCT than for CBCT by both observers (all Ps < 0.001). Definitive diagnoses (Class A and C) were achieved in more cases with U-HRCT than with CBCT (93.3% vs. 65.0%, Fisher’s exact value = 7.959, P = 0.012). Among the 21 cases which were ambiguously diagnosed (Class B) by CBCT, definitive diagnosis was achieved for 17 cases (81.0%) using U-HRCT.ConclusionsU-HRCT can identify osseous changes in TMD, providing improved image quality and a more definitive diagnosis, which makes it a feasible diagnostic imaging method for TMD.

Evaluation of Temporomandibular Joint Changes with Functional Appliance—An MRI Study

Evaluation of Temporomandibular Joint Changes with Functional Appliance—An MRI Study

Three-dimensional analysis of the morphological changes of the craniofacial jaw and condyle in patients with idiopathic condylar resorption

In this study we aim to describe the three-dimensional analysis of condylar deformation of the temporomandibular joint (TMJ) and morphological changes of the craniofacial jaw in patients with idiopathic condylar resorption (ICR). We also compare those with a control group that is healthy and matched for age and gender. Cone-beam computed tomography (CBCT) and cephalometric radiograph (X-ray) were conducted and analysis of craniofacial measurement, condylar width, length, height, and condylar axial angle changes were done three-dimensionally using ProPlan CMF™ 3.0 software (Materialise). The craniofacial jaw measurements of the ICR patients were significantly different than the control group and the significant changes in the mandible can be seen in ICR patients according to the results of this study. The results of smaller condylar width and height in the ICR group reflect the smaller size of the condyle compared with an unaffected condyle. Also, both right and left sagittal condylar angles (p = 0.001 and p = 0.003), respectively, and axial condylar angles (p = 0.01 and p = 0.02), respectively, displayed significant differences between the two groups. In conclusion, the vertical development of the condyle decreased along with reduced measurements in the width and height of the condyle in ICR patients, and differences in the morphology of the craniofacial jaw and condylar angles were observed between study groups.

Evaluation of Effects of Bimaxillary Anchored Fixed Functional Appliance on Temporomandibular Joint and Maxillomandibular Complex in Late Adolescents: An MRI Study

Objective To evaluate and assess changes in temporomandibular joint (TMJ), dental, skeletal and soft tissue changes following bimaxillary anchored fixed functional appliance (FFA) treatment of skeletal Class II malocclusion using Magnetic Resonance Imaging. Methods The prospective single-arm clinical trial included 15 patients (8 males, 7 females; mean age 15.71 + 1.81years) with Class II Division 1 malocclusion treated with bimaxillary anchored Forsus FRD. Four miniplates were placed bilaterally in maxilla and mandible. Then Forsus FRD L pin module was attached to miniplates without levelling of the arches. Pre-treatment (T1) and post-functional (T2) lateral cephalograms and MRI of TMJ were recorded. A total of 7 parameters were used to assess TMJ in all the 3 planes using MRI. Student’s t-test was carried out to compare pre- and post-treatment-induced changes. Results The mandible significantly moved forward (SNB, 3.71 + 0.91°; SND, 3.21 + 1.25°; Pg-OLp, 2.61 + 0.66 mm, p &lt; 0.001) and there was distalizing effect on maxilla (SNA, –0.79 + 0.89°; A-OLp, –0.57 + 0.47mm, &amp;lt;0.001). Mean overjet correction of 4.43mm was achieved, of which 71.8% were skeletal changes. 65% of skeletal changes contributed to molar relationship correction. The forward positioning of mandible seems to be because of condylar and glenoid fossa remodelling, with condyle moving in anterior position within glenoid fossa (3.28 + 2.29) and articular disc moved posteriorly relative to condylar head (2.27 + 1.62°). Conclusion Significant skeletal changes and TMJ remodelling were observed with bimaxillary anchored FFA in correcting skeletal Class II malocclusion.

Evaluation of temporomandibular joint changes seen in pre-operative and post-operative patients of oral submucous fibrosis using MRI: A prospective study

To evaluate alterations in temporomandibular joint due to immobilisation and re-mobilisation in oral submucous fibrosis patients. The study population included 2 groups, patients and normal – 22 TMJ’s of 11 individuals respectively. MRI was performed on all patients pre-operatively and 5 month post-operatively and also on controls. Disc thickness (anterior, intermediate and posterior zone), disc length, joint space and structural changes in the glenoid fossa and condylar head were assessed in all the MRI scans. The severity of changes in relation to duration of reduced mouth opening was noted. And, finally regeneration potential of the TMJ after remobilizing the jaw, on 5th month POD was observed. All the measurements were tabulated and subjected to statistical analysis. The study showed that there were significant differences in the pre-op and normal. The post treatment values/dimensions were comparatively the same as that of the normal population (except for joint space on right side and disc length on left side, which is negligible). It proves that the treatment makes the condition comparably similar to that of normal dimension over a time period of 5 months, sighting the potential capacity of the TMJ to regenerate and repair. The study revealed statistically highly significant changes in the components of Temporomandibular joint in OSMF patients with varying degrees of restriction in mouth opening when compared to controls, and return of the joint structurally towards recovery at 5 month POD stresses upon the need for an early intervention.

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

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

MANAGING TEMPOROMANDIBULAR JOINT DISORDERS: TREATMENT STAGES AND ESSENTIAL ASPECTS

Introduction. Meniscus displacement in the temporomandibular joint (TMJ) is known to provoke the development of TMJ dysfunction, thereby impairing the quality of life. Managing TMJ disorders is divided into three stages, the first of which is intermediate in determining the prognosis and further tactics. The aim of the study is to evaluate the effectiveness of occlusal splint systems and to assess the different stages of TMJ dysfunction management. Materials and methods. The study included 54 patients. Based on the findings of magnetic resonance imaging, patients were divided into two groups: group I included patients with dysfunctional changes in the TMJ (n=38), group II involved patients with dysfunctional changes in the joints and concomitant osteoarthritic changes (n=16).&#x0D; Results and discussion. The first stage of treatment was carried out using a Michigan occlusal splint. During this time, the myotatic reflex was restructured and clinical symptoms of the TMJ disorder disappeared. The treatment outcomes were as follows: the subjects of the 1st group reported about health improvement in a month since the treatment started, 20 individuals out of 38 patients had no symptoms of TMJ dysfunction. The treatment course of these patients was completed. The other 18 patients were referred for the orthodontic treatment. After the end of the splint treatment, no longer than in 2 weeks, the patients of the II group reported bout the recurrence of some symptoms that indicated a relapse of the disease; therefore, patients were recommended to continue the treatment. In the second stage of the treatment, we used occlusal plates on the lower unprepared teeth. At the third stage of treatment, radical prosthetics was carried out, which includes temporary fixation of polymethyl methacrylate prototypes on specially prepared teeth, and then the final fixation of permanent structures in the new medical condition of the lower jaw.&#x0D; Conclusion. Bite-sized intraoral guards that allow mesialisation of the lower jaw and increase the height of the bite, in particular, the Michigan occlusal splint have been found as effective appliances. Patients who had only dysfunctional TMJ changes (group I) over the course of treatment need only restructuring of the myotonic reflex, rather than those who suffer from osteoarthritic changes (group II), and therefore should undergo radical orthopaedic treatment.

Temporomandibular joint and skeletal changes in response to Twin block and Advansync appliance therapy – A three dimensional study

Objectives: This study aimed to analyze and compare the temporomandibular joint (TMJ) and skeletal changes three dimensionally in growing patients with Class II malocclusion treated with the Twin block (TB) and Advansync appliance. Material and Methods: This prospective study included 20 patients with Class II Division 1 malocclusion of which ten patients comprised the TB group and ten patients the Advansync group. Cone-beam computed tomographs were taken before treatment, and at the end of the functional phase (6–8 months). The condyle, glenoid fossa, and skeletal changes were assessed in all the three planes and the measurements were made using CARESTREAM software. Results: The TB group demonstrated a significant increase in the condylar dimensions, superior joint space, mandibular length (P = 0.005), and decrease in anterior joint space (P = 0.001) in response to treatment and the Advansync group showed a significant increase in the condylar dimensions, mandibular length, and a significant restriction in the maxillary length. Comparison between the two groups showed a significant increase in the fossa depth in the TB group and restriction in the maxillary growth in the Advansync group. Conclusion: TB and Advansync group showed TMJ and skeletal changes. However, the Advansync showed more headgear effect but less glenoid fossa changes compared to the TB group.

Prevalence of Oral Parafunctional Habits in Children and Related Factors: An Observational Cross-sectional Study.

Parafunctional habits cause movements indicating their effect as functional and structural disorders such as malocclusion and temporomandibular joint changes in the oral and dental organs. This cross-sectional study was conducted to investigate the prevalence and factors associated with parafunctional habits in 6-12-year-old children in Qom, Iran. This analytical cross-sectional study was performed on 403 6-12-year-old schoolchildren of Qom, Iran. Data collection tools included a demographic questionnaire and a checklist prepared along with a clinical examination. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), with chi-square and analysis of variance (ANOVA) tests. The mean age of children was 8.9 ± 2.03 years. Bruxism was more common than other parafunctional habits (22.6%). There was a significant relationship between oral habits with children's gender and age (p <0.001). However, there was no significant relationship between oral habits and other variables such as underlying disease, economic status and parent's smoking (p >0.05). Given the relatively high prevalence of parafunctional habits in children, it seems that children should be investigated for the presence of such habits in order to provide the necessary education to parents and perform dental interventions to prevent complications from oral habits. Dental interventions at a younger age are easier to conduct and have a more effective preventive role. Mehdipour A, Aghaali M, Janatifar Z, et al. Prevalence of Oral Parafunctional Habits in Children and Related Factors: an Observational Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):308-311.

A Comparative Study of Temporomandibular Joints in Adults with Definite Sleep Bruxism on Magnetic Resonance Imaging and Cone-Beam Computer Tomography Images.

The aim was to study the imaging characteristics of the temporomandibular joint (TMJ) of definite sleep bruxers through magnetic resonance imaging (MRI) and cone-beam computer tomography (CBCT). Nineteen definite sleep bruxers diagnosed by polysomnography and twenty asymptomatic non-bruxers matched by age, gender, and education level participated in this study. After obtaining MRI and CBCT images of all TMJs of the subjects, evaluation and measurement were conducted, respectively. The analyzed parameters included disc position, disc configuration, joint effusion (JE), joint space or condyle position, and condylar bony changes. Of the 38 joints in the study group, disc deformity and disc displacement of TMJs were both 57.9% when the mouth was closed, and 76.3% showed condylar bony changes, while when the mouth was open, 82% of all TMJs showed physiological biconcave discs. Comparison of joint space revealed that the anterior space was larger in the study group. There was no significant difference between the mild and the moderate to severe sleep bruxism subgroups in the changes of TMJ. The results demonstrated that a higher prevalence of disc deformity, disc displacement, JE, and condylar bony changes occurred in temporomandibular joints of sleep bruxers. These changes were not related to the severity of sleep bruxism.

The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models.

Temporomandibular disorders (TMD) represent a group of musculoskeletal conditions involving the temporomandibular joints (TMJ), the masticatory muscles and associated structures. Painful TMD are highly prevalent and conditions afflict 4% of US adults annually. TMD include heterogenous musculoskeletal pain conditions, such as myalgia, arthralgia, and myofascial pain. A subpopulations of TMD patients show structural changes in TMJ, including disc displacement or degenerative joint diseases (DJD). DJD is a slowly progressing, degenerative disease of the TMJ characterized by cartilage degradation and subchondral bone remodeling. Patients with DJD often develop pain (TMJ osteoarthritis; TMJ OA), but do not always have pain (TMJ osteoarthrosis). Therefore, pain symptoms are not always associated with altered TMJ structures, which suggests that a causal relationship between TMJ degeneration and pain is unclear. Multiple animal models have been developed for determining altered joint structure and pain phenotypes in response to various TMJ injuries. Rodent models of TMJOA and pain include injections to induce inflammation or cartilage destruction, sustained opening of the oral cavity, surgical resection of the articular disc, transgenic approaches to knockout or overexpress key genes, and an integrative approach with superimposed emotional stress or comorbidities. In rodents, TMJ pain and degeneration occur during partially overlapping time periods in these models, which suggests that common biological factors may mediate TMJ pain and degeneration over different time courses. While substances such as intra-articular pro-inflammatory cytokines commonly cause pain and joint degeneration, it remains unclear whether pain or nociceptive activities are causally associated with structural degeneration of TMJ and whether structural degeneration of TMJ is necessary for producing persistent pain. A thorough understanding of the determining factors of pain-structure relationships of TMJ during the onset, progression, and chronification by adopting novel approaches and models should improve the ability to simultaneously treat TMJ pain and TMJ degeneration.

Three dimensional evaluation of the skeletal and temporomandibular joint changes following stabilization splint therapy in patients with temporomandibular joint disorders and mandibular deviation: a retrospective study

BackgroundThree-dimensional (3D) detailed evaluations of the mandibular mediolateral position, mandibular condylar position, and temporomandibular joint (TMJ) spaces following stabilization splints (SS) therapy in patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD) have not been reported in the available literature. Accordingly, this study aimed to three-dimensionally analyze the skeletal and bony temporomandibular joint changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation.MethodsThis study is a retrospective clinical study that enrolled 26 adult patients with TMD and MD with a mean age of 24.86 years. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to diagnose TMD. SS was adjusted weekly until occlusal contact stabilization occurred, and then adjusted monthly, patients were instructed to wear it at night for at least 10 h. The SS was removed after the elimination of TMD symptoms (TMJ/muscle pain on palpation, muscle spasm, and clicking) and having both condyles completely seated in a musculoskeletally stable position. Pre- and post-therapeutic Cone Beam Computed Tomography (CBCT) was analyzed. Mandibular mediolateral position, TMJ spaces, and mandibular condyle position were analyzed three-dimensionally using Mimics 21.0 software. Paired t-test or Wilcoxon rank-sum test was performed, and the significance level was considered at P < 0.05.ResultsThe treatment period with SS therapy was 10.07 ± 3.1 months. The deviated chin was improved in 69.23% of the sample; the range of improvement was > 0 mm ≤ 3.9 mm. The mandibular rotation was significantly decreased from 3.58 ± 2.02° to 3.17 ± 1.60. The deviated side’s superior and posterior joint TMJ spaces were significantly increased from 2.49 ± 0.88 mm and 1.25 ± 0.79 mm to 2.98 ± 1.02 mm and 1.86 ± 0.72 mm, respectively. The value of the difference from the bilateral condyle head position to the X and Z axes significantly decreased from 2.50 ± 1.56 mm and 2.30 ± 1.57 mm to 1.64 ± 1.58 mm and 1.82 ± 1.11 mm, respectively.ConclusionThe main positional effect of the stabilization splint treatment in TMD patients with MD includes considerable correction of mandibular deviation, improving facial asymmetry, and moving the condyle into a stable condylar position; these were done by promoting the mandible to rotate around the Z (roll) and Y (yaw) axes and by forward, downward, and outward condylar movement on the deviated side, respectively.

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.

Changes of temporomandibular joint on Cone Beam CT

Chronic periodontitis is a common chronic infectious disease, which can cause the destruction of periodontal support tissue, even the loss of teeth and the disorder of oral and maxillofacial system. Oral and maxillofacial system is the general name of various structures including oral and maxillofacial tissues, such as teeth, temporomandibular joint, masticatory muscles, nerves, etc., which is a functional whole with mutual restriction and coordination. The temporomandibular joint (TMJ) is an important joint in human body, which plays a crucial role in mandibular movement during chewing, swallowing and speaking [1]. At present, many studies have examined the temporomandibular joint (TMJ) in patients with occlusal disorders and dentition defects, and found that these adverse effects would cause structural changes in TMJ. However, there are few studies on TMJ in patients with chronic periodontitis. This paper will review the morphological and structural changes of TMJ in different patients.