Analysis of MRI findings in minimum invasive treatment for habitual temporomandibular joint dislocation by autologous blood injection around the temporomandibular joint capsule.

The aim of this study was to investigate magnetic resonance imaging (MRI) findings following autologous blood injection (ABI) for habitual temporomandibular joint (TMJ) dislocation. MRI was performed one hour and four and twelve weeks after ABI, revealing three types of significant findings. The first type was similar to hematoma and/or joint effusion in the articular capsule of the TMJ (type I). The second showed sporadic and diffuse T2 emphasis around the TMJ capsule (type II). The third involved a decreased range of condyle movement compared to before ABI (type III). Furthermore, we analyzed the three types of significant MRI findings. At one hour after ABI, type I was Grade 0 in 0 of 14 patients, Grade 1 in 8, Grade 2 in 2, and Grade 3 in 4. Type II was seen in 9 of the 14 cases and type III in 8. After twelve weeks, all cases of type I were Grade 0, no type II cases were evident, and type III was seen in 11 cases. Injecting autologous blood into surrounding TMJ tissues is an important factor in ABI. Minimally invasive treatment for habitual TMJ dislocation using ABI around the TMJ capsule appears to represent a very effective and safe treatment.

Preliminary report of Ki-67 reactivity in synovial chondromatosis of the temporomandibular joint: an immunohistochemical study.

BACKGROUND: Synovial chondromatosis (SC) is rare benign condition characterized by the formation of metaplastic cartilaginous nodules in the synovial membrane and joint space. Cartilaginous nodules from and may become pedunculated and detached from the synovial membrane, so becoming loose bodies within the joint space. PURPOSE: The aim of this study was to determine the proliferative activity of loose body and synovial membrane of SC in temporomandibular joint by using Ki-67 antibody. MATERIAL AND METHODS: We obtained 4 specimens (4 female) of released loose body and 2 specimens of synovial membrane with attached loose bodies by surgical operation. The specimens were fixed in 10% formalin solution, and embedded in paraffin. The immunohistochemical study was carried out using an anti-human Ki-67 monoclonal antibody. The sections were visualized by 3, 3'-diaminobenzidine-tetrahydrochloride (DAB). RESULTS: The expression of Ki-67 was scarcely detected in all cases of loose bodies. In second phase cases, the mild expression of Ki-67 was detected at both cases of synovial membrane which were attached loose bodies. CONCLUSION: These results suggested that released loose bodies into the joint compartment did not have independent proliferating activity. However, the synovial membrane may play a very important role in the proliferation of the loose bodies.

Evaluation of mandibular condylar movement exercise for patients with internal derangement of the temporomandibular joint on initial presentation.

The aim of the present study was to evaluate mandibular condylar movement in a group of Japanese women who presented with closed lock of the temporomandibular joint. A total of 148 women aged between 19 and 75 years were included in the study. We examined mouth-opening, protrusion, and lateral excursive movements, and divided the patients into two groups (74 experimental cases and 74 controls). The experimental group was treated with exercises of the mandibular condyle, and the median (range) maximum mouth-opening increased from 27 (range 11-34)mm to 38 (24-47)mm. In control cases, it increased from 29 (range 20-35)mm to 30 (20-39)mm without exercise. In the experimental group, the median (range) maximum lateral movement on the opposite (unaffected) side increased from 8 (3-12)mm to 9 (5-13)mm. In the control group it remained similar at 7 (3-12)mm and 7 (3-12)mm. In the experimental group, the median (range) lateral movement on the affected side increased from 6 (2-13)mm to 8 (3-13)mm. In controls it remained similar at 6 (2-12)mm and 6 (2-12)mm. In the experimental group, the median (range) maximum protrusion increased from 6 (3-12)mm to 7 (4-12)mm, and in the control group from 6 (2-10)mm to 7 (2-10)mm. There was a significant difference between the experimental (50/74, 68%) and control groups (3/74, 4%) in the degree of increased mouth-opening. Exercise of the first mandibular condylar seems to be useful in the treatment of closed lock on initial treatment.