SEARCH · PubMed Health

Results for “TEMPOROMANDIBULAR JOINT”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources

PubMed1993

Surgical management of temporomandibular joint ankylosis in the pediatric population.

The treatment of temporomandibular joint ankylosis requires excision of the involved structures and immediate reconstruction. This paper presents a consecutive series of nine pediatric patients (mean age 7.7 years) who underwent a standardized treatment protocol to 13 affected joints. Four patients had unilateral temporomandibular joint ankylosis, five bilateral. One child required bilateral release but only unilateral reconstruction. Radiographic evidence demonstrated bony ankylosis in a total of 13 joints. Two patients had undergone surgical intervention of the temporomandibular joint before presentation to the authors. Two patients had preoperative temporomandibular joint pain. The cause of ankylosis was primarily traumatic or congenital. Our operative protocol included excision of the involved ankylotic structures through a coronal and Risdon incision, followed by immediate costochondral grafting. Fixation with miniplates and screws allowed for early mobilization. For unilateral patients, maximal incisal opening was improved from 5.4 mm before surgery to 24.8 mm after it, and for bilateral patients, from 6.0 to 17.5 mm. Mean follow-up was 2 years; only one patient was followed for less than 1 year. Pain symptoms were relieved after surgery. Perioperative complications were minimal, with no evidence of infection, facial nerve injuries, or bleeding. Patients with unilateral or bilateral ankylosis of traumatic cause achieved satisfactory functional results after surgery, while those in our bilateral congenital patients were far more limited. Rationales for this divergence in results are presented.

Adolescent↗

PubMed2005

Temporomandibular joint internal derangement: relationship between joint pain and MR grading of effusion and total protein concentration in the joint fluid.

OBJECTIVES: The objective of this study was to determine whether there is any association between the protein concentration in the synovial fluid and (i) the amount of articular hydrops, as graded in magnetic resonance (MR) images, and (ii) joint pain in temporomandibular joints (TMJs) with and without displacement of the disc. PATIENTS AND METHODS: This study involved 16 joints in 16 patients referred to our clinic with the complaint of pain and limited mouth opening. The control group consisted of 15 joints in 15 patients with unilaterally normal disc and condyle relationship and no pain while the opposite side had a non-painful joint with disc displacement without reduction (DDwoR). The subjects and controls were different individuals and only a single joint was used for each. Pain and dysfunction were evaluated by visual analogue scale. Bilateral proton density and T2 weighted images of the TMJs of the 31 subjects were analysed for fluid and condyle bony changes as well as disc position. The amount of fluid, identified as an area of high signal intensity in the region of the upper and lower joint spaces, was characterized as none, minimal, moderate or marked. Arthrocentesis was performed both for synovial fluid analysis of total protein concentration and the treatment of the joints with DDwoR. Total protein concentration was measured by using protein dye binding on spectrophotometry. RESULTS: All patients experienced a significant (P<0.01) increase in maximal mouth opening immediately post-arthrocentesis. In the study group, the disc was displaced most frequently in an anteriormedial direction (75%) and deformation of disc form was seen in 13 joints. Condylar bony changes were seen in 27% of joints in the control group and in 81% of joints in the study group. A statistically significant association was found between joints with disc displacement, disc form and condylar bony changes (P<0.05). In the control group, only one joint, which had an osteophyte, showed joint effusion (JE) with moderate fluid. In the study group, only four joints had no fluid (25%). JE was found in 10 (63%) joints with disc displacement on anteromedial direction, in 10 (63%) joints with disc deformation and in 10 (63%) joints with osteophytes and erosion. Mean total protein concentration was 16.87+/-7.9 (range 7.4-34.1 mg dl-1) in control joints, 55.08+/-35.16 (range 21.5-153.9 mg dl-1) in study joints. There were significant differences in the mean total protein concentration between the control and study groups (P<0.01). Significant positive correlation was found between the total protein concentration and JE (r=0.65, P<0.01). No significant correlation was found between the level of pain and dysfunction and JE and total protein concentration in either control or study groups (P>0.05). CONCLUSION: Pain in the TMJ was not related to MR findings of effusion in internal derangement and synovial fluid aspirate findings of total protein concentration. However, total protein concentration was related to the amount of JE in DDwoR joints and painful joints were more likely to demonstrate the JE.

Adolescent↗

PubMed1980

Semiopaque arthrography of the temporomandibular joint.

Arthrography was performed in 166 temporomandibular joints with known disorders. The results reflected the pathology expected in each disorder. Clicking and locking were characterized by an increased inferior synovial cavity. The superior cavity was either normal or with irregularity of the articular space. In degenerative diseases, the most frequent finding was perforation of the disc. Rheumatoid arthritis was characterized by reduced extent and irregular outline of the synovial cavities. A late effect from contusion of the temporomandibular joint was a slight reduction in the extent of the synovial cavity. Late effects from intracapsular fracture of the mandibular condyle were considerable irregularity of the articular space and perforation of the disc. As a rule, the arthrographs were highly characteristic, and it seems possible to distinguish between the current disorders by means of arthrography. The arthrographs of 15 intact joints are described. The features of unsuccessful arthrography based on 32 instances of extrasynovial injection are described.

Arthritis, Rheumatoid↗

PubMed1987

Comparison of magnetic resonance imaging, arthrotomography and clinical and surgical findings in temporomandibular joint internal derangements.

Twenty-four temporomandibular joints were evaluated by means of tomography and magnetic resonance imaging (MRI). Seventeen of these joints were also examined with the use of arthrotomography. Meniscus surgery was carried out on 13 of the temporomandibular joints. The three imaging techniques were compared for diagnosis of disk displacement, of degenerative joint disease, and of perforations. All imaging techniques were compared with clinical and surgical findings. MRI was as accurate as arthrotomography in confirming disk displacement. MRI was more accurate in disclosing gross arthrosis than tomography. The best use of arthrography was in disclosing perforations. The best correlation to surgical findings was shown by the clinical examination.

Adolescent↗

PubMed1987

Computed tomography of condylar and articular disk positions within the temporomandibular joint.

The computed tomograms of temporomandibular joints in 25 patients (41 joints) were retrospectively evaluated for condylar position and joint space with General Electric computer software. Computed tomography scans of the temporomandibular joint were made in the axial plane with the teeth in centric occlusion, and measurements were made from vertically reformatted images. Interarticular joint spaces were measured anterosuperiorly, superiorly, posterosuperiorly, and posteriorly from the condylar surfaces. This was repeated in five equidistant (3.1 mm) serial sagittal planes across the condyle, beginning and ending, on average, 2.5 mm from the lateral and medial condylar poles. Articular disk positions (anterolateral, anterior, anteromedial, medial, and normal) were correlated with condylar position. Significant differences between disk positions and joint spaces were found most frequently in the anterosuperior and the superior joint interval. When the disk was positioned normally, the anterosuperior joint space was consistent (1.5 to 2.0 mm) across the joint (standard deviation, 0.3 to 0.8 mm). The superior, the posterosuperior, and the posterior joint spaces in the normal joint were greater than the anterosuperior joint space. When the disk was anterior to the condyle, the anterosuperior joint interval was widened. When the disk was medial, the superior joint space was significantly wider than normal across the breadth of the condyle. In those joints in which the disk was anteromedial, there was an absence (0.2 mm) of joint space, and this occurred in all areas of the condyle except in its medial one fourth. In the internally deranged joint, joint space narrowing may be focal in nature.

Adolescent↗

PubMed1987

[Craniofacial growth under the influence of blood supply. 10. Arthrosis of the temporomandibular joint].

Unilateral and bilateral deformation of the temporomandibular joint was observed in young rats after unilateral ligature of the common carotid artery. They involved both the mandibular condyle and the mandibular fossa and were usually associated with a reduction in the dry weight of the masticatory muscles on the ligated side. This leads to the assumption that muscular atrophy is causally related to arthropathy of the temporomandibular joint. The methodological approach to induce changes in the temporomandibular joint may be used as a model of arthrosis of that joint.

Age Factors↗

PubMed1999

[Anatomical and pathological study of the temporomandibular joint disk in Colombian individuals].

BACKGROUND: The temporomandibular joint is an oval fibrous plate that completely divides the joint and accommodates irregularities existent in the bone articular surfaces. AIM: To study the frequency of temporomandibular joint disk abnormalities among Colombian subjects. MATERIAL AND METHODS: We studied 120 temporomandibular joint disks obtained from fresh cadavers arrived in the Instituto de Medicina Legal, in Cali Colombia. These were analyzed according to subject's dental status and age. RESULTS: Nineteen percent of disks had small erosions. In 7.5% of disks there were wider erosions or perforations. Twenty six percent of discs were very thin and this alteration was seen mostly in people aged 50 years or older. CONCLUSIONS: These results are intermediate between those who claim that disk perforations are rare and those who had shown tile opposite. The loss of dental pieces seems to be a risk factor leading to such disk perforation.

Adult↗

PubMed2006

Cytokine profile in synovial fluid from patients with internal derangement of the temporomandibular joint: a preliminary study.

OBJECTIVES: Temporomandibular joint disorders (TMD) comprise a group of chronic painful conditions of mastication in the temporomandibular joint (TMJ). Although the association between TMD and internal derangement of the TMJ is well documented, the functional relevance is still unclear. Increased concentrations of inflammatory mediators have been identified in the synovial fluid of affected patients with TMD, suggesting an underlying degenerative or inflammatory process. The aim of this study was to generate a comprehensive cytokine expression profile in TMD. METHODS: 15 samples from patients with internal derangement of TMJ were analysed using a novel cytokine array that enables the analysis of 79 different cytokines simultaneously. RESULTS: Cytokine levels were correlated with the presence of joint effusion (JE) determined by MRI. In the majority of synovial fluid samples, angiogenin (Ang), fibroblast growth factor (FGF)-9, insulin-like growth factor-binding protein (IGFBP)-3, interleukin (IL)-1alpha, IL-1beta, IL-8, inducible protein (IP)-10, macrophage inflammatory protein (MIP)-1beta, osteoprotegerin (OPG), transforming growth factor (TGF)-beta2, tissue inhibitor of metalloproteinase (TIMP)-1, TIMP-2, tumour necrosis factor (TNF)-beta and vascular endothelial growth factor (VEGF) were detectable. Furthermore, the expression levels of Ang, brain-derived neurotrophic factor (BDNF), FGF-4, FGF-9, IGFBP-2, IL-8, MIP-1beta, OPG, pulmonary and activation-regulated protein (PARC), TGF-beta2, TIMP-2 and VEGF were significantly associated with the presence of JE; among these, nine cytokines (Ang, BDNF, FGF-4, FGF-9, IGFBP-2, MIP-1beta, PARC, TGF-beta2 and TIMP-2) were hitherto not described in TMD. CONCLUSIONS: This study confirmed previous reports of elevated cytokine levels in TMD. Additionally, we identified previously undescribed cytokines that were upregulated and correlated significantly with the presence of JE. We were able to identify novel cytokines that have hitherto not been described in TMD. Strategies targeting the identified cytokines may represent a novel therapy option in TMD.

Adult↗

PubMed1993

Osteoarthrosis, the temporomandibular joint, and Eagle's syndrome.

Temporomandibular joint osteoarthrosis is common but typically asymptomatic. This article describes a patient with symptomatic left temporomandibular joint osteoarthrosis in whom pain in the right side of the tongue and ear, and dysphagia, subsequently developed simulating Eagle's syndrome. The concept of Eagle's syndrome is reviewed.

Adult↗

PubMed1992

Magnetic resonance spectroscopy of inflammation associated with the temporomandibular joint.

Noninvasive early recognition and treatment of temporomandibular joint dysfunction remains a diagnostic challenge. This pilot study evaluated the use of phosphorus 31 magnetic resonance spectroscopy with magnetic resonance imaging to measure alterations in pH and high-energy phosphate metabolite ratios of muscle that is adjacent to an inflamed temporomandibular joint. Ten New Zealand white rabbits were used in this study. Two animals were used to develop signal acquisition protocols and to ensure that stable baseline data could be measured. In each of the eight animals used in the experiment, one temporomandibular joint was injected with a suspension of silica particles and the contralateral joint served as a control. Data were collected from control and experimental joints on days 0, 7, 14, 21, and 28, after the injection. At the end of the study, temporomandibular joints were block resected and histologically examined to confirm the presence of an inflammatory response. Results indicated that pH and metabolite ratios could be obtained by 31P-magnetic resonance spectroscopy. Changes in pH and some metabolite ratios in experimental joints showed statistical significance (p < 0.001). Differences were seen on day 2 and day 7 (p = 0.040 and p = 0.008, respectively) in the phosphocreatine/alpha-adenosine triphosphate ratios. This contrasts with phosphocreatine/beta adenosine triphosphate ratios that showed significance that began at day 7 (p = 0.022) and continued to day 14 (p = 0.025). Histologic examination indicated that the tissue response within the joint capsule was less than the granulomatous reaction expected.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗

PubMed1994

A preliminary investigation of a method of detecting temporomandibular joint sounds.

This study established a method of detecting temporomandibular joint sounds based on signal-to-noise ratios. After comparing the temporomandibular joint signals obtained from three different sites over the skin, the articular eminence was found to be the best site for detecting temporomandibular joint sounds; this site provided the highest mean amplitude in the time domain waveform. However, using an electret condenser microphone at the intra-auditory meatus provided a broader, 20-decibel signal-to-noise bandwidth, which resulted in minimized artifacts. This method may be useful for recording temporomandibular joint sounds in the differential diagnosis of various temporomandibular joint conditions using spectral analysis.

Adolescent↗

PubMed2006

Temporomandibular joint arthritis in juvenile idiopathic arthritis: the forgotten joint.

PURPOSE OF REVIEW: This review explores the prevalence, clinical and radiographic signs, and treatment of temporomandibular joint arthritis in children with juvenile idiopathic arthritis. RECENT FINDINGS: Temporomandibular joint arthritis seems to be a more frequent manifestation in patients with juvenile idiopathic arthritis than previously believed, in part due to the paucity of clinical symptoms and poor sensitivity of conventional radiographs used for diagnosis. Antinuclear antibody positivity, early onset of disease, and presence of systemic or polyarticular disease are all risk factors for temporomandibular joint arthritis but may underpredict temporomandibular joint involvement in juvenile idiopathic arthritis. Magnetic resonance imaging enhanced with gadolinium is currently the gold standard in detection of temporomandibular joint arthritis, and treatment with intra-articular corticosteroids has been shown to be effective and safe, with minimal side effects. SUMMARY: Given the paucity of clinical symptoms in temporomandibular joint arthritis, detection of temporomandibular joint inflammation using contrast-enhanced magnetic resonance imaging is essential for instituting appropriate therapy in a timely fashion. The use of intra-articular corticosteroids holds promise for control of temporomandibular joint inflammation and prevention of associated morbidities.

Adolescent↗

PubMed2006

Comparative study of eminectomy and use of bone miniplate in the articular eminence for the treatment of recurrent temporomandibular joint dislocation.

UNLABELLED: Dislocation of the temporomandibular joint occurs when the mandibular condyle exits the glenoidal cavity and remains anteriorly locked to the articular eminence. It is repetitive (recurrent dislocation), usually associated with mandibular hypermobility and inclination of the articular eminence. AIM: This study intended to clinically and radiologically assess the technique of eminectomy and the use of a miniplate on the articular eminence for the treatment of recurrent dislocation of the temporomandibular joint of patients operated on at Oswaldo Cruz University Hospital from January to September 2003. STUDY DESIGN: Retrospective cohort. MATERIAL AND METHOD: The sample consisted of 11 patients. Eminectomy was performed on nine joints of five patients and the placement of a miniplate on the articular eminence was performed on 11 joints of six patients. Data collection was carried out through analysis of patient's medical charts and new postoperative visit. RESULTS: The results showed that there were no major postoperative complications with either technique. Maximum mouth opening was greater with eminectomy procedure and none of the patients operated on presented any recurrence of dislocation. CONCLUSION: It is concluded that both techniques were effective in the treatment of recurrent dislocation of the temporomandibular joint.

Adolescent↗

PubMed1984

Radionuclide skeletal imaging and single photon emission computed tomography in suspected internal derangements of the temporomandibular joint.

Fifty one subjects who had pain involving the temporomandibular joint were evaluated using multidirectional tomography, arthrography, conventional nuclear scanning, and single photon emission computed tomography (SPECT) to assess the association of arthritis of the temporomandibular joint with internal derangements related to meniscal dysfunction. Five (56%) of the nine subjects who had normal arthrograms and normal multidirectional tomograms had SPECT scans that were positive for osseous changes. Twenty-two subjects (27 temporomandibular joints) were diagnosed by arthrography to have meniscal displacement with reduction. Multidirectional tomograms of the 27 joints were positive for osseous changes in five (18%) joints, whereas SPECT scans were positive in nine (70%) joints. Twenty subjects (20 temporomandibular joints) had an arthrographic diagnosis of meniscal displacement without reduction. Multidirectional tomograms of the 20 joints were positive for osseous changes in 14 (70%) joints, and SPECT scans were positive in 16 (80%) joints (P less than 0.001 vs control group). Initial observations with SPECT indicate it is a promising imaging method for detecting and staging osseous disease of the TMJ related to meniscal dysfunction.

Adolescent↗

PubMed1994

The reliability of clinical methods for recording temporomandibular joint sounds.

Measurement errors in recording temporomandibular joint sounds may originate from variation between observers and from variation in the phenomenon. Laboratory settings enable various procedures to be used to minimize both sources of variation. These procedures yield some excellent intra- and inter-examiner reliabilities, but this does not imply that dentists in a clinical setting are likely to evaluate temporomandibular joint sounds in a comparable way. This study was designed to evaluate clinical joint sound assessment methods (palpation and stethoscopy) without using special precautions to minimize variance. An attempt was made to quantify the signal variance. Within- and between-examiners agreement is estimated for both methods in a sample of 44 non-patients. The results show that two clinically experienced craniomandibular disorders specialists were able to reach fair to good agreement on the identification of (the number of) temporomandibular joint sounds. There was some disagreement with respect to the number of reciprocal clicks. Compared with the palpation technique, stethoscopy is more sensitive, especially with regard to crepitation. Based on the electronically recorded sounds, both examiners appeared to be overconsistent. It is concluded that the use of both palpation and stethoscopy in clinical settings can be justified but that both methods have limitations. When, in a given clinical setting, these limitations are acceptable, there appears to be no need for extra-sensitive but expensive electronic recording devices.

Auscultation↗

PubMed1990

CT diagnosis of synovial chondromatosis of the temporomandibular joint.

Synovial chondromatosis of the temporomandibular joint (TMJ) is a very rare condition. It is characterised by the presence of loose bodies in the joint space. Clinical signs, histopathological findings and radiography play an important role in the diagnostic process. Conventional X-rays have shown to be of limited value, for they fail to depict the intra-articular loose bodies in a significant amount of cases. Axial as well as coronal computer tomography (CT) is extremely useful in detecting loose bodies in the temporomandibular joint (TMJ). In this report we present and discuss a further case, and the use of CT in the diagnosis of TMJ-synovial chondromatosis is illustrated.

Chondromatosis, Synovial↗

PubMedDate not supplied

Propofol bolus facilitates reduction of luxed temporomandibular joints.

"Locked" or dislocated temporomandibular joint (TMJ) is a common problem in emergency medicine. Like many other joint dislocations, the repositioning of the joint can be facilitated by conscious sedation and muscular relaxation. Propofol is a useful agent for use in the emergency department because of its extremely short half-life, its antiemetic properties, and its safety record. We report two cases of locked TMJ that were repositioned under sedation with propofol. We review methods for repositioning the locked TMJ and review appropriate agents for sedation and muscular relaxation.

Adult↗

PubMed1992

Erosion and heterotopic bone formation after alloplastic temporomandibular joint reconstruction.

Twenty-three temporomandibular joint arthroplasties using metallic condylar prostheses were performed because of severe ankylosis (8 patients), segmental mandibular resections in tumor surgery (9 patients), and after extensive trauma (2 patients). A clinical and radiological follow-up study showed heterotopic bone formation in 52% of cases and glenoid fossa resorption in 43%. In one patient with rheumatoid arthritis the condyle eroded through the skull base 10 months after surgery. Seven prostheses (30%) were removed and/or exchanged during the average 27.6-month follow-up.

Adult↗