Temporomandibular Joint In Patients Research Articles

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.

Effect of condylar rotation on the stress environment of the temporomandibular joint in patients with mandibular protrusion

Purpose: The study aims to analyse the effects of condylar rotation on the biomechanical environment of the TMJ after bilateral sagittal split ramus osteotomy (BSSRO) through the finite element method (FEM). Methods: Thirteen patients with mandibular prognathism and twenty-three normal subjects were recruited. The three-dimensional (3D) models were reconstructed. 13 representative morphological parameters were measured for comparison. A patient was selected to perform virtual BSSRO surgery by rotating the condyles in MIMICS. The preoperative and postoperative 3D models of the patient were subsequently imported into ABAQUS for finite element analysis. The preoperative and postoperative stresses and joint spaces in the TMJs were investigated. Results: The maxillofacial morphologies of the patients with mandibular protrusion was significantly different from those of the asymptomatic subjects (P<.05). Stresses in the postoperative group were lower than those in the preoperative group. The rotation of the condyle could cause the variations in stress levels and joint spaces within the TMJs. Inward and upward rotation of the condyle was associated with higher stress in the TMJ, whereas the lowest stress was observed when the condyle remained stationary following surgical intervention. Significance: Lateral, medial and superior joint spaces were more related to the stresses in the TMJs. The condyle should be kept in place as much as possible to avoid disrupting the balance of the TMJ in patients with mandibular protrusion.

Pre- and Post-Operative Cone Beam Computed Tomography Assessment of the Temporomandibular Joint in Patients with Orthognathic Surgery.

This study aimed to compare the pre- and post-operative temporomandibular joint (TMJ) condylar position in dentofacial deformity (DFD) patients who had orthognathic surgeries using cone beam computed tomography (CBCT). A retrospective study evaluating the pre- and post-operative CBCT for 79 DFD patients (equivalent to 158 TMJs) (mean age = 26.62 ± 9.5 years) with a bilateral sagittal split osteotomy with or without Le Fort I surgeries (n = 29 Class II DFD, n = 50 Class III DFD) was performed. This included the compartmental measurement of TMJ spaces, in addition to the measurement of intercondylar distances and angles. Condylar position centricity was assessed using the Pullinger and Hollender formula. Clinical data were analysed for DFD class, the type of surgery and post-operative CBCT timing. Pre- and post-operative measurements were compared statistically using a paired t-test, Wilcoxon signed-rank test, and Stuart-Maxwell test. TMJ condyles tended to relocate post-operatively in a posterosuperior position with internal rotation in Class II DFD and a superior position with internal rotation in Class III DFD. However, the overall changes were within <0.5 mm translation and <4° rotation and the number of concentrically positioned condyles (according to the Pullinger and Hollender formula) did not change significantly. Orthognathic surgery is associated with minor post-operative translational and rotational condylar positional changes in Class II and III DFDs.

Temporomandibular joint stress analysis of patients with different mandibular deformities during unilateral molar occlusion

Mandibular prognathism, retrusion and deviation are common mandibular deformities. They can lead to functional and aesthetic problems due to their important role in the oral system. Different from other occlusions, unilateral molar occlusion often occurs during mastication, which has a deep impact on the functions of temporomandibular joints (TMJs). Therefore, the study of unilateral molar occlusion is of great importance and significance to the daily life of patients with mandibular deformities. A total of 35 individuals were involved in this study, including 11 asymptomatic subjects, 10 patients with mandibular prognathism, 5 patients with mandibular retrusion and 9 patients with mandibular deviation. Finite element (FE) models corresponding to the unilateral molar occlusion were constructed. During unilateral molar occlusion, mandibular deformity increases the pressure on the condyle and articular disc. Compared with mandibular protrusion or retraction, facial asymmetry will significantly increase the stress of TMJ. Chewing on the non-deviated side also will lead to higher stress in the TMJ of patients with mandibular deviation. Therefore, patients with mandibular deviation have the highest risk of temporomandibular disorder (TMD), and it is recommended that patients with mandibular deviation chew bilaterally or with the deviated side.

Evaluation of Rheumatic Diseases Affecting the Temporomandibular Joint: A Cone Beam Computed Tomography Study and Literature Review.

Due to the silent manifestation of temporomandibular joint (TMJ), dentists and rheumatologists may neglect treatment for this joint. The aim of this study was to investigate the TMJ components in patients with various rheumatic diseases and to compare them with a control group based on cone beam computed tomography (CBCT) images. This study comprised an assessment of the CBCT images of 65 patients (130 temporomandibular joints) with various rheumatic diseases (mostly rheumatoid arthritis) affecting the TMJ. Moreover, 65 patients (130 temporomandibular joints) with a similar age and gender distribution were examined as the control group. Pathologies were classified into a total of 12 types for the presence of any osseous changes in the condylar head or articular fossa or for joint space narrowing. Statistical analysis of all data was performed with SPSS version 18. The conformity of continuous variables to a normal distribution was examined by the Kolmogorov-Smirnov test. The Mann-Whitney U test was used to compare the means of two independent groups. The Pearson Chi-square test, Yates correction and Fisher's exact test were used in the analysis of categorical variables. The mean age of the patient and control groups was 50 ± 13 and 48 ± 16, respectively, and no statistically significant difference was found between the patient and control groups in terms of age distribution (p = 0.123). Condylar erosion, condylar flattening, subcondylar sclerosis, osteophytes, subcortical cysts, articular eminence resorption and articular eminence flattening rates were found to be statistically significantly higher in the patient group than in the control group (p < 0.05). Dentomaxillofacial radiologists should examine the bony components of the TMJ in patients with rheumatic diseases, and a multidisciplinary approach involving a dental specialist and rheumatologist is required.

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.

Investigation of Condyle Positions in Patients with Temporomandibular Joint Disorder by Cone-Beam Computed Tomography

Objective: The condylar position refers to the location of the mandibular condyle within the glenoid fossa when the teeth are in maximum intercuspal, and it is an important indicator of the temporomandibular joint (TMJ) function. This study aimed to assess the condylar position of the TMJ in patients with TMJ disorder using cone-beam computed tomography (CBCT). Methods: The present study utilized CBCT to evaluate the condylar position of the TMJ in a sample of 56 patients. Among them, 28 patients were asymptomatic while the remaining 28 had been diagnosed with TMJ disease. To evaluate the presence of TMJ disorders, the Research Diagnostic Criteria for Temporomandibular Disorders was employed. This diagnostic tool is widely used in clinical and research settings to assess TMJ-related pain and dysfunction. Results: The agreement was excellent, according to the intra-observer and inter-observer correlation values obtained. There was no statistically significant difference between the two groups in terms of age and gender distribution. The results showed that the anterior and posterior joint spaces were significantly higher in the symptomatic group compared to the asymptomatic group. However, there was no statistically significant difference between the two groups in terms of superior joint space and articular eminence inclination values. Gender did not create a significant difference in any parameter. Conclusion: The results of this study emphasize that CBCT images have an important role in detecting significant changes in condyle position in patients with TMJ disorders. However, further large-scale studies are necessary to validate and enhance the findings.

Effects of a program consisting of strain/counterstrain technique, phonophoresis, heat therapy, and stretching in patients with temporomandibular joint dysfunction: A pilot study.

The present study was conceptualized as a pilot study to examine the effects of a 3-week program consisting of strain/counterstrain technique (SCST), phonophoresis, heat therapy, and stretching exercises on pain and functions in patients with temporomandibular dysfunction (TMD). Seven participants (mean age 25.85 years) diagnosed with TMD having pain in the temporomandibular joint (TMJ) area with decreased jaw opening were recruited for the study. Treatment interventions consisting of SCST, phonophoresis (ultrasound gel mixed with diclofenac gel), heat therapy, and stretching (mouth-opening) exercises were performed 3 days a week for 3 weeks. SCST was performed on the masseter, medial, and lateral pterygoid muscles. No control group was present in the study. Paired samples t test revealed a significant difference in numerical pain rating scale (NPRS) (decreased by 50%, P < .001) and jaw functional limitation scale (JFLS) (reduced by 59.58%, P < .001) scores after 3 weeks of intervention. A large effect size (Cohen d = -3.00 for NPRS and -3.16 for JFLS) was observed for both variables. No correlation (R = 0) was found between the baseline values of NPRS and JFLS. A 3-week program consisting of SCST, phonophoresis, heat therapy, and stretching exercises was effective in reducing the pain and improving the functions related to TMJ in patients suffering from TMD. However, a randomized controlled trial is needed to reach a definite conclusion.

Determination of the frequency of occurrence of functional disorders of the dental system in patients with different psycho-emotional status

Dysfunctions of the temporomandibular joint have long been the subject of discussions among dentists. Many researchers identify a close relationship between the development of dysfunction of the temporomandibular joint and the psychological factor that causes hypertonicity of the masticatory muscles and a pronounced pain symptom. The purpose of this article was to determine the frequency of occurrence of functional disorders of the temporomandibular joint in patients with different psycho-emotional status. Materials and methods: In this work, the primary diagnosis of 237 patients aged 20 to 29 years was carried out. A survey and clinical examination of the examined patients was conducted for the presence of anomalies and deformities of the dental system, pathological erasability of hard tissues of teeth, bruxism, musculoskeletal dysfunctions. Functional disorders of the temporomandibular joint were assessed using the Hamburg test. The psychoemotional status of patients was assessed using the clinical questionnaire of neurotic states by K.K. Yakhin, D.M. Mendelevich. Results: Among the examined patients, temporomandibular joint dysfunction in patients with anxiety and depression was much more common than in patients with stable psychological status, (28.3 2.9) and (4.2 1.3) % respectively. A statistically significant relationship between the development of temporomandibular joint pathologies and the psychoemotional status of the patient was revealed. Conclusion: Thus, anxiety and depressive states should be taken into account as a risk factor for the development of functional disorders of the temporomandibular joint.

Evaluation of Temporomandibular Joint in Patients with Parkinson's Disease: A Comparative Study.

(1) The aim of this study was to perform an evaluation of the temporomandibular joint (TMJ) in patients with Parkinson's disease (PD) and present the morphological differences of the TMJ between healthy subjects and patients with PD. (2) A total of 102 Caucasian subjects were divided equally into two groups. The study group consisted of patients with PD, while the control group comprised healthy subjects. Ten parameters, including anterior joint space (AJS), superior joint space (SJS), posterior joint space (PJS), condyle head length (CHL), condylar neck width (CNW), minor axis of the condyle (MAC), long axis of the condyle (LAC), condylar axis inclination (CI), medial joint space (MJS), and lateral joint space (LJS), were measured using magnetic resonance images. The data were statistically analyzed using paired samples t-test and Student's t-test, with a significance level set at p < 0.05. (3) In the PD group, all TMJ parameters showed a statistically significant difference between both sides of the face (p < 0.05). However, in the control group, AJS, SJS, PJS, CHL, CNW, MAC, CI, MJS, and LJS did not show a statistically significant difference between both sides of the face (p > 0.05), except for LAC (p < 0.05). The asymmetry index values of AJS, SJS, PJS, CHL, CNW, MAC, CI, MJS, and LJS demonstrated a statistically significant difference between the study and control groups (p < 0.05), except for LAC (p > 0.05). (4) Within the limitations of this retrospective study, the findings suggest that TMJ morphology and asymmetry could be associated with PD.

Temporomandibular joint involvement in patients with Juvenile Idiopathic Arthritis: comparison of ultrasonography and magnetic resonance imaging in assessing the periarticular space width

ObjectivesThis study aimed to compare the performance of Ultrasonography (US) and Magnetic Resonance Imaging (MRI) in assessing the Lateral Periarticular Space (LPAS) of Temporomandibular Joints (TMJs) in patients with Juvenile Idiopathic Arthritis (JIA).MethodsThe LPAS width was evaluated in two different patient groups. In the JIA group, including 29 children (13 ± 2.8 years) with JIA, the LPAS width was measured with both MRI and US. In the healthy group, including 28 healthy children (12.6 ± 2.5 years), the LPAS width was measured only with US. Comparisons of LPAS width based on patient groups and TMJ contrast enhancement in MRI were evaluated by applying the Mann–Whitney U test. Correlation and agreement between MRI and US measurements in JIA group were tested using Spearman rank correlation and Bland–Altman method.ResultsThe LPAS width was significantly greater in the JIA group than in the healthy group. In the JIA group, the LPAS width was significantly greater in TMJs with moderate/severe enhancement than those with mild enhancement. A positive significant correlation between MRI and US measurements of LPAS width was found in the JIA group. In the same group, Bland–Altman method showed a good level of agreement between MRI and US measurements.ConclusionAlthough, US cannot replace MRI in the evaluation of TMJ in patients with JIA, US could be used as a supplementary imaging method to MRI in assessing the TMJ disease.

Magnetic resonance imaging evaluation of the disc morphology of temporomandibular joint in patients with severe hemophilia.

This study aimed to assess the morphological differences in the articular disc (AD) between hemophilic patients and healthy individuals of the control group for further association with signs and symptoms. Fourteen severe hemophilic patients had their AD evaluated by magnetic resonance imaging (MRI). The morphological findings were compared to those of a control group consisting of 14 healthy individuals. MRI was used to evaluate all the components of the temporomandibular (TMJ), including the AD, resulting in sequential T1-weighted parasagittal images. All the images were acquired with teeth in maximum intercuspation position. Morphological alterations showed significant statistical differences (P-value = 0.0068), whereas no statistical differences were found in the other variables, including TMJ pain, headache, bruxism and mouth opening limitation. In the group of non-hemophilic individuals, only two (14.29%) presented AD with non-biconcave features, whereas in the group of hemophilic patients, nine (64.29%) presented AD with a morphology other than biconcave. In patients with severe hemophilia, there seems to be a pattern of morphological alterations in the articular disc over time. The standard biconcave morphology of AD tends to change into other ones, particularly biplanar, hemiconvex and folded.

Sonographic Measurement of Condylar Translation, Joint space and Mouth Opening in Healthy and Subjects with Temporomandibular Joint Disorders

Objectives: A sonographic approach can be used to quantify joint movement, muscle thickness, and available joint space. This study aimed to compare the amount of mouth opening, joint articular distance, and both anterior and inferior translation of the mandibular condyle between healthy participants and individuals with temporomandibular joint (TMJ) disorders. Methods: A cross-sectional study design was used with 52 participants (control: 26 healthy and TMJ: 26 symptomatic individuals) recruited using convenience sampling. The joint space distance and the anterior and inferior condylar translation on both sides were evaluated using sonography during maximum mouth opening and closing. Mouth opening was measured with a graduated ruler. Reliability was performed on a subgroup (n=10) with an interval of 3-7 days. Results: The reliability was good to excellent (ICC=0.57-0.94). The highest reliability was related to the joint space distance. The mean values for mouth opening were 43.1 and 35.3mm, respectively for healthy and TMJ patients. The anterior condylar translation was 7.14-7.57mm, inferior condylar translation was 2.35-2.66mm, and the joint space distance was 49.4-0.44mm. No significant differences were found between the left and right sides in either group. The mouth opening and joint space values were significantly higher in the healthy group while the rate of anterior transition movement was higher but not significant. Furthermore, there was a significant negative relationship between pain, mouth opening, and joint distance. Discussion: Sonography can be considered an accurate tool for the assessment of joint space and condylar translation in individuals with symptomatic TMJ disorders.

Effects of bilateral sagittal split ramus osteotomy and bimaxillary osteotomies on stress distribution of temporomandibular joints in patients with maxillofacial deformity under asymmetric occlusions.

Bilateral sagittal split ramus osteotomy (BSSRO) and bimaxillary osteotomies (BSSRO plus Lefort1 osteotomy) are representative surgeries to solve maxillofacial deformity. It is important to understand the biomechanical impact of the surgeries on the temporomandibular joint (TMJ). The purpose of this study is to compare the stress variations of the patients before and after the two surgeries. Twenty-four patients with maxillofacial deformities and 14 asymptomatic subjects were recruited to be the preoperative group and control group in this study. Ten patients were performed BSSRO and other 14 underwent bimaxillary osteotomies. Finite element models of the preoperative, postoperative, and control groups were established according to the CBCT data of the subjects. The muscle forces of the left and right unilateral occlusion were applied on the models. And the contact was used to simulate the interaction within the TMJs and between the maxillary and mandibular teeth. Under the asymmetric occlusion, bimaxillary osteotomies were found to be superior to BSSRO in the stress distributions of the TMJs. The magnitude of the asymmetric stresses was strongly correlated with the TMD symptoms in the patients. And the stress variation of the postoperative TMJs was the cause of the improvement or aggravation of the TMD symptoms.

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.

Research progress of temporomandibular joint in adolescent malocclusion

The prevalence of malocclusion in permanent dentition was 72.97%. Temporomandibular joint (TMJ) is one of the most important joints in human body, and its functional structure is the most complex. The shape and position of the temporomandibular joint in patients with malocclusion were affected by occlusal occlusion. This review focuses on the effects of different types of malocclusion on the morphology and function of temporomandibular joint (TMJ) in adolescents.

Evaluation of Oral Health Status and Temporomandibular Joint in Patients with Various Psychiatric Disorders in a Tertiary Care Center of Maharashtra, India

Introduction: Living a physically and mentally healthy lifestyle is equally vital. It occurs at all socioeconomic levels and affects individuals of all backgrounds. It is estimated that 450 million people are suffering from mental problems worldwide. Irrespective of the cause, everyone should be aware that poor dental health impacts overall health. Aim: The purpose of this study was to assess the level of oral health for people with different psychiatric illnesses in Maharashtra, to determine whether these people’s level of oral health correlates with other characteristics and to determine the extent of the issue with dental health and the best way to address it. Materials and Methods: In this cross-sectional study, ninetyeight patients receiving care at the Psychiatric department of Maharashtra, India, between April and May 2022 were included. A case history Performa was prepared to gather detailed information on all aspects. The oral examination was done by examining lymph nodes, lips, tongue, gums and tissue, saliva, natural teeth, oral cleanliness, and dental pain with a sterile mouth mirror and probe using Oral Health Assessment Tool (OHAT) for Dental Screening Modified from Kayser-Jones . Dental caries was reported using the Decayed, Missing, and Filled Teeth (DMFT) index. Furthermore, Helkimo’s TMJ Index was used to assess Temporomandibular Joint (TMJ). Descriptive statistics were used to observe frequency variation. Result: The participants patients mean age was 41.33±13.58 years, and their range of age was 21-65 years. The male to female ratio of the study population was 1:1.13. Sleep disorders (24.50%) and anxiety (22.40%) were the most prevalent psychiatric conditions impacting the research population. The oral health examination of the patients described changes in the oral cavity and associated factors, including lips, tongue, gums and tissues, saliva, natural teeth, oral cleanliness, and dental pain. 59.10% of the participants had moderate to severe TMJ dysfunction. The range of the DMFT score was 3 to 17 (mean 7.89±3.21). The participants’ TMJ Index score ranged from 0 to 17 (mean 5.51±4.48). More than half of the participants (59.10 %) had moderate to severe TMJ dysfunction. Conclusion: Maharashtra’s psychiatric patients have poor oral health conditions, highlighting the need for oral health education and expanding access to dental care for these patients.

Arthrocentesis, Injectable Platelet-Rich Plasma and Combination of Both Protocols of Temporomandibular Joint Disorders Management: A Single-Blinded Randomized Clinical Trial.

Introduction Osteoarthritis is one of the most common disorders of the temporomandibular joint (TMJ). The complex etiopathogenesis of the temporomandibular disorders (TMDs), and the variability of symptoms make it difficult to adopt standardized therapeutic protocols. Recently, platelet-rich plasma (PRP) injections have been applied into the TMJ in patients with TMJ osteoarthritis. On the other hand, arthrocentesis has received a widespread acceptance, as a minimally-invasive surgical procedure for TMDs. This study aimed to assess and compare the effect of each of these protocols (arthrocentesis, PRP injection, combination of them) in the management of TMJ osteoarthritis. Methods A single-blinded randomized clinical trial was conducted on a sample of 33 participants with limited mouth opening, pain on function and joint sounds due to TMJ osteoarthritis. Participants were assigned randomly into three groups: Arthrocentesis with PRP group; PRP group; Arthrocentesis group. Maximum mouth opening (MMO), pain and joint sounds were re-evaluated during a six-month observation period. Intra- and inter-group comparisons regarding these variables were performed. Results Participants in all study groups showed statistically significant improvement in terms of MMO and pain during the six-month postoperative period (p<0.05), and showed no significant improvements regarding joint sounds (p>0.05). Pain evaluations showed better outcomes in arthrocentesis with PRP group in comparison to arthrocentesis or injectable PRP alone after six months of follow-up (p<0.05). There were no significant differences in the outcomes of MMO and joint sounds evaluations between the three groups after six months. Conclusions Within the limitations of this study, it can be concluded that the three assessed treatment protocols were effective in improving limited mouth opening and pain in patients with TMJ osteoarthritis. A combination of TMJ arthrocentesis and PRP intra-articular injections showed the best outcomes regarding pain symptoms. None of the tested treatment protocols showed improvement in terms of articular sounds.

Three-Dimensional Morphology of Temporomandibular Joint in Patients with Class I, Class II and Class III Malocclusion: A CBCT Study

Background: Varying types of malocclusions may have an effect on the morphology and position of the condyle in the glenoid fossa.Aim: This retrospective study aims to evaluate and compare the three-dimensional position and morphology of the condyle in the glenoid fossa in Angle’s Class I, Class II division I, Class II division II and Class III malocclusions using cone-beam computed tomography panoramic reconstructions.Material and Method: Pre-treatment CBCT scans of 40 subjects (17-30 years) with 10 subjects in each of the study groups as per Angle’s malocclusion were obtained. The CBCT images of all subjects were evaluated and compared following parameters, i.e., differences in anterior joint space, posterior joint space, superior joint space, anteroposterior and mediolateral width of the condyle, condylar height, and the vertical distance of the geometric center of the condyle from the mid-sagittal plane.Result: Statistical analysis revealed all parameters were statistically similar for all the malocclusion groups except the anterior and the superior joint space. The latter two parameters were significantly smaller in subjects with class III malocclusion compared to class I (p &lt;0.05).Conclusion: The Anterior joint space and the Superior joint space were statistically significantly larger in the Class I malocclusion group when compared with the Class III malocclusion group. This implies that condyles were more superiorly and anteriorly placed in subjects with class III malocclusion. These differences could be considered during the diagnosis temporomandibular disorders and orthodontic treatment.

СРАВНЕНИЕ ДАННЫХ КОНУСНО-ЛУЧЕВОЙ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ У ПАЦИЕНТОВ С ВНУТРИСУСТАВНОЙ ПАТОЛОГИЕЙ ВИСОЧНО-НИЖНЕЧЕЛЮСТНОГО СУСТАВА С НАЛИЧИЕМ И ОТСУТСТВИЕМ АСИММЕТРИИ ЛИЦА

Introduction. Diseases of the temporomandibular joint are an acute problem for the entire dental community, so they are widely studied by various authors both in our country and abroad. This is due to the high prevalence both among patients at the dental reception (78.3–95.3%), and in the general population — up to 80% of the able-bodied population.&#x0D; The presence of a certain forced position of the lower jaw, in the case of a compensated state of pathology of the temporomandibular joint, during total dental treatment, can lead to a sharp decompensation of the disorders of the temporomandibular joint and the appearance of patient complaints. &#x0D; The purpose of the study is to identify predisposing factors for the formation of intraarticular pathology of the temporomandibular joint, which can be assessed by available diagnostic methods.&#x0D; Materials and methods. The object of the study was 80 patients (18 men and 62 women) aged 18 to 67 years, the average age is (45.7 ± 0.5) years: with functional disorders of the TMJ, lateral displacement of the lower jaw, condition after resection of the upper jaw and planned orthopedic and orthodontic patients without signs of intraarticular pathology of the temporomandibular joint.&#x0D; Research results. Based on the data of digital radiological diagnostic methods, the features of the relationship between the intraarticular structures of the temporomandibular joint in patients with lateral displacement of the lower jaw in comparison with people without the manifestation of intraarticular pathology were studied, a narrowing of the middle and distal articular gaps to (2.14 ± 0.20) and (1.74 ± 0.25) mm, respectively (norm indicators — (2.89 ± 0.30) and (2.17 ± 0.25) mm, respectively).&#x0D; Findings. The cone beam computed tomography (CBCT) format 17×20 in the usual bite can be used in a much wider range of diagnostics than the CBCT of the TMJ region, or CBCT of the dentition.