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At least 379 records · Page 21Linked to original sources
PubMed1990

Bony ankylosis of the temporomandibular joint: a computed tomography study.

Bony ankylosis of the temporomandibular joint is a disabling disease that almost invariably manifests itself in the first two decades of life. CT of the temporomandibular joints was performed in 50 patients--axial CT in 2 and coronal CT in 48--of whom 43 (86%) had received trauma to the joints. New bone of variable form and thickness was observed in 64 joints (the involvement was bilateral in 14 patients). These joints were classified into one of two categories: type I, medially angulated condyle with deformed articular fossa and a mild-to-moderate amount of new bone formation; and type II, no recognizable condyle or fossa but instead a large mass of new bone. Type I was etiology-specific and seen only when trauma was the antecedent, whereas type II was a sequelae of either insult. A pseudofracture in the new bone was seen in 49 (77%) joints. Six joints showed subtle deformities but no new bone. Since coronal CT fully characterizes the lesion at acceptable radiation exposure levels, it appears to be valuable in the preoperative workup of these patients.

Adolescent↗
PubMed2006

A case series of closed reduction for acute temporomandibular joint dislocation by a new approach.

OBJECTIVE: The management of acute temporomandibular joint dislocation relies on the traditional method, which involves intraoral manipulation of the mandible on both sides of the patient. Often, intravenous sedative or analgesic agents are needed to facilitate closed reduction. In this report, the authors introduce a new approach called the ipsilateral approach, in which extraoral or intraoral manipulation of the dislocated side is performed to accomplish closed reduction, without using sedatives or analgesics. Three methods, namely, extraoral, intraoral and combined, are described. METHODS: A prospective observational study was performed to investigate this ipsilateral approach. Six medical officers were recruited to attend to patients with acute temporomandibular joint dislocation. The following protocol was used: (1) Try the extraoral method in all patients first. (2) If it fails, use the intraoral method. (3) If both fail, attempt using a combined method. (4) If all fail, perform the traditional method as usual. RESULTS: A total of 24 episodes of temporomandibular joint dislocation were examined, out of which 13 were successfully reduced by the extraoral method. Of the remaining 11 episodes, 10 were successfully reduced by the intraoral method, the last case being reduced by the combined method. None of them requires sedation or analgesia. CONCLUSION: This ipsilateral approach, using extraoral and intraoral methods, is cost-effective, simple and convenient for the management of acute temporomandibular joint dislocation.

Emergency Service, Hospital↗
PubMed1987

Arthroplasty for temporomandibular joint ankylosis secondary to ankylosing spondylitis.

Although temporomandibular joint involvement is frequent in ankylosing spondylitis, ankylosis seldom ensues. A patient with a temporomandibular joint ankylosis secondary to ankylosing spondylitis is presented. Treatment consisted of an osteoarthrectomy, followed by a costochondral ribgraft. A follow-up period of 39 months showed a satisfactory result.

Adult↗
PubMed2003

Cross-sectional and functional imaging of the temporomandibular joint: radiology, pathology, and basic biomechanics of the jaw.

The temporomandibular joint (TMJ) is a common site of complaint. Clicking sounds and pain are indicators of a frequent condition called internal derangement, most often affecting females. As a general term, internal derangement describes a structural abnormality within an articulation. The internal derangement of the TMJ is a specific term defined as an abnormal positional and functional relationship between the disk and articulating surfaces. Imaging of the joint is an important element in the diagnostic work-up. Trauma and inflammatory arthritis account for most of the other TMJ problems. A thorough understanding of joint anatomy and normal function is a prerequisite for perceiving abnormalities and making the correct diagnosis. The authors elucidate joint anatomy, correlating cadaveric specimen and anatomic slices with conventional and cross-sectional imaging studies. TMJ biomechanics are illustrated with schematics and animations, and an overview of imaging strategies and techniques is presented. Common abnormalities are described and illustrated, and a brief discussion of therapeutic options is included.

Adolescent↗
PubMed2002

[Distraction osteogenesis for treatment of temporomandibular joint ankylosis].

OBJECTIVE: To study the application of distraction osteogenesis in temporomandibular joint (TMJ) ankylosis patients. METHODS: 11 temporomandibular joint ankylosis patients (13 sides of TMJ) were treated by this technique. After removal of bony mass on the ankylosis area, a L-shape osteotomy of the ramus was performed to create the distraction transport disc which connected the mandible by distractor. Distractions were started on the 4 approximately 8th postoperative day. The distraction rhythm and rate were 0.25 mm 4 times a day. Distraction was stopped when contact was made between the transport disc and glenoid fossa. The patients underwent active mouth opening postoperatively. Distractor was kept in place for 3 approximately 4 months after completion of distraction and then removed under local anesthesia. RESULTS: Postoperatively, the range of mouth opening of the 11 patients (13 sides) was increased to normal (33 approximately 45 mm), bone formation in the gaps were perfect and the neocondyle was remodeling and approximated normal shape. No complications were found. CONCLUSION: Distraction osteogenesis for arthroplasty has many advantages compared with traditional methods. It is valuable in clinical practice as a new method for treatment of TMJ ankylosis.

Adolescent↗
PubMed1999

Temporomandibular joint remodeling in adolescents and young adults during Herbst treatment: A prospective longitudinal magnetic resonance imaging and cephalometric radiographic investigation.

The aim of this prospective study was to analyze and compare the temporomandibular joint adaptive mechanisms in 25 adolescent and 14 young adult Class II malocclusions treated with the Herbst appliance. Temporomandibular joint remodeling was analyzed by magnetic resonance imaging. In each subject, 4 magnetic resonance images of both temporomandibular joints were available: before treatment, at the start of treatment (when the Herbst appliance was placed), during treatment (6 to 12 weeks after appliance placement), and after treatment (when the appliance was removed). Furthermore, effective temporomandibular joint changes (the sum of condylar remodeling, fossa remodeling, and condyle-fossa relationship changes) were analyzed with the aid of lateral cephalometric radiographs from before and after treatment. All subjects were treated to Class I or overcorrected Class I dental arch relationships, and their mandibles became significantly (P <.001) more prognathic. After 6 to 12 weeks of Herbst treatment, signs of condylar remodeling were seen at the posterosuperior border in 48 of the 50 adolescent condyles and in 26 of the 28 young adult condyles. Bilateral remodeling of the mandibular ramus could be detected in 1 adolescent and 2 young adult patients. Signs of glenoid fossa remodeling at the anterior surface of the postglenoid spine were noted in 36 adolescent and 22 young adult temporomandibular joints. Effective temporomandibular joint changes during treatment were more horizontally directed and larger in both adolescents and young adult patients treated with the Herbst appliance than in an untreated group of subjects with ideal occlusion (Bolton standards). The increase in mandibular prognathism accomplished by Herbst therapy in both adolescents and young adults seems, in particular, to be a result of condylar and glenoid fossa remodeling. Because the Herbst appliance is most successful in Class II patients also at the end of the growth period, the treatment method could be an alternative to orthognathic surgery in borderline skeletal Class II cases. Magnetic resonance imaging renders an excellent opportunity to visualize the temporomandibular joint remodeling growth processes.

Adaptation, Physiological↗
PubMed1998

Oxidative stress and degenerative temporomandibular joint disease: a proposed hypothesis.

The molecular events that underlie degenerative temporomandibular joint diseases are poorly understood. Recent studies have provided evidence that a variety of molecular species, including cytokines, matrix degrading enzymes, neuropeptides, and arachidonic acid catabolites may be involved. This paper advances the theory that mechanical stresses lead to the accumulation of damaging free radicals in affected articular tissues of susceptible individuals. This condition is called oxidative stress. The authors postulate mechanisms that may be involved in the production of free radicals in the temporomandibular joint and in the subsequent induction of molecular events that may amplify damage of articular tissues initiated by free radicals. If the proposed model is correct, then future therapeutic strategies directed at the control of oxidative stress could be effective in the management of degenerative temporomandibular joint diseases.

Arachidonic Acids↗
PubMed1989

Internal derangements of the temporomandibular joint. Pathological variations.

A retrospective analysis of 540 operated cases (740 joints) of internal derangements of the temporomandibular joint was carried out. Observations of this patient population provided the basis for describing pathological variations of internal derangements. Radiologic studies, including tomograms and arthrograms or magnetic resonance scans, and surgical/pathological findings were correlated with clinical data in each case. It was found that clinical manifestations varied in a characteristic way and were directly related to the degree of pathological change and time course. Various stages of internal derangements were identified. Pathophysiological mechanisms responsible for the observed changes, as well as clinical signs and symptoms and causal factors, were discussed. Internal derangements are organic lesions that appear to be progressive and are probably of traumatic origin. The view is given that internal derangements represent the basic pathological entity responsible for clinical manifestations of what has been known as the temporomandibular joint pain-dysfunction syndrome or similarly described conditions. Effective clinical management takes on new importance because progression to advanced degenerative states may occur.

Adult↗
PubMed2006

The relationship between temporomandibular joint synovitis and adhesions: pathogenic mechanisms and clinical implications for surgical management.

PURPOSE: The purpose of this investigation was to determine the relationship between arthroscopically diagnosed synovitis and adhesions in a population of patients with significant limitation of mandibular opening and temporomandibular joint pain. PATIENTS AND METHODS: Temporomandibular joint arthroscopy was performed on 126 joints in 80 patients (female:male = 5.7:1; mean age = 35.5 years; mean duration of symptoms = 50 months). All patients were diagnosed with severe temporomandibular joint disease recalcitrant to conservative therapy. Each joint was evaluated arthroscopically for the presence of synovitis and adhesions. Chi-squared analysis was performed to determine if there was a significant relationship between the presence of synovitis and adhesions. RESULTS: Diagnostic arthroscopic examination showed the following: no synovitis and no adhesions in 18/126 joints (14%), no synovitis with adhesions present in 33/126 joints (26%), synovitis with no adhesions in 13/126 joints (10%), and synovitis and adhesions present in 62/126 joints (49%). Statistical analysis showed a significant relationship between arthroscopically diagnosed synovitis and adhesions. CONCLUSION: Synovitis and adhesions are commonly present in the temporomandibular joints of patients requiring arthroscopic surgery due to painful limitation of mandibular movement. Excessive mechanical stress on the temporomandibular joint leads to maladaptive responses in the articular and synovial tissues, ultimately leading to synovitis, osteoarthritis and the formation of adhesions. An understanding of the pathogenic mechanisms that lead to synovitis, osteoarthritis and adhesions has important clinical implications for the nonsurgical as well as surgical management of patients suffering from these disorders.

Adult↗
PubMed2001

[Internal derangement of the temporomandibular joint].

Internal Derangement is one of the most common disorders of the Temporomandibular joint. It is defined as an abnormal anatomical relationship between the discus articularis and the other structures of the temporomandibular joint. More than 2/3 of patients with clinical symptoms of the temporomandibular joint have an internal derangement. The most frequent finding in internal derangement is an anterior dislocation of the disc with reduction after mouth opening. In more severe cases a complete anterior dislocation is found without reduction of the disc. Internal derangement is a risk factor for developing osteoarthritis with remodeling of the condylus and the fossa mandibularis. The most important modalities of radiologic diagnosis are arthrography, CT and MRI. The diagnosis of craniofacial dysfunction has been improved dramatically by modern imaging techniques, which have become essential tools for primary diagnostic and evaluation after conservative or surgical therapy. MRI has become the gold standard.

Humans↗