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1.
BMJ Case Rep ; 14(5)2021 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-34059547

RESUMEN

Intracranial extension of acquired cholesteatoma is a rare occurrence that can develop secondary to trauma, chronic otitis media or acquired aural cholesteatoma. The most commonly observed symptoms are headache and hearing loss. The authors report on a rare case of intracranial cholesteatoma presenting with atypic symptoms: swelling and temporomandibular joint disorders.


Asunto(s)
Colesteatoma del Oído Medio , Pérdida Auditiva , Otitis Media , Trastornos de la Articulación Temporomandibular , Colesteatoma del Oído Medio/complicaciones , Colesteatoma del Oído Medio/diagnóstico por imagen , Colesteatoma del Oído Medio/cirugía , Humanos , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/etiología , Trismo/etiología
2.
BMC Oral Health ; 21(1): 211, 2021 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-33902543

RESUMEN

BACKGROUND: Temporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters. METHODS: A total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components. RESULTS: The overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008). CONCLUSION: Dental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.


Asunto(s)
Estudiantes de Odontología , Trastornos de la Articulación Temporomandibular , Estudios Transversales , Dolor Facial/epidemiología , Dolor Facial/etiología , Femenino , Humanos , Arabia Saudita/epidemiología , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología
3.
Nutrients ; 13(4)2021 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-33919716

RESUMEN

BACKGROUND AND AIMS: Vitamin D is synthesized in the skin with the aid of ultraviolet-B radiation, playing a variety of roles in the body. Temporomandibular disorders (TMDs) are a group of pathological conditions involving the temporomandibular joints as well as the masticatory muscles and othersurrounding tissues. In the present narrative review, we investigated the potential role of vitamin D in the etiology of temporomandibular disorders in order todetermine whether the current knowledge supports 25-hidroxyvitamin D (25-OHD) supplementation in temporomandibular disorders associated with insufficient or deficient levels of vitamin D. METHODS: A literature research was performed in PubMed, Scopus, Science Direct, and Google Scholar databases, and a total of 10 articles were included for analysis. RESULTS: Among the observational studies published to date, investigating the role for vitamin D in the etiology of TMDs, six of them suggest that there is a connection between the two aspects. In this context, patients suffering from TMD, with deficient levels of vitamin D (<30 ng/mL), are most likely to benefit from supplementation, whereas individuals with vitamin D level >50ng/mL probably have little benefit from supplementation. CONCLUSION: Vitamin D might be a safe, simple, and potentially beneficial way to prevent TMDs or to reduce pain; however, more randomized and placebo-controlled trials are required before any firm conclusions can be drawn.


Asunto(s)
Suplementos Dietéticos , Músculos Masticadores/fisiopatología , Trastornos de la Articulación Temporomandibular/dietoterapia , Deficiencia de Vitamina D/dietoterapia , Vitamina D/análogos & derivados , Humanos , Estudios Observacionales como Asunto , Trastornos de la Articulación Temporomandibular/sangre , Trastornos de la Articulación Temporomandibular/etiología , Trastornos de la Articulación Temporomandibular/fisiopatología , Resultado del Tratamiento , Vitamina D/administración & dosificación , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/diagnóstico
4.
Angle Orthod ; 91(3): 377-383, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33534890

RESUMEN

OBJECTIVES: To determine the prevalence and severity of temporomandibular disorders (TMDs) in prospective orthodontic patients. The association between TMDs and malocclusion severity as well as the impact of TMDs on oral health-related quality of life (OHRQoL) were also examined. MATERIALS AND METHODS: A total of 350 consecutive patients seeking orthodontic treatment were invited to participate in the study. The presence of TMDs was established with the Fonseca Anamnestic Index (FAI), while malocclusion severity and OHRQoL were evaluated using the Peer Assessment Rating (PAR) index and Oral Health Impact Profile-14 (OHIP-14), respectively. Data were analyzed using chi-square, Kruskal-Wallis, and Mann-Whitney U tests and Spearman's correlation (P < .05). RESULTS: Of the 350 patients, 164 consented to participation. Data from 26 participants were excluded because of incomplete entries, and that from 138 subjects (mean age 21.02 ± 5.45 years) were examined. TMD-related symptoms were present in two-thirds of the subjects, with 20.3% experiencing moderate/severe TMDs. While no significant difference in PAR scores were observed between the group with no TMDs and those with TMDs, subjects with TMDs had significantly higher OHIP-14 summary/domain scores than those without TMDs. Although a moderately strong correlation was observed between the FAI and summary OHIP-14 scores (rs = 0.57), no association was observed between FAI and PAR index scores. CONCLUSIONS: The prevalence of TMD-related symptoms in prospective orthodontic patients was high, emphasizing the importance of screening the masticatory system before initiating orthodontic therapy. Although the presence of TMDs was not associated with malocclusion severity, it had a significant negative impact on OHRQoL.


Asunto(s)
Maloclusión , Trastornos de la Articulación Temporomandibular , Adolescente , Adulto , Humanos , Maloclusión/epidemiología , Salud Bucal , Estudios Prospectivos , Calidad de Vida , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología , Adulto Joven
5.
Artículo en Inglés | MEDLINE | ID: mdl-33530378

RESUMEN

Osteogenesis imperfecta is a heterogeneous group of hereditary disorders of connective tissue diseases characterized by increased bone fragility, low growth, sometimes accompanied by abnormalities within the dentine, blue sclera, and partial or total hearing impairment. The changes may affect all joints, including the cervical spine and temporomandibular joints in the future, resulting in pain. The aim of the present study was to assess whether there is a relationship between the active range of motion of the cervical spine and the mobility of temporomandibular joints due to differential diagnosis in children with osteogenesis imperfecta, and to present a prevention algorithm for temporomandibular disorders. The study involved a group of 34 children with osteogenesis imperfecta, and the control group included 23 children (age 9.1 ± 3.8 years). Data were collected through an interview based on the author's questionnaire, and the physical examination consisted in measuring the mobility of the cervical spine using an inclinometer (Cervical Range of Motion Instrument), the Helkimo scale, and linear measurements. In children with congenital bone fragility, there were acoustic symptoms from the temporomandibular joints more often than in healthy children. A correlation was found between the mobility of the cervical spine and temporomandibular joints in the study group. In the case of detecting irregularities in the temporomandibular joints, children were ordered to perform jaw-tongue coordination exercises.


Asunto(s)
Osteogénesis Imperfecta , Trastornos de la Articulación Temporomandibular , Vértebras Cervicales , Niño , Preescolar , Humanos , Osteogénesis Imperfecta/diagnóstico , Proyectos Piloto , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología
6.
Int J Clin Pract ; 75(5): e13961, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33387380

RESUMEN

BACKGROUND: Temporomandibular disorders (TMD) are the most common orofacial impairment, but the relevance of certain clinical features in TMD is not clear. OBJECTIVE: The main objective of this study was to analyse if temporomandibular disorders (TMD) are associated with sociodemographic (eg age, height, weight, body mass index and gender), psychological (eg anxiety and depression) and clinical features (eg use of dental splints, orthodontics, retainers, bruxism, sleep disturbance, familiar prior history of TMD and dental occlusion). METHODS: An observational study was conducted to calculate the correlation of TMD, as assessed with DC/TMD criteria, with sociodemographic, psychological and clinical features on 59 voluntary subjects with TMD (n = 45) and without TMD (n = 14). Sex, height, weight, body mass index, age, use of dental splint, orthodontics, retainers, parafunctional disorders, sleep disturbance, familiar history of TMD, bruxism, anxiety, stress and dental occlusion class data were included in a multivariable correlation analysis to determine which variables are associated with TMD and bruxism. RESULTS: TMD was found to be correlated with none of the features assessed (P > .05), but a negative correlation with the use of dental splint (P < .05). Dental occlusion class showed no statistically significant correlation with any assessed feature (P > .05). CONCLUSION: The etiology of TMD is not clear and considering certain clinical features including dental occlusion are not justified in the evidence-based TMD practice for making irreversible occlusal treatment decisions.


Asunto(s)
Bruxismo , Trastornos de la Articulación Temporomandibular , Ansiedad , Humanos , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología
7.
J Oral Rehabil ; 48(5): 632-642, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33474771

RESUMEN

OBJECTIVE: To determine the prevalence of temporomandibular disorders (TMD) in musicians. MATERIALS AND METHODS: Electronic database searches and a manual search were performed. Qualitative and quantitative analysis including risk of bias was performed for studies that met the inclusion criteria. A meta-analysis of proportions with a random effects model was performed, and heterogeneity was explored according to the moderating variable through subgroup analysis and metaregression. The certainty of the evidence was assessed using the GRADE tool. RESULTS: A total of 13 articles were included for the meta-analysis. Pooled prevalence estimate was 52.8% (CI 95%; 33.4%-71.7%) for wind instruments, 53.9% (CI 95%; 42.4%-65.2%) for string instruments and 53.9% (CI 95%; 23.5%-82.7%) for string and wind instruments. The average time of use of the musical instrument explained 82.38%, the heterogeneity between the sizes of the effects observed in the analysis (R2  = 82.38%; P < .0001). For prevalence of TMD, the GRADE criteria were considered very low. CONCLUSION: The overall combined prevalence of TMD in musicians was approximately 53.9%, and musicians who use their instruments daily and for a long period of time may have a higher prevalence of TMD. CLINICAL SIGNIFICANCE: Due to the high prevalence of TMD in musicians, health professionals must be careful not to underestimate signs and symptoms and correctly diagnose these cases.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Humanos , Prevalencia , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología
8.
Int J Oral Maxillofac Surg ; 50(5): 665-669, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33309472

RESUMEN

The aim of this study was to investigate the contributing factor of impaired skeletal quality in the pathogenesis of idiopathic condylar resorption (ICR). One hundred and twenty-six patients with MRI-confirmed ICR and 596 patients with disc displacement (DD) without a diminished condyle, of both sexes, were included. Dental examinations and retrospective surveys regarding temporomandibular joint symptoms and progression of maxillofacial deformities were conducted. Skeletal bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) and converted to T-scores and Z-scores. Results showed that ICR patients had a smaller overbite (1.56±3.3 vs 3.05±2.0mm), larger overjet (4.9±2.4 vs 3.5±1.9mm), larger range of mouth opening (36.5±6.7 vs 33.6±7.1mm), and higher rates of anterior open bite and mandibular retrusion compared to DD patients (all P<0.001). ICR was associated with an increased probability of low skeletal BMD at chronological age in females (P=0.020) but not in males (P=0.095). This study indicates that reduced BMD may predispose females to an exacerbated condylar resorption process in addition to increased joint loading initiated from DD.


Asunto(s)
Resorción Ósea , Trastornos de la Articulación Temporomandibular , Densidad Ósea , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/etiología , Femenino , Humanos , Masculino , Cóndilo Mandibular/diagnóstico por imagen , Estudios Retrospectivos , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/etiología
9.
Rev. Ateneo Argent. Odontol ; 63(2): 28-33, nov. 2020. tab, graf
Artículo en Español | LILACS | ID: biblio-1150550

RESUMEN

El objetivo de este estudio es determinar la frecuencia y características del edentulismo parcial y patologías de la articulación temporomandibular en pacientes adultos. Se realizó un estudio observacional y descriptivo de pacientes que concurrieron al Módulo de Odontología Rehabilitadora de la Facultad de Odontología, se seleccionaron 60 pacientes que necesitaban rehabilitación protésica parcial. Las variables estudiadas fueron: edad, sexo, clase de Kennedy, dolor articular, ruidos articulares, restricción y desviación mandibulares. Los datos fueron cargados en una base de datos diseñada a tal efecto, para su análisis estadístico. Del análisis del estudio se observó ausencia parcial de piezas dentarias con mayor frecuencia en el sexo femenino (58%), el 52% correspondieron a la clase I de Kennedy: el 64% en el maxilar inferior, el 17% presentó dolor articular, 28% ruidos articulares, 68% presentó desviación mandibular (siendo lo más frecuente hacia la derecha), y el 42% presentó restricción mandibular leve y solo un n=1, grave. Las pérdidas de las piezas dentarias bilaterales posteriores del maxilar inferior son las de mayor frecuencia asociado a patologías frecuentes del ATM. Partiendo desde la prevención, evitando las pérdidas de piezas dentarias y con una correcta rehabilitación se podrá lograr una buena salud bucodental (AU)


The objective of this study is to determine the frequency and characteristics of partial edentulism and pathologies of the temporomandibular joint in adult patients. An observational and descriptive study of patients who attended the Rehabilitation Dentistry Module of the Faculty of Dentistry was carried out; 60 patients who needed partial prosthetic rehabilitation were selected. The variables studied were age, sex, Kennedy class, joint pain, joint noises, mandibular restriction, and mandibular deviation. The data were loaded into a database designed for this purpose, for statistical analysis. From the analysis of the study, partial absence of teeth was observed with greater frequency in females (58%), 52% corresponded to Kennedy Class I: 64% in the lower jaw, 17% presented joint pain, 28 % joint noises, 68% presented mandibular deviation being the most frequent to the right, 42% presented mild mandibular restriction and only one n = 1 severe. Loss of the posterior bilateral teeth of the lower jaw are the most frequent associated with frequent TMJ pathologies. Starting from prevention, avoiding the loss of teeth and with correct rehabilitation, good oral health can be achieved (AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Trastornos de la Articulación Temporomandibular/etiología , Arcada Parcialmente Edéntula/patología , Argentina , Facultades de Odontología , Epidemiología Descriptiva , Artralgia , Estudio Observacional
10.
Scand J Rheumatol ; 49(4): 271-280, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32757729

RESUMEN

OBJECTIVE: To study the proportion of patients with temporomandibular joint (TMJ) involvement among patients with juvenile idiopathic arthritis (JIA), as well as associated clinical characteristics and signs/symptoms. METHOD: We performed a retrospective chart review on consecutive patients followed in the Hamburg Centre for Paediatric and Adolescent Rheumatology Eilbek between January 2010 and July 2012. TMJ involvement was diagnosed based on clinical examination; a subgroup of patients was also assessed by magnetic resonance imaging (MRI). RESULTS: The study included 2413 patients with JIA (52.1% girls, mean age at JIA onset 9.5 years). The most frequent JIA category was oligoarthritis (46.6%), followed by enthesitis-related arthritis (ERA; 38.1%). TMJ involvement was diagnosed in 843/2413 patients (34.9%) (677 MRI-confirmed, four not MRI-confirmed, no MRI examination in 162). Female gender (p = 0.017), higher number of additional joints with active arthritis (p < 0.001), anti-nuclear antibody (ANA) positivity (p = 0.005), higher age (p = 0.020), and oligoarthritis (persistent and extended; p = 0.043) were significantly associated with TMJ involvement. Human leucocyte antigen-B27-positive patients were less likely to have TMJ involvement (p = 0.023). Pain on palpation and pain while chewing were statistically significantly associated with TMJ involvement (p = 0.008 and p = 0.020, respectively). CONCLUSIONS: Based on our findings, to identify TMJ involvement special attention should be paid to JIA patients with female gender, ANA positivity, and oligoarthritis, as well as those with a higher number of additional joints with active arthritis; and regular examinations of the TMJ should be performed.


Asunto(s)
Artritis Juvenil/complicaciones , Trastornos de la Articulación Temporomandibular/etiología , Adolescente , Artritis Juvenil/diagnóstico por imagen , Niño , Preescolar , Femenino , Alemania/epidemiología , Humanos , Imagen por Resonancia Magnética , Masculino , Estudios Retrospectivos , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/epidemiología
11.
Reumatol. clín. (Barc.) ; 16(4): 262-271, jul.-ago. 2020. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-194952

RESUMEN

OBJETIVO: Caracterizar las afecciones orofaciales en pacientes con artritis reumatoide (AR) y compararlas con las presentes en pacientes sin la enfermedad de la ciudad de Chihuahua, Chihuahua, México. MÉTODOS: El estudio incluyó a 30 pacientes con diagnóstico de AR y 30 pacientes consecutivos en una consulta de odontología. A través de una revisión clínica odontológica, se compararon entre los grupos variables relacionadas con: 1) trastornos clínicos y radiográficos de la articulación temporomandibular, 2) análisis biomecánico craneocervical, 3) estado de la dentición y necesidades de tratamiento, 4) estado periodontal, 5) estado de higiene oral y 6) dolor facial. Además se determinó la asociación entre las variables estudiadas a través de pruebas de correlación. RESULTADOS: Los pacientes con AR tuvieron una mayor prevalencia de alteraciones en la articulación temporomandibular, tanto clínicas (100 vs. 60%; p < 0,001) como radiográficas incluyendo erosiones (50 vs. 16; p = 0,010), en comparación con la población de referencia. Además los pacientes con AR tuvieron mayor cantidad de pérdidas dentales (6,9±5,7 vs. 3±2; p = 0,001), caries (13,4±5,4 vs. 4,9±6,5; p = 0,001), periodontitis (1,3±0,9 vs. 0,8±0,8; p = 0,015), higiene oral deficiente (43,3 vs. 13,3%; p = 0,005) y más dolor facial (66,7 vs. 20%; p < 0,001). El análisis de cefalometría de Rocabado mostró diferencias en el ángulo craneocervical y triángulo hioideo entre AR y controles. Se obtuvieron correlaciones significativas entre las alteraciones orales y las temporomandibulares. CONCLUSIONES: Los pacientes con AR mostraron un mayor deterioro orofacial, lo que refleja la importancia de atención multidisciplinaria incluyendo la evaluación odontológica periódica


OBJECTIVE: To characterize the orofacial abnormalities in patients with rheumatoid arthritis (RA) and compare them with those in a reference population. METHODS: The study included 30 RA patients and 30 consecutive patients in an odontology clinic in whom RA was ruled out. Patients underwent a clinical dental examination which included: 1) clinical and radiographic abnormalities of the temporomandibular joint; 2) biomechanical craniocervical analysis; 3) state of dentition and treatment needs; 4) periodontal status; 5) oral hygiene status; and 6) facial pain, which was compared among study groups. In addition, the association between the variables studied was determined through correlation tests. RESULTS: Patients with RA showed a higher prevalence of temporomandibular abnormalities, both clinical (100.0% vs. 60.0%, P<.001) and radiographic, including erosions (50.0% vs. 16.0%, P=.010), compared with individuals in the control group. Likewise, patients with RA had a greater number of missing teeth (6.9±5.7 vs. 3.0±2.0, P=.001), more caries (13.4±5.4 vs. 4.9±6.5, P=.001), periodontitis (1.3±0.9 vs. 0.8±0.8, P=.015), poorer oral hygiene (43.3% vs. 13.3%, P=.005) and greater facial pain (66.7% vs. 20.0%, P <.001). The cephalometric analysis of Rocabado showed differences in the craniocervical angle and hyoid triangle between RA and controls. Significant correlations were obtained between oral and temporomandibular abnormalities. CONCLUSIONS: Patients with RA showed a greater orofacial deterioration, which reflects the importance of multidisciplinary care, including periodic dental examination


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Artritis Reumatoide/complicaciones , Trastornos de la Articulación Temporomandibular/etiología , Enfermedades Periodontales/etiología , Índice CPO , Factores Socioeconómicos , México
13.
J Stomatol Oral Maxillofac Surg ; 121(5): 563-568, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32151696

RESUMEN

Diagnosis classification system of Temporomandibular disorders (TMD) is based on the biopsychosocial model of pain. The pathogenesis is poorly understood, leading to difficulties in treating these multifactorial conditions. The predisposing factors are pathophysiological, psychological or structural processes that alter the masticatory system and lead to an increase in the risk of development of TMD. The purpose of this integrative review was then to point out the specific mechanisms of TMD in the oral oncologic context to optimize the TMJ functional results in the management of patients with oral oncologic conditions. We explored in this paper the role of Axis II assessment of the biopsychosocial model of pain, the involvement of mechanical concepts such as dental occlusion, mandibular condyle positioning and related-structures reconstruction, and the stomatognathic changes induced by radiation.


Asunto(s)
Neoplasias de Cabeza y Cuello , Trastornos de la Articulación Temporomandibular , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/epidemiología , Humanos , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología
14.
Pediatr Rheumatol Online J ; 18(1): 10, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-32005249

RESUMEN

BACKGROUND: Juvenile idiopathic arthritis (JIA) can cause osseous deformity in the temporomandibular joint (TMJ) and may impair mandibular growth. This study aimed to evaluate whether facial asymmetry determined clinically or by morphometric analysis of three-dimensional (3D) photographs in JIA patients is associated with an asymmetric affection of theTMJ. METHODS: Of 76 consecutive JIA patients with a mean age of 11.7 years (range: 6.3-17.9), facial asymmetry was evaluated clinically (chin asymmetry, gonion asymmetry), and stereophotogrammetrically with 3D photographs. The facial surfaces were demarcated, then mirrored, superimposed using semi-automated landmarks, and quantitatively assessed (chin asymmetry, Hausdorff distances). Clinical and digital measurements were related to the diagnosis of right and left TMJ involvement derived from magnetic resonance images (MRI). RESULTS: Twenty-seven (34%) patients had an asymmetrical osseous deformity of the TMJ. By clinical evaluation, chin asymmetry was related to asymmetrical osseous destruction (p = 0.02), but gonion asymmetry was not (p = 0.14). In regard to 3D-photograph based morphometric measurements, chin asymmetry was also related to asymmetrical osseous destruction (p = 0.01), but neither the mean (p = 0.06) nor the maximal Hausdorff distance (p = 0.67). Despite the attested significance, none of the chin asymmetry evaluation methods appeared to hold sufficient predictive value (positive predictive values ≤54%; coefficient of determination ≤7%). CONCLUSIONS: For the assessment of facial asymmetry in JIA patients, morphometric measurements originating from 3D-photographs seem to deliver results comparable to the clinical assessment methods. The asymmetry of the face, especially around the chin, appears to be related to asymmetrical TMJ destruction, but none of the investigated measurement methods of the face were able to reliably predict the TMJ affection. Thus, facial asymmetry assessments, both qualitatively in a clinical setting and quantitatively based on 3D-photographs, have limited diagnostic value for TMJ involvement in JIA patients.


Asunto(s)
Artritis Juvenil/complicaciones , Asimetría Facial/etiología , Trastornos de la Articulación Temporomandibular/etiología , Adolescente , Artritis Juvenil/diagnóstico por imagen , Artritis Juvenil/patología , Niño , Asimetría Facial/diagnóstico por imagen , Asimetría Facial/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Fotogrametría/métodos , Estudios Retrospectivos , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/patología
15.
J Stomatol Oral Maxillofac Surg ; 121(5): 517-522, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31904532

RESUMEN

INTRODUCTION: The aim of this experimental study was to investigate, under the premise of discectomy, whether damage to either the fibrous layer of the condyle or that of the glenoid fossa, could induce temporomanibular joint (TMJ) ankylosis. And if not, which of the fibrous layer was more important in the genesis of TMJ ankylosis. MATERIALS AND METHODS: Bilateral TMJ surgery was performed in 6 growing Xiao-wei Han sheep. Disk and condylar fibrous layer removal (DCFLR) was performed on the left TMJ, and disk and glenoid fibrous layer removal (DGFLR) was performed on the right TMJ. All animals were sacrificed at 3 months postoperatively. The TMJ complexes were examined by histological evaluation. RESULTS: Partial fibrous ankylosis was achieved on the DCFLR side in the 6 sheep at 3 months after surgery. On the DGFLR side, pathologic characteristics of TMJ osteoarthritis could be seen; however, no evidence of ankylosis was observed. The scores of TMJ ankylosis for the DGFLR side were significantly lower than those for the DCFLR side (P<0.05). CONCLUSION: This study demonstrated that removal of the condylar fibrous layer, not the glenoid fibrous layer, combined with discectomy could lead to traumatic TMJ ankylosis.


Asunto(s)
Cavidad Glenoidea , Trastornos de la Articulación Temporomandibular , Anquilosis del Diente , Animales , Cavidad Glenoidea/cirugía , Humanos , Cóndilo Mandibular/cirugía , Ovinos , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/etiología , Trastornos de la Articulación Temporomandibular/cirugía
16.
Rev Med Interne ; 41(1): 50-53, 2020 Jan.
Artículo en Francés | MEDLINE | ID: mdl-31474430

RESUMEN

INTRODUCTION: Langerhans cell histiocytosis (HL) is a rare disease that can affect all tissues. Oral manifestations such as mucosal ulcer and tooth mobility are often the first signs of the disease. We report a rare case of mandibular condyle unifocal HL mimicking a temporomandibular joint disorder. CASE REPORT: A 44-year-old patient presented with a left temporomandibular disorder with painful left preauricular swelling. The imaging assessment found a bone lesion of the left mandibular condyle. A curettage with biopsy was used to diagnose HL. Six months later, the patient had no more pain. DISCUSSION: The craniofacial clinical expressions of HL mainly concern the bones, which can cause: pain, swelling, fracture, compression of noble organs. The other sites are: oral cavity, skin, lymph nodes, or eyes. Isolated forms are generally benign, and their treatment is discussed between abstention and non-aggressive surgery.


Asunto(s)
Histiocitosis de Células de Langerhans/diagnóstico , Cóndilo Mandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/etiología , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Osteólisis/diagnóstico por imagen , Osteólisis/etiología , Radiografía Panorámica
17.
Surg Radiol Anat ; 42(3): 337-346, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31538248

RESUMEN

PURPOSE: The purpose of the current study is twofold. First, to investigate the variability of the petrotympanic fissure's (PTF) morphology in anatomized human cadaveric specimens using multi-detector computed tomography (MDCT), and second, to compare the resulting measurements to investigate the possibilities of applying MDCT in the determination of PTF morphology in living humans. METHODS: Specimens (n = 15) containing the temporal bone and TMJ were obtained from embalmed adult female (53.3%) and male (46.7%) cadavers and imaged using a helical 16-row scanner. Afterwards, cryosections were obtained and morphometric parameters were measured. Degree of agreement between both determinations was investigated and morphometric variables were also compared between PTF types. RESULTS: Three different types of PTF were identified. Type 1 was a wide tunnel-shaped structure. It was found in 20% of the cases. Type 2 was wide in the entrance but gradually narrows to the tympanic cavity. It was found in 46.7% of specimens. Finally, type 3, which was observed in 33.3% of the cases, was wide at the entrance of the mandibular fossa, followed by a middle region with flat-shaped tunnel structure and a narrow exit. The PTF's vertical diameters at the mandibular fossa, midpoint, and tympanic cavity and the width at the mandibular fossa all were significantly greater in type 1 specimens. CONCLUSIONS: MDCT is suitable for investigating the variable morphology of human PTF and its association with middle ear's and TMJ pathologies.


Asunto(s)
Variación Anatómica , Hueso Temporal/anatomía & histología , Tomografía Computarizada por Rayos X/instrumentación , Anciano , Anciano de 80 o más Años , Cadáver , Enfermedades del Oído/diagnóstico , Enfermedades del Oído/etiología , Estudios de Factibilidad , Femenino , Humanos , Masculino , Hueso Temporal/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/etiología
18.
Arthritis Care Res (Hoboken) ; 72(7): 907-916, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-30973675

RESUMEN

OBJECTIVE: To estimate the cumulative incidence of arthritis-induced orofacial symptoms, dysfunction, and dentofacial deformities in growing individuals with juvenile idiopathic arthritis (JIA) in a 36-month regional cohort study and to identify predictors for the development of arthritis-induced dentofacial deformities. METHODS: Data were retrieved from the Aarhus JIA temporomandibular joint (TMJ) cohort register, which contains standardized, longitudinal, observational data regarding orofacial conditions in patients with JIA (n = 1,040). This regional cohort represents the majority of all subjects with JIA from the western part of Denmark between 1990 and 2016, regardless of TMJ arthritis status. Cumulative incidences of orofacial conditions were reported using Kaplan-Meier methods, and predictors for dentofacial deformity were identified using Cox proportional hazards analysis. RESULTS: Follow-up data from 351 subjects for 36 months were included in this study. Median age at first clinical examination was 6.6 years (interquartile range 4.8-9.9 years). Orofacial symptoms and dysfunctions were common findings at 36 months after the first clinical examination and 5 years after JIA onset, with a cumulative incidence of 38% and 53%, respectively. Dentofacial deformities were found in 35% of subjects at the 36-month follow-up and were significantly associated with the presence of orofacial dysfunction. CONCLUSION: Orofacial conditions were frequently observed in individuals with JIA and were represented in all JIA subcategories in this regional study. One-third of subjects had arthritis-induced dentofacial deformities that required orthopedic appliance treatment at the 36-month follow-up.


Asunto(s)
Artritis Juvenil/complicaciones , Trastornos de la Articulación Temporomandibular/epidemiología , Trastornos de la Articulación Temporomandibular/etiología , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Incidencia , Masculino
19.
Arthritis Care Res (Hoboken) ; 72(8): 1057-1065, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-31207153

RESUMEN

OBJECTIVE: Sjögren's syndrome (SS) induces difficulty in chewing and swallowing due to low salivary flow. However, these symptoms may be associated with other factors, such as orofacial myofunctional disorders and temporomandibular disorder (TMD), which have not been comprehensively assessed in this population. The aims of this study were to investigate orofacial muscles and functions as well as the presence of TMD in patients with SS compared with a group without SS and to analyze whether the patients' experience of limitations in orofacial functioning is associated with the orofacial functional status and muscle pain related to TMD. METHODS: Women with SS based on the 2002 American-European Consensus Group criteria and volunteers paired by age and sex were compared. The examinations included the orofacial myofunctional evaluation with scores (OMES) protocol, tongue and lip strength measures, and electromyography of the masticatory muscles. TMD investigations included clinical examination, self-report of symptoms, and assessment according to the Jaw Functional Limitation Scale. RESULTS: Patients with SS present with impaired muscle and orofacial functions based on lower scores of all categories of OMES (P < 0.0001), tongue strength (P = 0.0003-0.0004), and masticatory muscle activity (P = 0.0002-0.007), as well as worse TMD signs and symptoms (P < 0.05) and jaw functional limitation (P < 0.0001-0.0003). CONCLUSION: Patients' experiences with limitation in mastication and swallowing were associated with orofacial myofunctional status and muscle pain related to TMD. Those disorders should be monitored along with disease control and must be addressed in the clinical evaluation to prevent nutritional and metabolic comorbidities in patients with SS.


Asunto(s)
Discinesias/etiología , Enfermedades Musculares/etiología , Síndrome de Sjögren/complicaciones , Síndrome de Sjögren/fisiopatología , Trastornos de la Articulación Temporomandibular/etiología , Adolescente , Adulto , Estudios de Casos y Controles , Estudios Transversales , Deglución/fisiología , Músculos Faciales/fisiopatología , Femenino , Humanos , Masticación/fisiología , Músculos Masticadores/fisiopatología , Persona de Mediana Edad , Adulto Joven
20.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 808-814, 2019 Dec 09.
Artículo en Chino | MEDLINE | ID: mdl-31874479

RESUMEN

Temporomandibular joint (TMJ) related signs and symptoms are frequently found in adolescent and adult orthodontic patients. TMJ health has long been considered important in orthodontic treatment for many decades, and routine screening and management of TMJ problems should be emphasized in orthodontic population. This paper was to review the TMJ problems in orthodontic patients and to set the strategy in clinical orthodontics.


Asunto(s)
Maloclusión/terapia , Ortodoncia Correctiva , Trastornos de la Articulación Temporomandibular/etiología , Humanos , Gestión de Riesgos , Articulación Temporomandibular/fisiopatología
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