RESUMEN
Viscosupplementation is a relatively new treatment concept for restoring the normal rheologic properties of the osteoarthritic joint. It is most often used for the knee. This case report describes results that were achieved using viscosupplementation following conservative therapy for a patient with osteoarthritis of the temporomandibular joint. Further study in the use of these treatments is recommended.
Asunto(s)
Ácido Hialurónico/análogos & derivados , Ácido Hialurónico/uso terapéutico , Osteoartritis/tratamiento farmacológico , Líquido Sinovial/efectos de los fármacos , Trastornos de la Articulación Temporomandibular/tratamiento farmacológico , Femenino , Humanos , Ácido Hialurónico/administración & dosificación , Ácido Hialurónico/química , Inyecciones Intraarticulares , Lubrificación , Persona de Mediana Edad , Líquido Sinovial/química , Articulación Temporomandibular/fisiopatología , ViscosidadRESUMEN
This report followed the management of a 56-year-old female suffering from TMD caused by trauma to her temporal head area. The management consisted of occlusal devices until her condition stabilized followed by prosthodontic rehabilitation to obtain and maintain a physiologic maximum intercuspation.
Asunto(s)
Traumatismos Craneocerebrales/complicaciones , Trastornos de la Articulación Temporomandibular/terapia , Terapia Combinada , Oclusión Dental Céntrica , Restauración Dental Provisional , Dentadura Parcial Fija , Femenino , Humanos , Persona de Mediana Edad , Ferulas Oclusales , Tratamiento del Conducto Radicular , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/etiologíaRESUMEN
PURPOSE: The purpose of the first phase of this two-part investigation was to determine if the opening motion of the mandible could be illustrated and described using a dynamic imaging method. The purpose of the second phase of the investigation was to determine if a center of rotation would be discovered. MATERIALS AND METHODS: Five volunteer subjects, 2 female and 3 male, whose temporomandibular joints had previously been determined to be asymptomatic, were examined by magnetic resonance imaging (MRI) during opening from a standardized position. The serial static images were reconstructed by the MRI's computer in "cine mode" to simulate dynamic motion, similar to a motion picture. For the second phase, each patient's series of static images were digitally added and manipulated by a computer graphics program to locate the center of hinge motion. RESULTS: After reviewing the animated images recorded on videotape, three independent dentist observers confirmed that the opening movement of the mandible was initially rotational, followed by translation within the glenoid fossa. A center of rotation was calculated to be in the anatomic center of the condylar head of all of the subjects in this study. CONCLUSIONS: This study showed that opening dynamics of the mandibular condyle could be studied by cine-MRI and that an opening hinge axis appears to be located in the anatomic center of the condylar head.
Asunto(s)
Articulación Temporomandibular/fisiología , Fenómenos Biomecánicos , Cartílago Articular/fisiología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética/métodos , Masculino , Cóndilo Mandibular/fisiología , Rango del Movimiento Articular/fisiología , RotaciónRESUMEN
Of 353 patients screened, 86 answered positively to questions designed to identify bruxers. The bruxing patient profile revealed that 100% had working excursive interferences, 78% had balancing excursive interferences, and 95.4% had a premature contact into maximum intercuspation. Most of the bruxing patients had a chief complaint that related to pain, and 89.6% of the patients had a craniomandibular disorder. The patients were initially managed with an anterior deprogrammer and were later managed with other occlusal devices as signs and symptoms dictated. Definitive treatment was determined by the patient's maxillomandibular relationship.
Asunto(s)
Bruxismo/terapia , Ferulas Oclusales , Adulto , Bruxismo/complicaciones , Trastornos Craneomandibulares/complicaciones , Femenino , Humanos , Masculino , Maloclusión/complicaciones , Planificación de Atención al Paciente , Articulación Temporomandibular/fisiopatologíaRESUMEN
A method is presented to restore severely eroded dentition. Due to the complexity of the case, many facets of restorative dentistry and orthodontics were used in the treatment plan. By following the basic principles described, general dentists can perform this type of restorative therapy.