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1.
J Craniomaxillofac Surg ; 49(3): 171-176, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33546966

RESUMEN

The aim of the present study is to assess the outcomes of monoportal arthroscopic disc repositioning (discopexy) for disc displacement of the temporomandibular joint. A retrospective, single-institutional clinical study included patients with temporomandibular joint internal derangements diagnosed and treated by monoportal discopexy. Each patient was diagnosed as having anterior disk displacement with or without reduction. The arthroscopy treatment consists of one portal approach fixing the disc with a 3/0 nylon to the tragus cartilage without anterior liberation. Arthroscopy surgery was carried out with a 1.9-mm 0° arthroscope and only one simple cannula. We use a needle to pierce of the disc through the skin and retrieve the suture inside the joint using a blind method through the arthroscopic cannula. The evaluated variables included the maximum interincisal opening, the presence of clicking and pain score. A total of 19 patients, 21 joints, were included in the present study. Of the 21 joints, 16 were classified as disc displacement with reduction and 5 without. Visual analogue scale (VAS) values (0-10) decreased from 5.5 to 1.26 (p < 0.0001) 1 year after surgery. At the first review, all patients had a VAS of at least 4 points less than before the surgery, four patients showed a VAS of 0, and nine patients near to 1. Mouth opening increased from 36.6 (±8.09) mm to 39.37 (±4.35) mm, and no significant limitations in the mouth opening range were seen (p < 0.12) 1 year after surgery. Clicking disappeared in all patients and remained stable after 12 months of follow-up. Postoperative magnetic resonance imaging demonstrated a correct or improved position of the disc in all but one patient. A minimally invasive single portal arthroscopic discopexy is an effective technique to improve function and pain reduction in patients with anterior disk displacement with or without reduction.


Asunto(s)
Luxaciones Articulares , Disco de la Articulación Temporomandibular , Artroscopía , Humanos , Imagen por Resonancia Magnética , Rango del Movimiento Articular , Estudios Retrospectivos , Articulación Temporomandibular , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/cirugía
2.
FP Essent ; 501: 17-23, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33595264

RESUMEN

Temporomandibular disorders (TMDs) is a collective term for a group of heterogeneous musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ) complex, masticatory muscles, and surrounding osseous structures. TMDs affect 5% to 12% of the US population, with a peak incidence at ages 45 to 65 years. Common clinical manifestations include facial pain, ear pain, headache, TMJ discomfort, and adventitious sounds. The etiologies of TMDs are multifactorial and include behavioral, social, emotional, and occlusive factors. Common causes of TMDs are myofascial pain and dysfunction, articular disk displacement, and degenerative joint conditions. In most cases, the diagnosis can be made based on the history and physical examination. In the absence of trauma, imaging typically is reserved for patients with chronic TMDs. Initial management includes education, self-management, behavioral therapy, and physical therapy. Occlusal devices are recommended for management of sleep bruxism or diurnal clenching. Adjunctive pharmacotherapies include nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, antidepressants, and anticonvulsants. (This is an off-label use of some NSAIDs and an off-label use of benzodiazepines, antidepressants, and anticonvulsants.) Intra-articular injections have been used alone or with arthrocentesis. Patients who do not benefit from these therapies should be referred to an oral and maxillofacial surgeon.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Anciano , Dolor Facial/diagnóstico , Dolor Facial/etiología , Dolor Facial/terapia , Cefalea/etiología , Cefalea/terapia , Humanos , Inyecciones Intraarticulares , Persona de Mediana Edad , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/tratamiento farmacológico , Trastornos de la Articulación Temporomandibular/terapia
3.
Stomatologiia (Mosk) ; 100(1): 44-51, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33528955

RESUMEN

AIM OF THE STUDY: Assessment of the effectiveness of botulinum toxin A in the treatment of temporomandibular joint pain dysfunction syndrome. MATERIAL AND METHODS: In accordance with the diagnostic and treatment guidelines for TMJPDS, 20 patients with TMJPDS with pronounced pain on palpation of the chewing muscles, discoordination of the chewing muscles according to the EMG, and degenerative changes in the temporomandibular joint according to the MRI were examined. The patients had no contraindications to the use of botulinum toxin. Exclusion criteria: 1) age under 21 years, 2) somatic pathology, 3) refusal of the steps of the proposed diagnostic and treatment algorithm. Methods used: clinical, psychometric (visual analogue scale (VAS) - for pain assessment), X-ray, electromyographic and statistical methods. RESULTS: An objective reduction in the tone of the chewing muscles was observed after treatment In both groups. However, 30 days after the injection of BtA the IMPACT indicator in the first group was reduced by 403.5 µV or more (38.5%, p<0.05), while in the second group it decreased by 201.5 µV or more (25%, p<0.05). A correlation was identified between the VAS index (mean 7 points, severe pain level) and IMPACT (p<0.05). The onset of a significant pain reduction was observed one week after BtA injection, the most pronounced effect was achieved after 2 weeks and lasted for about 3 months. CONCLUSION: The use of BtA as part of the temporomandibular joint pain dysfunction syndrome treatment algorithm contributes to the creation of a «therapeutic window¼ for comprehensive rehabilitation of patients in this group. It increases the efficacy of the conducted treatment and contributes to a significant prolongation of the TMJPDS remission.


Asunto(s)
Toxinas Botulínicas Tipo A , Trastornos de la Articulación Temporomandibular , Síndrome de la Disfunción de Articulación Temporomandibular , Adulto , Humanos , Dolor , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/tratamiento farmacológico , Síndrome de la Disfunción de Articulación Temporomandibular/complicaciones , Síndrome de la Disfunción de Articulación Temporomandibular/tratamiento farmacológico , Resultado del Tratamiento , Adulto Joven
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(2): 158-163, 2021 Feb 09.
Artículo en Chino | MEDLINE | ID: mdl-33557499

RESUMEN

Objective: To compare changes of condylar height, disc length and displaced distance in adolescent temporomandibular joint (TMJ) disc displacement with or without arthroscopic discopexy. Methods: From September 2015 to November 2018, adolescents with magnetic resonance image (MRI) comfirmed disc displacement without reduction (DDwoR) were recruited in operation group (OG) and control group (CG) and were classified into five subgroups according to age (11-14 years, 15-16 years, 17-18 years, 19-20 years and 21-24 years). Changes of condylar height, disc length and displaced distance were measured before and after follow-up MRI. Student's t-test, Welch's t-test, Mann-Whitney U test, Wilcoxon signed-rank test, One-way ANOVA and Kruskal-Wallis test were used; P-value less than 0.05 was considered statistically significant. Results: One hundred and seventy two patients were recruited in the present study. One hundred and twenty six cases patients (183 joints, 17 males, 109 females, mean age 17.4±3.0 years) were in OG and 119 patients (175 joints, 20 male, 99 females, mean age 17.1±3.1) in CG. The mean follow-up time were 8.4 (2.7-22.0) and 9.5 (3.0-22.1) months respectively. Average condylar height changes of OG were significantly greater than CG (1.3±1.8 mm vs -0.6±1.5 mm, P<0.001) and differences were also seen in each age group (P<0.001). In terms of age variations, average increase of condylar height in OG were (2.4±2.2) mm, (1.3±1.7) mm, (1.6±1.7) mm, (0.8±1.9) mm, (0.4±1.1) mm respectively (P<0.001), differences were observed between 11-14 years vs 19-20 years (P<0.05), 11-14 years vs 21-24 years (P<0.01) and 17-18 years vs 21-24 years (P<0.01) subgroups; and average changes in CG were (-0.7±1.6) mm, (-0.4±1.6) mm, (-0.8±1.5) mm, (-0.3±1.4) mm and (-0.9±1.5) mm respectively (P>0.05). After follow-up in CG, further displaced disc was observed (P<0.05) while disc length remained unchanged (P>0.05). Conclusions: DDwoR in adolescents resulted in decreased TMJ condylar height while arthroscopic discopexy restored growth potential and promoted condylar new bone formation which was most prominent during growth period.


Asunto(s)
Luxaciones Articulares , Disco de la Articulación Temporomandibular , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Imagen por Resonancia Magnética , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Estudios Retrospectivos , Articulación Temporomandibular , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/cirugía , Adulto Joven
5.
J Craniomaxillofac Surg ; 49(3): 177-183, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33451942

RESUMEN

BACKGROUND: Anterior Disc Displacement without Reduction (ADDwoR) in adolescence can result in condylar resorption which produces mandibular retrusion/deviation (MR/D) in adulthood. This study aims to analyze the therapeutic effect of simultaneous genioplasty and temporomandibular joint (TMJ) anchorage surgery on ADDwoR with MR/D patients. METHODS: During 2016-2018, ADDwoR with MR/D cases were included and underwent TMJ anchorage surgery and genioplasty guided by digital design. Pre-/Post-surgical clinical manifestations, facial photography, radiographic data, facial shape satisfaction of clinicians/patients/third-party were recorded and analyzed. RESULTS: A total of 32 cases (52 joints) were included. The average age was 24.09. Ratio of male/female was 4/28. Visual analog pain scale (VAS) score pre-/post-surgical ranged from 3 to 9 and 0-3, with an average of 6.03 and 1.18 (p < 0.01). Maximal mouth opening pre-/post-surgical ranged from 16 to 33 mm and 33-40 mm, with an average of 22.43 mm and 36.46 mm (p < 0.01). MRI was completed and showed stable disc reduction without recurrence 1 year postoperatively. MR/D was corrected and a better face shape was obtained. The satisfaction rate of clinicians, patients and third-parties was 92.375%, 94.156% and 94.218%, with an average of 93.583%. CONCLUSION: For ADDwoR with MR/D patients, simultaneous TMJ anchorage surgery and genioplasty can improve TMJ symptoms/functions, correct facial appearance, and enhance the degree of satisfaction. The postoperative effect is stable, safe and reliable, which is worthy of clinical promotion.


Asunto(s)
Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Adolescente , Adulto , Femenino , Mentoplastia , Humanos , Imagen por Resonancia Magnética , Masculino , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/cirugía , Resultado del Tratamiento , Adulto Joven
6.
Am J Orthod Dentofacial Orthop ; 159(3): 373-388, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33485717

RESUMEN

Orthodontists often have trouble treating patients who have temporomandibular joint disorders because occlusion changes depend on the position of unstable condyles. This characteristic means the patients do not have definite criteria with which to make an accurate orthodontic diagnosis, so clinicians are unable to establish a reliable treatment plan. This article reports on the treatment of a patient with skeletal Class II relationship and condylar resorption. A stabilization splint was used before any active orthodontic tooth movement to stabilize her condylar position. Although the patient exhibited dramatically increased open bite and a retruded mandibular position after splint therapy, her occlusion and facial esthetics were resolved by orthodontic camouflage treatment with appropriate orthodontic mechanics after extraction of 4 premolars.


Asunto(s)
Mordida Abierta , Trastornos de la Articulación Temporomandibular , Cefalometría , Femenino , Humanos , Mandíbula , Cóndilo Mandibular , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/terapia
7.
J Appl Oral Sci ; 29: e20200575, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33503223

RESUMEN

OBJECTIVE: Mirror-image pain is a kind of pain that occurs on the contralateral side, but its pathogenesis remains unclear. To develop an osteoarthritis mouse model for investigating mirror-image pain through observing nocifensive behaviors, histological changes, and nociceptive activity at days 3, 7, 14, 21, and 28 after the chemical induction of unilateral temporomandibular joint (TMJ) osteoarthritis. METHODOLOGY: We randomly divided 6-week-old mice into sham and complete Freund adjuvant groups. To induce nocifensive behaviors, we applied 0.04 g of von Frey filament, 10 psi of air puff, and cold acetone on both sides of whisker pads at different days. The histology of TMJ on both sides was observed by hematoxylin/eosin staining and microcomputed tomography scanning. Furthermore, the nociceptive activity was evaluated using the phosphorylated cyclic AMP response element binding protein (pCREB) and a microglia marker at different days in the trigeminal subnucleus caudalis. RESULTS: Nocifensive behaviors against mechanical and temperature stimuli on the contralateral side became stronger than the baseline on day 28, in agreement with the elevation of the pCREB and the microglia marker in the trigeminal subnucleus caudalis. Thus, hypernociception on the contralateral side occurred at day 28. CONCLUSIONS: Clearly, the TMJ model with unilateral osteoarthritis exhibited mirror-image pain. Therefore, this model is useful in investigating the pathogenesis of pain and in developing treatments.


Asunto(s)
Osteoartritis , Articulación Temporomandibular , Animales , Adyuvante de Freund , Ratones , Osteoartritis/diagnóstico por imagen , Dolor , Microtomografía por Rayos X
8.
Clin Oral Investig ; 25(2): 441-453, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33409693

RESUMEN

OBJECTIVES: The aim of this systematic review was to evaluate the prevalence of temporomandibular joint disorders (TMJD) among the general population. MATERIALS AND METHODS: Five main electronic databases and three grey literature were searched to identify observational studies in which TMJD was diagnosed using the research diagnostic criteria (RDC/TMD) or diagnostic criteria (DC/TMD). The studies were blindly selected by two reviewers based on eligibility criteria. Risk of bias (RoB) was assessed using the Joanna Briggs Institute Critical Appraisal Checklist, and the "R" Statistics software was used to perform meta-analyses. RESULTS: From 2741 articles, 21 were included. Ten studies were judged at low RoB, seven at moderate, and four at high. The TMJD investigated were as follows: arthralgia, disk displacement (DDs) with reduction (DDwR), DDwR with intermittent locking, DDs without reduction (DDwoR) with limited opening, DDwoR without limited opening, degenerative joint disease (DJD), osteoarthritis, osteoarthrosis, and subluxation. The main results from prevalence overall meta-analyses for adults/elderly are as follows: TMJD (31.1%), DDs (19.1%), and DJD (9.8%). Furthermore, for children/adolescents are as follows: TMJD (11.3%), DDs (8.3%), and DJD (0.4%). Considering the individual diagnosis meta-analyses, the most prevalent TMJD is DDwR for adults/elderly (25.9%) and children/adolescents (7.4%). CONCLUSIONS: The overall prevalence of TMJD was approximately 31% for adults/elderly and 11% for children/adolescents, and the most prevalent TMJD was DDwR. CLINICAL RELEVANCE: Knowledge about the frequency of TMJD can encourage dentists to consider appropriate strategies for early and correct diagnosis and, if need be, correct management.


Asunto(s)
Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Adolescente , Adulto , Anciano , Niño , Humanos , Luxaciones Articulares/epidemiología , Prevalencia , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/epidemiología
10.
Gen Dent ; 69(1): 38-43, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33350954

RESUMEN

This study evaluated the influence of chewing-side preference on the volume of the mandibular condyle and coronoid process and the dynamic parameters of the temporomandibular joint (TMJ). Cone beam computed tomographic scans of both TMJs of 90 individuals with a chewing-side preference were obtained while the patients were in the closed-mouth and maximum mouth-opening positions (test power ≥ 0.80). The preferred chewing side was identified with a chewing gum test as well as by patient self-reports of preferred side and hemispheric dominance (ie, dominant side of the body). Two trained examiners assessed the volume of the mandibular condyle and coronoid process and the dynamic parameters of the TMJs on both sides. The volumes of the mandibular condyle on the 2 sides were compared using a paired t test (α = 0.05). McNemar and Bowker tests of symmetry (α = 0.05) were used for concordance analyses of the dynamic parameters of the TMJ on the chewing and nonchewing sides. No statistically significant difference was observed in the volume of the mandibular condyle (chewing gum test, P = 0.4548; interview, P = 0.7191; hemispheric dominance, P = 0.3471) or coronoid process (chewing gum test, P = 0.7718; interview, P = 0.8072; hemispheric dominance, P = 0.8301) on the chewing and nonchewing sides, regardless of the method used to identify chewing preference. The preferred chewing side also did not significantly affect the dynamic parameters of the mandibular condyle (P = 0.5538). Chewing-side preference does not influence the volume of the mandibular condyle or coronoid process or the dynamic parameters of the TMJ.


Asunto(s)
Tomografía Computarizada de Haz Cónico Espiral , Trastornos de la Articulación Temporomandibular , Tomografía Computarizada de Haz Cónico , Humanos , Cóndilo Mandibular/diagnóstico por imagen , Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen
11.
Angle Orthod ; 90(3): 376-382, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378428

RESUMEN

OBJECTIVES: To compare, using surface-to-surface (StS) matching, any shape differences between the crossbite and noncrossbite side of the glenoid fossa and articular eminence in adult patients affected by posterior unilateral crossbite (PUXB) and compare them with unaffected controls. MATERIALS AND METHODS: 32 cone beam computed tomography (CBCT) scans of patients (mean age: 23.72 ± 3.74 years) undergoing surgical maxillary expansion were analyzed to obtain three-dimensional models of the left and right glenoid fossae that were superimposed using stable anatomical reference points and then compared using StS matching to evaluate the presence of any shape differences. These findings were compared with those obtained from 16 CBCT scans of unaffected controls (mean age: 23.72 ± 3.73 years). RESULTS: A mean difference of >11% was found between the study group and controls when comparing the matching percentages of the two sides of the glenoid fossa and articular eminence at all three levels of tolerance selected for this study. These differences were found to be highly statistically significant (P ≤ .0001). CONCLUSIONS: According to the shape analysis findings, adult PUXB patients exhibit a higher degree of glenoid fossa and articular eminence shape differences compared to unaffected controls.


Asunto(s)
Cavidad Glenoidea , Maloclusión , Tomografía Computarizada de Haz Cónico Espiral , Adulto , Tomografía Computarizada de Haz Cónico , Cavidad Glenoidea/diagnóstico por imagen , Humanos , Maloclusión/diagnóstico por imagen , Cóndilo Mandibular , Técnica de Expansión Palatina , Articulación Temporomandibular , Adulto Joven
12.
Angle Orthod ; 90(5): 707-714, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378480

RESUMEN

OBJECTIVE: To evaluate and compare articular disk position, condylar position, and joint spaces in Class II vertical, Class II horizontal, and Class I cases. The purpose was to assess the potential for development of temporomandibular disorders (TMDs) in the three groups. MATERIALS AND METHODS: A sample of 75 cases, 25 cases in each group of Class I, Class II vertical, and Class II horizontal, were selected based on inclusion and exclusion criteria. Magnetic resonance imaging (MRI) assessments were made with a 1.5-Tesla basic system with a closed-mouth technique for evaluating articular disk position in the sagittal and transverse planes, condylar position, and joint spaces in the sagittal plane. Philips 3.0 software was used to analyze the MR images. RESULTS: There was evidence of alterations in the temporomandibular joint (TMJ) morphology in both Class II vertical and Class II horizontal cases, with maximum discrepancy in Class II vertical cases. MRI evaluation suggested a tendency for antero-medial disk displacement with anteriorly positioned condyles in Class II vertical cases. The discrepancy was milder in the Class II horizontal group. CONCLUSIONS: Class II vertical cases are more susceptible to the development of TMDs and should be subjected to TMJ evaluation before starting any orthodontic treatment to intercept and prevent a mild asymptomatic TMD from developing into a more severe form. Class II vertical cases should be subjected to MRI evaluation before starting any orthodontic treatment.


Asunto(s)
Luxaciones Articulares , Maloclusión de Angle Clase I , Trastornos de la Articulación Temporomandibular , Humanos , Imagen por Resonancia Magnética , Cóndilo Mandibular/diagnóstico por imagen , Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen
13.
Angle Orthod ; 90(6): 831-836, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378516

RESUMEN

OBJECTIVES: To evaluate the influence of experimentally induced progressive condylar resorption (PCR) on temporomandibular joint (TMJ) mechanoreception. MATERIALS AND METHODS: Twenty 13-week-old male albino Wistar rats were divided equally into control and PCR groups. A compressive force was loaded on the left TMJ of PCR group rats to induce condylar resorption. Single-unit activities of TMJ mechanoreceptors were also induced through passive jaw movement. Recording was performed for the left Gasserian ganglion at 3 days and 1 week after the establishment of PCR group. The effects of PCR on TMJ units were assessed by measuring the firing threshold, maximum instantaneous firing frequency, and average firing frequency. RESULTS: Compared with the control group, there were no significant differences in the firing threshold of the PCR group after 3 days. The thresholds were significantly higher 1 week after compressive force loading on the condyle. The maximum instantaneous firing frequencies and the average firing frequencies showed no significant differences after 3 days. However, these were significantly lower 1 week after compressive force loading. CONCLUSIONS: The findings suggest that compressive force loading on the condyle may influence the function of TMJ mechanoreceptors.


Asunto(s)
Cóndilo Mandibular , Articulación Temporomandibular , Animales , Masculino , Mecanorreceptores , Ratas , Ratas Wistar , Ganglio del Trigémino
14.
Angle Orthod ; 90(6): 866-872, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378519

RESUMEN

OBJECTIVES: To test the hypotheses that mechanobehavior scores (MBS) were correlated with mandibular ramus lengths (Co-Go) and differed between facial phenotypes. MATERIALS AND METHODS: Subjects gave informed consent to participate. Co-Go (mm), mandibular plane angles (SN-GoGn, °), and three-dimensional anatomy were derived from cephalometric radiography or cone beam computed tomography. Temporomandibular joint (TMJ) energy densities (ED) (mJ/mm3) were measured using dynamic stereometry and duty factors (DF) (%) were measured from electromyography, to calculate MBS (= ED2 × DF,) for each TMJ. Polynomial regressions, K-means cluster analysis, and analysis of variance (ANOVA) with Tukey post-hoc tests were employed. RESULTS: Fifty females and 23 males produced replete data. Polynomial regressions showed MBS were correlated with Co-Go (females, R2 = 0.57; males, R2 = 0.81). Cluster analysis identified three groups (P < .001). Dolichofacial subjects, with shorter normalized Co-Go, clustered into two subgroups with low and high MBS compared to brachyfacial subjects with longer Co-Go. SN-GoGn was significantly larger (P < .03) in the dolichofacial subgroups combined (33.0 ± 5.9°) compared to the brachyfacial group (29.8 ± 5.5°). CONCLUSIONS: MBS correlated with Co-Go within sexes and differed significantly between brachyfacial and dolichofacial subjects.


Asunto(s)
Cara , Mandíbula , Cefalometría , Cara/anatomía & histología , Cara/diagnóstico por imagen , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Fenotipo , Articulación Temporomandibular
15.
Wiad Lek ; 73(10): 2241-2245, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33310956

RESUMEN

OBJECTIVE: The aim: The purpose of the research was to increase the efficiency of treatment at patients with dentition defects and functional disorders of the temporomandibular joint. PATIENTS AND METHODS: Materials and methods: We examined 140 patients aged from 25 to 65 years with functional disorders of the temporomandibular joint, analysed there diagnostic models in the articulator and 3D scanner, used radiographic methods of examination and condylography. RESULTS: Results: The results of the conducted studies showed that in the 1st group, the biomechanical parameters of temporomandibular joint movements before treatment were significantly lower: 6,4 ± 0,2 mm and 6,8 ± 0,2 mm for right and left temporomandibular joint during protrusion movements; 7,8 ± 0,1 mm and 7,9 ± 0,2 mm during vertical movements; 6,7 ± 0,1 mm and 6,5 ± 0,2 mm during transversal movements. After 12 month of complex and prosthetic treatment with a help of non-removable dentures the magnitude of movements remains at the achieved level at all excursions. As a result, proposed by us comprehensive treatment of functional disorders of the temporomandibular joint is carried out in stages. The proposed design of an individual tire makes it possible to gradually increase the bite height and perfectly forms the occlusal ratio. After 6 and 12 months of the proposed treatment, we have found that the indicators of vertical and protrusion movements of articular heads at patients of 2nd group were significantly better than before treatment. CONCLUSION: Conclusions: The proposed design of an individual tire makes it possible to gradually increase the bite height and perfectly forms the occlusal ratio.


Asunto(s)
Dentición , Trastornos de la Articulación Temporomandibular , Adulto , Anciano , Humanos , Persona de Mediana Edad , Articulación Temporomandibular
16.
Angle Orthod ; 90(3): 442-456, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378434

RESUMEN

OBJECTIVE: To evaluate the impact of rapid maxillary expansion (RME) on the condylar position, disc joint, joint space, and interarticular relationship in growing patients. MATERIALS AND METHODS: A systematic search was performed in nine databases. The clinical studies selected included those with pre- and post-magnetic resonance, conventional computed tomography or cone beam tomography in growing patients. Risk of bias assessment was performed using the Cochrane Collaboration tool for controlled clinical studies and National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment for Before-After Studies With No Control Group. RESULTS: Initially, 4303 records were identified. Only eight studies fulfilled the criteria and were included in the qualitative analysis. Of those, two were controlled clinical studies with a risk of uncertain to high bias. The remaining papers had a low to moderate risk of bias. Results showed that RME in children and adolescents promoted the following: remodeling in the head and or condylar branch, changes in condylar position and joint space, maintenance of improved symmetry between the condyles, and no ability to modify the position or shape of the articular disc. CONCLUSIONS: RME in growing patients is able, in the short term, to modify the condyle-fossa relationship but does not change the position or shape of the articular disc. The intercondylar symmetric relationship is maintained or improved. Although the NHLBI score shows low to moderate risk of bias, the clinical relevance of these review findings is limited by Cochrane and Grades of Recommendation, Assessment, Development and Evaluation scores.


Asunto(s)
Técnica de Expansión Palatina , Trastornos de la Articulación Temporomandibular , Adolescente , Niño , Tomografía Computarizada de Haz Cónico , Cabeza , Humanos , Cóndilo Mandibular/diagnóstico por imagen , Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen
17.
Eur J Paediatr Dent ; 21(4): 303-308, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33337907

RESUMEN

BACKGROUD: Juvenile Idiopathic Arthritis (JIA) encompasses a wide range of mostly idiopathic autoimmune arthritis which affect growing individuals. Temporomandibular disorders are a diffuse spectrum of diseases which involve temporomandibular joint (TMJ) and associated structures. However, much more need to be defined in order to detect and manage these conditions. Albeit satisfying evidences exist about their impact on the adult population, there is great lack of information in children. The current study has been developed in order to overview what it is known about these disorders and their mutual interactions. A case report as support to the scientific evidence has been further described. CASE REPORT: A 7-year-old patient affected by an undifferentiated form of JIA developed arthritis to TMJs, complaining pain and functional impairments. After 2 years, the follow-up with combined pharmacological therapies and a modified oral stabilisation appliance shows no objective worsening of the joints' structures. However, the more complex symptomatic management of inflammation highlights the need for further knowledge. CONCLUSION: The present study shows that both literature and clinical activity highlight a strong relationship between JIA and TMDs, that can affect the quality of life of children and adolescents. Diagnosis and management of these conditions are extremely complex, thus additional studies and evidence are needed. However, the need of an interdisciplinary approach between rheumatologists, paediatricians and dentists has been demonstrated.


Asunto(s)
Artritis Juvenil , Trastornos de la Articulación Temporomandibular , Adolescente , Adulto , Artritis Juvenil/diagnóstico , Artritis Juvenil/terapia , Niño , Humanos , Inflamación , Imagen por Resonancia Magnética , Calidad de Vida , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/terapia
18.
J Clin Pediatr Dent ; 44(5): 364-372, 2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-33181847

RESUMEN

OBJECTIVES: Temporomandibular disorder (TMD) is considered a functional disorder with multifactorial aspects. The goal of this study was to investigate if genetic polymorphisms in the COL2A1 gene could be associated with TMD in adolescents. STUDY DESIGN: The case group (TMD-affected) included individuals diagnosed with any of the following TMD subgroups according to the RDC/TMD criteria: myofascial pain, disc displacements and arthralgia. Genomic DNA for molecular analysis was extracted from buccal cells and genetic polymorphisms in COL2A1 were genotyped by real time polymerase chain reactions using the TaqMan assay. Data were analyzed using the Epi Info 3.5.7 and Stata software. RESULTS: 249 subjects were included in this study (148 subjects "affected" by TMD). There were no significant differences between the affected and unaffected individual (p>0.05), for TMD, arthralgia and myofascial pain however, rs2276454 was borderline in the genotype distribution (p=0.07) and was associated with disc displacement (p=0.03) in the allelic distribution. Recessive model showed significant differences between groups for with disc displacement (p=0.02). CONCLUSIONS: Genetic polymorphisms in COL2A1 are not associated with myofascial pain, arthralgia or TMD in adolescents but this study provides evidence that rs2276454 is involved in the disc displacement of the temporomandibular joint.


Asunto(s)
Luxaciones Articulares , Polimorfismo Genético , Trastornos de la Articulación Temporomandibular , Síndrome de la Disfunción de Articulación Temporomandibular , Adolescente , Artralgia , Colágeno Tipo II/genética , Dolor Facial , Humanos , Mucosa Bucal , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/genética
19.
J Craniofac Surg ; 31(8): e809-e810, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33136921

RESUMEN

The epidemic of coronavirus disease 2019 (COVID-19) has become a major public health disaster worldwide. From January 23 to March 20, total 17 patients with TMJ dislocation were treated in dental emergency department in School and Hospital of Stomatology, Wuhan University. Almost half of the patients are older than 80 years of age and they have recurrent joint dislocations. They are also at high risk for the COVID-19. The supine position technique method is suggested. The authors consider it necessary to recommend a practical management for TMJ dislocation.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Servicio de Urgencia en Hospital , Luxaciones Articulares/terapia , Neumonía Viral/epidemiología , Trastornos de la Articulación Temporomandibular/terapia , Adulto , Anciano de 80 o más Años , Betacoronavirus , China , Brotes de Enfermedades , Humanos , Masculino , Pandemias , Posición Supina , Articulación Temporomandibular/fisiopatología
20.
Orthod Fr ; 91(1-2): 69-81, 2020 06 01.
Artículo en Francés | MEDLINE | ID: mdl-33146135

RESUMEN

Standard TMJ is the key to the morphology of the face as it enables the occlusive function and spatially situates the chin. The diagnosis of the temporomandibular joint disorders is made intricate not only by the multifactorial etiology of these pathologies but also by the difficulty to comprehend the pain felt by the patient. Through a review of the literature and our respective practices (over 30 years) and teachings, this article surveys the main principles of temporomandibular joint disorder. As numerous writers have focused on the problems created by TMJ pathologies, it's only natural that various therapeutic approaches be suggested. What primarily matters is that they lead to a stabilization of the occlusion. As far as diagnosis is concerned, only a precise and rigorous protocol - followed by everyone - can produce a therapeutic result that would be acceptable for each patient. The orthodontist can and must be the coordinator of the cross-disciplinary team. He steps in over 72 % of temporomandibular joint disorder cases and proposes the most conservative, cheapest, and the best cost/benefit ratio for the patient.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Oclusión Dental , Humanos , Masculino , Dolor , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/terapia
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