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Results for “TEMPOROMANDIBULAR JOINT”

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PubMed1987

Sexual dimorphism in the distribution of estrogen receptors in the temporomandibular joint complex of the baboon.

The localization of radiolabeled estradiol was examined in the temporomandibular complex of male baboons by means of an autoradiographic technique. Five baboons were studied. Four animals received only the tritiated estrogen (1 microgram/kgm) and one animal, which served as the control, received both the tritiated estrogen and the unlabeled estrogen (100 micrograms/kgm). The study failed to demonstrate nuclear uptake and retention of tritiated estrogen in any of the tissues of the temporomandibular joint complex, including the articular surface of the condyle, articular disk, capsule, and muscles of mastication. However, estrogen receptors were identified in other tissues, including the pituitary. All tissues examined in the control animal were negative for estrogen receptors. It was concluded that there were no estrogen receptors in the temporomandibular joint complex of aged male baboons. As in previous studies, these findings provide additional evidence of a sexual dimorphism with respect to estrogen receptor distribution in the temporomandibular joint complex of the baboon. Furthermore, it is reasonable to speculate that estrogens may modulate a variety of metabolic functions in these tissues that could be important in the maintenance, repair, and/or pathogenesis of the temporomandibular joint.

Animals↗

PubMed1979

[Hirtz's incidence in the study of the manducatory apparatus. Application to temporomandibular joint affections (author's transl)].

Radiological examinations have always been considered of secondary importance during diagnostic investigations of temporomandibular joint affections because of the frequency with which negative results were obtained. For most authors its only value has been to establish a differential diagnosis from other lesions of the manducatory apparatus in which clinical manifestations are comparable. A systematic study of the manducatory apparatus in patients with temporomandibular joint affections was carried out by taking two films, one with the month open, the other with the month closed, according to Hirtz's incidence. The results showed that abnormalities of varying degrees of severity were present relatively frequently. They usually involved the temporomandibular joint, either morphologically or physiologically. The multiplicity of the abnormalities observed, their character, and their frequency raise the problem of defining their role in the genesis of the disorders described and strongly suggests that the place of radiological investigations in the diagnostic tests for temporomandibular joint affections has to be reconsidered. The examination described would be, because of its simplicity, the basic investigation in the radiological study, with other studies possibly following on later to complement it.

Diagnosis, Differential↗

PubMed1988

Organ culture providing an articulating function for the temporomandibular joint.

Cranial bases of 5 days old mice along with the temporomandibular joints and the whole mandibles were maintained in organ culture for one, two or three weeks. A device consisting of an electric motor rotating a bar with three magnets was developed for providing an articulating function for the temporomandibular joints. The tissue samples were attached to the end of a lever arm inside a container and a piece of iron was fixed to the other end of the lever arm to allow it to be lifted magnetically every 45 seconds. This movement pressed the other end of the lever arm downwards, submerging the tissues in the medium. As the anterior end of the mandible was attached to a wire above the tissues with a silk thread while the rest of the tissue sample moved downwards, a rotating movement was produced in the mandibular joint. Control mandibles were cultured without any such movement in the temporomandibular joints. The reactions in the condyles were studied macroscopically after alizarin red injections and microscopically with haematoxylin and eosin, alcian blue, osteoid and von Kossa stains. The condylar processes had increased 0.6 mm in length in functional organ culture, 0.4 mm more than the sham-cultured condyles. Osteoid formation was more marked in the latter and calcification had proceeded closer to the superior surface of the cartilage than in the condyles cultured with articulatory function. The organ culture system developed here obviously resembles the situation in vivo more closely than do previously available organ culture systems and is the first in which it has been possible to provide the function necessary for maintaining growth. The system also seems suitable for culturing organs in which tissue size has previously been a limiting factor.

Animals↗

PubMed2000

Distribution of substance P-like immunoreactive fibers in feline temporomandibular joint.

OBJECTIVE: To study the distribution of substance P-like immunoreactive fibers in feline temporomandibular joint. METHODS: The immunohistochemical PAP method was used for the investigation of the distribution of substance P-like immunoreactive fibers in feline temporomandibular joint. RESULTS: The TMJ capsule and the anterior and posterior disc attachments all contained SP-immunoreactive nerve fibers, but the medium fibers in diameter were mainly observed. The density of the distribution of SP-positive nerve fibers was the highest in the subsynovium of the TMJ capsule. The density of distribution was similar in the anterior and posterior disc attachments, but lower than in the subsynovium and the lateral joint capsule. Such fibers in the synovial membrane were sparser, and a part of the fibers were seen around the thin blood vessels in all the foregoing tissues. CONCLUSION: These results provide the morphological data for exploring the neurobiological mechanisms of temporomandibular joint disorder and its pain.

Animals↗

PubMed2006

[Distraction osteogenesis for treatment of unilateral temporomandibular joint ankylosis and secondary OSAHS in children: report of 4 cases].

PURPOSE: To evaluate the efficiency of distraction osteogenensis for treatment of unilateral temporomandibular joint ankylosis and secondary OSAHS in children. METHODS: 4 children with temporomandibular joint ankylosis and secondary OSAHS were retrospectively reviewed for their treatment. There were 2 males and 2 females, ranging from 5 to 13 years in age with the median of 6.5 years. Based on the history of the disease, the clinical manifestations, CT scan and PSG findings, the diagnosis was confirmed to be unilateral temporomandibular joint ankylosis and secondary OSAHS. All the patients were treated by gap arthroplasty to restore mouth opening, combined with mandibular body distraction osteogenesis for treatment of OSAHS. One-stage operation was performed on 3 patients, and two-stage operation on 1 patient. Unilateral and bilateral mandibular distraction osteogenesis was undergone on 2 patients individually. At the end of consolidation period of 3 months, the PSG examination was performed again and the distractor was removed. RESULTS: OSAHS was cured, the average AHI was lowered from 42.7 to 4.9, the average lowest saturation of blood oxygen rose from 74.3% to 89.8%, the average incisor distance reached 25.5mm compared to 6.5mm before surgery and facial deformity was corrected satisfactorily. Following up 38.1 months (13-58 months), no relapse appeared. CONCLUSION: Mandibular body distraction osteogenesis, combined with gap arthroplasty, could be the potential treatment modality for children with unilateral temporomandibular joint ankylosis, secondary OSAHS and facial asymmetry; it is recommended that both procedures be performed at the same time.

Adolescent↗

PubMed2002

Microvascular temporomandibular joint and mandibular ramus reconstruction in hemifacial microsomia.

Microvascular temporomandibular joint (TMJ) and mandibular ramus reconstruction was performed in a 4-year-old hemifacial microsomia patient with multiple craniofacial and extracranial anomalies (Goldenhar syndrome). Her major craniofacial anomalies included bilateral cleft lip and palate, left macrostomia, left microtia, and complete absence of the left vertical mandibular ramus and TMJ. Most of her other anomalies had been corrected surgically before TMJ and vertical mandibular ramus reconstruction, which was accomplished with a metatarsophalangeal (MTP) joint transplantation. The MTP joint was placed in hyperextended position in the skull base inserting the proximal phalanx under the remnants of the zygomatic arch and replacing the vertical mandibular ramus with the metatarsal bone. Straight mouth opening, correction of the midline, and normalized lateral movements of the mandible were accomplished. The graft includes two epiphyseal plates, which should maintain growth of the transplant. During the follow-up period (16 months) the achieved results have been maintained without adverse effects. The present technique appears to be a promising alternative in the treatment of children with Pruzansky type 3 hemifacial microsomia.

Abnormalities, Multiple↗

PubMedDate not supplied

Common abnormalities in temporomandibular joint imaging.

Magnetic resonance imaging has evolved as a prime diagnostic method for soft-tissue abnormalities of the temporomandibular joint. The most common temporomandibular joint abnormalities are internal derangement and osteoarthritis, but there are many other reasons for pain and dysfunction that are often overlooked. The purpose of this paper is to illustrate several of these more unusual and less well-recognized causes for temporomandibular joint pain and dysfunction. For example, internal derangement is often seen in asymptomatic individuals. Another purpose is to illustrate the difference in magnetic resonance imaging of asymptomatic and symptomatic internal derangement.

Body Fluids↗

PubMed1989

Diffuse pigmented villonodular synovitis of the temporomandibular joint diagnosed by fine-needle aspiration cytology.

Diffuse pigmented villonodular synovitis is a rare tumor in the temporomandibular joint region. This article deals with a 32-yr-old male who suffered from pain and swelling in the right temporomandibular joint region associated with restricted mouth opening. Computed tomography showed a tumor lateral to the temporomandibular joint. Arthrography revealed a displaced temporomandibular joint disk. Fine-needle aspiration cytology showed characteristic cellular changes, including rounded or oval cells with abundant cytoplasm and intracytoplasmatic hemosiderin deposits and numerous multinucleated giant cells without nuclear atypia. A benign mesenchymal lesion suggestive for pigmented villonodular synovitis was diagnosed and later verified at histologic examination. Fine-needle aspiration cytology seems to be useful for this diagnosis.

Adult↗

PubMed1991

A functional approach to the treatment of temporomandibular joint internal derangement.

The goal of treatment for temporomandibular joint internal derangement has traditionally been the anatomic reduction of the displaced disc. Recent magnetic resonance imaging postoperative studies suggest that successful treatment may require only the mobilization of the adhered disc and release of capsular restraints rather than anatomic reduction. It is hypothesized that this mobilization of fibrosed and inflamed tissues decreases load concentration and allows pain-free function through physiologic adaptation.

Arthroscopy↗

PubMed1986

Clinical and arthrographic evaluation of temporomandibular joint sounds.

Two hundred five patients were examined for temporomandibular joint pain and dysfunction. Arthrograms were performed on 222 joints (188 unilateral and 17 bilateral). Patients with joint sounds suspected of being caused by meniscus displacement with reduction were evaluated. Seventy-two patients (38%), were suspected of "clicking" (a reducing meniscus), but only 53 had arthrographic findings of a reducing meniscus. Further evaluation of this patient group revealed that only 41 probably could be candidates for a protrusive splint. This represents only 57% (41 of 72) of patients with "clicking" who may be candidates for protrusive splint treatment.

Arthrography↗

PubMed1980

[Symptomatology of pain-dysfunction of the temporomandibular joint].

Symptomatology of pain-dysfunction in the temporomandibular joints. The symptomatology of 135 patients treated for pain-dysfunction syndrome (PDS) of the temporomandibular joints has been described. They were divided into five dysfunction groups according to the clinical dysfunction-index of Helkimo (1976). 75,3% of the patients were females, especially between 25-40 years of age. Most of the patients fell into the dysfunction II and III group. 20,0% of the patients waited 0-3 months between the onset of the pain and the first demand for treatment, 41,7% waited 0-6 months. 18.0% waited even longer than 25 months to consult the dentist. Almost 40% had psychological problems. Bruxism was present in 66% and joint noises have been found in 92,0%. A deviation in the openings movement occured in 55%, a reduction of the lateral movement has been observed in 38%. No correlation could be found between the dysfunction index and the number of occluding pairs of molars (r = .03) or premolars and molars combined (r = .20). This was also the case for all other anamnestic and occlusal parameters except for the occurrence of premature contacts on the balancing side. The fact is stressed that the etiology of PDS is multifactorial.

Adolescent↗

PubMedDate not supplied

The TMJ and the middle ear: structural and functional correlates for aural symptoms associated with temporomandibular joint dysfunction.

Several anatomic relationships existing between the ear and the temporomandibular joint have been proposed to account for the presence of aural symptoms that occur in some patients with temporomandibular joint dysfunction. There are a plethora of functional hypotheses for aural symptoms relating to disturbed functions of the eustachian tube (as well as neuromuscular relationships and neurovascular functions integrating with these hypotheses). Investigators explain the presence of aural symptoms relative to the anatomic relationship of the middle ear to the TMJ as hypothetically due in part to the "tiny ligament," the sphenomandibular ligament, or the diskomalleolar ligament. This article reviews hypotheses, explanations, and current research on this controversial issue.

Ear Diseases↗

PubMed2006

Sensory innervation of temporomandibular joint disk.

PURPOSE: To investigate the nerve endings of the adult temporomandibular joint disk, in particular the presence and configuration of the sensory nerve endings by silver staining and electron microscopy. METHODS: 20 cadaveric temporomandibular joints impregnated with silver stain were studied using an optical microscope; 2 other joints were studied using a transmission electron microscope. RESULTS: Free nerve endings were found in the disk parenchyma of all joints. Golgi-Mazzoni corpuscles, Ruffini corpuscles, and articular corpuscles were also observed as sensory nerve end organs. Myelinated and nonmyelinated nerve fibres were visualised in the disk parenchyma using the transmission electron microscope. CONCLUSION: Free nerve endings and sensory nerve end organs are present in the disk parenchyma of the human temporomandibular joint and are associated with sensation and proprioception, just as they are in the acetabular labrum, glenoid labrum, triangular fibrocartilage complex, and meniscus.

Adult↗

PubMed1996

[Results of follow-up of temporomandibular joint fractures in 30 children].

Disturbances of facial growth and occlusion as well as temporomandibular joint dysfunction are possible sequelae of temporomandibular joint fractures in children. In a follow-up study we examined 30 children with conservatively treated condylar fractures of the mandible (age at time of accident from 9 months to 13 years) regarding dysfunction or growth disturbances within the stomatognathic system. The mean interval between the accident and the follow-up was 4 years and 11 months. We found 6 cases with tilted occlusional planes in the 'en face' analysis, 3 of them with bilateral condylar fractures. There was only one case with a facial asymmetry. The interincisive distance was never below 35 mm. Only 3 patients, all of them with bilateral condylar fractures, had a restricted mobility of the mandible. Remodelling of the condylar head was good in 92% of the cases. Two patients with bilateral fractures showed formation of a bifid condyle without ankylosis. Deviation of the ascending ramus in the horizontal plane was observed radiographically in 21% of the cases with unilateral fractures and in 33% with bilateral fractures respectively and always in a medial direction. Measurement of the length of the Processus articularis in the orthopantomogramm showed a shortening in 70% of the cases on the fracture side. The radiographic evaluation of facial asymmetry after Ricketts and Mulick only revealed an angle difference of more than 5 degrees in some cases.

Adolescent↗

PubMed2002

Experimentally induced unilateral tooth loss: histochemical studies of the temporomandibular joint.

Occlusal abnormality may contribute to osteoarthrosis of the temporomandibular joint (TMJ). Since mechanical force may induce changes in the extracellular matrix, we tested the hypothesis that unilateral removal of teeth and the resulting unilateral mastication change the content of glycosaminoglycans (GAGs) in the TMJ condyle and disc. Lower-right-side teeth were extracted from 12 adult male rabbits, which were killed 3 or 6 weeks later. Three normal rabbits served as controls. Sections were analyzed for morphological changes and levels of sulfated GAGs in the condyle and disc. Unilateral removal of teeth led to thickening of the condylar cartilage, alterations in the morphology of chondrocyte nuclei in the condylar cartilage and disc, and increases in levels of negatively charged ions in the hypertrophic layer of condylar cartilage. Small differences were observed, after unilateral removal of teeth, between the functional and non-functional sides of the TMJ. The results suggest that in response to mechanical stress, chondrocytes alter sulfated glycosaminoglycan (GAGs) synthesis and degradation rates, resulting in an elevated level of sulfated GAGs in the condylar cartilage.

Animals↗

PubMed1994

The development of the human lateral pterygoid muscle and the temporomandibular joint and related structures: a three-dimensional approach.

The development of the human fetal temporomandibular joint and surrounding structures was investigated in 11 specimens on the basis of histologic examination and three-dimensional reconstructions. Until the 10th week, there were no signs of the disc, joint spaces and capsule formation of the temporomandibular joint (TMJ). Apart from Meckel's cartilage, all the temporomandibular joint and related structures attained their adult shape at 14 weeks. Throughout the embryologic and fetal development, the relative positions of the branches of the mandibular nerve remained unchanged. From 11-12 weeks onwards, the lateral pterygoid muscle became a complex structure which was segmented by aponeuroses dividing the muscle into three main parts: superior, infero-medial and infero-anterior parts. The superior segment was attached to the TMJ disc superiorly and medially. The infero-medial segment was inserted onto the antero-medial aspect of the TMJ condyle and disc. The infero-anterior portion was attached to the anterior aspect of the condyle.

Embryonic and Fetal Development↗

PubMed1999

Temporomandibular joint biomechanical restrictions: the fluid and synovial membrane.

The authors analyze the functions of the synovial membrane and the chemical-physical properties of synovial fluid. In particular they evaluate the role played by synovial fluid in the complex mechanism of the temporomandibular joint. Every single part that belongs to the temporomandibular joint, together with the stomatognathic apparatus, plays a specific and particular role according to the dynamics and to the preservation of the correct temporomandibular joint physiology. The physiological postural and functional relationship between the various parts of the temporomandibular joint is guaranteed by a number of biomechanical restrictions that lead and influence the regular execution of the articular movements. The most involved biomechanical restrictions in the temporomandibular joint are the temporomandibular ligament, the lateral disc ligament, the bilaminar zone or retrodiscal tissue, the synovial membrane, and the synovial fluid.

Biomechanical Phenomena↗

PubMed1991

Asymptomatic, radiologically detected chondrometaplasia in the temporomandibular joint.

Asymptomatic loose bodies were detected in the temporomandibular joint of a 62-year-old woman during an examination before comprehensive dental care. The radiologic interpretation was synovial chondrometaplasia (synovial osteochondromatosis). A histologic diagnosis was not obtained, because surgery was unwarranted in view of the lack of symptoms and the benign differential diagnosis. Review of the literature revealed 62 reported cases of temporomandibular joint chondrometaplasia, all of which included one or more of the following: swelling, pain, joint noise, and limited mandibular movement. These reports have described this entity as a rare lesion, but the rate of reports has increased, perhaps because of greater practitioner awareness and increased sensitivity of diagnostic tests.

Chondromatosis, Synovial↗