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1.
Yonsei Med J ; 61(4): 331-340, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32233176

RESUMEN

PURPOSE: Osteoarthritis (OA) of the temporomandibular joint (TMJ) elicits cartilage and subchondral bone defects. Growth hormone (GH) promotes chondrocyte growth. The aim of this study was to evaluate the efficacy of intra-articular injections of GH to treat TMJ-OA. MATERIALS AND METHODS: Monosodium iodoacetate (MIA) was used to induce OA in the TMJs of rats. After confirming the induction of OA, recombinant human GH was injected into the articular cavities of rats. Concentrations of GH and IGF-1 were measured in the blood and synovial fluid, and OA grades of cartilage and subchondral bone degradation were recorded by histological examination and micro-computed tomography. RESULTS: MIA-induced OA in the rat TMJ upregulated insulin-like growth factor-1 (IGF-1) rather than GH levels. GH and IGF-1 concentrations were increased after local injection of GH, compared with controls. Locally injected GH lowered osteoarthritic scores in the cartilage and subchondral bone of the TMJ. CONCLUSION: Intra-articular injection of GH improved OA scores in rat TMJs in both cartilage and subchondral bone of the condyles without affecting condylar bone growth. These results suggest that intra-articular injection of human GH could be a suitable treatment option for TMJ-OA patients in the future.


Asunto(s)
Condrocitos/efectos de los fármacos , Hormona del Crecimiento/administración & dosificación , Factor I del Crecimiento Similar a la Insulina/administración & dosificación , Osteoartritis/tratamiento farmacológico , Articulación Temporomandibular/efectos de los fármacos , Anciano , Animales , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/patología , Hormona del Crecimiento/efectos adversos , Hormona de Crecimiento Humana , Humanos , Inyecciones Intraarticulares , Masculino , Osteoartritis/diagnóstico por imagen , Osteoartritis/patología , Ratas , Líquido Sinovial , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/fisiopatología , Microtomografía por Rayos X
2.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 68-72, Jan.-Mar. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1090546

RESUMEN

Abstract Introduction The prevalence of tinnitus is higher in individuals with temporoman- dibular joint disorder (TMD) than in the general population. Magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) is the method of choice for investigation, and it has been hypothesized that specific MRI findings might be observed in TMD with comorbid tinnitus. Objective To comparatively describe MRI findings in patients with TMD with and without tinnitus, identifying the most common TMJ alterations and determining whether a correlation exists between severity of TMD and tinnitus. Methods A cross-sectional study of 53 adult patients with bilateral or unilateral TMD (30 with and 23 without tinnitus). The association between tinnitus and morphological aspects of TMD (changes in condylar morphology, articular eminence morphology, and disc morphology), disc displacement (with/without reduction), condylar translation, and intra-articular effusion was analyzed on MRI images. Results The mean patient age was 46.12 ± 16.1 years. Disc displacement was the most common finding in both groups (24 patients with tinnitus versus 15 without; p = 0.043). Only the frequency of disc displacement with reduction was significantly different between groups. Conclusion Additional imaging techniques should be explored to detect specific aspects of the relationship between tinnitus and TMD.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Articulación Temporomandibular/diagnóstico por imagen , Acúfeno/diagnóstico por imagen , Imagen por Resonancia Magnética , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Audiometría de Respuesta Evocada , Audiometría de Tonos Puros , Articulación Temporomandibular/patología , Acúfeno/diagnóstico , Acúfeno/etiología , Índice de Severidad de la Enfermedad , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/patología , Estudios Transversales
4.
Int J Oral Sci ; 12(1): 5, 2020 02 06.
Artículo en Inglés | MEDLINE | ID: mdl-32024813

RESUMEN

Rheumatoid arthritis (RA) is an autoimmune disease affecting 1% of the world population and is characterized by chronic inflammation of the joints sometimes accompanied by extra-articular manifestations. K/BxN mice, originally described in 1996 as a model of polyarthritis, exhibit knee joint alterations. The aim of this study was to describe temporomandibular joint (TMJ) inflammation and damage in these mice. We used relevant imaging modalities, such as micro-magnetic resonance imaging (µMRI) and micro-computed tomography (µCT), as well as histology and immunofluorescence techniques to detect TMJ alterations in this mouse model. Histology and immunofluorescence for Col-I, Col-II, and aggrecan showed cartilage damage in the TMJ of K/BxN animals, which was also evidenced by µCT but was less pronounced than that seen in the knee joints. µMRI observations suggested an increased volume of the upper articular cavity, an indicator of an inflammatory process. Fibroblast-like synoviocytes (FLSs) isolated from the TMJ of K/BxN mice secreted inflammatory cytokines (IL-6 and IL-1ß) and expressed degradative mediators such as matrix metalloproteinases (MMPs). K/BxN mice represent an attractive model for describing and investigating spontaneous damage to the TMJ, a painful disorder in humans with an etiology that is still poorly understood.


Asunto(s)
Artritis Experimental/patología , Artritis Reumatoide/patología , Huesos/diagnóstico por imagen , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/lesiones , Microtomografía por Rayos X/métodos , Animales , Artritis Experimental/inmunología , Artritis Reumatoide/inmunología , Huesos/metabolismo , Huesos/patología , Modelos Animales de Enfermedad , Humanos , Imagen por Resonancia Magnética , Metaloproteinasa 8 de la Matriz/inmunología , Ratones , Ratones Transgénicos , Articulación Temporomandibular/metabolismo , Tomografía Computarizada por Rayos X
6.
Dentomaxillofac Radiol ; 49(3): 20190002, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31559845

RESUMEN

OBJECTIVE: To compare and evaluate the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) values between a 15-channel phased array head coil and 6-channel dS Flex M surface coil in the MRI of temporomandibular joint. METHODS: 300 patients were randomly assigned to two groups: 150 patients were examined by using a 15-channel phased array head coil and the other 150 patients were scanned by using a 6-channel dS Flex M surface coil. All of the data were set in the same 6 regions of interest including the temporal lobe, condyle neck, lateral pterygoid muscle, parotid gland, the adipose area and an area of the background noise). SNR and CNR values were measured respectively. RESULTS: The numerical variation law of SNR and CNR values measured in regionsof interest of each group was similar, although different coils were used. There were statistically significant differences of SNR values in all of the oblique sagittal (OSag) proton density-weighted imaging, the part of OSag T 2 weighted image (T 2WI) except for SNR4 and SNR5. and oblique coronal (OCor) T 2WI sequence except for SNR2. On the contrary, SNR4 and SNR5 values in the OCor T 2WI and SNR5 values in OSag T 2WI sequences by using the surface coil were higher than those by using the head coil. There were no statistically significant intergroup differences of CNR values in OSag proton density-weighted imaging sequence except CNR1 and in OSag T 2WI sequence except CNR5. But, statistically significant differences of all the values in the OCor T 2WI sequence except for CNR1 were observed. CONCLUSION: Both the phased array head coil and dS Flex M surface coil can be used for temporomandibular joint MRI.


Asunto(s)
Imagen por Resonancia Magnética , Articulación Temporomandibular , Humanos , Cuello , Músculos Pterigoideos , Relación Señal-Ruido , Articulación Temporomandibular/diagnóstico por imagen
7.
Dentomaxillofac Radiol ; 49(3): 20190272, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31670578

RESUMEN

OBJECTIVE: This study was conducted to assess the clinical usability of the zero-echo time (ZTE) technique of MRI for evaluating bone changes of the temporomandibular joint (TMJ) in comparison with CBCT. METHODS: Twenty patients with TMJ disorder who underwent both CBCT and MRI were randomly selected. CBCT images were obtained with an Alphard 3030 device (Asahi Roentgen Ind., Co. Ltd, Kyoto, Japan). MRIs were obtained using a 3.0 T scanner (Pioneer; GE Healthcare, Waukesha, WI, USA) and a 21-channel head coil. An isotropic three-dimensional proton-density-weighted ZTE sequence was acquired. Two radiologists evaluated 40 joints of 20 patients for the presence of the following osseous changes: flattening, erosion, osteophyte and sclerosis of the condyle; and flattening, erosion and sclerosis of the articular fossa. CBCT and ZTE-MRI assessments were performed at a 2-month interval. The prevalence-adjusted and bias-adjusted κ statistic was used to analyse interexaminer and intraexaminer agreement and the agreement between ZTE-MRI and CBCT. RESULTS: Intraexaminer and interexaminer agreement analyses of ZTE-MRI showed high reproducibility (κ>0.80), which was comparable to that of CBCT. Flattening, osteophyte and sclerosis of the condyle and all types of bone changes in the mandibular fossa showed nearly perfect agreement between CBCT and ZTE-MRI (κ = 0.80-0.90). Erosion of the condyle showed substantial agreement between both sets of images (κ = 0.65-0.70). CONCLUSIONS: It is suggested that ZTE-MRI provides clinically reliable images for bone assessment in TMJ disorder. MRI may become a beneficial diagnostic tool for patients with both TMJ disc and bone pathology, with advantages involving medical costs and radiation dose.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Imagen por Resonancia Magnética , Trastornos de la Articulación Temporomandibular , Articulación Temporomandibular , Humanos , Japón , Cóndilo Mandibular/diagnóstico por imagen , Reproducibilidad de los Resultados , Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen
8.
Dentomaxillofac Radiol ; 49(1): 20190186, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31530023

RESUMEN

OBJECTIVES: This study was undertaken as an attempt to assess radiographic temporomandibular joint (TMJ) changes in relation to rheumatoid factor (RF), anticitrullinated protein (ACCP) antibodies and disease activity score 28 (DAS28) in rheumatoid arthritis (RA) patients to find the best predictor of rheumatoid affection of the TMJ with the ultimate goal of maintaining TMJ function and preventing joint damage. METHODS: 20 Rheumatoid Arthritis patients as well as 20 volunteers were included in this study. RA group were assessed for RF, ACCP, DAS28. Both groups were assessed by CBCT for TMJ dimensions and radiographic osteoarthritic changes. All data were statistically analyzed. RESULTS: Rheumatoid Arthritis group showed significantly less condylar height and more radiographic osteoarthritic changes than the control group. RF showed no significant correlation with either TMJ measurements or TMJ radiographic osteoarthritic changes. ACCP showed significant inverse correlation with condylar height and anteroposterior (AP) dimensions, but non-significant relation with mediolateral dimension and radiographic osteoarthritic changes. DAS28 showed significant inverse correlation with condylar AP and mediolateral dimensions. It also showed significant correlation with flattening of the TMJ condylar head and flattening of the articular fossa. Patients with high and moderate disease activity showed significantly smaller AP TMJ dimension than patients with low disease activity. Disease activity showed statistically significant direct correlation with all osteoarthritic changes except for erosions of the glenoid fossa and condyle. CONCLUSION: Disease Activity Score28 score and disease activity are strong indicators of TMJ affection in RA patients when compared to RF and ACCP. ACCP is a better indicator of changes in condylar measurements than TMJ osteoarthritic changes. While RF is the least efficient indicator of TMJ involvement in RA patients.


Asunto(s)
Artritis Reumatoide , Cóndilo Mandibular , Articulación Temporomandibular , Artritis Reumatoide/sangre , Artritis Reumatoide/diagnóstico por imagen , Humanos , Cóndilo Mandibular/diagnóstico por imagen , Articulación Temporomandibular/diagnóstico por imagen
9.
Int. j. morphol ; 37(4): 1347-1352, Dec. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1040136

RESUMEN

The objective of the study was to investigate the morphological features of the temporomandibular joint in adult patients with posterior occlusal plane and different inclinations. Fifty five skeletal I occlusion patients with average were included, shooting CBCT in the intercuspal position, divided into 3 groups according to OPP-FH angle, and measurement of the temporomandibular joint morphology was calculated with cone beam computed tomography (CBCT) special software Invivo 5.0, Statistical analysis of three groups of data using SPSS23.0. The condyle usually locates in the middle of the fossa, the maximum axial area of the condyle (A) was statistically significant between the group 1 and the group 3. The internal and external diameter (MD) of the condyle was statistically significant between group 1 and group 3, and group 2 and group 3. The bilateral TMJ morphological features of the three groups were basically symmetrical. The position of the condyle in the fossa is mostly centered, and some of the posterior, the maximum axial area and the internal and external diameter of the condyle are different in three groups.


El objetivo de este estudio fue investigar las características morfológicas de la articulación temporomandibular (ATM) en pacientes adultos con plano oclusal posterior y diferentes inclinaciones. Se incluyeron 55 pacientes con oclusión esquelética tipo I, visualizados por tomografía computarizada de haz cónico (CBCT) en posición intercuspiana, y se dividieron en 3 grupos según el ángulo OPP-FH. La medición morfológica de la articulación temporomandibular se calculó con CBCT y mediante el software especial Invivo 5.0. El análisis estadístico de datos se realizó con el software SPSS 23.0. El cóndilo de la mandíbula generalmente se ubica en el centro de la fosa; el área axial máxima del cóndilo de la mandíbula (A) fue estadísticamente significativa entre los grupos 1 y 3. Los datos de los diámetros medial y lateral (DM) del cóndilo de la mandíbula fueron estadísticamente significativos entre los grupos 1 y 3 y los grupos 2 y 3. Las características morfológicas de la ATM de los tres grupos fueron básicamente simétricas. La posición del cóndilo de la mandíbula en la fosa fue principalmente centrada, y parte del área axial máxima, posterior y los diámetros medial y lateral del cóndilo de la mandíbula fueron diferentes en los tres grupos.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Articulación Temporomandibular/anatomía & histología , Articulación Temporomandibular/diagnóstico por imagen , Oclusión Dental , Tomografía Computarizada de Haz Cónico
10.
J Craniomaxillofac Surg ; 47(12): 1898-1902, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31690477

RESUMEN

Synovial chondromatosis (SC) of the temporomandibular joint is a pseudoneoplastic condition characterized by benign cartilaginous metaplasia of synovial tissue mesenchymal residues with intra-articular nodule formation. TMJ involvement is rare. Interposition of loose bodies in the articular space can generate pressure, leading to glenoid fossa erosion with intracranial extension. The aim of this study was to present six SC cases with intracranial extension treated using a surgical procedure. All the patients were treated with open surgery. The superior compartment of the TMJ was opened widely to carefully remove the metaplasic mass. Temporal synovectomy was then performed. Attention was paid to preserving the integrity of the articular disc. The exposed dura mater was also preserved. No material was used to reconstruct the gap in the glenoid fossa. A 1-year follow-up showed no swelling or pain. Patients demonstrated good recovery of mouth opening, with improvement over previous mouth limitations. Morphological studies, performed using MRI and CT, showed complete anatomical recovery of the TMJ and total bone reconstruction of the glenoid fossa. Simple removal of intra-articular nodules, with TMJ arthroplasty and articular disk preservation, represents an efficient treatment option for full anatomical and functional recovery in synovial chondromatosis of the temporomandibular joint with glenoid fossa erosion of less than 1 cm2.


Asunto(s)
Condromatosis Sinovial/cirugía , Fosa Craneal Media/patología , Trastornos de la Articulación Temporomandibular/cirugía , Articulación Temporomandibular/diagnóstico por imagen , Adulto , Condromatosis Sinovial/diagnóstico por imagen , Fosa Craneal Media/cirugía , Femenino , Cavidad Glenoidea , Humanos , Luxaciones Articulares , Cuerpos Libres Articulares , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
11.
Shanghai Kou Qiang Yi Xue ; 28(3): 275-278, 2019 Jun.
Artículo en Chino | MEDLINE | ID: mdl-31489415

RESUMEN

PURPOSE: To explore the correlation between increased vertical dimensions and temporomandibular joint (TMJ) spaces of patients with severe tooth wear after occlusal reconstruction treatment. METHODS: The TMJ spaces and the condylar positions of 30 patients were measured by cone-beam CT (CBCT) before and after treatment. SPSS 19.0 software package was used to analyze the anterior, superior and posterior space of TMJ. Independent sample t test was utilized to evaluate the correlation between vertical dimension and TMJ spaces. RESULTS: There was no significant difference between TMJ spaces of two sides, the data of two sides were combined for further analysis. The mean anterior interspace, superior interspace, posterior interspace was (2.01±0.52)mm, (3.15±0.94)mm, (2.70±0.98)mm before treatment, and (2.03±0.35)mm, (3.46±0.74)mm, (2.79±0.58)mm after treatment, respectively. Based on calculating the In(P/A) and linear ratio(LR), condylar position moved backward for 52% patients before treatment. After occlusal reconstruction, the reduction rate of anterior displacement of condyle was 86.7%. CONCLUSIONS: In addition to restoring its vertical dimensions of patients with severe tooth wear, the condyle should be induced to appropriate position to prevent TMJ symptoms.


Asunto(s)
Cóndilo Mandibular , Articulación Temporomandibular , Desgaste de los Dientes , Tomografía Computarizada de Haz Cónico , Humanos , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/cirugía , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Dimensión Vertical
15.
Am J Orthod Dentofacial Orthop ; 156(1): 125-136, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256825

RESUMEN

This case report describes the successful treatment of a 14-year-old girl with severe bilateral idiopathic condylar resorption and resultant mandibular retrusion, increased overjet, and anterior open bite. The nonextraction treatment plan included (1) aligning and leveling the teeth in both arches, (2) performing Le Fort I maxillary osteotomy, bilateral condylectomy, and mandibular joint replacement, and (3) postsurgical correction of the malocclusion. The orthodontic treatment was initiated with the use of custom lingual appliances followed by orthognathic surgery planned with virtual surgical planning. Patient-fitted and customized temporomandibular joint implants were designed and manufactured based on the patient's stereolithic bone anatomic model. Treatment was concluded with detailed orthodontic finishing. Optimum esthetic and functional results were achieved with the cooperation of 2 specialties and the use of state-of-the-art technology.


Asunto(s)
Tirantes , Prótesis Articulares , Cóndilo Mandibular/cirugía , Mordida Abierta/cirugía , Mordida Abierta/terapia , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Trastornos de la Articulación Temporomandibular/terapia , Adolescente , Puntos Anatómicos de Referencia , Resorción Ósea/complicaciones , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/cirugía , Resorción Ósea/terapia , Cefalometría , Estética Dental , Femenino , Humanos , Imagenología Tridimensional , Mandíbula/cirugía , Cóndilo Mandibular/diagnóstico por imagen , Maxilar/cirugía , Mordida Abierta/diagnóstico por imagen , Aparatos Ortodóncicos , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/instrumentación , Osteotomía , Planificación de Atención al Paciente , Radiografía Panorámica , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/cirugía , Resultado del Tratamiento
16.
J Craniofac Surg ; 30(8): e707-e710, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31261325

RESUMEN

Unilateral condylar hyperplasia (UCH) is characterized by an overgrowth of the mandibular condyle responsible for a facial and dental asymmetry associated with temporomandibular joint function and maxillary growth consequences. The diagnosis is based on a body of clinical, radiological and histological arguments. A 38 years old woman with a reactivation of UCH after a latency period of 16 years following an orthognathic surgery performed for facial asymmetry normalization is presented. She was addressed to our department for a facial progressive asymmetry relapse and dental prosthetic consequences.The radiological images and the planar scintigraphy combined with single-photon emission computed tomography scans showed an active left unilateral condylar hyperplasia. A left proportional condylectomy was performed.The case presented highlights the possibility for the UCH to be reactivated after a long period of latency, leading to a relapse of the occlusal and facial disorders and so advocates the need for first condylectomy or at least a long-term follow-up if condylectomy is not performed as a first-line treatment.


Asunto(s)
Hiperplasia/diagnóstico por imagen , Cóndilo Mandibular/diagnóstico por imagen , Adulto , Asimetría Facial/cirugía , Femenino , Humanos , Cóndilo Mandibular/cirugía , Procedimientos Quirúrgicos Ortognáticos , Articulación Temporomandibular/diagnóstico por imagen
17.
J Craniofac Surg ; 30(5): 1462-1465, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31299744

RESUMEN

OBJECTIVE: To assess the temporomandibular joint (TMJ) osseous components morphology and the condyle position in patients with different sagittal skeletal relationships, sex, and age, using cone-beam computed tomography (CBCT). METHODS: The CBCT images of 180 asymptomatic patients (60 class I, 60 class II, and 60 class III) were assessed retrospectively. Groups were also divided according to age (<40 years, n = 90; ≥40 years, n = 90) and sex (male, n = 90; female, n = 90). Right- and left-sided TMJ spaces, articular eminence inclination (AEI) and height (AEH), thickness of the roof of the glenoid fossa (TRGF) and the anteroposterior position of the condyle in glenoid fossa were evaluated. Differences were tested using the analysis of variance, Tukey and t-tests (P < 0.05). RESULTS: For condylar position, no differences were found between sex and age groups, but spatial differences existed among skeletal classes. Significant differences were found between the right and left angular position in patients with malocclusion. Class II individuals presented lower anterior articular spaces. The condyle-glenoid fossa relationship presented a moderate correlation of bilaterality. The AEI and AEH were significant lower in class III individuals and class I patients presented the lowest values for TRGF. The values of AEH, TRGF and of all joint spaces of males were higher. In individuals over the age of 40 years, the AEI and AEH measurements were significant greater. CONCLUSION: Sagittal skeletal relationships have a significant effect on condyle position, AEI, and AEH. The eminence inclination and height and TRGF are influenced by sex and age.


Asunto(s)
Articulación Temporomandibular/diagnóstico por imagen , Adulto , Distribución por Edad , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Humanos , Masculino , Maloclusión , Cóndilo Mandibular , Estudios Retrospectivos , Caracteres Sexuales
18.
Dentomaxillofac Radiol ; 48(7): 20190216, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31322927

RESUMEN

OBJECTIVES: The aim of this study is to evaluate the effects of functional orthodontic appliances on the masticatory muscles, temporomandibular joint (TMJ), and brain to determine whether using functional appliances full-time or only at night yields different results. METHODS: 16 patients with Class II malocclusion were included in this study. Eight patients were instructed to wear their appliances (monoblock/twinblock) full-time and the other eight patients were instructed to wear them at night while sleeping. An additional 10 patients with Class II malocclusion were later included as a pre-treatment control group. Signal intensity ratios (SIR) of TMJ structures and morphological evaluations of the masticatory muscles were done for all patients. Functional MRI (fMRI) data were also obtained from the patients while performing chewing and biting movements. RESULTS: ANB angle was reduced significantly in both the full-time and night wear groups, by values of 1.17° and 1.35°, respectively (p < 0.05). MRI showed that SIRs were significantly increased in both groups in the masticatory muscles, retrodiscal pad, condylar process, and articular disc (p < 0.05). Both resting and task-based fMRI evaluation revealed significant increases in blood oxygen level dependent signals in several regions of the brain in both groups (p < 0.05). CONCLUSIONS: The cephalometric and MRI findings of this study indicate that the treatment effects were similar for both wear schedules. Functional appliances should be regarded not as simple devices that treat Class II malocclusion through skeletal and dental correction alone, but as exercise devices that lead to neuromuscular changes by facilitating muscle adaptation and activating various brain regions.


Asunto(s)
Encéfalo , Imagen por Resonancia Magnética , Músculos Masticadores , Aparatos Ortodóncicos Funcionales , Articulación Temporomandibular , Encéfalo/diagnóstico por imagen , Femenino , Humanos , Músculos Masticadores/diagnóstico por imagen , Estudios Prospectivos , Articulación Temporomandibular/diagnóstico por imagen
19.
Ann R Coll Surg Engl ; 101(6): 415-421, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31155887

RESUMEN

INTRODUCTION: We discuss our findings on the retention of the medially displaced residual condyle during the treatment of type III temporomandibular joint ankylosis, as well as the postoperative results observed during follow-up. MATERIALS AND METHODS: Thirty-two patients with type III temporomandibular joint ankylosis that met the inclusion criteria of the study were included as subjects. The morphological integrity of the medially displaced residual condyle was verified in all of the participating patients through the use of cone beam computed tomography. The duration of the ankylosis ranged from 2 to 12 years. The maximum length that patients were able to open their mouths ranged from 6 mm to 14 mm. The surgical treatments used in this report included the separation of bony fusions between the condyle and the glenoid fossa, resection of the ankylosed sites, preservation of the displaced condyles in their medial position and suturing the remains of the disc to its typical position or taking the temporalis myofascial flap instead. The long-term results were evaluated by computed tomography and clinical follow-up examinations. RESULTS: Three-year postoperative follow-up examinations were performed for all of the patients included in this study. No recurrences were observed in the patients who adhered to the postoperative therapeutic advice. Patients had an average maximal mouth opening distance of 34.50 ± 5.75 mm as recorded during the final follow-up examination. CONCLUSIONS: The released medially residual condyle can still function normally in temporomandibular joint movement and without reankylosis after a bone fusion resection. The displaced condyle should thus be preserved instead of being removed during the treatment of type III temporomandibular joint ankylosis.


Asunto(s)
Anquilosis/cirugía , Artroplastia/métodos , Trastornos de la Articulación Temporomandibular/cirugía , Adolescente , Adulto , Anquilosis/diagnóstico por imagen , Niño , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Cóndilo Mandibular/cirugía , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Resultado del Tratamiento , Adulto Joven
20.
ORL J Otorhinolaryngol Relat Spec ; 81(2-3): 171-182, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31242479

RESUMEN

BACKGROUND/AIMS: To review the existing literature on pigmented villonodular synovitis (PVNS) of the temporomandibular joint (TMJ) and report a rare case of PVNS of the TMJ presenting with unilateral hearing loss. METHODS: Review of the existing literature and a description of personal experience with PVNS of the TMJ presenting with unilateral hearing loss. RESULTS: Review of the existing literature revealed 76 reported cases of PVNS of the TMJ. The most common presenting symptom was of a slowly enlarging mass or swelling of the preauricular area, with dysfunctional TMJ also frequently reported. All patients underwent surgical excision with some pursuing radiation as adjuvant therapy. Presented Patient: A 46-year-old man presented with several months of unilateral subjective hearing loss and aural fullness. Imaging revealed a mass centered along the superior TMJ with expansion through the squamous temporal bone and extra-axial intracranial extension into the middle cranial fossa. Imaging characteristics and fine-needle aspiration biopsy were consistent with PVNS. INTERVENTION: The patient underwent near-total excision of the mass via frontotemporal craniectomy and lateral temporal bone resection. FOLLOW-UP: At the 16-month follow-up there was no evidence of disease recurrence. CONCLUSION: PVNS of the TMJ represents a rare entity that can present with a variety of symptoms including unilateral hearing loss.


Asunto(s)
Pérdida Auditiva Unilateral/etiología , Sinovitis Pigmentada Vellonodular/complicaciones , Articulación Temporomandibular/diagnóstico por imagen , Audiometría , Biopsia con Aguja Fina , Terapia Combinada , Diagnóstico Diferencial , Audición/fisiología , Pérdida Auditiva Unilateral/diagnóstico , Pérdida Auditiva Unilateral/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Sinovitis Pigmentada Vellonodular/diagnóstico , Sinovitis Pigmentada Vellonodular/terapia , Tomografía Computarizada por Rayos X
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