Could different TMJ disc positions observed in MRI cause different sounds? Analysis on a group of subjects with ADD with reduction: a pilot study.

AIMS: Magnetic resonance imaging (MRI) is the method of choice for examining soft-tissue pathology of the temporomandibular joint (TMJ). MRI shows a high spatial resolution with accuracy for the identification of internal derangement. Tasaki developed a classification system for disc displacement in the TMJ, identifying eight different types of disc displacements in addition to the superior disc position. This study aims to test the ability of electrosonography (ESG) in discriminating different kinds of disc displacement according to the disc position criteria proposed, comparing the ESG results with those obtained by MRI. METHODOLOGY: Twenty-seven patients were selected from an initial group of 50 patients with articular disc displacement, selected by means of clinical examinations, according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and who had both MRI and ESG studies performed. For each patient and for each peak in ESG, both in the opening and closing movements, three different parts of the sound were analyzed. The frequency (Hz) and the mean amplitude (µV) of the sounds were calculated in the three analyzed windows. Afterwards, gathering the data for the Tasaki's classes and dividing opening and closing sounds, the number of peaks was calculated, as well as average and standard deviations for both the Hz and µV. RESULTS: The peak frequency shows significant differences between different disc positions during the first and second third of the opening phase and during the first third of the closing phase. The peak amplitude shows significant differences between different disc positions during all of the opening and closing phases. CONCLUSIONS: Although limited by sample size, the present study shows the presence of different sounds with different Hzs and µVs associated with different disc positions that were recorded with ESG.

Diagnostic concordance between MRI and electrovibratography of the temporomandibular joint of subjects with disc displacement disorders.

OBJECTIVES: The aim of this study is to evaluate the diagnostic concordance of MRI and electrovibratography (EVG) of the temporomandibular joint (TMJ) in the diagnosis of articular disc displacement with reduction (ADDwR) and articular disc displacement without reduction (ADDw/oR). METHODS: 50 patients (12 males, 38 females; mean age 37.46 ± 15.64 years) with a hypothesis of disc displacement were selected. For each patient an MRI of the TMJ was performed. MRIs were evaluated sorting the 100 TMJs by kind of pathology (no pathology, ADDwR, ADDw/oR, and joint hypermobility). Afterwards, the patients had an EVG exam. The EVG exams were performed with vibration transducers over each TMJ, enabling simultaneous, bilateral recording of vibrations emanating from joint sounds during the opening and closing movements. The presence of a sound peak was compared with the MRI diagnosis of ADDwR, while a multipeak aspect was compared with ADDw/oR diagnosis using Cohen's kappa test. RESULTS: The presence of a peak-shaped track has high specificity for ADDwR (90.27%). The Cohen's kappa calculated for the ADDwR was 0.5615 (good-moderate). The presence of a multipeak-shaped track has low specificity (65.22%) and sensitivity (70.42%). The Cohen's kappa calculated for the ADDw/oR was 0.2992 (poor). CONCLUSIONS: The present study recommends the use of EVG to support the clinical diagnosis of a disc displacement with reduction when MRI is not available or when subjects cannot be investigated by MRI.

Sterility validity period of vials after multiple sampling under vertical laminar airflow hood.

STUDY OBJECTIVES: The aim of this study is to validate the sterility period of vials after multiple sampling under Grade A vertical laminar airflow hood. METHODS: Vials filled aseptically with a sterile culture medium have been sampled with syringes three times a week over one month under Grade A vertical laminar airflow hood and in the mean-while, keeping the vials out of the laminar airflow hoods. RESULTS: No microbial growth has been observed. On the basis of these results, it has been decided to modify our standard operating procedures, to allow keeping the vials for two weeks in a box out of the laminar airflow hoods (ambient temperature Grade B) or any controlled environment (under refrigeration). CONCLUSIONS: This study validates the multiple use of vials of small to large volumes (5-100 mL), to simplify handling and to reduce the costs in centralized cytostatic reconstitution units in hospital pharmacies, with no microbial risk.