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1.
Sci Rep ; 14(1): 24125, 2024 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-39406788

RESUMO

Mandibular movement is complex and individual due to variations in the temporomandibular joint (TMJ). Consequently, patient-centered dentistry should incorporate patients' specific anatomy and condylar function in treatment planning. Real-time magnetic resonance imaging (rt-MRI) visualizes relevant structures and tracks mandibular movement. However, current assessments rely on qualitative observations or time-consuming manual tracking, lacking reliability. This study developed an automatic tracking algorithm for mandibular movement in rt-MRI using least mean square registration (LMS) and compared it to manual tracking (MT) during mouth opening. Ten participants with skeletal class I underwent rt-MRI (10 frames/s). The same operator tracked the condylar pathway for the two methods, setting 2000 landmarks (2 landmarks x100 frames x10 participants) for MT and 210 landmarks (3 landmarks x7 frames x10 participants) for LMS. Time required, superimposition error, and the distance between tracked condylar pathways were compared between methods. LMS tracking was 76% faster and showed significantly better superimposition (0.0289 ± 0.0058) than MT (0.059 ± 0.0145) (p = 0.002). During one-third of the movement, the pathways tracked by both methods were more than 1 mm and 1° apart. These findings highlight the benefits of automatic condylar movement tracking in rt-MRI, laying the groundwork for more objective and quantitative observation of TMJ function.


Assuntos
Imageamento por Ressonância Magnética , Mandíbula , Movimento , Articulação Temporomandibular , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Feminino , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/fisiologia , Mandíbula/diagnóstico por imagem , Mandíbula/fisiologia , Mandíbula/anatomia & histologia , Movimento/fisiologia , Adulto , Algoritmos , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/fisiologia , Côndilo Mandibular/anatomia & histologia , Adulto Jovem , Processamento de Imagem Assistida por Computador/métodos
2.
Int J Mol Sci ; 25(17)2024 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-39273351

RESUMO

Hyaluronic acid (HA) is the main component of the temporomandibular joint (TMJ) synovial fluid. Arthritis in temporomandibular disorders (TMDs) disrupts HA metabolism, resulting in shorter polymeric chain predominance and increased friction. Intra-articular injections of HA supplement the larger molecules of this glycosaminoglycan, and the platelet-rich plasma (PRP) delivered in this way releases growth factors, suppressing inflammation. This PRISMA-compliant PROSPERO-registered (CRD42024564382) systematic review aimed to assess the validity of mixing HA with PRP in the injectable treatment of TMJ disorders. We searched the medical literature for eligible randomized clinical trials using BASE, Google Scholar, PubMed and Scopus engines on 9 May 2024, with no time frame limit. Selected reports were assessed for risk of bias using the Cochrane RoB2 tool. Numerical data were collected on articular pain and mandibular mobility. We provided mean differences from baseline and between study and control groups at each observation point. The efficacy of TMD treatment with HA/PRP versus HA or PRP alone was assessed meta-analytically. Of 171 identified records, we selected 6 studies. In the 6-month follow-up, the mean advantage of PRP supplementation with HA was 2.52 (SE = 2.44; d = 0.83) mm and the benefit of adding PRP to HA was 1.47 (SE = 2.68; d = 0.34) mm in mandibular abduction. The pain-improvement scores were -1.33 (SE = 1.02; d = -1.05) and -1.18 (SE = 0.92; d = 0.80), respectively. Presumably, the HA/PRP range of therapeutic efficiency includes cases non-respondent to HA or PRP alone.


Assuntos
Ácido Hialurônico , Plasma Rico em Plaquetas , Transtornos da Articulação Temporomandibular , Articulação Temporomandibular , Humanos , Fenômenos Biomecânicos/efeitos dos fármacos , Fenômenos Biomecânicos/fisiologia , Ácido Hialurônico/administração & dosagem , Injeções Intra-Articulares , Articulação Temporomandibular/efeitos dos fármacos , Articulação Temporomandibular/fisiologia , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Transtornos da Articulação Temporomandibular/fisiopatologia
3.
Int J Numer Method Biomed Eng ; 40(10): e3862, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39142807

RESUMO

Surgery of jawbones has a high potential risk of causing complications associated with temporomandibular joint disorder (TMD). The objective of this study was to investigate the effects of two drive modeling methods on the biomechanical behavior of the temporomandibular joint (TMJ) including articular disc during mandibular movements. A finite element (FE) model from a healthy human computed tomography was used to evaluate TMJ dynamic using two methods, namely, a conventional spatial-oriented method (displacement-driven) and a compliant muscle-initiated method (masticatory muscle-driven). The same virtual FE model was 3D printed and a custom designed experimental platform was established to validate the accuracy of experimental and theoretical results of the TMJ biomechanics during mandibular movements. The results show that stress distributed to TMJ and articular disc from mandibular movements provided better representation from the muscle-driving approach than those of the displacement-driven modeling. The simulation and experimental data exhibited significant strong correlations during opening, protrusion, and laterotrusion (with canonical correlation coefficients of 0.994, 0.993, and 0.932, respectively). The use of muscle-driven modeling holds promise for more accurate forecasting of stress analysis of TMJ and articular disc during mandibular movements. The compliant approach to analyze TMJ dynamics would potentially contribute to clinic diagnosis and prediction of TMD resulting from occlusal disease and jawbone surgery such as orthognathic surgery or tumor resection.


Assuntos
Análise de Elementos Finitos , Músculos da Mastigação , Articulação Temporomandibular , Humanos , Articulação Temporomandibular/fisiopatologia , Articulação Temporomandibular/fisiologia , Fenômenos Biomecânicos/fisiologia , Músculos da Mastigação/fisiologia , Músculos da Mastigação/fisiopatologia , Movimento/fisiologia , Modelos Biológicos , Tomografia Computadorizada por Raios X
4.
Med Eng Phys ; 130: 104195, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-39160014

RESUMO

There is a close physiological connection between swallowing and the temporomandibular joint (TMJ). However, a shortage of quantitative research on the biomechanical behavior of the TMJ during swallowing exists. The purpose of this study was to reconstruct the movement of the temporomandibular joint (TMJ) based on in vivo experiment and analyze the biomechanical responses during swallowing in healthy adults to investigate the role of the TMJ in swallowing. Motion capture of swallowing, computed tomography (CT), and magnet resonance images (MRI) were performed on six healthy subjects. The movements of the TMJ during swallowing were reconstructed from the motion capture data. The three-dimensional finite element model was constructed. The dynamic finite element analysis of the swallowing process was performed based on the motion data. The range of condylar displacement was within 1 mm in all subjects. The left and right condyle movements were asymmetrical in two-thirds of the subjects. The peak stresses of the discs were relatively low, with a maximum of 0.11 MPa. During swallowing, the condylar displacement showed two trends: slow retraction and slow extension. The tendency to extend could lead to a gradual increase in stress on the disc.


Assuntos
Deglutição , Análise de Elementos Finitos , Movimento , Articulação Temporomandibular , Humanos , Articulação Temporomandibular/fisiologia , Articulação Temporomandibular/diagnóstico por imagem , Deglutição/fisiologia , Adulto , Masculino , Fenômenos Biomecânicos , Feminino , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Voluntários Saudáveis , Saúde , Processamento de Imagem Assistida por Computador , Adulto Jovem
5.
Sci Rep ; 14(1): 16423, 2024 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014120

RESUMO

This study aimed to predict dental freeway space by examining the clinical history, habits, occlusal parameters, mandibular hard tissue movement, soft tissue motion, muscle activity, and temporomandibular joint function of 66 participants. Data collection involved video-based facial landmark tracking, mandibular electrognathography, surface electromyography of mandibular range of motion, freeway space, chewing tasks, phonetic expressions, joint vibration analysis, and 3D jaw scans of occlusion. This resulted in a dataset of 121 predictor features, with freeway space as the target variable. Six models were trained on synthetic data ranging from 500 to 25,000 observations, with 65 original observations reserved for testing: Linear Regression, Random Forest, CatBoost Regressor, XGBoost Regressor, Multilayer Perceptron Neural Network (MPNN), and TabNet. Explainable AI indicated that key predictors of freeway space included phonetics, resting temporalis muscle activity, mandibular muscle activity during clenching, body weight, mandibular hard tissue lateral displacements, and dental arch parameters. CatBoost excelled with a test error of 0.65 mm using 5000 synthetic data points, while a refined MPNN achieved the best performance with 25,000 synthetic data points and 121 unique predictors, yielding an absolute error of 0.43 mm on the 65 original observations.


Assuntos
Oclusão Dentária , Eletromiografia , Mandíbula , Articulação Temporomandibular , Humanos , Feminino , Masculino , Mandíbula/fisiologia , Mandíbula/diagnóstico por imagem , Adulto , Articulação Temporomandibular/fisiologia , Articulação Temporomandibular/diagnóstico por imagem , Movimento/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto Jovem , Mastigação/fisiologia , Redes Neurais de Computação
6.
Comput Biol Med ; 178: 108725, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38878405

RESUMO

Alterations in occlusal features may have significant consequences, ranging from dental aesthetics to health issues. Temporomandibular joint disorders (TMDs) are often associated with joint overload, and the correlation between occlusal features and TMDs has been thoroughly discussed. In current work, we introduced a novel stomatognathic model that aligns well with in vivo experimental measurements, specifically designed to decouple the impact of occlusal contact and periodontal ligament (PDL) negative feedback on temporomandibular joint (TMJ) loading. Utilizing an in-silico approach, the simulation analysis included six symmetric occlusal contact scenarios. Furthermore, a biomechanical lever model was employed to clarify the mechanical mechanism and investigate the multi-factorial effects of TMJ overload. These findings indicate that anterior shifts in the occlusal centre lead to increased TMJ loading, particularly in occlusal contact cases with anteroposterior changes. Considering the symmetrical distribution of occlusal contact, mediolateral alterations had a more modest effect on TMJ loading. Additionally, potential negative feedback activated by principal strain of periodontal could not only alleviate joint load but also diminish occlusal force. These investigations enhance our understanding of the intricate interactions between masticatory muscles, occlusal forces, and joint contact forces, thereby providing motivation for future comprehensive studies on TMJ biomechanical overload.


Assuntos
Simulação por Computador , Modelos Biológicos , Articulação Temporomandibular , Humanos , Articulação Temporomandibular/fisiopatologia , Articulação Temporomandibular/fisiologia , Força de Mordida , Oclusão Dentária , Fenômenos Biomecânicos/fisiologia , Ligamento Periodontal/fisiologia , Ligamento Periodontal/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia
7.
J Oral Rehabil ; 51(9): 1770-1777, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38840513

RESUMO

BACKGROUND: A quantitative approach to predict expected muscle activity and mandibular movement from non-invasive hard tissue assessments remains unexplored. OBJECTIVES: This study investigated the predictive potential of normalised muscle activity during various jaw movements combined with temporomandibular joint (TMJ) vibration analyses to predict expected maximum lateral deviation during mouth opening. METHOD: Sixty-six participants underwent electrognathography (EGN), surface electromyography (EMG) and joint vibration analyses (JVA). They performed maximum mouth opening, lateral excursion and anterior protrusion as jaw movement activities in a single session. Multiple predictive models were trained from synthetic observations generated from the 66 human observations. Muscle function intensity and activity duration were normalised and a decision support system with branching logic was developed to predict lateral deviation. Performance of the models in predicting temporalis, masseter and digastric muscle activity from hard tissue data was evaluated through root mean squared error (RMSE) and mean absolute error. RESULTS: Temporalis muscle intensity ranged from 0.135 ± 0.056, masseter from 0.111 ± 0.053 and digastric from 0.120 ± 0.051. Muscle activity duration varied with temporalis at 112.23 ± 126.81 ms, masseter at 101.02 ± 121.34 ms and digastric at 168.13 ± 222.82 ms. XGBoost predicted muscle intensity and activity duration and scored an RMSE of 0.03-0.05. Jaw deviations were successfully predicted with a MAE of 0.9 mm. CONCLUSION: Applying deep learning to EGN, EMG and JVA data can establish a quantifiable relationship between muscles and hard tissue movement within the TMJ complex and can predict jaw deviations.


Assuntos
Eletromiografia , Músculos da Mastigação , Amplitude de Movimento Articular , Articulação Temporomandibular , Humanos , Articulação Temporomandibular/fisiologia , Feminino , Masculino , Adulto , Músculos da Mastigação/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto Jovem , Movimento/fisiologia , Vibração
8.
J Oral Rehabil ; 51(10): 1973-1980, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38886597

RESUMO

BACKGROUND: Mandibular range of motion (MROM) variables are widely used to evaluate oral function. OBJECTIVE: The aim of this study was to establish the reliability of MROM variables in healthy children. METHODS: In this cross-sectional study, healthy children were examined 2 weeks apart. The following MROM variables were established: active maximum interincisal opening (AMIO), passive maximum interincisal opening (PMIO), protrusion and left and right laterotrusion. The reliability of the MROM measurements was determined by analysing the intra-class correlation coefficient (ICC), standard error of measurement (SEM), smallest detectable change (SDC) and limits of agreement (LoA). RESULTS: A total of 167 healthy children were examined. The ICC indicated good reliability for AMIO (0.885); excellent reliability for PMIO (0.925); and moderate reliability for protrusion (0.578), laterotrusion left (0.601) and laterotrusion right (0.634). The SDC was 0.9 mm for AMIO, 0.4 mm for PMIO, 2.2 mm for protrusion, 1.6 mm for laterotrusion left and 1.4 mm for laterotrusion right. The LoA was -5.67 to 5.82 for AMIO, -3.90 to 3.57 for PMIO, -3.89 to 3.55 for protrusion, -2.99 to 2.77 for laterotrusion left, and - 2.71 to 2.77 for laterotrusion right. CONCLUSIONS: AMIO and PMIO measurements are both highly reliable in healthy children. The low SDC indicate that AMIO and PMIO are promising longitudinal measurements. Protrusion and laterotrusion measurements had moderate reliability. These results support our clinical recommendation to measure AMIO rather than PMIO, as PMIO is more difficult and more time-consuming to perform than AMIO.


Assuntos
Mandíbula , Amplitude de Movimento Articular , Humanos , Reprodutibilidade dos Testes , Feminino , Estudos Transversais , Criança , Masculino , Amplitude de Movimento Articular/fisiologia , Mandíbula/fisiologia , Voluntários Saudáveis , Articulação Temporomandibular/fisiologia
9.
J Mech Behav Biomed Mater ; 156: 106603, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38815434

RESUMO

OBJECTIVES: The objective of this investigation was to assess the stress and displacement pattern of the craniomandibular complex by employing finite element methodology to simulate diverse angulations of inclined planes that are incorporated in the Twin Block appliance. METHODS: A 3D finite element representation was established by use of Cone Beam Computed Tomography (CBCT) scans. This comprehensive structure included craniofacial skeletal components, the articular disc, a posterior disc elastic layer, dental elements, periodontal ligaments, and a Twin Block appliance. This investigation is the first to incorporated inclined planes featuring three distinct angulations (45, 60, and 70°) as the study models. Mechanical impacts were evaluated within the glenoid fossa, tooth, condylar, and articular disc regions. RESULTS: In all simulations, the stress generated by the Twin Block appliance was distributed across teeth and periodontal ligament, facilitating the anterior movement of mandibular teeth and the posterior displacement of maxillary teeth. Within the temporomandibular joint region, compressive forces on the superior and posterior facets of the condyle diminished, coinciding with the stress configuration that fosters condylar and mandibular growth. Stress dispersion homogenized in the condylar anterior facet and articular disc, with considerable tensile stress in the glenoid fossa's posterior aspect conforming to stress distribution that promote fossa reconfiguration. The 70° inclined plane exerts the highest force on the tissues. The condyle's maximum and minimum principal stresses are 0.36 MPa and -0.15 MPa, respectively, while those of the glenoid fossa are 0.54 MPa and -0.23 MPa. CONCLUSION: Three angled appliances serve the purpose of advancing the mandible. A 45° inclined plane relative to the occlusal plane exerts balanced anteroposterior and vertical forces on the mandibular arch. Steeper angles yield greater horizontal forces, which may enhance forward growth and efficient repositioning.


Assuntos
Análise de Elementos Finitos , Estresse Mecânico , Fenômenos Biomecânicos , Mandíbula/fisiologia , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/fisiologia , Humanos , Testes Mecânicos , Tomografia Computadorizada de Feixe Cônico
10.
Ned Tijdschr Tandheelkd ; 131(5): 191-200, 2024 05.
Artigo em Holandês | MEDLINE | ID: mdl-38715531

RESUMO

An internal derangement of the temporomandibular joint is described as a deviation in the position or shape of the joint tissues. Such a change is only functionally manifest if it interferes with smooth movements of the jaw joint. There are a number of internal derangements associated with jaw movements in which popping jaw joint sounds can occur. Examples are an anteriorly or posteriorly displaced disc and hypermobility of the condylar head. Although most internal derangements are harmless and only cause minor discomfort to patients, disc displacements can in some cases develop into a clinical problem, for example when there is a limitation of mouth opening (so-called closed lock) or an inability to close the mouth (so-called open lock). Most patients with these conditions do not require any or only conservative treatment.


Assuntos
Transtornos da Articulação Temporomandibular , Humanos , Articulação Temporomandibular/fisiologia , Articulação Temporomandibular/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Instabilidade Articular/diagnóstico , Luxações Articulares/etiologia , Luxações Articulares/terapia , Luxações Articulares/diagnóstico
11.
Med Biol Eng Comput ; 62(6): 1763-1779, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38376739

RESUMO

Challenges arise in accessing archived signal outputs due to proprietary software limitations. There is a notable lack of exploration in open-source mandibular EMG signal conversion for continuous access and analysis, hindering tasks such as pattern recognition and predictive modelling for temporomandibular joint complex function. To Develop a workflow to extract normalised signal parameters from images of mandibular muscle EMG and identify optimal clustering methods for quantifying signal intensity and activity durations. A workflow utilising OpenCV, variational encoders and Neurokit2 generated and augmented 866 unique EMG signals from jaw movement exercises. k-means, GMM and DBSCAN were employed for normalisation and cluster-centric signal processing. The workflow was validated with data collected from 66 participants, measuring temporalis, masseter and digastric muscles. DBSCAN (0.35 to 0.54) and GMM (0.09 to 0.24) exhibited lower silhouette scores for mouth opening, anterior protrusion and lateral excursions, while K-means performed best (0.10 to 0.11) for temporalis and masseter muscles during chewing activities. The current study successfully developed a deep learning workflow capable of extracting normalised signal data from EMG images and generating quantifiable parameters for muscle activity duration and general functional intensity.


Assuntos
Aprendizado Profundo , Eletromiografia , Mandíbula , Processamento de Sinais Assistido por Computador , Humanos , Eletromiografia/métodos , Mandíbula/fisiologia , Adulto , Masculino , Feminino , Adulto Jovem , Músculo Masseter/fisiologia , Mastigação/fisiologia , Articulação Temporomandibular/fisiologia
12.
J Mech Behav Biomed Mater ; 151: 106371, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38176197

RESUMO

BACKGROUND: Temporomandibular joint (TMJ) overloading is considered a primary cause of temporomandibular joint disorders (TMD). Accordingly, craniomaxillofacial structural parameters affect the loading situation in the TMJ. However, no effective method exists for quantitatively measuring the loading variation in human TMJs. Clinical statistics, which draws from general rules from large amounts of clinical data, cannot entry for exploring the underlying biomechanical mechanism in craniomaxillofacial system. The finite element method (FEM) is an effective tool for analyze the stress and load on TMJs for several cases in a short period of time; however, it is difficult to generalize general patterns through calculations between different cases due to the different geometric characteristics and occlusal contacts between each case. METHODS: (1) This study included 88 subjects with 176 unilateral data to measure angle (α) of the distance to the plane of occlusion. The bone destruction score was evaluated for clinical statistics. To rule out effects of the potential factors and ensure the generality of the study, one participant with no obvious bone destruction was selected as the standard case for establishing the three-dimensional (3D) theoretical model and FEM. (2) Three groups of forces, including biting, muscles and joint reaction forces on mandible, were adopted to establish a 3D theoretical model. (3) By modifying the sagittal α and coronal three types of deviation angle (φ) of the original model, nine candidate models were obtained for the FEM studies. RESULTS: (1) The static equilibrium equations, were used to establish a 3D theoretical model for describing the loading of the TMJ. The theoretical model was validated by monotonously modifying the structural parameter in comparison to two-dimensional theoretical models reported previously; (2) The force on the TMJ gradually decreased with α, and this trend was validated by both clinic statistics and FEM results; (3) The effects of the three types of deviation angle were different. The results of the case where only rotating biting forces were considered was consistent with clinical statistics, indicating that the side with lower α experiences higher TMJ load. (4) Changing the unilateral proportionality coefficients of biting and muscle force produced opposite effects, wherein the effects of the muscle force were stronger than those of the biting forces. CONCLUSIONS: A negative correlation was observed between the joint load and α. Among the three types of asymmetric deformities, occlusal deviations were the primary factors leading to TMD. Unilateral occlusion can result in a greater load on the ipsilateral joint and should be avoided when using the side corresponding to the TMD. This study provides a theoretical basis for the biomechanical mechanism of TMD and also enables the targeted mitigation and treatment of TMD through structural modification.


Assuntos
Transtornos da Articulação Temporomandibular , Articulação Temporomandibular , Humanos , Articulação Temporomandibular/fisiologia , Mandíbula/fisiologia , Músculos , Modelos Teóricos
13.
J Mech Behav Biomed Mater ; 151: 106401, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38237207

RESUMO

Mastication is a vital human function and uses an intricate coordination of muscle activation to break down food. Collection of detailed muscle activation patterns is complex and commonly only masseter and anterior temporalis muscle activation are recorded. Chewing is the orofacial task with the highest muscle forces, potentially leading to high temporomandibular joint (TMJ) loading. Increased TMJ loading is often associated with the onset and progression of temporomandibular disorders (TMD). Hence, studying TMJ mechanical stress during mastication is a central task. Current TMD self-management guidelines suggest eating small and soft pieces of food, but patient safety concerns inhibit in vivo investigations of TMJ biomechanics and currently no in silico model of muscle recruitment and TMJ biomechanics during chewing exists. For this purpose, we have developed a state-of-the-art in silico model, combining rigid body bones, finite element TMJ discs and line actuator muscles. To solve the problems regarding muscle activation measurement, we used a forward dynamics tracking approach, optimizing muscle activations driven by mandibular motion. We include a total of 256 different combinations of food bolus size, stiffness and position in our study and report kinematics, muscle activation patterns and TMJ disc von Mises stress. Computed mandibular kinematics agree well with previous measurements. The computed muscle activation pattern stayed stable over all simulations, with changes to the magnitude relative to stiffness and size of the bolus. Our biomedical simulation results agree with the clinical guidelines regarding bolus modifications as smaller and softer food boluses lead to less TMJ loading. The computed mechanical stress results help to strengthen the confidence in TMD self-management recommendations of eating soft and small pieces of food to reduce TMJ pain.


Assuntos
Mastigação , Transtornos da Articulação Temporomandibular , Humanos , Mastigação/fisiologia , Articulação Temporomandibular/fisiologia , Disco da Articulação Temporomandibular/fisiologia , Músculos
14.
Tissue Eng Part B Rev ; 30(1): 29-59, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-37432898

RESUMO

The craniofacial region contains skin, bones, cartilage, the temporomandibular joint (TMJ), teeth, periodontal tissues, mucosa, salivary glands, muscles, nerves, and blood vessels. Applying tissue engineering therapeutically helps replace lost tissues after trauma or cancer. Despite recent advances, it remains essential to standardize and validate the most appropriate animal models to effectively translate preclinical data to clinical situations. Therefore, this review focused on applying various animal models in craniofacial tissue engineering and regeneration. This research was based on PubMed, Scopus, and Google Scholar data available until January 2023. This study included only English-language publications describing animal models' application in craniofacial tissue engineering (in vivo and review studies). Study selection was based on evaluating titles, abstracts, and full texts. The total number of initial studies was 6454. Following the screening process, 295 articles remained on the final list. Numerous in vivo studies have shown that small and large animal models can benefit clinical conditions by assessing the efficacy and safety of new therapeutic interventions, devices, and biomaterials in animals with similar diseases/defects to humans. Different species' anatomical, physiologic, and biological features must be considered in developing innovative, reproducible, and discriminative experimental models to select an appropriate animal model for a specific tissue defect. As a result, understanding the parallels between human and veterinary medicine can benefit both fields.


Assuntos
Medicina Regenerativa , Engenharia Tecidual , Animais , Humanos , Materiais Biocompatíveis/uso terapêutico , Modelos Animais , Articulação Temporomandibular/fisiologia
15.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 52(3): 386-397, 2023 Jun 25.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-37476950

RESUMO

Chewing-side preference is one of the risk factors for temporomandibular disorders (TMD), and people with chewing-side preference is more prone to have short and displaced condyles, increased articular eminence inclination and glenoid fossa depth. The proportion of TMD patients with chewing-side preference is often higher than that of the normal subjects. Clinical studies have shown a strong correlation between chewing-side preference and TMD symptoms and signs; and animal studies have shown that chewing-side preference can affect the growth, development, damage and repair of the mandible. After long-term unilateral mastication, changes in the stress within the joint cause the imbalance of temporomandibular joint (TMJ) structural reconstruction, the transformation and even destruction of the fiber structure of masticatory muscle, resulting in uncoordinated movement of bilateral muscles. The joint neurogenic diseases caused by the increase of neuropeptide substance P and calcitonin-gene-related-peptide (CGRP) released locally by TMJ may be the mechanism of TMD. This article reviews the research progress of the influence of chewing-side preference on the structure of TMJ, the relationship between chewing-side preference and TMD, and the related mechanisms.


Assuntos
Mastigação , Transtornos da Articulação Temporomandibular , Humanos , Mastigação/fisiologia , Articulação Temporomandibular/fisiologia , Transtornos da Articulação Temporomandibular/etiologia , Mandíbula/fisiologia
16.
Int. j. morphol ; 41(2): 374-382, abr. 2023. ilus
Artigo em Espanhol | LILACS | ID: biblio-1440333

RESUMO

El objetivo de registrar los movimientos mandibulares es obtener parámetros relevantes que permitan evaluar el estado de la articulación temporomandibular (ATM) y de los músculos involucrados en la masticación. El movimiento mandibular se debe a un conjunto complejo de rotaciones y traslaciones tridimensionales realizadas por la ATM, limitado por los ligamentos y las superficies articulares de estas, y por la morfología y la alineación de los dientes, cuando la mandíbula se desplaza sobre estos límites, se llaman movimientos bordeantes mandibulares. El objetivo de este artículo es realizar una descripción actualizada de los movimientos mandibulares a través de articulografía electromagnética. Los movimientos mandibulares bordeantes se clasifican según el plano del espacio en que se muevan, de esta manera tenemos movimientos bordeantes en el plano sagital, en el plano horizontal y el plano frontal, y en cada plano dibujan un polígono distinto, llamados polígonos de Posselt. Estos polígonos pueden ser registrados mediante Articulografía electromagnética, gracias a esta tecnología también se pueden extraer algunos parámetros interesantes, como por ejemplo: la trayectoria total recorrida por la mandíbula al describir cada polígono, rangos de desplazamiento en cada plano, área total de cada polígono de Posselt. La apertura mandibular se mide como la distancia entre los márgenes incisales de los incisivos centrales superiores e inferiores en apertura máxima más la sobremordida. El análisis de esta es una parte importante del examen clínico en odontología, ya que una apertura limitada puede ser resultado de trastornos en la articulación temporomandibular, fibrosis oral submucosa, enfermedad reumática o trauma facial. Las mediciones tridimensionales que se obtienen gracias a la Articulografía electromagnética, son apropiados para determinar los rangos normales de apertura, su exactitud permite la realización de investigaciones en el área, abriendo un amplio campo en el análisis de los movimientos mandibulares.


SUMMARY: The objective of recording mandibular movements is to obtain relevant parameters that allow the evaluation of the state of the temporomandibular joint (TMJ) and of the muscles involved in mastication. Mandibular movement is due to a complex set of three-dimensional rotations and translations performed by the TMJ, limited by the ligaments and their articular surfaces, and by the morphology and alignment of the teeth, when the mandible moves over these limits, they are called mandibular border movements. The aim of this article is to provide an updated description of mandibular movements through electromagnetic articulography. Mandibular border movements are classified according to the plane of space in which they move, thus we have border movements in the sagittal plane, in the horizontal plane and the frontal plane, and in each plane they draw a different polygon, called Posselt polygons. These polygons can be recorded by electromagnetic articulography, thanks to this technology some interesting parameters can also be extracted, such as: the total trajectory covered by the mandible when describing each polygon, displacement ranges in each plane, total area of each polygon of Posselt. Mandibular opening is measured as the distance between the incisal edges of the upper and lower central incisors at maximum opening plus the overbite. The analysis of mandibular opening is an important part of the clinical examination in dentistry as a preliminary evaluation, since limited opening can be the result of temporomandibular joint disorders, submucous oral fibrosis, rheumatic disease or facial trauma. The three-dimensional measurements that are obtained thanks to the electromagnetic Articulography, are appropriate to determine the normal ranges of opening, its accuracy allows the realization of investigations in the area, opening a wide field in the analysis of mandibular movements. Analysis of mandibular opening is an important part of the clinical examination in dentistry, since limited opening can be the result of temporomandibular joint disorders, oral submucous fibrosis, rheumatic disease, or facial trauma. Analysis of mandibular opening is an important part of the clinical examination in dentistry, since limited opening can be the result of temporomandibular joint disorders, oral submucous fibrosis, rheumatic disease, or facial trauma. The three-dimensional measurements that are obtained thanks to the electromagnetic Articulography, are appropriate to determine the normal ranges of opening, its accuracy allows the realization of investigations in the area, opening a wide field in the analysis of mandibular movements.


Assuntos
Humanos , Articulação Temporomandibular/fisiologia , Fenômenos Eletromagnéticos , Mandíbula/fisiologia
17.
J Mech Behav Biomed Mater ; 141: 105764, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36965216

RESUMO

Temporomandibular joint disorder (TMD) often coincides with malocclusion, and in some cases TMDs are reported after orthodontic treatment. Intermaxillary elastics (also known as orthodontic elastics, OE) are a common way to apply force during orthodontic treatment, and they might cause mechanical effects on the temporomandibular joint (TMJ), thereby lead to joint remodeling. It is still a controversial topic whether the adapted remodeling of the TMJ or of the alveolar bone is the main cause for the alteration of occlusion after treatment with OEs. It was the aim of this study to analyze whether variations of OEs would develop harmful effects on the healthy TMJ. A TMJ model with a masticatory system based on Hill-type muscle actuators was established. Mouth opening and closure with and without OEs were simulated, and maximum principal stresses in the disc and condylar cartilage as well as the displacement of the mandible were analyzed. We found no considerably difference in the mandibular movement without and with symmetrical OEs during mouth opening and closing. At full mouth opening, stresses in the disc and condylar cartilage of some models with OEs were much smaller than without OEs, but we did not find consistency in the results from the left and right sides of the same model (e.g. the lowest compressive stress on the left side of disc from the model with Class II OEs is much smaller than without OEs, -17.3 MPa compared with -28.2, while on the right side, there was no obvious difference). Hence, we could not conclude that OEs would develop deleterious effects on the healthy TMJ.


Assuntos
Disco da Articulação Temporomandibular , Transtornos da Articulação Temporomandibular , Humanos , Articulação Temporomandibular/fisiologia , Mandíbula , Movimento , Côndilo Mandibular
18.
Orthod Craniofac Res ; 26 Suppl 1: 142-150, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37000157

RESUMO

INTRODUCTION: This study tested orthognathic surgery effects on temporomandibular joint (TMJ) compressive stresses. METHODS: Pre- (T1) and post-surgery (T2) cone-beam computed tomography images were collected from consenting subjects aged ≥15 years. Anatomical data were used to measure surgical changes in anteroposterior mandibular position and occlusal plane angle (FH-OP), estimate condylar loading areas (mm2 ) and calculate T1 and T2 TMJ and jaw muscle forces (N) during canine biting via numerical modelling. Analysis of covariance tested for sex and biting angle differences in T2 - T1 TMJ compressive stresses (TMJ force/loading area, MPa). Principal component analyses identified jaw muscle forces that accounted for changes in T2 - T1 TMJ loads. Regression analyses tested the correlations between surgical changes in mandibular position, FH-OP, TMJ loads and muscle forces. RESULTS: Of 148 cases screened, 28 females and 16 males provided complete records. Condylar loading areas were significantly smaller (P = .024) for females vs males (124 ± 5 vs 144 ± 7 mm2 ). T2 - T1 differences in TMJ compressive stresses varied by surgical change, biting angle and sex. Overall, the largest increases in TMJ compressive stresses post-surgery were for females with mandibular setbacks where FH-OP angle decreased. T2 - T1 changes in jaw muscle forces had moderate (ipsilateral, λ = 4.59; η2 = 0.071) to large (contralateral, λ = 1.49; η2 = 0.31) effects on TMJ loads. CONCLUSIONS: T2 - T1 differences in TMJ compressive stresses during canine biting were affected by surgical changes in mandibular position and occlusal plane angle, biting angle and sex. Surgical changes altered jaw muscle forces for the same biting conditions and, thus, affected TMJ loads and compressive stresses.


Assuntos
Cirurgia Ortognática , Transtornos da Articulação Temporomandibular , Masculino , Feminino , Humanos , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/fisiologia , Mandíbula , Oclusão Dentária , Côndilo Mandibular
19.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 45(1): 50-56, 2023 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-36861155

RESUMO

Objective To compare the image quality of three high-resolution dynamic MRI methods for evaluating the motion of temporomandibular joint disc and condyle. Methods Twenty-five patients with suspected temporomandibular joint disorders were examined by single-shot fast spin-echo (SSFSE),fast imaging employing steady-state acquisition (FIESTA),and spoiled gradient echo (SPGR) on the oblique sagittal position.Two radiologists performed subjective and objective evaluation on the images with double-blind method.The subjective evaluation included the signal intensity of mandibular condyle,articular disc,soft tissue around articular disc,and lateral pterygoid muscle,the contrast between articular disc and condyle,the contrast between articular disc and surrounding soft tissue,condylar motion,and disc movement.The objective evaluation indexes included image signal intensity,signal-to-noise ratio (SNR),and contrast-to-noise ratio (CNR).The subjective and objective indexes of the image quality were compared between the three sequences. Results The SSFSE sequence had lower signal intensity of articular disc and higher signal intensity of condyle and surrounding soft tissue than FIESTA and SPGR sequences (all P<0.001).The SPGR sequence showed higher signal intensity of lateral pterygoid muscle than the SSFSE and FIESTA sequences (P=0.017,P<0.001).Among the three sequences,SSFSE sequence showed the clearest articular disc structure (χ2=41.952,P<0.001),the strongest contrast between articular disc and condyle (χ2=35.379,P<0.001),the strongest contrast between articular disc and surrounding soft tissue (χ2=27.324,P<0.001),and the clearest movement of articular disc (χ2=44.655,P<0.001).SSFSE and FIESTA sequences showed higher proportion of disc displacement and reduction than SPGR sequence (all P<0.001).The CNR (χ2=21.400,P<0.001),SNR (χ2=34.880,P<0.001),and condyle signal intensity (F=337.151,P<0.001) demonstrated differences among SSFSE,FIESTA,and SPGR sequences.The CNR of SSFSE sequence was higher than that of FIESTA sequence (P<0.001),while it had no significant difference between SSFSE and SPGR sequences (P=0.472).In addition,the SSFSE sequence had higher SNR and signal intensity than FIESTA and SPGR sequences (all P<0.001). Conclusion The best image quality can be observed from SSFSE sequence where both the structure and movement of temporomandibular joint are well displayed.Therefore,SSFSE is preferred for the examination of temporomandibular joint movement.


Assuntos
Amplitude de Movimento Articular , Articulação Temporomandibular , Humanos , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/fisiologia , Imageamento por Ressonância Magnética , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/fisiopatologia
20.
Med Biol Eng Comput ; 61(6): 1427-1437, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36723783

RESUMO

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.


Assuntos
Osteotomia Sagital do Ramo Mandibular , Dente , Humanos , Osteotomia Sagital do Ramo Mandibular/efeitos adversos , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/cirurgia , Articulação Temporomandibular/fisiologia , Fenômenos Mecânicos , Mandíbula/cirurgia
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