Dissertations / Theses on the topic 'Mobility of temporomandibular joints'

Includes bibliographical references. Temporomandibular joint (TMJ) pain and dysfunction occurs commonly in the general population. Various surgical procedures have been used in the management of those patients who have not responded to conservative measures. Research into the surgical management of TMJ dysfunction and pathology has been restricted due to the lack of a suitable animal model. This study was undertaken initially to develop the sheep as an animal for TMJ research. The study has shown that Australian Merino sheep, with a TMJ broadly similar in size to humans, provides a satisfactory experimental model for TMJ research.

The temporomandibular joint (TMJ) complex consists of the condyle, articular eminence, and articular disc. This disc divides the intracapsular components of the joint into upper and lower joint spaces. Magnetic resonance imaging (MRI) is considered the reference standard for soft tissue diagnosis of the TMJ. One aim of the study was to identify if an association exists between arthralgia of the TMJ and MRI identified joint effusion.

The clinical significance of identifying the presence of TMJ effusion on MRI lies in its potential association with inflammation, clinically assessed as pain at the lateral TMJ pole or around the pole area. Unfortunately the literature has been divided in asserting whether pain in the joint area is associated with the presence of MRI assessed effusion. A systematic review of the literature was unable to provide conclusive evidence for or against an association between TMJ pain and effusion.

Materials and methods: Clinical and imaging findings from 336 joints were obtained from a historical cohort involving individuals with temporomandibular disorders. Two by two tables of association were used to determine if clinical signs associated with arthralgia were associated with the presence of ipsilateral effusion in the TMJ. These clinical signs included pain on range of motion (maximum unassisted and assisted opening as well as excursive movements), TMJ manipulation (compression and translation), and palpation of the lateral pole of the TMJ and around the TMJ pole. In addition, a total pain score (range 0-7) was created which represented the sum of positive responses to pain on any of the clinical range of motion tests. Statistical testing included the T-test to test for possible association of joint effusion with any pain to these clinical measures.

Results: Statistical tests of association between joint effusion and range of motion, excursions, protrusion, joint manipulation and palpation all had p values > .05.

Conclusion: The results suggest that there is no statistically significant association between an MRI diagnosis of joint effusion and TMJ arthralgia.

Joint mobility is dependent on comfort, thus pain is associated with mobility. This study examined the relationship between pain perception and joint mobility in arthritis patients before and after total knee arthroplasty. Pain perception was indicated by pain intensity, pain distress and pain expectation; joint mobility was represented by the degree of knee joint flexion. Visual analogue scales were used for pain intensity, pain distress and pain expectation; knee joint flexion as measured using a goniometer. Data were collected on 24 subjects preoperatively (T1), immediately postoperatively (T2) and forty-eight to seventy-two hours postoperatively (T3). Twenty-four subjects participated in the study. Significant paired t-test resulted for joint flexion at T1 and T3 and pain expectation at T2 and T3. Pearson product-moment correlation coefficients were significant for pain intensity and pain distress at all three times, pain intensity and joint flexion at T1 and pain intensity at T1 and at T2.

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Dissertacao (Mestrado)
IPEN/D
Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

This thesis will be organized into three chapters discussing the mechanism underlying the onset and progression of osteoarthritis (OA) in the temporomandibular joint (TMJ). Understanding the mechanism of OA development in the TMJ helps in understanding how OA progresses and how to treat this disease. The goal of this investigation is to examine the process of cartilage degeneration and OA biomarker expression in the TMJ to understand their role in TMJ OA onset and development.Chapter one covers mechanisms that are altered in TMJ OA during disease progression. Using animal models with different stressors such as mechanical disturbances, direct injury, and changes in the extracellular matrix composition revealed the role of the different mechanisms that are up-regulated and down regulated during cartilage destruction. Chapter two will cover a paper I wrote that introduces a novel non-invasive technique applied to mice, which induces an early onset of OA in the TMJ. I developed this technique with the aim to provide a new mouse model where the onset and progression of OA more closely mimic the natural TMJ OA progression in humans. The histopathological analysis of the cartilage demonstrates that onset of OA starts at 2 weeks after treatment induction and is aggravated by week eight. This data demonstrated the effectiveness of our technique in inducing OA in the TMJ. Chapter three will cover a second paper I wrote on the association of RAGE with the progression of OA in the TMJ of mice by using mice with and without RAGE expression. RAGE has been show to contribute to the progression of OA by releasing several pro-inflammatory and catalytic cytokines. Additionally, RAGE has been shown to modulate the expression of specific OA biomarkers, including HtrA-1, Mmp-13, and Tgf-β1 in knee cartilage. The objective of this study was to study the effect of knocking out RAGE on the expression of Mmp-1 3, HtrA-1, and Tgf-β1 in the TMJ. After histophatological and quantitative analysis of biomarkers expression, the results demonstrated for the first time that absence of RAGE expression in the TMJ provides a protective effect against development of TMJ OA in mice.

Objetivo: Avaliar a função da coluna cervical, utilizando testes clínicos cervicais em indivíduos com e sem Disfunção Temporomandibular (DTM) associados ou não ao relato de dor de cabeça. Métodos: Estudo Transversal. Foram avaliadas 57 mulheres com idade de 18 a 60 anos, divididas em dois grupos: DTM (n=40), e controle (n=17). Dada a alta frequência de relato de dor de cabeça a amostra de DTM foi estratificada em DTM com cefaleia (n=25) e DTM sem cefaleia (n=15). A incapacidade cervical foi avaliada pelo Índice de Incapacidade Cervical (NDI) e a dor na ATM pela Escala Visual Analógica de dor (EVA). A avaliação funcional da coluna cervical foi conduzida uma única avaliação por um examinador fisioterapeuta experiente e foi constituída pelos testes clínicos: análise da Amplitude de Movimento Ativa da Coluna Cervical (ADM); realização do Flexion-Rotation Test (FRT) e Cranio-Cervical Flexion Test (CCFT). Os sujeitos com DTM que relataram a presença de dores de cabeça foram instruídos a responder um questionário sobre as principais características da cefaleia referida. Para comparações entre os grupos foram aplicados ANOVA one way seguida por teste Post Hoc de Tukey ou por Teste Kruskall Wallis quando necessário. Para a análise de associação entre as variáveis categóricas foram aplicados Teste chi-quadrado ou Teste Exato de Fisher quando apropriado e para a análise de associação entre variáveis ordinais/contínua foram aplicados Testes de Correlação de Spearman. Resultados: Os indivíduos com DTM independente do relato de dor de cabeça apresentaram menor mobilidade no plano sagital, menores valores no FRT e apresentaram pior performance dos flexores profundos cervicais comparados aos controles (p<0.05). Além disso, os dados de ADM, FRT e CCFT foram associados com a intensidade de dor na ATM e a incapacidade cervical (p<0.01). Conclusão: Pacientes com DTM independente do relato de cefaleia apresentaram limitação na amplitude de flexão/extensão e do segmento C1-C2 da coluna cervical, além do menor desempenho dos músculos flexores profundos. Adicionalmente, a incapacidade cervical e a dor na ATM apresentaram correlação moderada com os testes funcionais cervicais nos indivíduos com DTM.
Objective: To evaluate the function of the cervical spine, using cervical clinical tests in individuals with and without Temporomandibular Disorders (TMD)associated or not to the report of headache. Methods: Were analyzed 57 women with age between 18 and 60 years, divided in two groups: TMD (n=40) and control (n=17). Given the high frequency of headache report, the TMD sample was stratified into TMD with headache (n=25) and TMD without headache (n=15). Cervical disability was assessed by the Neck Disability Index (NDI) and TMJ pain by the Visual Analogue Scale of pain (VAS). The functional evaluation of the cervical spine was conducted by a physiotherapeutic examiner with 10 years of experience and was constituted by the clinical tests: Analysis of the Cervical Range of Motion (CROM); Flexion-Rotation Test (FRT) and Craniocervical Flexion Test (CCFT). Subjects with TMD who reported the presence of headaches were instructed to answer 11 questions that contained the main characteristics of referred headache. For comparisons between control groups, TMD with Headache and TMD without Headache, ANOVA was applied one way followed by Tukey\'s Post Hoc test or by Kruskall Wallis test when necessary. For the analysis of association between the categorical variables, chi-square test or Fisher\'s exact test were applied when appropriate and for analysis of association between ordinal / continuous variables, Spearman\'s Correlation Tests were applied. Results: Individuals with TMD independent of headache report showed less mobility in the sagittal plane, lower values in FRT and showed worse performance of the deep cervical flexors compared to Controls (p<0.05). In addition, CROM, FRT and CCFT were associated with an intensity of TMJ pain and cervical disability (p <0.01). Conclusion: Patients with TMD independently of the headache report showed limited flexion / extension range and C1-C2 segment of the cervical spine, as well as deficits in the performance of the deep flexor muscles. In addition, a cervical disability and TMJ pain report showed a moderate correlation with the functional tests of FRT and CCFT in individuals with TMD.

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CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
O uso de simuladores médicos é de grande importância para o estudo, diagnóstico e decisão sobre a melhor forma de tratamento de inúmeras patologias. Uma patologia que afeta inúmeras pessoas é o deslocamento ou displasia dos discos da articulação temporomandibular trazendo grandes transtornos no processo de abertura e fechamento da boca e fortes dores no momento da mastigação. O presente trabalho tem por objetivo modelar os deslocamentos mandibulares baseado em colisões entre os côndilos e as fossas temporais, bem como a interferência do disco articular com patologia na trajetória do movimento da mandíbula. O presente estudo utilizou dados reais de um paciente traduzidos por modelos tridimensionais de ossos reconstruídos a partir de imagens de tomografia computadorizada e de discos articulares reconstruídos a partir de imagens de ressonância magnética. O modelo de movimento da Articulação Tempormandibular é baseado no movimento mandibular de Posselt aliado ao tratamento de colisões entre as partes anatômicas em questão a partir de leis da física. Como resultado é apresentado comparações de trajetórias de movimento entre uma articulação saudável e uma articulação com patologia relacionada ao disco articular. No movimento realizado por uma ATM com anteposição de disco, a mandíbula é impedida de se deslocar corretamente, impossibilitando a abertura total da boca.
The use of medical simulators is of great importance for the study, diagnosis and decision about how best to treat numerous diseases. A condition that affects many people is the displacement or dysplasia of temporomandibular joint discs bringing major disruptions in the process of opening and closing the mouth and severe pain when chewing. This study aims to model the mandibular displacements based on collisions between the condyles and temporal fossa, and the disc with pathology interference on jaw motion trajectory. Real data as three-dimensional models of bones reconstructed from CT images and articular disc reconstructed from RM images was used as model parameters. The Tempormandibular joint motion model is based on Posselt’s mandibular movement joined to the processing of collisions between anatomical parts in question using physics laws. As a result is presented comparisons of motion trajectories between a healthy joint and a joint with pathology related to articular disk. In the motion carried by an ATM with disk fronting , the jaw is prevented from moving correctly, making it impossible to fully open the mouth.

碩士
國立臺灣大學
臨床牙醫學研究所
92
Abstract The mandibular kinematics, which has been often represented by the condylar movement of the temporomandibular joint (TMJ), has played a crucial role in the foundation of the modern dentistry. Though the fact that the condyle could perform rotation and translation has been long recognized, the calculation of the amount of rotation hasn’t been solved till recently, after the introducing of rigid-body mechanics into this field. Since then, errors of the classical mandibular kinematics, which has been built based on the pantographic observations, were gradually disclosed. Unfortunately, an unbiased, clear, concrete conclusion of the normal mandibular kinematics is still lacking. To study the mandibular kinematics completely, i.e. including 3 translational and 3 rotational degree-of-freedoms (DOF), needs sophisticated hardware and high data manipulation ability. Now combining the opto-electronic tracing devices and the rigid-body mechanics to record and analyze the 6 DOF mandibular movements has been gradually become the main-stream methodology in dentistry. However, the standard operating procedure of placing the markers to represent the head and mandible position in space hasn’t been established, yet. Some data presenting ways of the mandibular kinematics hasn’t been validated, either. The aims of these serial studies were therefore first to optimize the use of an opto-electronic tracking device, Vicon 512, to study the human mandibular kinematics, and second to analyze the motion data by using calculations successfully applied to other major human joints. The results would be compared with other analyses ever proposed in dentistry. Instrument setup: Five mega-pixel Vicon IR cameras were used to pick up the positions of markers within the global coordinating system with the temporal resolution of 120 Hz. The camera placements were optimized configured after several trials so the following working environments can be yielded: Working volume: 50 cm x 50 cm x 50 cm Spatial resolution: 0.0008 mm Absolute system measuring error: < 0.4 mm Skin marker placements: In order to reduce the interfering of physiological movements by the trans-oral metal framework, the skin markers were used to represent the head position. After quantitative comparisons the following conclusions were obtained: 1. Skin areas near upper facial midline possessed least amount of skin movement. Their relative movements were even smaller than the optical frame by referencing to the gold standard, i.e. the clutch attached to the maxillay anteriors. 2. After the adjustment by applying the “Segmental Optimization Method” (S.OM.), the adverse effect of skin movement on these least mobile markers could be significantly reduced. 3. Skin markers could be used to represent the head positions while put on selective areas plus the S.O.M. adjustment. Their error was roughly equaled to the absolute system measuring error. Translation/Rotation Diagram: The translation/rotation diagram, which was proposed by Salaorni et al in 1994, is a concise description of condylar kinematics in 2D. However, the methodology itself hasn’t been validated. Namely, 1. The amount of condylar translation was reference-point dependent. Different condylar points would have different diagrams. 2. If we re-plotted the diagram by using the first order derivative of translation/ rotation vs. rotation, the kinematic behavior of the condyle would have dramatic different characters. The classification of 5 patterns proposed by Salaroni et al. was thus challenged. Helical axis: The mandibular helical axis was also calculated. The intersections of the helical axis on sagittal planes passing both side condyles were also presented. Contrast to the condylar trajectories, the orientations and paths of the helical axes changed dramatically and were hardly predictable. These findings were compatible with the helical axes of other major joints.

The objective of this study was to evaluate the prevalence and potential clinical significance of incidental sinonasal findings in cone beam computed tomography (CBCT) scans requested for TMJ diagnostic purposes. This project comprised the retrospective analysis of CBCT images from 500 consecutive scans taken with the original purpose of TMD diagnosis. The assessment of potential clinical significance of incidental sinonasal findings was accomplished by the design of a set of guidelines, which may ultimately lead to a better evaluation of incidental sinonasal CT abnormalities by non-sinus specialists. Our results detected incidental sinonasal findings in 84% of the CBCT scans studied, a considerably higher prevalence than previous estimations using random populations studies. Potentially clinically important variables were detected in approximately one fourth of the scans studied, which potentially requires an otolaryngology evaluation.
Medical Sciences - Temporomandibular Disorders/Orofacial Pain

Thesis (M.Sc.)--University of Alberta, 2010.
A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Medical Sciences, Temporomandibular Disorders/Orofacial Pain. Title from pdf file main screen (viewed on April 23, 2010). Includes bibliographical references.

碩士
臺灣大學
機械工程學研究所
95
The concept of mobility type requirement is introduced in this work. On the basis of mobility type requirement, the topological analysis of planar linkage mechanisms is accomplished with an oriented assignment of actuating pairs and ground link. In this thesis, the relation between type of freedom and mobility types is introduced. Briefly speaking, total mobility mechanisms can be obtained by assigning actuating pairs and ground link onto total and partial freedom kinematic chains; partial and fractionated mobility mechanisms can be obtained by assigning actuating pairs and ground link onto partial and fractionated freedom kinematic chains. On this concept, the systematic assigning processes of actuating pairs and ground link of planar linkage mechanisms are developed with a convenient tool, modified dual graph representation. According to these assigning procedures, designers can acquire fully constrained mechanisms with the expected mobility type.

Orientação : David Ferreira ; co-orientação : António Martinho ; responsabilidade externa : Jorge Cid
As afecções da articulação temporomandibular (ATM) no gato podem causar alterações na normal anatomia das superfícies articulares, por vezes difíceis de quantificar. A caracterização métrica da ATM normal poderá contribuir para o diagnóstico de afecções desta articulação, e no estabelecimento de parâmetros que podem ser usados para o estudo comparativo de diversas afeções articulares que alterem a normal configuração da ATM. Este estudo propõe a quantificação objetiva através de tomografia axial computorizada (TAC) de sete parâmetros da ATM de gatos: Dimensão transversal condilar (DTC), dimensão longitudinal condilar (DLC), dimensão da superfície articular (DSA), distância intercondilar (DIC) (entre o extremo medial dos côndilos direito e esquerdo), distância extracondilar (DEC) (entre o extremo lateral dos côndilos direito e esquerdo), ângulo corpo mandibular-côndilo mandibular (ACM-CM) e o ângulo corpo mandibular-tubérculo mandibular (ACM-TM). Foram estudados 14 cadáveres de gatos (sete machos e sete fêmeas), com o peso compreendido entre 3 e 4,5 kg, com a anatomia normal da ATM. Os animais foram colocados em decúbito esternal, estandardizado em todos os animais, e foi realizada uma TAC à cabeça de cada animal. Da observação dos resultados verifica-se que os machos apresentam uma DSA maior que nas fêmeas (p<0,05) ao nível da ATM esquerda. Todos os restantes parâmetros são clinicamente similares entre machos e fêmeas. Estes dados sugerem a existência de uma certa homogeneidade entre lado direito e lado esquerdo da ATM, e entre gatos e gatas, à exceção da DSA. Estas observações corroboram a possibilidade da utilização de valores padronizados na caracterização métrica da ATM em gatos.
The disorders of the temporomandibular joint (TMJ) in the cat can cause changes in the normal anatomy of the articular surfaces, sometimes difficult to quantify. A metric characterization of standard TMJ may contribute to diagnose disorders in this joint, and to establish the parameters that can be used for the comparative study of various joint disorders that alter the normal configuration of the TMJ. This study aims to quantify objectively by computerized axial tomography (CAT) of seven parameters of TMJ cats: condylar transverse dimension (CTD), condylar longitudinal dimension (CLD), size of the articular surface (SAS), intercondylar distance (ICD) (between the medial extreme of the right and left condyle), extracondylar distance (ECD) (between the lateral of right and left condyle), mandibular body - mandibular condyle angle (MB-MCA) and mandibular body - mandibular tubercle angle (MB-MBA). Fourteen cat cadavers were studied (seven males and seven females), weighing between 3 and 4,5 kg, presenting a normal anatomy of the TMJ. The animals were placed in prone position standardized for all animals, and a CT scan of each head was carried out. Observing the results verify that the males have bigger SAS than females (p <0,05), on the left TMJ. All the other parameters are clinically similar between males and females. This data suggests the existence of certain homogeneity between the right and left side of the ATM, and between males and females, except for the SAS. These observations support the possibility of using standardized values in metric characterization of ATM in cats.