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1.
Tokai J Exp Clin Med ; 45(3): 152-155, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901906

RESUMO

BACKGROUND: Temporomandibular joint (TMJ) dislocation can be categorized into three groups: acute, habitual or recurrent, and long-standing. Long-standing TMJ dislocation refers to a condition that persists for more than one month without reduction. Long-standing dislocation of the TMJ is rare and the most challenging and difficult to treat of the three. CASE REPORT: The present case study relates to a 53-year-old woman with long-standing TMJ dislocation of a year's duration who presented for treatment. Due to this condition, she was unable to take food orally, and nutrition was managed by gastrostomy tube feeding. She also suffered from schizophrenia and had been admitted to a closed hospital. Bilateral mandibular condylectomy was performed, restoring oral function. However, post-reduction, an open bite remained, restricting the types of food that she could eat. Additional intermaxillary fixation and intermaxillary traction would have been required for an optimal outcome, but they were not possible for this patient. CONCLUSION: Despite an inability to provide comprehensive treatment, due to patient-related factors, occlusal and masticatory functions were restored to adequate levels following bilateral condylectomy alone. This enabled oral feeding and improved her quality of life.


Assuntos
Ingestão de Alimentos , Luxações Articulares/cirurgia , Côndilo Mandibular/cirurgia , Mastigação , Boca/fisiopatologia , Recuperação de Função Fisiológica , Articulação Temporomandibular/cirurgia , Feminino , Humanos , Luxações Articulares/fisiopatologia , Pessoa de Meia-Idade , Qualidade de Vida , Articulação Temporomandibular/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
2.
Yonsei Med J ; 61(4): 331-340, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32233176

RESUMO

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.


Assuntos
Condrócitos/efeitos dos fármacos , Hormônio do Crescimento/administração & dosagem , Fator de Crescimento Insulin-Like I/administração & dosagem , Osteoartrite/tratamento farmacológico , Articulação Temporomandibular/efeitos dos fármacos , Idoso , Animais , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/patologia , Hormônio do Crescimento/efeitos adversos , Hormônio do Crescimento Humano , Humanos , Injeções Intra-Articulares , Masculino , Osteoartrite/diagnóstico por imagem , Osteoartrite/patologia , Ratos , Líquido Sinovial , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/fisiopatologia , Microtomografia por Raio-X
3.
BMC Oral Health ; 20(1): 93, 2020 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228551

RESUMO

BACKGROUND: Intra-articular disorders (ID) or anterior and/or medial displacement of the temporomandibular joint disorder (TMJ) disc are the most common form of TMJ dysfunction (TMD). TMD causes changes in the friction coefficient during TMJ movement. Herein, we provided a three-dimensional (3D) finite-elements model (FEM) including the maxilla, disc, and mandible and evaluated the stress distribution with different friction coefficient. METHODS: Fourteen volunteers without TMD and 20 patients with MRI-diagnosed TMD were selected. CT and MRI data were collected to build the 3D FEA model of the mandible and TMJ disc. Stress distribution with different friction coefficient was measured. RESULT: In the normal model, stress distribution on the TMJ disc was 2.07 ± 0.17, 1.49 ± 0.14, and 1.41 ± 0.14 MPa with 0.001, 0.3, and 0.4 friction coefficient, respectively. In the TMD model, stress distribution was 3.87 ± 0.15, 7.23 ± 0.22, and 7.77 ± 0.19 MPa respectively. CONCLUSION: When the friction coefficient of the side with anterior displacement increased, stress on the disc, condyle and mandible of the opposite side increased. Simultaneously, stress values of the disc, condyle and mandible were higher than those of the normal lateral joint.


Assuntos
Luxações Articulares/fisiopatologia , Disco da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/fisiopatologia , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Análise de Elementos Finitos , Humanos , Luxações Articulares/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Articulação Temporomandibular/diagnóstico por imagem , Disco da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/fisiopatologia , Tomografia Computadorizada por Raios X , Adulto Jovem
4.
Niger J Clin Pract ; 23(3): 376-380, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32134038

RESUMO

Background: There are important criteria in the diagnosis of temporomandibular disorders (TMDs). These become significant if supported by magnetic resonance imaging (MRI). Otherwise, these findings alone may not be sufficient to diagnose TMD. Aim: This study compared the relationship between clinical findings indicated by patient and physician and MRI results in the diagnosis of TMD. Materials and Methods: Clinical examinations were performed in patients suspected of TMD for pain, difficulty in mouth opening, masticatory muscle tenderness, deviation (during mouth opening), normal mouth opening, and presence of bruxism. The MRI findings of the patients were compared with the clinical examinations. Results: MRI and clinical examination data of 136 patients were examined. The results showed significant correlations between deviation, normal mouth opening, and MRI results of TMD (P < 0.05). No correlation was found between age groups and clinical findings of TMD. TMJ was determined in normal limits in 61% of MRI results. Conclusions: Except for deviation and normal mouth opening, complaints and clinical findings determined by the clinicians do not support TMD. This may be due to the subjective nature of the clinical findings, and MRI results are needed for precise results.


Assuntos
Imagem por Ressonância Magnética , Transtornos da Articulação Temporomandibular , Articulação Temporomandibular , Bruxismo , Humanos , Dor , Exame Físico , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/fisiopatologia
5.
Cell Prolif ; 53(4): e12755, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32154622

RESUMO

OBJECTIVES: Ageing could be a contributing factor to the progression of temporomandibular joint osteoarthritis (TMJ OA), whereas its pathogenesis and potential therapeutic strategy have not been comprehensively investigated. MATERIALS AND METHODS: We generated ageing mouse models (45-week and 60-week; 12-week mice as control) and intermittently injected 45-week mice with parathyroid hormone (PTH(1-34)) or vehicle for 4 weeks. Cartilage and subchondral bone of TMJ were analysed by microCT, histological and immunostaining. Western blot, qRT-PCR, ChIP, ELISA and immunohistochemical analysis were utilized to examination the mechanism of PTH(1-34)'s function. RESULTS: We showed apparent OA-like phenotypes in ageing mice. PTH treatment could ameliorate the degenerative changes and improve bone microarchitecture in the subchondral bone by activating bone remodelling. Moreover, PTH inhibited phosphorylation level of Smad3, which can combine with p16ink4a gene promoter region, resulting in reduced senescent cells accumulation and increased cellular proliferation of marrow mesenchymal stem cells (MSCs). ELISA also showed relieved levels of specific senescent-associated secretory phenotype (SASP) in ageing mice after PTH treatment. CONCLUSIONS: In summary, PTH may reduce the accumulation of senescent cells in subchondral bone by inhibiting p16ink4a and improve bone marrow microenvironment to active bone remodelling process, indicating PTH administration could be a potential preventative and therapeutic treatment for age-related TMJ OA.


Assuntos
Hormônios e Agentes Reguladores de Cálcio/uso terapêutico , Osteoartrite/tratamento farmacológico , Hormônio Paratireóideo/uso terapêutico , Articulação Temporomandibular/efeitos dos fármacos , Envelhecimento , Animais , Células Cultivadas , Modelos Animais de Doenças , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Osteoartrite/patologia , Osteoartrite/fisiopatologia , Osteogênese/efeitos dos fármacos , Articulação Temporomandibular/patologia , Articulação Temporomandibular/fisiopatologia
6.
Int J Med Sci ; 17(2): 153-160, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32038098

RESUMO

Aims: Systemic Lupus Erythematosus (SLE) is a connective tissue disease characterized by a wide range of pleomorphic pictures, including mucocutaneous, renal, musculoskeletal and neurological symptoms. It involves oral tissues, with hyposalivation, tooth decay, gingivitis, angular cheilitis, ulcers and glossitis. Temporomandibular disorders represent a heterogeneous group of inflammatory or degenerative diseases of the stomatognatic system, with algic and/or dysfunctional clinical features involving temporomandibular joint (TMJ) and related masticatory muscles. The aim of this study was to investigate the prevalence of oral manifestations and temporomandibular disorders (TMD) in SLE patients (Lp) compared with a control group. Methods: Fifty-five patients (9 men and 46 women) with diagnosed Lupus were recruited in the study group. A randomly selected group of 55 patients, matched by sex and age, served as control group. The examination for TMD symptoms and signs was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a questionnaire and clinical examination. Results: Lupus patients complained more frequently (95.8%) of oral and TMJ symptoms (dysgeusia, stomatodynia, masticatory muscle pain during function, neck and shoulder muscles pain and presence of tinnitus) but only xerostomia (χ2=4,1548 p=0,0415), temple headache (χ2=4,4542 p=0,035) and the sensation of a stuck jaw (Mid-p-test p=0,043) were significant. About signs, cheilitis (p=0,0284) oral ulcers (χ2=4,0104 p=0,045) and fissured tongue are significantly more frequent in study group. The salivary flow was significantly decreased in the study group respect to the control one (p<0.0001). As regard to the oral kinematics, restricted movements (RM) in protrusion and left lateral movement were significantly different between study group and controls. In particular, 85,2% of Lp showed limited protrusion versus 56,4% of controls (χ2= 10,91 p<0,001); 59,3% of Lp had also a limitation during left lateral movement versus 47,3% of controls (T=2,225 p=0,0282). About bruxism, only the indentations on the lateral edges of the tongue were found in Lp group (72,7%), with a significant difference respect to controls (χ2=7,37 p=0,007). Conclusions: While masticatory muscles have an overlapping behavior in both groups, the findings collected show a more severe TMJ kinematic impairment in Lp than in controls, with protrusion and left lateral movements significantly different. In addition, a remarkable reduction of salivary flow has been detected in Lp compared to controls. In conclusion, this autoimmune disease seems to play a role in oral manifestations and TMJ disorders, causing an increase in orofacial pain and an altered chewing function.


Assuntos
Bruxismo/fisiopatologia , Dor Facial/fisiopatologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Adulto , Bruxismo/complicações , Bruxismo/diagnóstico , Dor Facial/complicações , Dor Facial/diagnóstico , Feminino , Cefaleia/complicações , Cefaleia/fisiopatologia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Masculino , Mastigação , Músculos da Mastigação/fisiopatologia , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Inquéritos e Questionários , Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico , Doenças Dentárias/complicações , Doenças Dentárias/diagnóstico , Doenças Dentárias/fisiopatologia , Xerostomia/complicações , Xerostomia/diagnóstico , Xerostomia/fisiopatologia
8.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 808-814, 2019 Dec 09.
Artigo em Chinês | MEDLINE | ID: mdl-31874479

RESUMO

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.


Assuntos
Má Oclusão/terapia , Ortodontia Corretiva , Transtornos da Articulação Temporomandibular/etiologia , Humanos , Gestão de Riscos , Articulação Temporomandibular/fisiopatologia
9.
Rev Prat ; 69(4): 432-437, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-31626502

RESUMO

Temporo-mandibular disorders -TMD- involve a whole set of anatomical, physiological and clinical disorders that exceed by far the sole temporo-mandibular joint. The main symptom of this condition, most frequent in female patients, is pain. Three syndromes are associated with TMD: a muscular syndrome, not only involving masticatory muscles but also muscles of the neck and pain in seemingly unrelated anatomical regions, which can be misleading; an inflammatory articular syndrome; a mechanical syndrome affecting mouth-opening path. The main treatment of this very common and benign disorder is based on physical therapy. However, physicians should be warned that some patients might exhibit similar symptoms in rare cases of malignant tumor.


Assuntos
Transtornos da Articulação Temporomandibular , Articulação Temporomandibular/fisiopatologia , Diagnóstico Diferencial , Feminino , Humanos , Músculos da Mastigação/patologia , Dor , Articulação Temporomandibular/fisiologia , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/terapia
10.
West Afr J Med ; 36(3): 262-266, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622489

RESUMO

BACKGROUND: Concern over the impact of playing wind instruments on the stomatognathic system has increased in the last few decades with many health practitioners attending to an increasing number of musical instrument players. OBJECTIVE: This study assessed the effects of playing wind musical instruments on the temporomandibular joints (TMJ) of male Nigerian adults. METHODS: This was a descriptive cross-sectional study which was conducted in the Dental clinic of Aminu Kano Teaching Hospital, Kano. Fifty male Wind Instrument Players (WIPs) were recruited for the study and compared with fifty non-Wind Instrument Players (non-WIPs) of the same age, gender and environment. The temporomandibular dysfunction was assessed in both groups using Helkimo index. Reliability test demonstrated an excellent intra-rater correlation (Cronbach's Alpha; 0.98). Data was analyzed using SPSS version 17 and statistical significance set at p<0.05. RESULTS: The majority of participants in the WIP group (32, 64%) had mild to severe anamnestic dysfunction score compared with (20, 40.0%) in the non-WIP group. The difference between the two groups was statistically significant (p<0.05). The class of instruments played, number of years and frequency of play had a significant negative impact on the anamnestic dysfunction of the TMJ with statistically significant difference (p<0.05). No statistically significant differences in clinical dysfunction scores were observed in the two groups (p>0.05). CONCLUSIONS: Playing wind instruments including the class of instrument, number of years and frequency of playing affected the TMJ function, especially anamnesis. Clinical dysfunction was not affected by playing wind instruments.


Assuntos
Música , Doenças Profissionais/etiologia , Transtornos da Articulação Temporomandibular/etiologia , Articulação Temporomandibular/fisiopatologia , Adolescente , Adulto , Estudos Transversais , Humanos , Masculino , Nigéria/epidemiologia , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/fisiopatologia
12.
Med Hypotheses ; 130: 109280, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31383322

RESUMO

There is large support in literature linking tinnitus to dental occlusion and temporomandibular joint disorders (TMD). However, there is no model to explain such a link. This hypothesis explains how the fusimotor system of the muscles innervated by the trigeminal motor nucleus is affected by inadequacies in the occlusion of the teeth that cause changes in posture and movement of the mandible. Reptile to mammal evolution shows that stomatognathic structures underwent changes related to mastication. Among several changes, there was the appearance of a new articulation between the mandible and skull: the temporomandibular joint. The bones of the old reptile joint, quadrate-articular, have detached from the mandible and are part of the middle ear bone chain. The former becomes the incus and the latter the malleus. This bone change also carried the tensor tympani and its trigeminal motor innervation. Inadequate occlusal contacts give rise to an adapted function of the mandible and the most common compensatory muscular response is hypertonia involving all mandibular muscles, including the tensor tympani. A fundamental clinical feature that demonstrates the involvement of the trigeminal fusimotor system is the characteristic pain by palpation, but no pain on the mandibular movement. Muscle pain is always felt in the dermatome innervated by the mandibular branch of the trigeminal nerve, which carries the motor fibers, reported as tightening, similar to cramp, and has regular behavior in intensity, duration and frequency. In addition, the patient has increased musculature volume, detected by palpation of certain anatomical landmarks, but with loss of functional efficiency. The neuromotor control of the mandibular movements is poor and when asked to make lateral jaw movement touching the teeth, it is common to observe that the patient moves the lips, eyes, and even turns the head in the same direction as the movement. There is also difficulty eating hard foods and talking fast. Tongue biting while chewing is frequent, meaning that these non-physiological events surpass protective reflex circuits. The report of ear pain, tinnitus, blocked ear sensation and sudden hearing loss is common in such patients, compatible with the tonic contraction of the tensor tympani. The fusimotor system hypothesis is able to explain all events related to the symptoms and helps to establish a correct diagnosis for certain types of hearing disorders.


Assuntos
Oclusão Dentária , Transtornos da Articulação Temporomandibular/complicações , Articulação Temporomandibular/fisiopatologia , Zumbido/etiologia , Evolução Biológica , Humanos , Hipercinese , Mandíbula/fisiopatologia , Mastigação , Modelos Teóricos , Movimento , Músculo Temporal/patologia , Tensor de Tímpano , Dente/fisiopatologia , Núcleo Motor do Nervo Trigêmeo
13.
East Asian Arch Psychiatry ; 29(1): 20-25, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31237253

RESUMO

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.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/psicologia , Idoso , Transtornos de Ansiedade/psicologia , Comorbidade , Depressão , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Côndilo Mandibular/fisiopatologia , Prevalência , População Rural/estatística & dados numéricos , Fatores Sexuais , Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , População Urbana/estatística & dados numéricos , Vietnã/epidemiologia
14.
J Appl Oral Sci ; 27: e20180510, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31166550

RESUMO

INTRODUCTION: Intermaxillary fixation (IMF) is a classic method for immobilization of the mandible after mandibular fractures and corrective surgery. However, it has been suggested that IMF may be a risk for developing temporomandibular joint (TMJ)-related symptoms, especially when applied for longer periods. OBJECTIVE: To evaluate the clinical function of TMJs and masticatory muscles 10-15 years after mandibular setback surgery and subsequent six weeks of IMF. The patients' self-reported TMJ and masticatory muscle symptoms were also addressed. METHODOLOGY: Thirty-six patients (24 women and 12 men) treated with intraoral vertical ramus osteotomies and subsequent six weeks of IMF, underwent a clinical examination of TMJs and masticatory muscles 10-15 years after surgery and completed a five-item structured questionnaire reporting subjective TMJ-related symptoms. Mean age by the time of clinical examination was 34.1 years (range 27.2-59.8 years). The clinical outcome was registered according to the Helkimo clinical dysfunction index. Descriptive and bivariate statistics were performed and level of significance was set to 5%. RESULTS: Mean maximum unassisted mouth opening 10-15 years after surgery was 50.1 mm, (range 38-70 mm, SE 1.2), statistically significantly greater in men compared to women (p=0.004). Mean Helkimo dysfunction group was 1.5 (range 1-3, SE 0.10). Eighty-one percent experienced pain on palpation in either the masseter muscle, temporal muscle or both, and 31% experienced pain when moving the mandible in one or more directions. Thirty-one percent reported pain from palpating the TMJs. In the questionnaire, none reported to have pain during chewing or mouth opening on a weekly or daily basis, but 22% reported difficulties with maximum opening of the mouth. CONCLUSION: Ten to fifteen years after mandibular setback surgery the patient's mandibular range of movement is good. Despite clinically recognizable symptoms, few patients reported having TMJ- or masticatory muscle-related symptoms in their daily life.


Assuntos
Técnicas de Fixação da Arcada Osseodentária/efeitos adversos , Má Oclusão de Angle Classe III/cirurgia , Músculos da Mastigação/fisiopatologia , Maxila/cirurgia , Transtornos da Articulação Temporomandibular/fisiopatologia , Articulação Temporomandibular/fisiopatologia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Má Oclusão de Angle Classe III/fisiopatologia , Maxila/fisiopatologia , Pessoa de Meia-Idade , Mialgia/fisiopatologia , Valores de Referência , Autorrelato , Estatísticas não Paramétricas , Transtornos da Articulação Temporomandibular/etiologia , Fatores de Tempo , Resultado do Tratamento
15.
Neurosci Lett ; 707: 134301, 2019 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-31152853

RESUMO

We previously demonstrated that sodium channel 1.7 (Nav1.7) in trigeminal ganglion (TG) was a critical factor in temporomandibular joint (TMJ) inflammation-induced hypernociception, but the mechanism underlying inflammation-induced upregulation of Nav1.7 remained unclear. Glial-neuron interaction plays a critical role in pain process and connexin 43 (Cx43), a gap junction protein expressed in satellite glial cells (SGCs) has been shown to play an important role in several pain models. In the present study, we investigate the role of Cx43 in TMJ inflammation-induced hypernociception and its possible impact on neuronal Nav1.7. We induced TMJ inflammation in rats by injecting complete Freund's adjuvant (CFA) into TMJ and observed a decrease in head withdraw threshold after 24 h. Electron microscopy showed morphological alterations of SGCs in TMJ-inflamed rats. The expression of Cx43, glial fibrillary acidic protein (GFAP), and Nav1.7 increased greatly compared with controls. In addition, pretreatment with Cx43 blockers in TMJ-inflamed rats could alleviate mechanical hypernociception, inhibit SGCs activation and IL-1ßrelease, and thus block the upregulation of Nav1.7. These findings indicate that the propagation of SGCs activation via Cx43 plays a critical role in Nav1.7-involved mechanical hypernociception induced by TMJ inflammation.


Assuntos
Conexina 43/metabolismo , Hiperalgesia/fisiopatologia , Canal de Sódio Disparado por Voltagem NAV1.7/metabolismo , Nociceptividade , Articulação Temporomandibular/metabolismo , Gânglio Trigeminal/metabolismo , Animais , Conexina 43/antagonistas & inibidores , Hiperalgesia/etiologia , Hiperalgesia/metabolismo , Inflamação/complicações , Inflamação/fisiopatologia , Masculino , Ratos Sprague-Dawley , Articulação Temporomandibular/fisiopatologia
16.
J Plast Reconstr Aesthet Surg ; 72(8): 1265-1271, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31060989

RESUMO

INTRODUCTION: The nerve-to-masseter is one of the most frequently used neural sources in smile reanimation surgery. Very little information has been reported on patient experience with regard to reanimated smile usage and sequelae following transfer. The aim of this study was to quantify patient perception of nerve-to-masseter use in smile reanimation surgery. METHODS: An online questionnaire was developed based on the clinical expertise of our team, patient interviews, and existing questionnaires of facial palsy-related quality of life and temporomandibular joint dysfunction. All patients treated with nerve-to-masseter-driven smile reanimation surgery, both nerve transfers and muscle transplantations, between 2007 and 2016 with a valid email address were invited to participate. RESULTS: Of 171 operated patients, 122 with a valid email address were invited to participate. Seventy-one patients responded (63.4% female, mean age 51.1 years) after a median follow-up of 3.8 years. A voluntary smile while biting down at least "most of the time" was reported by 83.1% of patients; 46.5% reported ability to smile on the affected side without bite. A "normal" or "almost normal" spontaneous smile was reported in 23.9% of patients. A total of 18.3% of patients self-reported masseter muscle atrophy, and 1.4-14.1% reported temporomandibular joint dysfunction. Forty-one patients (57.7%) reported prandial movement of the face at least "most of the time," with 9 patients (12.7%) considering this bothersome. CONCLUSION: Patients report good voluntary smiling ability following nerve-to-masseter-driven smile reanimation surgery, with low rates of sequelae.


Assuntos
Paralisia Facial/fisiopatologia , Paralisia Facial/cirurgia , Músculo Grácil/transplante , Nervo Mandibular/fisiologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Sorriso/fisiologia , Feminino , Seguimentos , Músculo Grácil/inervação , Músculo Grácil/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Atrofia Muscular , Transferência de Nervo , Medidas de Resultados Relatados pelo Paciente , Complicações Pós-Operatórias , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Articulação Temporomandibular/fisiopatologia
17.
Medicine (Baltimore) ; 98(6): e14391, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30732181

RESUMO

INTRODUCTION: Temporomandibular disorder (TMD) is considered the main cause of orofacial pain of non-dental origin, and a public health problem. The symptomatology is muscular and/or articular pain, restriction of the mandibular range of motion, and changes in the mandibular movement pattern. Due to its complexity there are already treatments using various forms of therapy. Photobiomodulation using light sources, such as low-level laser or light emitting diodes (LED), with different wavelengths, in a single or combined form, allows one more therapeutic resource to be explored. The objective of this study is to evaluate the effects of photobiomodulation with the simultaneous use of red and infrared LEDs, on pain, range of mandibular movements, and on the electrical activity of masticatory muscles in individuals with TMD. METHODS: A randomized, controlled, double-blind clinical trial is proposed, which will involve 33 individuals (n = 11 per group) of both sexes, ages 18 to 45 years in 3 groups: LED group; placebo group; and control group, submitted to 6 non-consecutive sessions of photobiomodulation totaling 2 weeks of treatment. The Research Diagnostic Criteria for Temporomandibular Disorders-RDC/TMD will be used to assess and determine the participants' TMD. The pain will be assessed using the Visual Analog Scale - VAS, the mandibular range of motion will be determined with the aid of a digital caliper, and the electrical activity of the masticatory muscles will be verified by electromyography. A mixed plate of 18 red LEDs-660 nm and 18 infrared LEDs-850 nm with power of 3.5 mW per LED, 4.45 mW/cm, radiant exposure of 5.35 J/cm, will be used for photobiomodulation. The irradiated area will be 14.13 cm, and energy of 75.6 J, in the TMJ region and in the bilateral masseter and temporal muscles. Participants from all groups will be reassessed after the first therapeutic intervention, and at the end of treatment. DISCUSSION: We expect the use of photobiomodulation with LEDs, infra and red, to reduce pain, improve temporomandibular joint function in patients with TMD, and thus improve the general conditions of the patient.


Assuntos
Raios Infravermelhos/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos da Articulação Temporomandibular/radioterapia , Adolescente , Adulto , Método Duplo-Cego , Eletromiografia , Feminino , Humanos , Masculino , Mandíbula/fisiopatologia , Músculos da Mastigação/fisiopatologia , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
18.
J Craniomaxillofac Surg ; 47(3): 438-442, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30709759

RESUMO

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.


Assuntos
Côndilo Mandibular/anatomia & histologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Articulação Temporomandibular/fisiopatologia , Adolescente , Adulto , Idoso , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Feminino , Humanos , Masculino , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/fisiopatologia , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Transtornos da Articulação Temporomandibular/patologia , Adulto Jovem
19.
J Bodyw Mov Ther ; 23(1): 148-152, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30691742

RESUMO

Temporomandibular disorders (TMD) may present with diverse signs and symptoms, and one very significant is the limitation of mandibular movements. Additionally, the Helkimo indices allow for the reliable quantification of the signs and symptoms of TMD. The purpose of this study was to ascertain whether there are any correlations between the Helkimo indices and the maximal mandibular excursion capacity in a group of patients with TMD. Eighty patients (72 women and 8 men, mean age 33.6 years) with diagnosis of TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were evaluated to obtain the Helkimo indices and their maximal mandibular excursion capacities. Normal or decreased maximum mandibular movements, i.e., opening, lateral and protrusion were compared with the anamnestic index, muscular pain symptoms, joint pain symptoms and the dysfunction index. Chi-squared analysis was used to compare normal and decreased movement capacities in terms of the Helkimo indices, and the muscle and temporomandibular joint (TMJ) pain. The statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 19.0. There were statistically significant differences in the clinical dysfunction index with the maximum opening (p = .011) and lateral movements (p = .024) but not with the maximum protrusion. There were no significant differences in the anamnestic index or the muscle pain and TMJ pain items of the clinical dysfunction index according to the mandibular excursions. The occurrences of limitations in the maximum opening and lateral movements are indications of greater TMD intensity.


Assuntos
Movimento/fisiologia , Índice de Gravidade de Doença , Transtornos da Articulação Temporomandibular/fisiopatologia , Articulação Temporomandibular/fisiopatologia , Adulto , Avaliação da Deficiência , Feminino , Humanos , Masculino , Amplitude de Movimento Articular/fisiologia
20.
Int J Rheum Dis ; 22(4): 636-645, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30666791

RESUMO

INTRODUCTION: The subject of the present study was a systematic comparative analysis of the rheumatoid arthritis (RA)-induced pathomechanisms in the temporomandibular joint with those of the limb joints using the serum-induced arthritis K/BxN model. METHODS: In 18 BALB/c mice the induction of RA was performed according to the Kouskoff method. Another healthy cohort served as controls (n = 12). Joint swelling of the paws was measured using a micrometer. Functional data were obtained analyzing locomotion. Three-dimensional examination of the temporomandibular joint was performed with micro-computed tomography imaging, followed by histological evaluation of the extremity joints and the temporomandibular joint. Additionally, immunohistochemical investigations were carried out to evaluate inflammatory and immunological changes. RESULTS: Measurement of joint swelling showed a significant increase in the diameter of the paws, as well as a decrease in locomotor activity compared to control animals and the time before arthritis induction. Histological and immunohistochemical investigations showed clear signs of inflammation in the extremity joints. In contrast, no histological or immunohistochemical indications of an inflammatory process were detectable in the temporomandibular joint. In addition, the three-dimensional analysis by micro-computed tomography of the temporomandibular joints did not show any obvious morphological changes. CONCLUSION: For the first time, using the K/BxN model we could demonstrate that, due to its anatomical and mechanical conditions, the temporomandibular joint seems to be less susceptible to the initiation of RA compared to limb joints. Therefore, additional investigations are needed on other arthritis models as well, in order to further improve our understanding of the pathogenesis and defense mechanisms of the disease.


Assuntos
Artrite Experimental/fisiopatologia , Articulações do Pé/fisiopatologia , Locomoção , Articulação Temporomandibular/fisiopatologia , Animais , Artrite Experimental/sangue , Artrite Experimental/diagnóstico por imagem , Artrite Experimental/imunologia , Autoanticorpos/sangue , Autoanticorpos/imunologia , Citocinas/sangue , Citocinas/imunologia , Articulações do Pé/diagnóstico por imagem , Articulações do Pé/imunologia , Glucose-6-Fosfato Isomerase/imunologia , Imuno-Histoquímica , Camundongos Endogâmicos BALB C , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/imunologia , Microtomografia por Raio-X
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