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Journal articles on the topic 'Articular disks position'
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Tanne, Kazuo, Yuki Okamoto, Shao-Ching Su, Tomomi Mitsuyoshi, Yuki Asakawa-Tanne, and Kotaro Tanimoto. "Current status of temporomandibular joint disorders and the therapeutic system derived from a series of biomechanical, histological, and biochemical studies." APOS Trends in Orthodontics 5 (December 29, 2014): 4–21. http://dx.doi.org/10.4103/2321-1407.148014.
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This article was designed to report the current status of temporomandibular joint disorders (TMDs) and the therapeutic system on the basis of a series of clinical, biomechanical, histological and biochemical studies in our research groups. In particular, we have focused on the association of degenerative changes of articular cartilage in the mandibular condyle and the resultant progressive condylar resorption with mechanical stimuli acting on the condyle during the stomatognathic function. In a clinical aspect, the nature and prevalence of TMDs, association of malocclusion with TMDs, association of condylar position with TMDs, association of craniofacial morphology with TMDs, and influences of TMDs, TMJ-osteoarthritis (TMJ-OA) in particular, were examined. In a biomechanical aspect, the nature of stress distribution in the TMJ from maximum clenching was analyzed with finite element method. In addition, the pattern of stress distribution was examined in association with varying vertical discrepancies of the craniofacial skeleton and friction between the articular disk and condyle. The results demonstrated an induction of large compressive stresses in the anterior and lateral areas on the condyle by the maximum clenching and the subsequent prominent increases in the same areas of the mandibular condyle as the vertical skeletal discrepancy became more prominent. Increase of friction at the articular surface was also indicated as a cause of larger stresses and the relevant disk displacement, which further induced an increase in stresses in the tissues posterior to the disks, indicating an important role of TMJ disks as a stress absorber. In a histological or biological aspect, increase in TMJ loading simulated by vertical skeletal discrepancy, which has already been revealed by the preceding finite element analysis or represented by excessive mouth opening, produced a decrease in the thickness of cartilage layers, an increase in the numbers of chondroblasts and osteoclasts and the subsequent degenerative changes in the condylar cartilage associated with the expression of bone resorption-related factors. In a biochemical or molecular and cellular aspect, excessive mechanical stimuli, irrespective of compressive or tensile stress, induced HA fragmentation, expression of proinflammatory cytokines, an imbalance between matrix metalloproteinases and the tissue inhibitors, all of which are assumed to induce lower resistance to external stimuli and degenerative changes leading to bone and cartilage resorption. Excessive mechanical stimuli also reduced the synthesis of superficial zone protein in chondrocytes, which exerts an important role in the protection of cartilage and bone layers from the degenerative changes. It is also revealed that various cytoskeletal changes induced by mechanical stimuli are transmitted through a stretch-activated or Ca2+ channel. Finally, on the basis of the results from a series of studies, it is demonstrated that optimal intra-articular environment can be achieved by splint therapy, if indicated, followed by occlusal reconstruction with orthodontic approach in patients with myalgia of the masticatory muscles, and TMJ internal derangement or anterior disk displacement with or without reduction. It is thus shown that orthodontic treatment is available for the treatment of TMDs and the long-term stability after treatment.
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Novikov, V. M., M. A. Korostashova, V. I. Dodatko, O. S. Svyryda, and Ya O. Yushchenko. "THE ROLE OF MAGNETIC RESONANCE RESEARCH IN THE TREATMENT OF DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT." Ukrainian Dental Almanac, no. 2 (June 29, 2021): 59–63. http://dx.doi.org/10.31718/2409-0255.2.2021.11.
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The main criterion for diagnosis of dysfunctional conditions of the temporomandibular joint is the visualization of the intra-articular cartilaginous disc. The method of diagnosis, that the most perfectly determines the disorders in the temporomandibular joint, particular the displacement of the menisci, is magnetic resonance imaging. So, the aim of the work was to determine the amplitude of anterior displacements of the menisci in patients suffering from dysfunction of the temporomandibular joint using magnetic resonance imaging.
In 20 patients, who underwent magnetic resonance imaging, different amplitudes of the anterior displacements of the meniscus were determined. Patients were divided into groups. The first group included 6 patients who were diagnosed by MRI the anterior displacement of the disc to the center of the articular head. The second group included 4 patients who had anterior displacement of the disc to the center of the articular head by 2/3 of its own length. Ten patients of the third group had a displacement of the meniscus to the center of the articular head by 1/2 of its own length. For the future treatment of TMJ dysfunction, the distance of the pathological displacement of the meniscus determines the degree of occlusion. All patients were prescribed a Michigan-splint occlusal splint in combination with a sling-like head cap at night. The results of the selected treatment were interpreted after 3-6 months.
A series of magnetic resonance imaging has described the articular fissures of the temporomandibular joint, articular discs (their shape in frontal projection and on parasagittal sections), posterior ligaments, and lateral pterygoid muscles. Each of the joints was carefully examined in the case when the mouth is closed and open. During the MRI description, the shape of the joint heads and their possible pathological changes were determined. In the position of the closed or open mouth, the positions of each of the discs and their poles relatively to the articular head in centimeters were compared, and the movement of the menisci was described. The sizes of disks of the closed and open mouth were defined. The study protocol also reported the shape and amplitude of the movements of the articular heads.
Treatment was planned according to the selected protocol. For the first group of patients diagnosed with anterior meniscus dislocation, treatment was planned by separating the occlusion to the relatively physiological rest of the mandible (2 - 4 mm). The patients of the second group, in which anterior displacements of the disc relatively to the articular head by 2/3, were treated with detachment of the occlusion to contact with the cutting edge of the teeth of the upper and lower jaws. For the third patients’ group with diagnosed anterior displacement of the meniscus by 1/2, treatment was performed with a separation of the bite on 2 - 4 mm above the contact with the cutting edges of the front teeth. The main criterion for recovery is the complete disappearance of symptoms of dysfunction, even without the use of a splint.
At the first stage of treatment the task was the following: reconstruction of a myotatic reflex by means of the medical and diagnostic occlusal splint "Michigan-splint" completed with the main slingshot cap. Patients were monitored monthly. The main problems were the following: after a week of using the structure the patients complained of increased salivation, muscle pain and burning, headache, which disappeared after approximately 3 weeks. The main cause of such phenomena is the physiological rearrangement of the muscular reflex, which involves a certain tension in the muscles and irritation of the nerve endings in the muscles due to changes in the usual occlusion. During planned examination, the patients demonstrated supercontacts followed by cap correction. In 3 or 6 months of using the Michigan-splint occlusal splint, patients noted a significant improvement and they didn’t have any complaints. The main criterion for recovery is the complete disappearance of symptoms of dysfunction, even without the use of a splint. Therefore, the next stage of treatment depended on the anatomical and functional changes of TMJ and consolidation of therapeutic effect was been necessary.
Therefore, the use of magnetic resonance imaging of the temporomandibular joint to determine the amplitude of the displacements of the discs, ensures the effectiveness of the selected treatment.
Prospects for further research include improvement of the MRI protocol and its correlation with definite symptoms, the distance of the vertical separation of occlusal surfaces, and the introduction of the protocol into practical health care.
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Giannini, Silvana, Giorgio Chiogna, Rosario Francesco Balzano, and Giuseppe Guglielmi. "Dynamic Weight-bearing Magnetic Resonance in the Clinical Diagnosis of Internal Temporomandibular Joint Disorders." Seminars in Musculoskeletal Radiology 23, no. 06 (November 19, 2019): 634–42. http://dx.doi.org/10.1055/s-0039-1697938.
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AbstractTemporomandibular joint (TMJ) disorders can be painful and cause functional limitations and bone changes. Deeper clinical knowledge of the pathologies related to the TMJ has always been hindered by the difficult identification of the causes that limit its movement. Weight-bearing magnetic resonance imaging (WBMRI) can reproduce the articular movement in orthostasis and allows the evaluation of joint movement. WBMRI, compared with other procedures such as double-type condylography and real-time dynamic ultrasound, helps to better identify tissue characteristics of the articular glenoid-condylar surfaces, articular space, disk position on both the open and closed mouth, and the locoregional musculotendinous area. WBMRI also identifies the true position of the articular disk in orthostasis, emphasizing the different joint positions compared with the study carried out in a clinostatic (supine) position.
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de Mello Provenzano, Marcia, Israel Chilvarquer, and Marlene Fenyo-Pereira. "How Should the Articular Disk Position Be Analyzed?" Journal of Oral and Maxillofacial Surgery 70, no. 7 (July 2012): 1534–39. http://dx.doi.org/10.1016/j.joms.2011.08.004.
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Kawakami, Masayoshi, Kazuhiko Yamamoto, Tomohiro Inoue, Atsuhisa Kajihara, Masaki Fujimoto, and Tadaaki Kirita. "Disk Position and Temporomandibular Joint Structure Associated with Mandibular Setback in Mandibular Asymmetry Patients." Angle Orthodontist 79, no. 3 (May 1, 2009): 521–27. http://dx.doi.org/10.2319/040708-199.1.
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Abstract Objective: To determine the changes in articular disk position and the temporomandibular joint (TMJ) structure in patients who had an asymmetric setback of the mandible performed by a bilateral sagittal split ramus osteotomy with manual positioning of the condyle. Materials and Methods: Twenty-two patients with skeletal Class III malocclusion being treated at Nara Medical University Hospital were evaluated using clinical examination and pre- and postoperative magnetic resonance images of their TMJs. Results: Changes in articular disk position after asymmetric setback surgery were not statistically significant, although a tendency of anterior displacement in the fossa was noted. The anterior and posterior joint spaces did not show significant changes, whereas the condyle head of the deviated or contralateral side tended to be positioned downward. Conclusion: The asymmetric setback of the mandible with intraoperative manual positioning of the condyle does not significantly change the disk position in the fossa.
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Pancherz, Hans, Sabine Ruf, and Christine Thomalske-Faubert. "Mandibular articular disk position changes during Herbst treatment: A prospective longitudinal MRI study." American Journal of Orthodontics and Dentofacial Orthopedics 116, no. 2 (August 1999): 207–14. http://dx.doi.org/10.1016/s0889-5406(99)70219-2.
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Christiansen, Edwin L., Joseph R. Thompson, Grenith Zimmerman, David Roberts, Anton N. Hasso, David B. Hinshaw, and Sigvard Kopp. "Computed tomography of condylar and articular disk positions within the temporomandibular joint." Oral Surgery, Oral Medicine, Oral Pathology 64, no. 6 (December 1987): 757–67. http://dx.doi.org/10.1016/0030-4220(87)90182-4.
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John, Zynul Ali Sirsmith, Sunita S. Shrivastav, Ranjit Kamble, Eshita Jaiswal, and Rajasbala Dhande. "Three-dimensional comparative evaluation of articular disc position and other temporomandibular joint morphology in Class II horizontal and vertical cases with Class I malocclusion:." Angle Orthodontist 90, no. 5 (May 19, 2020): 707–14. http://dx.doi.org/10.2319/121519-801.1.
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ABSTRACT Objective To evaluate and compare articular disk position, condylar position, and joint spaces in Class II vertical, Class II horizontal, and Class I cases. The purpose was to assess the potential for development of temporomandibular disorders (TMDs) in the three groups. Materials and Methods A sample of 75 cases, 25 cases in each group of Class I, Class II vertical, and Class II horizontal, were selected based on inclusion and exclusion criteria. Magnetic resonance imaging (MRI) assessments were made with a 1.5-Tesla basic system with a closed-mouth technique for evaluating articular disk position in the sagittal and transverse planes, condylar position, and joint spaces in the sagittal plane. Philips 3.0 software was used to analyze the MR images. Results There was evidence of alterations in the temporomandibular joint (TMJ) morphology in both Class II vertical and Class II horizontal cases, with maximum discrepancy in Class II vertical cases. MRI evaluation suggested a tendency for antero-medial disk displacement with anteriorly positioned condyles in Class II vertical cases. The discrepancy was milder in the Class II horizontal group. Conclusions Class II vertical cases are more susceptible to the development of TMDs and should be subjected to TMJ evaluation before starting any orthodontic treatment to intercept and prevent a mild asymptomatic TMD from developing into a more severe form. Class II vertical cases should be subjected to MRI evaluation before starting any orthodontic treatment.
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Garcia, Alicio Rosalino, Sérgio Folli, Paulo Renato Junqueira Zuim, and Valdir de Sousa. "Mandible protrusion and decrease of TMJ sounds: an electrovibratographic examination." Brazilian Dental Journal 19, no. 1 (2008): 77–82. http://dx.doi.org/10.1590/s0103-64402008000100014.
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This study quantified by, electrovibratography, the amount of mandible protrusion required to decrease significantly temporomandibular joint (TMJ) vibratory energy as an aid in the diagnosis of the recapture of anteriorly displaced disk. Eighteen patients diagnosed as having anterior disk displacement with reduction and TMJ clicking were submitted to electrovibratographic examination at the first appointment and treated with a stabilizing appliance and anterior positioning appliance with 1 to 5 mm protrusion. Vibratory energy was checked in each of these positions. Baseline data were used as control. At the first appointment, the patients had vibrations with more elevated intensities at the middle and late phases of the mouth opening cycle. At only one clinical step, mandible protrusion was obtained with the anterior repositioning appliance, ranging from 1 to 5 mm protusion. At each new position, a new electrovibratographic exam was made. After the 5-mm mandibular projection, only 2 patients presented vibration, with means between 0.6 and 2.8 Hz. Data were analyzed statistically by ANOVA and Tukey's test (alpha=0.05). The outcomes of this study indicate that 3 mm is the minimum amount of mandible protrusion to significantly decrease the TMJ vibratory energy and to recapture the displaced articular disk.
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Ilyin, A., T. Fazylova, A. Dergilev, A. Sudarkina, E. Olesov, and V. Olesova. "Radiation Diagnostics in Treatment of Displacement of a Joint Disk of a Temp-Jaw Joint and Myofascial Disorders." Medical Radiology and radiation safety 66, no. 3 (July 20, 2021): 29–34. http://dx.doi.org/10.12737/1024-6177-2021-66-3-29-34.
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Purpose: Determination of the volume and sequence of radiation studies in the treatment of patients with displacement of the articular disc of the temporomandibular joint (TMJ)and myofascial pain disorders.
Material and methods: The study included 48 patients with displacement of the articular disc of the TMJ and myofascial pain disorders. Clinical criteria for articular displacement were confirmed by MRI and CBCT. Studies of the function of the masticatory muscles were carried out at the Synapsis electromyograph. All patients underwent complex treatment, including relaxation of the masticatory muscles and relief of pain using injections of botulinum toxin in the actual masticatory, temporal and lateral pterygoid muscles (LPM), followed by repositioning split therapy. For the introduction of muscle relaxant in LPM, we have developed and applied external periarticular injection access to LPM. The method is based on reaching the zone of joint attachment of the upper and lower heads of the LPM with MRI navigation. Surveillance continued for up to 12 months with MRI monitoring of the position of the articular disc.
Results: The stages of treatment of SJS of the TMJ with control use of MRI and CT, as well as a method for the administration of botulinum toxin under MRI navigation, have been developed. The first stage included CT and MRI of the temporomandibular joint, the second stage – injections of botulinum toxin into the masticatory muscles using the developed periarticular access to the LPM with MRI navigation, as well as CBCT with a splint to control the new (established) position of the lower jaw; the third and fourth stages included continuation of the reduction splint therapy, correction of the splint, observation for 3-6 months with control CBCT after 6 months to assess the position of the mandible without splint. Achieved an increase in the posterior and upper temporomandibular joint distances and the correct position of the lower jaw.
Conclusion: Performing radiation studies on time at certain stages of treatment, differing in their content and volume, provided a complete diagnosis, planning treatment measures and monitoring the results.
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Kitai, Noriyuki, Shumei Murakami, Mariko Takashima, Souhei Furukawa, Sven Kreiborg, and Kenji Takada. "Evaluation of Temporomandibular Joint in Patients with Hemifacial Microsomia." Cleft Palate-Craniofacial Journal 41, no. 2 (March 2004): 157–62. http://dx.doi.org/10.1597/02-108.
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Objective The purpose of this study was to elucidate positional relationships between temporomandibular joint (TMJ) components, including the articular discs, using magnetic resonance imaging (MRI) in patients with hemifacial microsomia (HFM). Subjects and Methods Twenty TMJs in 10 patients with HFM were examined at closed- and open-mouth positions using an MRI scanner. The condyle-fossa and disc-condyle relationships, disc configuration at the closed-mouth position, and the reduction of the disc at the open-mouth position were evaluated. Results On the unaffected side, the condyle-fossa and disc-condyle relationships appeared fairly normal at the closed mouth position. The disc-condyle relationship at the open-mouth position was also normal. The TMJ disc showed normal biconcave configurations at both closed- and open-mouth positions. On the affected side, there was considerable variation in the state of the TMJ. At the closed-mouth position, 5 of the 10 patients revealed fairly normal disc-condyle relationships, one patient showed anterior displacement of the disc, and four patients had no disc. Two patients appeared biconcave, three patients appeared biplanar, and one patient was hemiconvex. At the open-mouth position, the condyle and disc moved in harmony in five patients with normal disc-condyle relationships, but the disc was reduced in a patients with anterior disc displacement. The degree of the TMJ disc dysplasia did not necessarily correspond with the degree of mandibular dysplasia. Conclusion The present study contributes to an improved understanding of TMJ pathology in patients with HFM. The results suggest that, in HFM patients, the examination of the TMJ using MRI is helpful for determining treatment procedures in mandibular distraction osteogenesis.
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Chatra, Laxmikanth, K. Prashanth Shenai, Sham Kishor Kanneppady, and Santosh B. Sakri. "Assessment of Articular Disc Position in Normal and Pathologic Temporomandibular Joints Using MRI." Journal of Oral Health and Community Dentistry 6, no. 2 (2012): 86–90. http://dx.doi.org/10.5005/johcd-6-2-86.
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ABSTRACT Aim The aim of this study was to determine the TMJ disc position in asymptomatic, normal TMJs and in joints with TMD (Temporomandibular disorders) using MRI. Material and Methods The study was performed on forty TMJs of 20 symptomatic patients and twenty TMJs of 10 asymptomatic volunteers. Intermediate Zone (IZ) Criterion is used to interpret disc position. The readers of MRI images were blinded to each other's MRI analysis and clinical diagnosis. Data analyses included Kappa statistics for inter observer reliability correlation. Results Scan results of 20 asymptomatic joints revealed ADDWR in one joint. Out of 26 joints clinically diagnosed as internal derangement (ID), 4 joints showed ADDWOR and 8 joints confirmed ADDWR. One joint showed ADDWR in patient with MPDS and two joints of fibrous ankylosis demonstrated ADDWOR. Conclusion From our study, we could conclude that in most of the asymptomatic normal TMJs, disc will be in normal position with few exceptions. Joint tenderness was the most common clinical symptom and among displaced discs, ADDWR is the most frequent MRI diagnosis in patients with ID.
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Lee, Yul, Ki Soon Park, Soo Young Chung, and Sang Hoon Bae. "A study on the normal position of articular disk of the temporomandibular joint on MRI." Journal of the Korean Radiological Society 29, no. 2 (1993): 187. http://dx.doi.org/10.3348/jkrs.1993.29.2.187.
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IDO, Yuusuke, Kazunori NOZAKI, Hisasi NAITO, Takesi MATUMOTO, Eiji TANAKA, and Masao TANAKA. "1B04 Influence of condyle position on biomechanical condition of articular disk and soft tissue in temporomandibular joint." Proceedings of the Bioengineering Conference Annual Meeting of BED/JSME 2013.25 (2013): 67–68. http://dx.doi.org/10.1299/jsmebio.2013.25.67.
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Persin, L. S., M. V. Zayceva, and A. N. Debelaya. "Evaluation of kinesiography in patients with an inclination of the occlusal plane with crossbite." Stomatology for All / International Dental review, no. 2019 4 (89) (December 2019): 40–45. http://dx.doi.org/10.35556/idr-2019-4(89)40-45.
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38 patients with pathology of transversal incisional occlusion and occlusal plane inclination were examined for study the position of the articular disk and the presence of its reposition, including determination of occlusal plane inclination using Hip-plane analyzer, orthopantomogram and telerentgenogram of the head in lateral and direct projections, anthropometric study of plaster models, kinesiography in case of mandibular movement disturbance and TMJ magnetic resonance imaging. Changes characteristic for this type of pathology revealed. The results can be taken into the diagnosis and preparation of a comprehensive treatment plan.
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Ortiz Barcia, Roberto Octavio, and Barona Terán Jorge Eduardo. "Temporomandibular Joint analysis in patients with Temporomandibular Dysfunction." Journal of America health 3, no. 1 (January 6, 2020): 21–30. http://dx.doi.org/10.37958/jah.v3i1.24.
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The disk displacement (DD) is a TMJ internal alteration that accompanies temporomandibular disorders, being found in up to 55% of the population. This can be defined as the anomalous relationship of the disc with the bone structures of the TMJ causing a Temporomandibular Dysfunction (TMD), that is, incoordination between the disc and the condyle. Objective: Establish specific characteristics of Tmj structures as a predisposing factors for Temporomandibular disorders. Materials y Methods: A cross-sectional and observational study was conducted in which 45 MRI magnetic resonances were analyzed, meaning 90 joints, which were found in the Imaging Diagnostic Department database of the Omni Hospital. Its analysis was carried out under different methods accordind the structure studied.Results: The most prevalent disk displacement was slight in 48.89%. The greatest inclination of joint eminence occurred in 85.71% of moderate DD in men and in 55.56% of severe DD in women. The posterior condylar position was found in 100% severe DD. Sigmoid type morphology occurred in 52.22%, being more prevalent in severe DD in 66.67%. The folded disk morphology was found in moderate DD and severe DD in 52.38% and 33.33%. Finally, vertical condylar asymmetry occurred in 55,56% of the patients analyzed. Conclusion: It was concluded that certain characteristics are more prevalent than others that could alert us the presence of disk displacement and its severity as the posterior condylar position and the articular eminence morphology.
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Elias, Fernando Melhem, Esther Goldenberg Birman, Cleide Kioco Matsuda, Ilka Regina de Souza Oliveira, and Waldyr Antonio Jorge. "Ultrasonographic findings in normal temporomandibular joints." Brazilian Oral Research 20, no. 1 (March 2006): 25–32. http://dx.doi.org/10.1590/s1806-83242006000100006.
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The purpose of this study was to determine some ultrasonographic standards of temporomandibular joints with normally positioned discs. Nineteen patients from 18 to 45 years old (average age: 27.4 years; 16 females and 3 males), with history of orofacial pain, but without clinical or radiological signs of disc displacement, underwent ultrasonography (US) and magnetic resonance imaging (MRI) for the examination of their joints. In 30 joints, the distance between the most lateral point of the articular capsule and the most lateral point of the mandibular condyle (lateral capsule-condyle distance) was measured, as well as the distance between the most anterior point of the articular capsule and the most anterior point of the mandibular condyle (anterior capsule-condyle distance). In the closed-mouth position, the average values found for the lateral capsule-condyle distance were 1.4 mm and 1.6 mm, respectively in the longitudinal (coronal) and transverse (axial) scans. In the open-mouth position, the average distance was 1.2 mm, in both longitudinal (coronal) and transverse (axial) scans. The average values found for the anterior capsule-condyle distance were 2.3 mm in the closed-mouth position and 1.1 mm in the open-mouth position, both in transverse (axial) scans. Intra-examiner agreement, measured in terms of the intraclass correlation coefficient, varied from 0.83 to 0.93. We believe that this study can contribute to the validation of US as a diagnostic method for temporomandibular joint disorders, provided that the obtained measurements be used in future studies as normal reference values.
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Lazic, Vojkan, Igor Djordjevic, and Ana Todorovic. "Occlusal splints in reversible occlusal therapy of craniomandibular dysfunction." Serbian Dental Journal 58, no. 3 (2011): 156–62. http://dx.doi.org/10.2298/sgs1103156l.
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Craniomandibular dysfunction (CMD) is a set of structural and functional disorders of different etiology that affects temporomandibular joint (TMJ) and orofacial muscles. The most common etiologic factors are psychogenic, occlusal, trauma and congenital anomalies of craniofacial structures. About 75% of the examined population have mild symptoms of CMD while 3-4% have more severe symptoms which require medical attention. The main symptoms why people seek for medical attention are: facial pain which increases with chewing and irradiates in surrounding areas and pain in TMJ which irradiates in the ear canal, temporal area or neck. Painful restriction of mandible during mouth opening and eccentric movements is frequent as well as mandible deviation or deflection. Sound effects in TMJ such as popping or clicking during mouth opening are common. Initial and least invasive therapeutic procedure is reversible occlusal therapy using splints. There are two main types of occlusal splints: stabilization and relaxation. First type of splints works on condyle stabilization in orthopedically stable position; it is superoanterior condylar position in articular fossa with position of intercondylar discs between condyle and articular fossa when working cusps of the antagonists are in maximal contact with the splint. Another type of splint causes disocclussion of posterior teeth and eliminates negative effects of occlusal interference in the intercuspal position or during eccentric mandibular movements. During therapy, occlusal splint temporarily changes occlusal relationships as well as relations within TMJ, causing reduction of CMD symptoms. The best therapeutic effect for reduction of CMD symptoms is achieved by combination of physical therapy and medication.
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Stewart, M. C., L. Ciobanu, P. D. Constable, and J. F. Naughton. "Contrast magnetic resonance imaging for measurement of cartilage glycosaminoglycan content in dogs: A pilot study." Veterinary and Comparative Orthopaedics and Traumatology 26, no. 02 (2013): 100–104. http://dx.doi.org/10.3415/vcot-12-03-0033.
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SummaryObjective: To assess the ability of a contrast-enhanced magnetic resonance imaging (MRI) technique to quantitatively determine glycosaminoglycan content in canine articular cartilage.Methods: Fifty-four full-thickness cartilage discs were collected from the femorotibial and scapulohumeral joints of three adult dogs immediately following euthanasia. One set of discs from each dog was analysed for glycosaminoglycan content using a colourimetric laboratory assay. The remaining position-matched set of discs from contralateral limbs underwent pre- and post-contrast gadolinium-enhanced MRI, using repeated saturation recovery pulse sequences which were used to generate calculated T1 maps of the cartilage discs. Linear regression analysis was then performed relating delayed gadolinium-enhanced MRI T1 calculated signal intensity to the cartilage glycosaminoglycan content normalized to DNA content. Repeatability of triplicate measurements was estimated by calculating the coefficient of variation.Results: Mean coefficient of variation estimates for the gadolinium-enhanced MRI T1 signal intensity values for nine sampling sites from three dogs ranged from 5.9% to 7.5%. Gadolinium-enhanced MRI T1 signal intensity was significantly correlated (p <0.05) with normalized glycosaminoglycan content in two dogs (r = 0.79, p = 0.011; r = 0.78, p = 0.048), but not in the third dog (r = 0.53, p = 0.071).Clinical significance: Gadolinium-enhanced MRI assessment of cartilage may be predictive of glycosaminoglycan content and therefore offer an in vivo assessment of changes in cartilage characteristics over time. Additional studies appear indicated to determine the reliability and clinical applicability of gadolinium-enhanced MRI in detecting changes in cartilage over time.
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Hayashi, Takafumi, Jusuke Ito, Jun-ichi Koyama, Ayumi Hinoki, Fukiko Kobayashi, Youko Torikai, and Yasuaki Hiruma. "Detectability of anterior displacement of the articular disk in the temporomandibular joint on helical computed tomographyThe value of open mouth position." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 88, no. 1 (July 1999): 106–11. http://dx.doi.org/10.1016/s1079-2104(99)70202-7.
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Hiraba, Katsunari, Kazuto Hibino, Kenji Hiranuma, and Takefumi Negoro. "EMG Activities of Two Heads of the Human Lateral Pterygoid Muscle in Relation to Mandibular Condyle Movement and Biting Force." Journal of Neurophysiology 83, no. 4 (April 1, 2000): 2120–37. http://dx.doi.org/10.1152/jn.2000.83.4.2120.
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Electromyographic (EMG) activities of the superior (SUP) and inferior heads (INF) of the lateral pterygoid muscle (LPT) were recorded in humans during voluntary stepwise changes in biting force and jaw position that were adopted to exclude the effects of acceleration and velocity of jaw movements on the muscle activity. The SUP behaved like a jaw-closing muscle and showed characteristic activity in relation to the biting force. It showed a considerable amount of background activity (5–32% of the maximum) even in the intercuspal position without teeth clenching and reached a nearly maximum activity at relatively lower biting-force levels than the jaw-closing muscles during increment of the biting force. Stretch reflexes were found in the SUP, the function of which could be to stabilize the condyle against the biting force that pulls the condyle posteriorly. This notion was verified by examining the biomechanics on the temporomandibular joint. The complex movements of the mandibular condyle in a sagittal plane were decomposed into displacement in the anteroposterior direction (Ac) and angle of rotation (RAc) around a kinesiological specific point on the condyle. In relation to Ac, each head of the LPT showed quite a similar behavior to each other in all types of jaw movements across all subjects. Working ranges of the muscle activities were almost constant (Ac <3 mm for the SUP and Ac >3 mm for the INF). The amount of EMG activity of the SUP changed in inverse proportion to Ac showing a hyperbola-like relation, whereas that of the INF changed rather linearly. The EMG amplitude of the SUP showed a quasilinear inverse relation with RAc in the hinge movement during which the condyle rotated with no movement in the anteroposterior direction. This finding suggests that the SUP controls the angular relationship between the articular disk and the condyle. On the other hand, the position of the disk in relation to the maxilla, not to the condyle, is controlled indirectly by the INF because the disk is attached to the condyle by tendinous ligaments.
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Kumar, Raman, Shambulingappa Pallagatti, Soheyl Sheikh, Amit Mittal, Deepak Gupta, and Sonam Gupta. "Correlation Between Clinical Findings of Temporomandibular Disorders and MRI Characteristics of Disc Displacement." Open Dentistry Journal 9, no. 1 (July 31, 2015): 273–81. http://dx.doi.org/10.2174/1874210601509010273.
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Objectives: Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers. It is important for the maxillofacial radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its advanced and irreversible phase which is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further the MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms. Henceforth, the aim of the study was to evaluate whether MRI findings of various degrees of disk displacement could be correlated with the presence or absence of clinical signs and symptoms of temporomandibular disorders in symptomatic and asymptomatic subjects.Materials and Methods:In this clinical study, 44 patients (88 TMJs) were examined clinically and divided into two groups. Group 1 consisted of 22 patients with clinical signs and symptoms of TMDs either unilaterally or bilaterally and considered as study group. Group 2 consisted of 22 patients with no signs and symptoms of TMDs and considered as control group. MRI was done for both the TMJs of each patient. Displacement of the posterior band of articular disc in relation to the condyle was quantified as anterior disc displacement with reduction (ADDR), anterior disc displacement without reduction (ADDWR), posterior disc displacement (PDD).Results:Disk displacement was found in 18 (81.8%) patients of 22 symptomatic subjects in Group 1 on MRI and 4 (18.1%) were diagnosed normal with no disc displacement. In Group 2, 2 (9.1%) of 22 asymptomatic patients were diagnosed with disc displacement while 20 (90.1%) were normal. Sensitivity and Specificity tests were applied in both the groups to correlate clinical findings of TMD and MRI characterstics of disc displacement and results showed Sensitivity of 90% and Specificity of 83.3%.Conclusion:Disk displacement on MRI correlated well with presence or absence of clinical signs and symptoms of temporomandibular disorders with high Sensitivity and Specificity of 90% and 83.3% respectively.
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Shaefer, Jeffry R., Cara Joy Riley, Paul Caruso, and David Keith. "Analysis of Criteria for MRI Diagnosis of TMJ Disc Displacement and Arthralgia." International Journal of Dentistry 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/283163.
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Aims. To improve diagnostic criteria for TMJ disc displacement (DD).Methods. The standard protocol for MRI diagnosis of DD, using a 12 o’clock reference position, was compared to an alternative protocol. The alternative protocol involves the functional relationship between the condyle and articular eminence, using a line perpendicular to the posterior slope of the eminence as a reference for disc position. The disc location was examined using both protocols, and disc diagnoses were compared in their relationship with joint pain. Statistical analyses includedPvalue, sensitivity, specificity, odds ratio, and kappa statistic.Results. 58 MRIs were interpreted. 36 subjects reported arthralgia; 22 did not. Both protocols demonstrated significance (standardP=0.004, alternativeP<0.001) for the ability to predict arthralgia. The odds of arthralgia increased in DD patients diagnosed by standard methods 9.71 times and in DD diagnosed by alternative means 37.15 times. The diagnostic sensitivity decreased 30% using the alternative versus the standard protocol (0.6389 versus 0.9444), while specificity increased 60% (0.9545 versus 0.3636).Conclusions. A stronger relationship occurs between DD and arthralgia when using a function-based protocol. The alternative protocol correctly identifies subjects without arthralgia, who by standard methods would be diagnosed with DD, as having nondisplaced discs, providing a more clinically relevant assessment of TMJ disc displacement.
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Makeev, V. F., Yu O. Rybert, V. Ya Shybinskyy, N. R. Kliuchkovska, and O. S. Kyrmanov. "FEATURES OF OCCLUSAL THERAPY IN FUNCTIONAL DISORDERS OF TEMPOROMANDIBULAR JOINTS." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 20, no. 3 (November 12, 2020): 249–57. http://dx.doi.org/10.31718/2077-1096.20.3.249.
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Temporomandibular joint (TMJ) dysfunctions are known as being highly prevalent, having multifactorial etiology, progressive course, and high recurrence rate. This combination of features typical of this pathology places it among pressing medical issues nowadays. The variety of concepts and approaches to the analysis of the etiopathogenesis of TMJ dysfunction causes a particular interest in both highly informative diagnostic techniques and functional methods of treatment. A complex pathological morphofunctional syndrome involving parafunctions of masticatory muscles, dysfunctional TMJ states and occlusal disorders ultimately leads to deformation and a low functional disproportion in the TMJ kinetics. The work analyzes the reports on the research of various occlusal splints, and in particular, the mechanism of their action, classification of their effectiveness in various types of TMJ disorders, advantages, and disadvantages of splints, as well as materials used for their manufacturing. It is important to emphasize that the choice of the optimal therapeutic approach to internal TMJ disorders should be chosen taking into account the position of the mandibular condyle, the nature of the articular disk displacement, the presence or absence of pain, its possible causes, and concomitant local and general aggravating factors. The study was performed as a part of the research project of the Department of Orthopaedic Dentistry, Danylo Halytskyi Lviv National Medical University.
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Friedman, Saul N., Miriam Grushka, Hussam K. Beituni, Madhu Rehman, Hart B. Bressler, and Lawrence Friedman. "Advanced Ultrasound Screening for Temporomandibular Joint (TMJ) Internal Derangement." Radiology Research and Practice 2020 (May 4, 2020): 1–10. http://dx.doi.org/10.1155/2020/1809690.
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Purpose. To present an advanced ultrasound (US) technique and propose its use as a screening diagnostic tool for temporomandibular joint (TMJ) internal derangement. Materials and Methods. The technique is based on maintaining the US probe parallel to the articular disc, rather than traditional axial and coronal views, with the position described relative to a clock face. Validation was achieved by direct comparison with magnetic resonance imaging (MRI). A total of 61 patients, with age ranging from 13 to 67 years, were prescreened for TMJ pain and internal derangement, underwent US imaging for screening, and MRI evaluation for final diagnosis. Results. 29 of the 61 patients had disc pathology on MRI. US screening produced no false positive results and only 6 false negative results, corresponding to a sensitivity of 79% and specificity of 100%. Half of the false negative cases involved disc pathology with a medial component to the disc displacement. Conclusion. US is both a sensitive and a specific screening tool for TMJ dysfunction when used by an appropriately trained operator, with the exception of medially displaced discs. If TMJ assessment is found to be abnormal, the patient should be referred for MRI, and any patient scheduled for surgery must have the diagnosis confirmed by MRI. If a component of medial disc displacement is suspected, MRI should be performed despite a normal screening US.
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Castro, Vanessa A., Rafael M. A. Pereira, Gustavo M. Mascarenhas, Antonio I. T. Neto, Daniel E. Perez, Daniel Rodrigues, Célio J. Prado, and Darceny Zanetta-Barbosa. "Magnetic resonance imaging evaluation of articular disk position after orthognathic surgery with or without concomitant disk repositioning: a retrospective study." Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, September 2020. http://dx.doi.org/10.1016/j.oooo.2020.08.035.
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Changoor, A., J. P. Coutu, M. Garon, E. Quenneville, M. B. Hurtig, and M. D. Buschmann. "Streaming Potential-Based Arthroscopic Device is Sensitive to Cartilage Changes Immediately Post-Impact in an Equine Cartilage Injury Model." Journal of Biomechanical Engineering 133, no. 6 (June 1, 2011). http://dx.doi.org/10.1115/1.4004230.
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Models of post-traumatic osteoarthritis where early degenerative changes can be monitored are valuable for assessing potential therapeutic strategies. Current methods for evaluating cartilage mechanical properties may not capture the low-grade cartilage changes expected at these earlier time points following injury. In this study, an explant model of cartilage injury was used to determine whether streaming potential measurements by manual indentation could detect cartilage changes immediately following mechanical impact and to compare their sensitivity to biomechanical tests. Impacts were delivered ex vivo, at one of three stress levels, to specific positions on isolated adult equine trochlea. Cartilage properties were assessed by streaming potential measurements, made pre- and post-impact using a commercially available arthroscopic device, and by stress relaxation tests in unconfined compression geometry of isolated cartilage disks, providing the streaming potential integral (SPI), fibril modulus (Ef), matrix modulus (Em), and permeability (k). Histological sections were stained with Safranin-O and adjacent unstained sections examined in polarized light microscopy. Impacts were low, 17.3 ± 2.7 MPa (n = 15), medium, 27.8 ± 8.5 MPa (n = 13), or high, 48.7 ± 12.1 MPa (n = 16), and delivered using a custom-built spring-loaded device with a rise time of approximately 1 ms. SPI was significantly reduced after medium (p = 0.006) and high (p<0.001) impacts. Ef, representing collagen network stiffness, was significantly reduced in high impact samples only (p < 0.001 lateral trochlea, p = 0.042 medial trochlea), where permeability also increased (p = 0.003 lateral trochlea, p = 0.007 medial trochlea). Significant (p < 0.05, n = 68) moderate to strong correlations between SPI and Ef (r = 0.857), Em (r = 0.493), log(k) (r = −0.484), and cartilage thickness (r = −0.804) were detected. Effect sizes were higher for SPI than Ef, Em, and k, indicating greater sensitivity of electromechanical measurements to impact injury compared to purely biomechanical parameters. Histological changes due to impact were limited to the presence of superficial zone damage which increased with impact stress. Non-destructive streaming potential measurements were more sensitive to impact-related articular cartilage changes than biomechanical assessment of isolated samples using stress relaxation tests in unconfined compression geometry. Correlations between electromechanical and biomechanical methods further support the relationship between non-destructive electromechanical measurements and intrinsic cartilage properties.