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1.
East Asian Arch Psychiatry ; 29(1): 20-25, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31237253

RESUMEN

OBJECTIVES: This study aimed (1) to determine the prevalence of anxiety, depression, and TMJ osseous changes in elderly Vietnamese according to sex and residence, and (2) to investigate the association of temporomandibular joint (TMJ) osseous changes with anxiety, depression, and limitation of mandibular function. METHODS: Elderly people living in Danang, Vietnam were recruited. Participants were screened for anxiety and depression using the self-reported 7-item Generalized Anxiety Disorder Scale (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Participants then self-rated the limitation of their mandibular function using the 20-item Jaw Functional Limitation Scale (JFLS-20) questionnaire. TMJ osseous changes (erosion, flattening, osteophytes, and sclerosis) were evaluated using digital orthopantomography. RESULTS: Of 179 participants aged 65 to 74 years, 17.9% and 35.8% had anxiety and depression symptoms, respectively. Compared with urban residents, rural residents had higher prevalence of anxiety (23.3% vs 12.4%, p = 0.009) and depression (46.62% vs 24.7%, p = 0.019). The prevalence of TMJ osseous changes was 58.1%. The most common TMJ osseous change was flattening (41.3%), followed by erosion (34.6%), sclerosis (16.2%), and osteophytes (7.8%). Participants with or without TMJ osseous changes were comparable in terms of GAD-7 score, PHQ-9 score, and JFLS-20 score and sub-scores. CONCLUSIONS: Anxiety and depression and TMJ osseous changes were prevalent in elderly Vietnamese. Rural residents had higher prevalence of anxiety and depression than urban residents. TMJ osseous changes were not associated with anxiety, depression, or limitation of mandibular function.


Asunto(s)
Trastornos de Ansiedad/epidemiología , Trastorno Depresivo/epidemiología , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/psicología , Anciano , Trastornos de Ansiedad/psicología , Comorbilidad , Depresión , Trastorno Depresivo/psicología , Femenino , Humanos , Masculino , Cóndilo Mandibular/fisiopatología , Prevalencia , Población Rural/estadística & datos numéricos , Factores Sexuales , Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/fisiopatología , Población Urbana/estadística & datos numéricos , Vietnam/epidemiología
2.
J Craniomaxillofac Surg ; 47(3): 438-442, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30709759

RESUMEN

PURPOSE: Temporomandibular disorder (TMD) is a common problem in modern societies. Causes of TMD, as a consequence of condylar asymmetry index (CAI), are still a subject of controversy. The aim of the present study was to determine the possible correlations between the degree of condylar asymmetry and clinical dysfunction indices. MATERIALS AND METHODS: In this cross-sectional study, we used the Habets method to measure the CAI in 42 TMD patients. The participants' age and sex were matched in the control group. Patients were divided into mild, moderate and severe dysfunction groups based on Helkimo's clinical Di. The data were analyzed using Mann-Whitney U and Kruskal-Wallis tests. Also, the study attempted to assess the possibility of correlation between age and CAI. RESULTS: The CAI values of TMD patients were significantly higher than those of the control group (P = 0.001). However, CAI was not significantly different among TMD patients with different dysfunction index. There was no significant correlation between CAI and age (Spearman r = 0.655, P = 0.23). CONCLUSION: Based on the findings of the present study, patients with condylar asymmetry index are more susceptible to TMD. However, degree of the condylar asymmetry is not a criterion for TMD signs and symptoms.


Asunto(s)
Cóndilo Mandibular/anatomía & histología , Trastornos de la Articulación Temporomandibular/fisiopatología , Articulación Temporomandibular/fisiopatología , Adolescente , Adulto , Anciano , Tomografía Computarizada de Haz Cónico , Estudios Transversales , Femenino , Humanos , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/fisiopatología , Persona de Mediana Edad , Rango del Movimiento Articular , Trastornos de la Articulación Temporomandibular/patología , Adulto Joven
3.
Ultrasound Med Biol ; 45(4): 944-953, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30732913

RESUMEN

The aim of this study was to assess the effect of low-intensity pulsed ultrasound (LIPUS) application on rat temporomandibular joints (TMJs) with early-stage of osteoarthritis-like conditions induced by mechanical overloading. Fifteen-week-old male Wistar rats were divided into two experimental groups and a control group (n = 10 each). Both TMJs of all rats in one experimental group were subjected to mechanical overloading for 5 d, and those in the other experimental group were exposed to LIPUS for 20 min/d after overloading. Condyles were assessed using micro-computed tomography, histology and histomorphometry. LIPUS treatment attenuated cartilage degeneration, decreased the number of osteoclastic cells and restored the expression of aggrecan after an initial decrease induced by mechanical overloading. These results indicate that LIPUS may have a protective effect on the early progression of TMJ osteoarthritis.


Asunto(s)
Cartílago Articular/fisiopatología , Cóndilo Mandibular/fisiopatología , Osteoartritis/prevención & control , Estrés Mecánico , Terapia por Ultrasonido/métodos , Animales , Modelos Animales de Enfermedad , Masculino , Ratas , Ratas Wistar , Ondas Ultrasónicas
4.
J Craniomaxillofac Surg ; 47(3): 406-413, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30639154

RESUMEN

The purpose of this study was to evaluate the association between kind of condylar displacement due to orthognathic surgery and the subsequent adaptive condylar head remodeling. The sample in this retrospective cohort study consisted of 30 patients (12 female and 18 male; mean age 22.7 y) with skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (SSRO). Three-dimensional superimpositions of cone-beam computed tomography (CBCT) scan derived images from immediately after and 6 months after surgery were to reveal the type of remodeling, while images from before and immediately after surgery were to identify the type of condylar displacement. Laterally displaced condyles showed bone resorption on the lateral surfaces and deposition on the medial surfaces, whereas the contrary was found in medially displaced condyles. Anteriorly displaced condyles showed resorption on the anterior surfaces and deposition on the posterior surfaces, whereas the contrary was found in posteriorly displaced condyles. Superior surfaces of the condyles showed bone resorption regardless of displacement direction. The results indicate that condylar remodeling patterns (resorption/deposition) are determined by the direction of condylar displacement during surgery. However, condylar displacement by surgery is not completely compensated by condylar head remodeling, especially in case of downward displacement.


Asunto(s)
Remodelación Ósea , Maloclusión de Angle Clase III/cirugía , Cóndilo Mandibular/cirugía , Osteotomía Sagital de Rama Mandibular , Cefalometría , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Imagenología Tridimensional , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/fisiopatología , Procedimientos Quirúrgicos Ortognáticos , Estudios Retrospectivos , Adulto Joven
5.
J Investig Clin Dent ; 10(1): e12375, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30474234

RESUMEN

AIM: The aim of the present study was to correlate the angle formed by inclination of the condylar long axis and median sagittal plane to the presence of internal disc derangement, as well as changes in eccentric mandibular positions. METHODS: The sample consisted of magnetic resonance images of 35 temporomandibular joint (TMJ) acquired with a 1.5T magnetic resonance imaging system with surface coils of 8.5 cm in diameter. Parasagittal images were used according to the following parameters: TMJ disc position with mouth closed, TMJ disc position with mouth open, TMJ disc function, and degrees of rotation and translation of the condyle. Next, we determined the angles between the condyle long axis and median sagittal plane by using axial images. RESULTS: The results showed correlations between TMJ disc position and disc function (P = 0.009), as well as between disc position and degree of condylar rotation (P = 0.008). The main purpose of the present study was to assess the angle of the condylar long axis, with no statistical correlation being found between this variable and disc position (P = 0.787), disc function (P = 0.091), condylar translation (P = 0.808), and condylar rotation (P = 0.115). CONCLUSION: There was no relationship between inclination of the condyle long axis and parameters of internal derangements.


Asunto(s)
Luxaciones Articulares/patología , Cóndilo Mandibular/patología , Disco de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/patología , Adolescente , Adulto , Anciano , Femenino , Humanos , Luxaciones Articulares/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/fisiopatología , Persona de Mediana Edad , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/patología , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/fisiopatología , Adulto Joven
6.
Cranio ; 37(4): 264-271, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29359644

RESUMEN

Objective: To evaluate whether osseous changes of the temporomandibular joint (TMJ) condyle affect backward rotation of the mandibular ramus in Angle Class II orthodontic patients with idiopathic condylar resorption (ICR). Methods: Twenty Japanese women with Class II malocclusion with ICR (ICR group) and 24 women with Class II malocclusion without ICR (non-ICR group) were examined. Pre-treatment panoramic radiographs were used to measure condylar ratios. Pre-treatment lateral cephalograms were used to evaluate maxillofacial morphology. Results: The ICR group had a significantly smaller condylar ratio, greater backward rotation of the ramus, less labially inclined upper incisors, and a steeper occlusal plane. The increased backward rotation of the ramus in the ICR group was significantly associated with a smaller condylar ratio. Conclusion: Angle Class II patients with ICR had shorter condylar height attributable to osseous changes of the TMJ condyle, and the shorter condylar height may affect subsequent backward rotation of the ramus.


Asunto(s)
Resorción Ósea/patología , Resorción Ósea/fisiopatología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/fisiopatología , Cóndilo Mandibular/patología , Cóndilo Mandibular/fisiopatología , Rotación , Trastornos de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/fisiopatología , Articulación Temporomandibular/patología , Articulación Temporomandibular/fisiopatología , Adulto , Resorción Ósea/diagnóstico por imagen , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Cóndilo Mandibular/diagnóstico por imagen , Persona de Mediana Edad , Radiografía Panorámica , Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Adulto Joven
7.
Int J Oral Maxillofac Surg ; 48(2): 225-232, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29954643

RESUMEN

According to recognized guidelines, a total alloplastic replacement may be indicated to resolve temporomandibular pain and functional limitations in cases where conservative and less aggressive surgical management strategies have failed. It is broadly believed that, as a result of the surgical procedure, the function of the lateral pterygoid muscle is lost and so are the laterotrusive and protrusive jaw movements. Furthermore, the joint prosthesis design may not be conducive to lateral and protrusive movements. Using a dynamic stereometry technique, it was possible to perform a quantitative analysis of kinematics in TJR patients. The cases of four patients who showed preserved lateral and/or protrusive motion are presented here. During mouth opening, prosthetic condyle translation ranged from 3.18mm to 10.09mm and it was also possible to observe this clinically. It has been suggested that changes in prosthesis design may have improved postoperative jaw kinematics. Considering the large diversity in treatment outcomes, it is recommended that the individual prognosis should always be discussed with the patient prior to surgery.


Asunto(s)
Artroplastia de Reemplazo , Prótesis Articulares , Rango del Movimiento Articular/fisiología , Articulación Temporomandibular/fisiopatología , Articulación Temporomandibular/cirugía , Adulto , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Cóndilo Mandibular/fisiopatología , Cóndilo Mandibular/cirugía , Persona de Mediana Edad , Resultado del Tratamiento
8.
J Oral Sci ; 60(4): 473-478, 2018 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-30146533

RESUMEN

Brain and muscle Arnt-like protein-1 (BMAL1) knockout mice exhibit accelerated aging, abnormal glucose metabolism, and impaired adipocyte differentiation, among other phenotypes, which are effects associated with the BMAL1 gene. No study has investigated temporal changes in the deformation of the mandibular condyle and the presence of calcification in areas surrounding the mandibular condyle. In a study of 12 C57/BL strain mice under inhalation anesthesia, we collected images of the mandibular condyle at 6 weeks after birth and then every 5 weeks from 10 to 25 weeks after birth. At 25 weeks, deformation of the mandibular condyle was seen in 8 of 12 joints in BMAL1 knockout mice and in 2 of 12 joints in wild-type mice. At 20 and 25 weeks, deformation in areas surrounding the mandibular condyle, which are known to undergo calcification, was seen in 2 of 12 joints in BMAL1 knockout mice and in 0 of 12 joints in wild-type mice. BMAL1 knockout mice exhibited premature aging of the mandibular condyle, which suggests that circadian rhythms affect mandibular condyle morphology.


Asunto(s)
Factores de Transcripción ARNTL , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/fisiopatología , Microtomografía por Rayos X , Animales , Calcinosis/diagnóstico por imagen , Calcinosis/fisiopatología , Relojes Circadianos , Femenino , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Fenotipo , Factores de Tiempo
9.
J Oral Rehabil ; 45(10): 777-782, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29971809

RESUMEN

BACKGROUND: Mandibular fractures, especially condylar fractures, are one of the most common facial fractures. Trauma to this region could possibly compromise masticatory performance, which is a vital function for humans. OBJECTIVE: To objectively determine masticatory performance (Mixing Ability Test; MAT) in patients treated for a unilateral condylar fracture, thereby comparing patients in open and closed treatment groups, and assessing whether there is a positive relationship between this performance and subjective mandibular function (Mandibular Functional Impairment Questionnaire; MFIQ). METHODS: Fifty-eight patients were enrolled in a cross-sectional study and examined on an additional appointment at least 1 year after trauma, during which the patients performed the MAT and completed the MFIQ. The Spearman test was used to assess the correlation between the Mixing Ability Index (MAI) and the MFIQ score. A linear regression was used to explore the effects of different factors on the MAI. RESULTS: The correlation between objective masticatory performance and the subjective mandibular function was positive (r = 0.250; P = 0.033). Better masticatory performance was observed in patients who were male, received physiotherapy, had no other mandibular fractures and/or had satisfactory self-perceived occlusion. No significant difference in the MAI was found between the open and closed treatment groups. CONCLUSION: Independent of the chosen treatment, at least 1 year after treatment, individuals who experienced a unilateral fracture of the mandibular condyle exhibit masticatory capacity comparable with that of individuals who have not suffered such injuries.


Asunto(s)
Fijación de Fractura , Cóndilo Mandibular/lesiones , Fracturas Mandibulares/fisiopatología , Masticación/fisiología , Rango del Movimiento Articular/fisiología , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Cóndilo Mandibular/fisiopatología , Cóndilo Mandibular/cirugía , Fracturas Mandibulares/cirugía , Persona de Mediana Edad , Dimensión del Dolor , Recuperación de la Función , Resultado del Tratamiento , Adulto Joven
10.
J Oral Rehabil ; 45(10): 783-789, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29972704

RESUMEN

Patients with hypermobility disorders of the jaw joint experience joint sounds and jerky movements of the jaw. In severe cases, a subluxation or luxation can occur. Clinically, hypermobility disorders should be differentiated from disc displacements. With biomechanical modelling, we previously identified the anterior slope angle of the eminence and the orientation of the jaw closers to potentially contribute to hypermobility disorders. Using cone-beam computed tomography (CBCT), we constructed patient-specific models of the masticatory system to incorporate these aspects. It is not known whether the clinical diagnosis of hypermobility disorders is associated with the prediction of hypermobility by a patient-specific biomechanical model. Fifteen patients and eleven controls, matched for gender and age, were enrolled in the study. Clinical diagnosis was performed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and additional testing to differentiate hypermobility from disc displacements. Forward simulations with patient-specific biomechanical models were performed for maximum opening and subsequent closing of the jaw. This predicted a hypermobility disorder (luxation) or a control (normal closing). We found no association between the clinical diagnosis and predictions of hypermobility disorders. The biomechanical models overestimated the number of patients, yielding a low specificity. The role of the collagenous structures remains unclear; therefore, the articular disc and the ligaments should be modelled in greater detail. This also holds for the fanned shape of the temporalis muscle. However, for the osseous structures, we determined post hoc that the anterior slope angle of the articular eminence is steeper in patients than in controls.


Asunto(s)
Simulación por Computador , Luxaciones Articulares/diagnóstico , Inestabilidad de la Articulación/diagnóstico , Cóndilo Mandibular/fisiopatología , Rango del Movimiento Articular/fisiología , Disco de la Articulación Temporomandibular/fisiología , Trastornos de la Articulación Temporomandibular/diagnóstico , Adulto , Fenómenos Biomecánicos , Femenino , Humanos , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/fisiopatología , Inestabilidad de la Articulación/diagnóstico por imagen , Inestabilidad de la Articulación/fisiopatología , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Persona de Mediana Edad , Modelos Biológicos , Sistema Estomatognático/fisiopatología , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/fisiopatología , Adulto Joven
11.
J Craniofac Surg ; 29(8): e767-e773, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30015735

RESUMEN

PURPOSE: The purpose of this study is to investigate the effect of orthognathic surgery with intended manual condylar positioning on condyle by examining a change in its position. METHOD: About 18 patients with mandibular prognathism who underwent orthognathic surgery with intentional manual condyle positioning were included. Condyle displacement was analyzed through 3D cone-beam computed tomography before and after operation. The patients were categorized into 2 experimental groups: group A (1-jaw) and group B (2-jaw). The experimental groups were examined before surgery (T0), 3 days (T1), and 6 months (T2) after surgery. Condylar displacement direction was investigated in terms of bodily shift and rotational movement. RESULTS: Downward bodily shift of condyle after surgery was significantly apparent from all of the patients. Condylar bodily shift in other directions was statistically insignificant. Gross bodily shift of condyle right after surgery was anterolateral-inferior direction. In perspective of rotational movement, condyle rotated in infero-medial direction right after operation, but no significant change was presented afterwards. In addition, no significant difference in the amounts of condylar shift and pattern existed between groups A and B. CONCLUSION: Intended manual condylar positioning may minimize postoperative displacement of condyle while accomplishing skeletal stability.


Asunto(s)
Maloclusión de Angle Clase III/cirugía , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/fisiopatología , Osteotomía Sagital de Rama Mandibular , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Imagenología Tridimensional , Masculino , Movimiento , Estudios Retrospectivos , Adulto Joven
12.
J Oral Maxillofac Surg ; 76(10): 2177-2182, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29678489

RESUMEN

PURPOSE: Unilateral condylar hyperplasia or hyperactivity (UCH) is a bone overgrowth disorder affecting the mandible. The purpose of this study was to determine the relations among age, condylar bone structure, condylar bone volume, and condylar bone activity on single-photon emission computed tomographic (SPECT) scans in patients with UCH. MATERIALS AND METHODS: This study included 20 patients with a clinical presentation of progressive mandibular asymmetry and a positive bone SPECT scan. A bone SPECT-derived standardized uptake value (bSUV) for the condylar region was determined. All patients underwent condylectomy to arrest further progression of the disease. The resected condyles were scanned with a micro-computed tomographic scanner (18-µm resolution). Bone architectural parameters were calculated with routine morphometric software. RESULTS: The mean bSUV of the condyle on the affected side was 15.32 (standard deviation [SD], 8.98) compared with 9.85 (SD, 4.40) on the nonaffected side (P = .0007). For trabecular bone structure, there was a nonsignificant correlation between the SUV of the affected condyle and the measured bone volume fraction (r = 0.13; P = .58) and trabecular thickness (r = 0.03; P = .90). CONCLUSION: No meaningful relation was found between condylar bone volume fraction and condylar activity on bone scan; therefore, the impact of bone volume fraction on the results of bone scans is limited. The measured condylar activity on SPECT scan seems to be primarily a reflection of the remodeling rate of bone.


Asunto(s)
Hueso Esponjoso/diagnóstico por imagen , Hiperplasia/diagnóstico por imagen , Hiperplasia/cirugía , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/cirugía , Enfermedades Mandibulares/diagnóstico por imagen , Enfermedades Mandibulares/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Tomografía Computarizada de Emisión de Fotón Único/métodos , Adolescente , Adulto , Hueso Esponjoso/fisiopatología , Niño , Femenino , Humanos , Hiperplasia/fisiopatología , Masculino , Cóndilo Mandibular/fisiopatología , Enfermedades Mandibulares/fisiopatología , Microtomografía por Rayos X
13.
Cranio ; 36(3): 167-173, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-28234550

RESUMEN

OBJECTIVE: Bruxism-induced mechanical load causes various dental problems, and its treatment is challenging. The present study analyzed upper and lower tooth contacts to determine actual occlusal contact during sleep bruxism. METHODS: Tooth contact patterns were analyzed in 49 patients attending dental clinics, using a Bruxchecker®, cephalograms, and condylographs. RESULTS: Approximately 80% of individuals demonstrated contact from the anterior teeth to the molar region (ICPM); about 96% had mediotrusive grinding and contact. The tooth contact area increased with the flatness of the anterior occlusal plane. The ratio of the contact area of the anterior teeth to the overall tooth contact area increased with overbite. Bilateral ICPM and mediotrusive contact patterns were associated with a high frequency of temporomandibular disorder symptoms, clicking, and/or pain. DISCUSSION: The tooth contact area, anterior occlusal plane, and overbite are closely related, suggesting that tooth contact with the anterior teeth should be controlled with occlusal therapy.


Asunto(s)
Oclusión Dental , Bruxismo del Sueño/fisiopatología , Adulto , Cefalometría , Clínicas Odontológicas , Femenino , Humanos , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/fisiopatología , Bruxismo del Sueño/diagnóstico por imagen , Estrés Mecánico
14.
Cranio ; 36(1): 19-28, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28128016

RESUMEN

OBJECTIVE: To evaluate the influence of ULF-TENS on the displacement of the mandibular condyle and on the repeatability of centric relation (CR) registration of three different techniques: bimanual manipulation (BM), long strip technique, and harmonic centric occlusal relationship (R.O.C.A. wires). METHODS: Twenty-five participants without temporomandibular disorder (TMD) underwent two study stages conducted via electronic position analysis: (1) three CR records were made, one for each manipulation technique; (2) the ULF-TENS was applied for 30 min, and after that the same CR records were repeated. STATISTICAL ANALYSES: Mann-Whitney, ICC, and one-tailed F test. RESULTS: The ULF-TENS did not influence the condyle total displacement, regardless of CR recording technique used (p > 0.05). BM showed an improvement in repeatability after ULF-TENS. DISCUSSION: Concerning the variance, BM showed less variation at the X-axis. Long strip technique and R.O.C.A. wires varied less at the Y-axis. Long strip technique was again less variable at the Z-axis.


Asunto(s)
Relación Céntrica , Cóndilo Mandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/terapia , Estimulación Eléctrica Transcutánea del Nervio/métodos , Adulto , Femenino , Humanos , Registro de la Relación Maxilomandibular , Masculino , Encuestas y Cuestionarios
15.
Arch Oral Biol ; 87: 102-109, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29275153

RESUMEN

OBJECTIVE: Aging is accompanied by a series of changes in mature tissues that influence their properties and functions. Collagen, as one of the main extracellular components of cartilage, becomes highly crosslinked during aging. In this study, the aim was to examine whether a correlation exists between collagen crosslinking induced by artificial aging and mechanical properties of the temporomandibular joint (TMJ) condyle. To evaluate this hypothesis, collagen crosslinks were induced using ribose incubation. METHODS: Porcine TMJ condyles were incubated for 7 days with different concentrations of ribose. The compressive modulus and stiffness ratio (incubated versus control) was determined after loading. Glycosaminoglycan and collagen content, and the number of crosslinks were analyzed. Tissue structure was visualized by microscopy using different staining methods. RESULTS: Concomitant with an increasing concentration of ribose, an increase of collagen crosslinks was found. The number of crosslinks increased almost 50 fold after incubation with the highest concentration of ribose. Simultaneously, the stiffness ratio of the samples showed a significant increase after incubation with the ribose. Pearson correlation analyses showed a significant positive correlation between the overall stiffness ratio and the crosslink level; the higher the number of crosslinks the higher the stiffness. CONCLUSION: The present model, in which ribose was used to mimic certain aspects of age-related changes, can be employed as an in vitro model to study age-related mechanical changes in the TMJ condyle.


Asunto(s)
Envejecimiento/metabolismo , Cartílago Articular/fisiopatología , Reactivos de Enlaces Cruzados/farmacología , Cóndilo Mandibular/fisiopatología , Ribosa/farmacología , Articulación Temporomandibular/fisiopatología , Envejecimiento/patología , Animales , Fenómenos Biomecánicos , Cartílago Articular/efectos de los fármacos , Cartílago Articular/metabolismo , Técnicas In Vitro , Cóndilo Mandibular/efectos de los fármacos , Cóndilo Mandibular/metabolismo , Modelos Animales , Estrés Mecánico , Porcinos , Articulación Temporomandibular/efectos de los fármacos , Articulación Temporomandibular/metabolismo
16.
Cranio ; 36(2): 113-120, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28303737

RESUMEN

OBJECTIVE: The aim of the study was to analyze the characteristics and changes in mandibular condylar motion in patients with skeletal Class III malocclusion. METHODS: Using a 3D motion analyzer, mandibular movements were recorded in 9 patients with skeletal Class III malocclusion and 22 control subjects with Angle Class I jaw relationships. RESULTS: Class III patients had a similar interincisor point displacement but a significantly reduced displacement of both condyles on the sagittal and frontal planes, with smaller translation paths than control subjects (right -9.4 mm; left -4.8 mm). The overall condylar rotation component was larger in Class III patients (right +8.8%; left +7.3%). The largest inter-group significant differences were observed in the first 10% of mouth opening, in which Class III patients had a larger rotating component than control subjects (+20%, p < 0.01). CONCLUSIONS: Condylar motion was reduced in skeletal Class III patients, in particular in the translational path.


Asunto(s)
Maloclusión de Angle Clase III/fisiopatología , Cóndilo Mandibular/fisiopatología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Imagenología Tridimensional , Masculino , Maloclusión de Angle Clase I/fisiopatología , Persona de Mediana Edad
17.
J Oral Maxillofac Surg ; 76(2): 304-313, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29127775

RESUMEN

Temporomandibular joint (TMJ) osteoarthritis (OA) is a disease of the bone, cartilage, and supporting tissues of the joint. Patients with advanced TMJ-OA often have symptoms such as pain, swelling, and joint dysfunction, and they sometimes require surgical intervention when conservative treatment is not effective. The etiology of TMJ-OA remains elusive. The usefulness of 4-dimensional (4D) computed tomography (CT) in motion analysis of various joints has recently been reported. This article introduces a novel imaging technique of 4D CT that aims to identify kinematic features that may be associated with the etiology of TMJ-OA. In a 69-year-old female patient with severe TMJ-OA, 4D CT evaluation of condylar movement was performed. During the scan, she was instructed to masticate a cookie normally and her natural condylar movement during mastication was evaluated. The coronal 4D CT motion images showed that the synovial cavity was narrower on the affected side than on the unaffected side. Repeated friction between the articular surface of the condyle and the caudal surface of the articular eminence was observed during natural mastication. Although friction between the condyle and articular eminence has been considered a factor in the initiation and progression of TMJ-OA in previous experimental studies using animals, this is the first study to directly visualize the friction between the atrophic and flattened condylar surface and the articular eminence. Four-dimensional CT is a novel imaging technique with the potential to assess kinematic features that cannot be visualized with other imaging modalities in patients with TMJ disease.


Asunto(s)
Tomografía Computarizada Cuatridimensional , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/fisiopatología , Osteoartritis/diagnóstico por imagen , Osteoartritis/fisiopatología , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/fisiopatología , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Cóndilo Mandibular/cirugía , Osteoartritis/cirugía , Radiografía Panorámica , Rango del Movimiento Articular/fisiología , Trastornos de la Articulación Temporomandibular/cirugía
18.
Int J Oral Maxillofac Surg ; 47(1): 57-63, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28826759

RESUMEN

This study aimed to analyze the changes in mandibular morphology after bilateral mandibular distraction osteogenesis (BMDO) in children with Pierre Robin sequence. The positions of the condyles were analyzed in reconstructed three-dimensional craniomaxillofacial images obtained for 18 children before and 8-12 weeks after BMDO. Differences between pre- and postoperative parameters were assessed using paired t-tests. After surgery, a significant decrease in superior joint space was detected (P<0.05), but no change in anterior joint space or posterior joint space was observed. The ratio of the distance between gonia and distance between condylion points (GoL-GoR/CoL-CoR) (P<0.001) and the distances between the condyle and midsagittal plane (P<0.001) increased after surgery, while the condylar horizontal angle decreased (P<0.05). No change in condylar vertical angle was noted. After BMDO, the condyle displayed an outward and upward shift, as well as outward rotation along the proximal segment. The mandible body exhibited forward movement with a more significant opening range. These changes were consistent with the extent of the newly formed bone tissue and the improvement in coordination and appearance of the children's facial structures. The long-term effects of changes in condylar position on the development of the maxillofacial structures needs to be studied further.


Asunto(s)
Cóndilo Mandibular/fisiopatología , Cóndilo Mandibular/cirugía , Osteogénesis por Distracción/métodos , Síndrome de Pierre Robin/fisiopatología , Síndrome de Pierre Robin/cirugía , Femenino , Humanos , Imagenología Tridimensional , Lactante , Recién Nacido , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Síndrome de Pierre Robin/diagnóstico por imagen , Interpretación de Imagen Radiográfica Asistida por Computador , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
19.
Arch Oral Biol ; 84: 125-132, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28987725

RESUMEN

OBJECTIVE: To examine the role of mechanical force and hypoxia on chondrocytes apoptosis and osteoarthritis (OA)-liked pathological change on mandibular cartilage through over-activation of endoplasmic reticulum stress (ERS). METHODS: We used two in vitro models to examine the effect of mechanical force and hypoxia on chondrocytes apoptosis separately. The mandibular condylar chondrocytes were obtained from three-week-old male Sprague-Dawley rats. Flexcell 5000T apparatus was used to produce mechanical forces (12%, 0.5Hz, 24h vs 20%, 0.5Hz, 24h) on chondrocytes. For hypoxia experiment, the concentration of O2 was down regulated to 5% or 1%. Cell apoptosis rates were quantified by annexin V and propidium iodide (PI) double staining and FACS analysis. Quantitative real-time PCR and western blot were performed to evaluate the activation of ERS and cellular hypoxia. Then we used a mechanical stress loading rat model to verify the involvement of ERS in OA-liked mandibular cartilage pathological change. Histological changes in mandibular condylar cartilage were assessed via hematoxylin & eosin (HE) staining. Immunohistochemistry of GRP78, GRP94, HIF-1α, and HIF-2α were performed to evaluate activation of the ERS and existence of hypoxia. Apoptotic cells were detected by the TUNEL method. RESULTS: Tunicamycin, 20% mechanical forces and hypoxia (1% O2) all significantly increased chondrocytes apoptosis rates and expression of ERS markers (GRP78, GRP94 and Caspase 12). However, 12% mechanical forces can only increase the apoptotic sensitivity of chondrocytes. Mechanical stress resulted in OA-liked pathological change on rat mandibular condylar cartilage which included thinning cartilage and bone erosion. The number of apoptotic cells increased. ERS and hypoxia markers expressions were also enhanced. Salubrinal, an ERS inhibitor, can reverse these effects in vitro and in vivo through the down-regulation of ERS markers and hypoxia markers. CONCLUSION: We confirmed that mechanical stress and local hypoxia both contributed to the chondrocytes apoptosis. Mechanical stress can cause OA-like pathological change in rat mandibular condylar cartilage via ERS activation and hypoxia existed in the meantime. Both mechanical forces and hypoxia can induce ERS and cause chondrocytes apoptosis only if the stimulate was in higher level. Salubrinal can protect chondrocytes from apoptosis, and relieve OA-liked pathological change on mandibular condylar cartilage under mechanical stress stimulation.


Asunto(s)
Apoptosis/fisiología , Condrocitos/metabolismo , Estrés del Retículo Endoplásmico , Hipoxia/fisiopatología , Cóndilo Mandibular/metabolismo , Cóndilo Mandibular/fisiopatología , Estrés Mecánico , Animales , Western Blotting , Cartílago Articular/fisiopatología , Cinamatos/farmacología , Inmunohistoquímica , Etiquetado Corte-Fin in Situ , Técnicas In Vitro , Masculino , Osteoartritis/fisiopatología , Ratas , Ratas Sprague-Dawley , Reacción en Cadena en Tiempo Real de la Polimerasa , Tiourea/análogos & derivados , Tiourea/farmacología , Tunicamicina/farmacología
20.
J Appl Oral Sci ; 25(5): 483-489, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29069145

RESUMEN

OBJECTIVE: To evaluate the effect of bite positions characterizing different splint treatments (anterior repositioning and stabilization splints) on the disc-condyle relation in patients with TMJ disc displacement with reduction (DDwR), using magnetic resonance imaging (MRI). MATERIAL AND METHODS: 37 patients, with a mean age of 18.8±4.3 years (7 male and 30 females) and diagnosed with DDwR based on the RDC/TMD, were recruited. MRI metrical analysis of the spatial changes of the disc/condyle, as well as their relationships, was done in three positions: maximum intercuspation (Position 1), anterior repositioning splint position (Position 2), and stabilization splint position (Position 3). Disc/condyle coordinate measurements and disc condyle angles were determined and compared. RESULTS: In Position 1, the average disc-condyle angle was 53.4° in the 60 joints with DDwR, while it was -13.3° with Position 2 and 30.1° with Position 3. The frequency of successful "disc recapture" with Position 2 was significantly higher (58/60, 96.7%) than Position 3 (20/60, 33.3%). In Positions 2 and 3, the condyle moved forward and downward while the disc moved backward. The movements were, however, more remarkable with Position 2. CONCLUSIONS: Anterior repositioning of the mandible improves the spatial relationship between the disc and condyle in patients with DDwR. In addition to anterior and inferior movement of the condyle, transitory posterior movement of the disc also occurred.


Asunto(s)
Luxaciones Articulares/fisiopatología , Luxaciones Articulares/terapia , Cóndilo Mandibular/lesiones , Ferulas Oclusales , Disco de la Articulación Temporomandibular/lesiones , Adolescente , Adulto , Análisis de Varianza , Niño , Diseño de Equipo , Femenino , Humanos , Incisivo/fisiopatología , Luxaciones Articulares/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/patología , Cóndilo Mandibular/fisiopatología , Variaciones Dependientes del Observador , Valores de Referencia , Reproducibilidad de los Resultados , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Disco de la Articulación Temporomandibular/fisiopatología , Resultado del Tratamiento , Adulto Joven
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