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At least 307 records · Page 17Linked to original sources
PubMed2003

Visually guided irrigation for patients with symptomatic internal derangement of the temporomandibular joint: a preliminary report.

OBJECTIVE: Visually guided irrigation (VGIR) is simple joint irrigation with minimally invasive intracapsular inspection through the use of a thin arthroscope. The aims of the present study were to develop VGIR for the superior joint compartment of the temporomandibular joint (TMJ) by using a 1.2-mm-diameter rod-lens arthroscope and to examine the short-term clinical outcomes. The correlation between the clinical outcome of VGIR of the TMJ and intracapsular findings was also evaluated. STUDY DESIGN: Twenty patients who underwent VGIR for symptomatic internal derangement of the TMJ (n = 20) were enrolled in this study. The clinical outcome of VGIR was evaluated in terms of the improvement in the painless range of mandibular motion (ROM: interincisal distance in millimeters), and functional jaw pain was evaluated by using a visual analog scale (VAS) ranging from 0 to 100. Painless ROM and VAS scores 6 months postoperatively were compared with the preoperative data. A good clinical outcome was defined as an increased ROM (ROM > 38 mm) and a decreased VAS score (VAS score < 20%, and <60% of the preoperative level). With respect to these criteria, all joints were classified into either good clinical outcome (GO) or poor clinical outcome (PO) groups. The difference in the distribution of the arthroscopic findings obtained during VGIR, with respect to severity, was analyzed between the GO and PO groups. RESULTS: None of the 20 patients experienced any serious local or systemic complications, including the breakage of instruments. We were able to perform a reliable intracapsular diagnosis during VGIR. Sixteen of 20 patients (80%) had significant improvements in postoperative painless ROM and the VAS score of functional pain, thereby being classified into the GO group. The distribution of the severity of intracapsular findings did not differ significantly between the GO group and the PO group. CONCLUSIONS: VGIR is useful for the treatment and diagnosis of internally deranged TMJs. These data suggest that the clinical outcome of TMJ irrigation is not related to the intracapsular condition of the superior joint compartment.

Adult↗
PubMed1989

Long-term follow-up after occlusal treatment to correct abnormal temporomandibular joint disk position.

Fifteen patients with temporomandibular joint disk displacement in whom a normal condyle-disk relationship could be established were treated with occlusal changes to maintain the disk in a recaptured position. Occlusal changes were achieved by prosthodontics in 11 patients and by orthodontics in four patients. Follow-up after about 3 years showed that joint function was improved, intensity of pain was reduced, and joint and muscle tenderness were less frequent than before treatment. Intermittent locking, use of analgesics, sleep disturbances, and absence from work because of temporomandibular joint symptoms were also less frequent. Radiographic examination performed in 11 patients at follow-up demonstrated anteroinferior condylar position in the majority of the patients, but only minor hard tissue changes. Arthrography showed the disk to be in a correct position relative to the condyle in 82% (9 of 11) of the patients. These results suggest that permanent change of the occlusion with the objective of eliminating abnormal disk position may be effective treatment for disk displacement when conventional methods of treatment have failed to alleviate the symptoms. The extent of dental treatment needed to maintain the disk in a correct position should, however, be considered relative to the severity of the symptoms.

Adolescent↗
PubMedDate not supplied

Association of generalized joint hypermobility with history, signs, and symptoms of temporomandibular joint dysfunction in children.

This study determined the prevalence of signs and symptoms of temporomandibular joint dysfunction (TMD) in children with and without generalized joint hypermobility (GJH). Twenty children with GJH, ages 4-19, and 20 age- and sex-matched control children completed a TMD signs/symptoms history and underwent an examination consisting of palpation of the joints and associated musculature for tenderness, clicking, or crepitation. Children with historical or clinical findings were designated positive for TMD signs/symptoms. Maximum vertical opening, expressed as a percentage of lower facial height, and maximum mandibular lateral excursion (in mm) were recorded. Fifteen (75%) of the GJH participants and ten (50%) of the controls were positive for TMD findings. There were statistically significant differences between the groups for the presence of total positive findings (P < 0.001) and for responses to palpation of muscle or joint (P = 0.03). There were no significant differences in positive responses to the history alone, joint palpation alone, or muscle palpation alone. There were no significant differences between the groups in jaw excursions. This study suggests that children with GJH may be more likely to demonstrate some signs and symptoms of TMD than children with normal joint mobility.

Adolescent↗
PubMed1994

Morphologic changes in the temporomandibular joint in different age groups. An autopsy investigation.

Comparisons among several temporomandibular joint autopsy studies indicate that the frequency of arthrosis and disk displacement is higher in elderly persons. The aim of this study was to investigate type, frequency, and location of morphologic changes in temporomandibular joint autopsy specimens divided into two groups according to age and to determine the differences between the two groups. For this purpose 68 temporomandibular joints were removed from 37 persons at autopsy. Group I (young) consisted of 36 specimens belonging to 19 persons with a mean age of 30 years (range, 16 to 39 years). Group II (elderly) consisted of 32 specimens from persons with a mean age of 68 years (range, 55 to 78 years). Significant differences between the two groups were observed with respect to several of the morphologic changes that were evaluated. The results of this study suggest that the frequency of morphologic changes such as deviation in form, arthrosis, perforations, disk displacement, disk deformation, and adhesions is higher in the temporomandibular joints of elderly persons.

Adolescent↗
PubMed2002

Chondrocyte apoptosis in rabbit temporomandibular joint after anterior disc displacement.

OBJECTIVE: To study the chondrocyte apoptosis in rabbit temporomandibular joint after anterior disc displacement. METHODS: Experimental anterior disc displacement was induced surgically in 20 Japanese rabbits without opening their temporomandibular joint bursas. Histopathologic and apoptotic (TUNEL) analysis was used to evaluate the changes in articular cartilage, disc and synovium. RESULTS: Condyle chondrocyte showed apoptosis most obviously at 1 or 2 weeks after surgery, and apoptotic cells concentrated in proliferative zone and hypertrophic zone. 4 or 6 weeks after surgery, the joint went into a remodelling period. CONCLUSIONS: Chondrocyte apoptosis in temporomandibular joint will be activated after anterior disc displacement, which initiates the remodelling in temporomandibular joint.

Animals↗
PubMed1979

Rehabilitating children with temporomandibular joint ankylosis.

Although the probability of ankylosis following injury of the temporomandibular joint is small, patients, especially children with temporomandibular joint ankylosis, are greatly handicapped. Of the 42 cases of ankylosis seen in our clinic, six occurred in the adult, and 36 in children under 14 years of age. Treatment in all cases was surgical, and the results were beneficial, although the greatest difficulty in the treatment had been the early recurrence of ankylosis. Based on our experience, osteoarthrotomy for temporomandibular joint ankylosis in children has been advocated.

Adolescent↗
PubMed1997

[Neurogenic temporomandibular joint dislocation. Definition and therapy with botulinum toxin].

Dislocation of the temporomandibular joint results from trauma, articulation disorders and changes in the equilibrium of the masticatory muscles. Previous classifications were mostly oriented on the interrelationships between the anatomical positions of the dislocated articular surfaces, like luxation, subluxation and discuss luxation. Etiologically, a distinction is made between traumatic and non-traumatic dislocation. Dislocation of the temporomandibular joint is described as a complication of a number of neurological diseases. We report on a patient who suffered recurrent dislocations of the temporomandibular joint as a complication of multiple sclerosis and whose luxations were successfully treated with botulinum toxin, thus warranting the introduction of the term "neurogenic dislocation of the temporomandibular joint".

Botulinum Toxins↗
PubMed1985

An evaluation of temporomandibular joint sounds.

The purpose of this study was to obtain authoritative opinion on the importance of joint noises. Experts in the areas of orthopedics, rheumatology, and arthritis were asked four questions to evaluate the importance of clicking and crepitus in joints other than the temporomandibular joint (TMJ). The general response of these experts indicated that clicking in the absence of other symptoms is not important, clicking in the presence of other symptoms may be important, crepitus in the absence of other symptoms may be important, and crepitus in the presence of other symptoms is important. Caution is advised in treating clicking when it is the only sign.

Diagnosis, Differential↗
PubMed1989

Arthroscopic diagnosis of perforation and adhesions of the temporomandibular joint: correlation with postmortem morphology.

Arthoscopy was performed in the upper joint compartment of 28 temporomandibular joints in 16 fresh cadavers to investigate the accuracy of arthroscopic diagnoses of perforation and adhesion. Subsequent dissections revealed that only three of nine perforations were seen arthroscopically and that three of four joints with adhesions were arthroscopically diagnosed. There was no overdiagnosis of perforation or adhesions. Intra-articular hyperplastic soft tissue formation (crab meat) was arthroscopically seen in ten joints (36%) and was with only two exceptions associated with either a perforation or adhesions. Histologically, the adhesion and the hyperplastic soft tissue consisted of fibrous connective tissue with collagen fibers and fibroblasts. It was concluded that a positive arthroscopic diagnosis of adhesion or perforation is reliable whereas a negative diagnosis of perforation is not reliable.

Aged↗
PubMed1986

[Nuclear magnetic resonance tomography of the temporomandibular joint].

Because of its position, the temporomandibular joint is difficult to demonstrate by conventional radiological methods. Even the use of complex methods, such as arthro-tomography or CT, does not result in the satisfactory demonstration of the soft tissues and, in particular, of the articular disc. Magnetic resonance was carried out in 24 patients; it was possible to differentiate functional from morphological changes in the cartilage and these are discussed. Measurements were carried out during progressive opening of the mouth. This permits direct demonstration of reversible and irreversible cartilage displacement and of other changes in the joint and cartilages.

Humans↗
PubMed2004

Fibronectin upregulation in human temporomandibular joint disks with internal derangement.

Fibronectin is a large fibril-forming extracellular glycoprotein that seems to be involved in joint diseases. The objective of this study was to investigate the expression of fibronectin in human temporomandibular joint disks obtained from patients with internal derangement and varying extents of disk tissue degeneration/regeneration with that of temporomandibular joint disks free of significant morphological alterations by means of immunohistochemical methods. Twelve adult human temporomandibular joint disks (10 diseased disks and 2 normal disks) were used in this study. Temporomandibular joint disks were fixed in 10% buffered formalin. Sections were then immunohistochemically processed using a monoclonal antibody specific to human fibronectin and streptavidin-biotin detection methods. Positive reactions to fibronectin were found in normal and diseased disk tissues but to a different extent. Normal disk tissues revealed weak fibronectin expression, which was mainly located along the collagen bundles. Temporomandibular joint disks with internal derangement exhibited a higher immunoreactivity. Distinct reticular fibronectin structures were found inside the diseased disk, particularly nearby the newly formed blood vessels, tears, and clefts. In the covering layer of the disk surface, fibronectin was expressed in a fascicular pattern running parallel to the disk surface. The findings suggest that temporomandibular joint disk tissue can express fibronectin and that the expression is more pronounced in disk specimens of patients with internal derangement of the temporomandibular joint, supporting a role of this glycoprotein in the degeneration/regeneration processes of human temporomandibular joint disk tissue.

Adult↗
PubMed1996

Analysis of facial and trigeminal nerve function after arthroscopic surgery of the temporomandibular joint.

PURPOSE: This study analyzes facial and trigeminal nerver function after arthroscopic surgery. PATIENTS AND METHODS: Eighty-one consecutive patients (81 joints) who underwent unilateral temporomandibular joint (TMJ) arthroscopic surgery were assessed postoperatively for facial and trigeminal nerve function. RESULTS: Twenty-four of 81 patients (29.6%) had some degree of sensory or motor nerve dysfunction. Two patients (2.5%) showed signs of facial nerve dysfunction, which completely resolved in one patient in 11 weeks, but persisted mildly in the other at the 1-year follow-up examination. CONCLUSIONS: Auriculotemporal syndrome was not detected in any of the 40 patients tested. However, transient numbness over the distribution of the auriculotemporal nerve was present in 19 of 81 patients (23.4%). This numbness persisted for 3 days to 3 months with a mean duration of 14 days. Three of the 81 patients (3.6%) showed signs of inferior alveolar and lingual nerve involvement, which returned to normal in 4 to 12 weeks in all 3 patients.

Adult↗
PubMed2005

Mitomycin C effect on fibrous adhesions of rabbit temporomandibular joint.

OBJECTIVE: To evaluate influence of mitomycin C on fibrosis in temporomandibular joints of rabbits with mandibular traction. STUDY DESIGN: Twenty rabbits (8 control, 12 mitomycin C group) were included. Titanium screws were placed in the anterior edge of the right masseter tuberosity and the posterior part of the right zygoma. Elastic bands were placed between 2 screws to initiate posterio-superior displacement of the mandible to the right. Animals in the control group (CG) received intraarticular NaCl (0.9%) on the nondrawing (left) side, and animals in the study group (SG) received mitomycin C weekly (0.4 mg/mL) for 6 weeks. Rabbits were decapitated, temporomandibular joints were removed, and histopathological investigation was performed. RESULTS: Microscopically, 4 of 6 rabbits in the CG had fibrosis in the temporomandibular joint, whereas only 1 of 11 rabbits in the SG had fibrosis (P < 0.05). CONCLUSION: Application of mitomycin C to the temporomandibular joint of rabbits significantly reduces formation of intraarticular fibrous adhesions. SIGNIFICANCE: This is the first study in the literature investigating the use of mitomycin C in the joints. EBM RATING: B-2.

Animals↗
PubMed2004

Arteriovenous fistula after temporomandibular joint arthroscopy successfully treated with embolization.

Temporomandibular joint arthoscopy is a minimal invasive surgical procedure commonly used to effectively treat some internal derangement of the TMJ. However, this method is not free of complications. Arteriovenous fistula (AVF) is a lesion that communicates the high flow arterial system and the low flow venous network. We describe a new case of preauricular traumatic AVF successfully treated with external carotid embolization, along with a review of the medical literature.

Adult↗
PubMed1979

Anatomical and physiological considerations regarding the temporomandibular joint.

The structure and function of the human temporomandibular joint has concerned several investigators but still fundamental questions exist and require further examination. A profound knowledge of the normal anatomy and histology of the temporomandibular joint is necessary to understand its function and functional disturbances. It is also necessary for a good understanding of clinical findings and the interpretation of radiographs. In this paper a clinically orientated description has been given of the anatomy and histology of the mandibular head, the articular fossa and eminence, the articular disc, the capsule and ligaments, the synovial membrane, the innervation of the joint and the normal relationship between the different components. About the physiology of the temporomandibular joint many controversial theories exist. A lot of research has still to be done, especially in the field of the co-ordination of the function of both joints, the muscles and the dentition.

Cartilage, Articular↗
PubMed2000

Connective tissue disease and other related rheumatic conditions among patients with finger and hand and temporomandibular joint prostheses in Denmark.

OBJECTIVE: To determine if finger and hand joint prostheses or temporomandibular joint (TMJ) implants may be involved in the initiation of specific connective tissue diseases (CTD), a nationwide cohort in Denmark was followed prospectively to evaluate rates of CTD after receiving these implants. METHODS: Danish patients with finger and hand joint implants (n = 562) or TMJ implants (n = 351) were identified and followed for subsequent hospitalizations. Observed numbers of hospitalizations due to CTD were compared with expected numbers based on national CTD hospitalization rates. To avoid confounding by indication, patients with a hospital discharge diagnosis of a CTD prior to prosthetic surgery were excluded from the cohort. RESULTS: After 4142 person-years of followup in the finger and hand joint cohort, 9 hospitalizations due to CTD were found [standard hospitalization rate (SHR) = 1.5; 95% CI 0.7-2.9]. The TMJ cohort had 1500 person-years of followup and 2 hospitalizations due to CTD (SHR = 1.3; 95% CI 0.2-4.5). CONCLUSION: This is the first cohort study to examine the relations between these implants and CTD. Although the number of events was small, this systematic national study revealed no significant or large increase in risk of CTD after finger and hand joint implants or TMJ implants.

Aged↗
PubMed1991

Effects of complete denture wearing on temporomandibular joints: a histomorphometric study.

At autopsy, 54 human temporomandibular joints were distributed in three groups. The first group was made up of 14 joints of dentate subjects (mean age = 51 years). The second group was composed of 12 temporomandibular joints of totally edentulous patients who had lost their teeth for at least 10 years (mean age = 82 years). The third group was composed of 28 joints of edentulous patients who had been wearing complete dentures for at least 20 years (mean age = 66 years). Sagittal serial decalcified sections were studied by light microscopy and was submitted to histomorphometry. Group 1 was characterized by a deep mandibular fossa with well-marked cortical layers of the temporal bones and the condyles. The fibrocartilages were multilayered and the articular disks had biconcave outlines. In group 2 a flattening of the mandibular fossa was observed, with a thinning of the cortical and spongy bones. The fibrocartilages were thin and not multilayered. In group 3, the structure of joints was similar to that of group 1. The mean values of the surfaces, thicknesses, and lengths of the measured parameters were systematically highest in group 1, whereas these mean values in group 3 were similar to or had a tendency to be close to the means of group 1. In contrast, the mean values of group 2 were always the lowest. It can be concluded that complete dentures had a favorable protective effect on temporomandibular joint structures.

Adult↗