Elongation of the styloid processes in kidney-transplanted patients: The role of ectopic calcification as possible cause of Eagle syndrome.

Objective: To investigate the relationship between the presence of ectopic calcification in the elongation of the styloid process (SP) and its possible clinical manifestation (Eagle syndrome) in a population of kidney-transplant patients previously treated with hemodialysis.Methods: Digital orthopantomography of 92 kidney-transplanted patients and 68 control subjects were analyzed to measure the length of SPs. Calcium, phosphate, alkaline phosphatase, and parathyroid hormone (PTH) blood levels were also available for comparison.Results: The mean length of SPs was significantly different between groups, as were phosphate and PTH values.Discussion: Renal transplant patients who have been treated with hemodialysis present elongated SPs, presumably due to alterations in phosphate balance and PTH levels. Thus, in cases of orofacial pain in patients with a history of altered bone metabolism, particularly when due to renal insufficiency, Eagle syndrome should be suspected as the main cause of symptoms.

Reliability of kinesiography vs magnetic resonance in internal derangement of TMJ diagnosis: A systematic review of the literature.

Objective: The aim of this systematic review was to evaluate the accuracy and the diagnostic reliability of kinesiography and magnetic resonance imaging (MRI) in diagnosis of patients presenting temporomandibular disorders. Methods: A literature survey carried out through PubMed, SCOPUS, LILIACS, and the Cochrane Library from the inceptions to the last access on August 18 2016 was performed to locate randomized clinical trials, controlled trials, prospective cohort studies, or retrospective studies (with or without a control group), that examined the diagnostic reliability of recording devices of mandibular movements in comparison to MRI. Results: From the results, it was found that a significant correlation between these electronic devices and MR images could not be detected in case of disc displacement. Discussion: The scientific evidence does not support the usefulness in clinical practice of the jaw-tracking devices to diagnose temporomandibular disorders because their diagnostic reliability is poor.

Orofacial pain induced by Eagle syndrome in an elderly patient with temporomandibular disorders - a case report.

BACKGROUND: Eagle syndrome (ES) is a rare disorder that can be responsible for orofacial pain. OBJECTIVE: To describe the treatment of an elderly patient affected by ES and temporomandibular disorders (TMD). MATERIALS AND METHODS: A patient complained of constant pain of the right temporomandibular joint (TMJ) and of the sensation of having a foreign body in the throat. Based on the patient's medical history and symptoms, a TMJs internal derangement and concomitant ES were suspected. A magnetic resonance and a computerised tomography confirmed the clinical diagnosis. A conservative treatment was initially performed to re-establish a functional occlusion. RESULTS: The rehabilitative treatment alleviated the pain almost totally. A slight residual uncomfortable sensation of the presence of a foreign body in the throat persisted after the oral rehabilitation but without any influence on the quality of life. CONCLUSION: In elderly patients complaining a chronic orofacial pain, the possibility of a concomitant TMD and ES has to be considered to correctly identify the source of pain. A conservative approach to identify weather TMD is the main source of pain is preferable, avoiding unnecessary invasive treatments.

Eagle's syndrome: signs and symptoms.

Eagle's syndrome, an uncommon sequela of an elongated styloid process, can manifest itself as a sensation of a foreign body in the throat and a retrogoniac or anterolateral neck pain often referred to the TMJ and the ear. When treating patients affected by temporomandibular disorders (TMD), complaining of atypical orofacial pain, and with a concomitant radiographic finding of a bilaterally elongated styloid, the possible coexistence of Eagle's syndrome should always be considered. The aim of this review is to present an overview of the epidemiology, pathophysiology, diagnosis, and therapy for Eagle's syndrome and to help the clinician in differential diagnosis with other conditions that can provide similar signs and symptoms.

Overjet and Overbite Influence on Cyclic Masticatory Movements: A CT Study.

Aim. To determine whether a relationship exists between the linear measurements of overjet and overbite and the interincisal space delimited by the morphology of the upper and lower incisors. Method and Materials. 30 subjects (age range from 14.1 to 34.8 years, with a median age of 23.5 years and sex ratio F/M: 5/10) with overjet and overbite equal to 2 mm were selected from a group of 381 individuals with a full and well-aligned dentition, no previous dental treatment, and no signs or symptoms indicative of temporomandibular disorder. Computed Tomography images of vinyl polysiloxane impressions of the 30 subjects' anterior teeth were acquired. The interincisal space was defined as Immediate Overjet Angle and was calculated on the Computed Tomography images. Results. Although the 30 subjects presented overlapping measures of overjet and overbite, the values of the Immediate Overjet Angles were different in a range of a minimum value of 12° and a maximum value of 54°. Conclusion. This study reveals that (1) only 30 (7.9%) of the 381 individuals considered have values of overjet and overbite equal to 2 mm and (2) the Immediate Overjet Angle values of the 30 subjects are not related to the values of overjet and overbite.

TMJ disorders and pain: assessment by contrast-enhanced MRI.

Though magnetic resonance (MRI) is a widely accepted standard for the assessment of patients with temporomandibular joint (TMJ) disorders, efforts to correlate symptoms to MRI findings have often given controversial results. Aim of this study was to investigate the correlation between TMJ pain and findings of contrast-enhanced MRI. Thirty-eight consecutive patients with TMJ dysfunction syndrome (study group) were examined with MRI. Protocol included T2 turbo spin-echo sequence, T1 spin-echo sequence, and T2 gradient-echo (acquired with closed jaw, at intermediate and maximal opening). Post-contrast phase was obtained through a fat sat 3D T1 gradient-echo sequence (VIBE). Post-contrast findings in the study group were matched with those obtained in a control group of 33 patients submitted to MRI of the paranasal sinuses. Statistically significant difference was found between condylar medullary bone enhancement in painful TMJ, in painless TMJ and control group. In addition the average thickness of joint soft tissue enhancement in painful TMJ was superior to painless TMJ (p<0.0001) and to control group. On multivariate logistic regression analysis, the odds ratio that a painful TMJ showed disk displacement, osteoarthrosis, effusion and JST enhancement were 3.05, 3.18, 1.2 and 11.36, respectively. Though not histologically proven, TMJ enhancement could reflect the presence of inflammation in painful joints. Furthermore, the administration of contrast could be of help for the assessment of patients with orofacial pain, particularly when clinical exploration is insufficient to ascribe the pain to TMJ.