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At least 613 records · Page 34Linked to original sources
PubMed2002

Relationships between pain-related mediators and both synovitis and joint pain in patients with internal derangements and osteoarthritis of the temporomandibular joint.

OBJECTIVE: The purpose of this study was to investigate the correlations between the concentrations of pain-related mediators in synovial fluid and the degree of synovitis and between the concentrations of pain-related mediators and the degree of joint pain in patients with internal derangement and osteoarthritis of the temporomandibular joint. STUDY DESIGN: The concentrations of substance P, serotonin, bradykinin, leukotriene B(4) (LTB(4)), and prostaglandin E(2) in SF and the degree of arthroscopic synovitis of 32 joints with internal derangement and osteoarthritis were assessed. The correlations between the concentration of each mediator and the score of arthroscopic synovitis and between the concentration of each mediator and the score of joint pain were analyzed statistically. RESULTS: The detection rates of substance P, serotonin, bradykinin, LTB(4), and prostaglandin E(2) were 25%, 25%, 91%, 53%, and 16%, respectively. Positive correlations were found between the concentrations of bradykinin and LTB(4) and the score of synovitis. CONCLUSION: Bradykinin in SF might be useful as an index of the degree of synovitis.

Adolescent↗
PubMed1996

Comparison of tomography and midfield magnetic resonance imaging for osseous changes of the temporomandibular joint.

The purpose of this study was to compare midfield (0.3 Tesla) magnetic resonance imaging with conventional tomography for assessment of osseous changes of the temporomandibular joint. The material consisted of magnetic resonance images and tomograms of 66 temporomandibular joints. Each set of images was assessed for osseous changes without knowledge about patient symptoms or findings of the other imaging modality. The results showed that 30 joints were normal both by magnetic resonance imaging and tomography, 21 joints showed osseous changes with both techniques, and there were discrepancies between the two techniques in 15 joints. In 12 of these 15 joints magnetic resonance imaging was negative, but tomography showed osseous changes. In the other three joints tomography was normal, but magnetic resonance imaging showed osseous changes. Based on previous tomographic and midfield magnetic resonance imaging studies with correlation to cryosections and dissection and the quality of the depiction of the osseous changes in these images, it was apparent that tomography represented a more accurate representation of the osseous anatomy. The results therefore suggest that conventional tomography is superior to midfield magnetic resonance imaging for assessment of osseous changes of the temporomandibular joint.

Adult↗
PubMed1979

Degenerative disease of the temporomandibular joint in young persons.

The majority of cases of temporomandibular joint pain that are referred to the consultant dental surgeon are diagnosed as pain-dysfunction syndrome, a term first suggested by Schwartz (1959) and now probably the most widely accepted. Another relatively common problem is degenerative disease or osteoarthrosis, and although this generally affects an older age group than pain-dysfunction syndrome, its occurance in the younger patient is by no means a rarity and is further evidence that the two conditions are expressions of the same problem, that is repetitive overloading of the joint. It is proposed that this should be termed mandibular stress syndrome.

Adolescent↗
PubMed2002

Clinical evaluation of patients with temporomandibular joint implants.

PURPOSE: An undetermined number of patients with temporomandibular joint (TMJ) symptoms have been treated with intra-articular disc implants composed of Teflon ethylene/propylene or Teflon polytetrafluoroethylene and aluminum oxide (Proplast-Teflon; Vitek, Houston, TX). These implants have shown the potential to fragment in situ resulting in nonbiodegradable particles that stimulate a giant cell reaction and lead to degeneration of local structures, pain, and limitation of mandibular opening. We examined the possible relationship between TMJ implants and persistent pain, responses to sensory stimuli, quality of life, and systemic immune dysfunction. PATIENTS AND METHODS: This case series (32 patients) were referred from university-based orofacial pain centers and private practices from across the United States. Laboratory and clinical assessments evaluated orofacial pain symptoms, neurologic function, clinical signs and symptoms of rheumatologic disease, physical function, systemic measures of immune function, and behavioral measures. RESULTS: We found that TMJ implant patients appeared to have altered sensitivity to sensory stimuli, a higher number of tender points with a diagnosis of fibromyalgia, increased self-report of chemical sensitivity, higher psychologic distress and significantly lower functional ability. Systemic illness or autoimmune disease was not evident in this series of TMJ implant patients. CONCLUSIONS: Significant problems were noted on clinical assessment of TMJ implant patients. This is a US government work. There are no restrictions on its use.

Adult↗
PubMed1990

The temporomandibular joint: the forgotten articulation.

Fifty-seven patients (79 temporomandibular joints) whose symptoms did not respond to conservative treatment subsequently underwent surgery to correct the internal derangement and obtain relief. This 8-year study emphasizes etiology, the diverse nature of the symptoms, clinical diagnosis, radiographic diagnostic features, surgical findings technique, postoperative treatment, complications, and long-term results. Special attention is given to a heretofore undescribed bilaminar posterior ligament repair technique which appears to provide greater strength of repair and more natural joint function.

Adolescent↗
PubMed1989

Morphologic and histologic changes in canine temporomandibular joint tissues following arthroscopic guided neodymium:YAG laser exposure.

A neodymium:yttrium aluminum garnet (Nd:YAG) laser beam was introduced by a quartz fiber passed arthroscopically into the superior joint space of the temporomandibular joints (TMJ) of five mongrel dogs, with one joint serving as a control without laser wounds. Immediate postoperative death and examination of the disc grossly and histologically revealed different patterns for contact and noncontact burn wounds. The wounds exhibited signs of thermal coagulation necrosis similar to those reported in other tissues. The potential implications of the adaptation of the Nd:YAG laser to TMJ arthroscopic surgery are discussed.

Animals↗
PubMed1985

Mandibular range of motion versus arthrographic diagnosis of the temporomandibular joint.

The range of mandibular movements has been correlated with arthrographic findings of the temporomandibular joint in 205 patients. Abnormalities of meniscus position and function have been found to influence mandibular movements in characteristic patterns. However, altered mandibular movements alone are insufficient for a definitive clinical diagnosis of the specific type of internal derangement of the temporomandibular joint.

Adult↗
PubMed1991

[Histological studies of the morphological relationship of the lateral pterygoid muscle to the articular disk in the human temporomandibular joint].

The biomechanical process which lead to the development of cracking sounds in the temporomandibular joints have received contradictory treatment in the literature. Most of the authors regard consider the cracking sounds to be caused by mechanical friction produced in translational movements of the condylus. According to this hypothesis the discus articularis which is dislocated in an anterior direction active pulling of the lateral pterygoid muscle, is regarded as being a mechanical obstacle. The morphological relationships however, between the lateral pterygoid muscle and the discus articularis are unclear. Our histomorphological investigations of 16 human temporomandibular joint samples from fresh cadavers of victims of accidental death revealed evidence that in the majority of cases a tendon connected the upper head of the lateral pterygoid muscle with the discus articularis. This would suggest that an anterior dislocation of the discus, resulting from an active pulling movement of the lateral pterygoid muscle, cannot be ruled out as a possible morphological cause for cracking sounds.

Adolescent↗
PubMed2006

Ultrasonographic findings in normal temporomandibular joints.

The purpose of this study was to determine some ultrasonographic standards of temporomandibular joints with normally positioned discs. Nineteen patients from 18 to 45 years old (average age: 27.4 years; 16 females and 3 males), with history of orofacial pain, but without clinical or radiological signs of disc displacement, underwent ultrasonography (US) and magnetic resonance imaging (MRI) for the examination of their joints. In 30 joints, the distance between the most lateral point of the articular capsule and the most lateral point of the mandibular condyle (lateral capsule-condyle distance) was measured, as well as the distance between the most anterior point of the articular capsule and the most anterior point of the mandibular condyle (anterior capsule-condyle distance). In the closed-mouth position, the average values found for the lateral capsule-condyle distance were 1.4 mm and 1.6 mm, respectively in the longitudinal (coronal) and transverse (axial) scans. In the open-mouth position, the average distance was 1.2 mm, in both longitudinal (coronal) and transverse (axial) scans. The average values found for the anterior capsule-condyle distance were 2.3 mm in the closed-mouth position and 1.1 mm in the open-mouth position, both in transverse (axial) scans. Intra-examiner agreement, measured in terms of the intraclass correlation coefficient, varied from 0.83 to 0.93. We believe that this study can contribute to the validation of US as a diagnostic method for temporomandibular joint disorders, provided that the obtained measurements be used in future studies as normal reference values.

Adolescent↗
PubMed2002

Fine-needle aspiration biopsy diagnosis of "invasive" temporomandibular joint pigmented villonodular synovitis.

The clinical and aspiration cytologic details of a case of temporomandibular joint pigmented villonodular synovitis are presented and correlated with imaging, surgical, histopathologic, and clinical follow-up findings; the origin of such lesions is discussed. The lesion originally presented in a 36-year-old, otherwise healthy, white man as a unilateral mass involving the temporal fossa and temporomandibular joint region. The tumor's extent was defined by magnetic resonance imaging and computed tomographic scan; there was destruction of the temporomandibular joint and erosion of the temporal cranial bones by a lesion whose maximum dimensions were estimated by imaging to be 2.75 x 3.25 cm. The lesion was initially sampled and classified by computed tomography-guided fine-needle aspiration biopsy. Following complete resection, the original diagnosis was confirmed with both hematoxylin-eosin-stained paraffin sections and immunohistochemical staining. The patient remains free of disease 7 years postoperatively.

Adult↗
PubMed2006

Mandibular condylectomy and meniscectomy for the treatment of septic temporomandibular joint arthritis in a horse.

OBJECTIVE: To report use of mandibular condylectomy for treatment of advanced degenerative joint disease of the temporomandibular joint (TMJ) caused by sepsis. DESIGN: Clinical case report. ANIMALS: Two-year-old Noriker filly. METHODS: Computed tomography (CT) was used to confirm advanced degenerative joint disease of the left TMJ and for follow-up after mandibular condylectomy and removal of necrotic meniscus. RESULTS: Painful swelling (3 weeks duration) with drainage located just caudal to the left lateral canthus of the eye was associated with atrophy of the left masseter muscle, masticatory problems, and inappetence. There was incisor malocclusion with a 1.4 cm resting lateral mandibular deviation to the right and inability to open the mouth more than a few centimeters. Left mandibular condylectomy combined with meniscectomy and thorough debridement of the septic left TMJ resulted in resolution of clinical signs and complete return of function. Streptococcus zooepidemicus, intermediately resistant to penicillin and subsequently to enrofloxacin, was isolated from the wound. Regeneration of a mandibular "pseudocondyle" was evident on CT at 4 months. At 4 months and 1 year the filly had maximal mouth opening >10 cm and no malocclusion. CONCLUSION: Mandibular condylectomy can be used to facilitate management of septic TMJ arthritis. There was no radiologic or clinical evidence of TMJ ankylosis >1 year after meniscal removal. CLINICAL RELEVANCE: Mandibular condylectomy, including meniscectomy, is an acceptable treatment option for advanced TMJ septic arthritis and allowed return of normal masticatory function.

Animals↗
PubMed1995

Dangerous angles and depths for middle ear and middle cranial fossa injury during arthroscopy of the temporomandibular joint.

PURPOSE: Several reports have suggested a risk of injury to the middle cranial fossa and middle ear during arthroscopic procedures in the superior joint space of the temporomandibular joint (TMJ). However, there has been no anatomic study of directions and distances of the TMJ from the posterior portal in relation to the risk of mandibular fossa injury. In this study, the angles and depths at which the risk is greatest for injury to the deepest point of the mandibular fossa (DP) and to the middle ear during arthroscopy were analyzed. MATERIALS AND METHODS: Three-dimensional measurements of 96 mandibular fossae in 48 dry skulls were made. RESULTS: It was found that the distance from the lateral rim of the fossa to DP and Hugier's canal was 9.50 +/- 2.07 mm and 17.04 +/- 3.09 mm, respectively. The most dangerous angle for DP injury in the Frankfort horizontal plane (FH plane) was an inclination of the instrument base of -8 degrees dorsad and 17 and 19 degrees caudad in the frontal plane. The most dangerous angle for Hugier's canal injury was a tilting of the instrument base of 15 degrees ventrad in the FH plane and -2 degrees craniad in the frontal plane. However, these values showed a wide range. CONCLUSION: It was concluded that great care must be exercised in manipulation of instruments near the DP and Hugier's canal to avoid injury to the middle ear or penetration into the middle cranial fossa.

Adolescent↗
PubMed1992

Cerebrospinal fluid leak associated with proplast implant removal from the temporomandibular joint.

Severe bone erosion within the temporomandibular joint reconstructed with polytetrafluoroethylene implants is a well-recognized phenomenon. Although erosion into the middle cranial fossa has been reported, we know of no report of dural disruption with cerebrospinal fluid leakage. We report a case of cerebrospinal fluid leak noted at the time of PTFE implant removal and its subsequent management. Perforation of the contralateral glenoid fossa and its reconstruction is also reported.

Aged↗
PubMed1989

Quantitative and subjective analysis of temporomandibular joint radiographs.

The lateral oblique transcranial radiograph of the temporomandibular joint is commonly used in dentistry. Changes in horizontal angulation of the x-ray beam can produce changes in radiographic condylar position. This study used quantitative and subjective methods to assess and rank changes in radiographic condylar position as a function of known horizontal x-ray beam changes. Six dry skulls were positioned in a craniostat device where known angulations could be measured. Nine sequential transcranial temporomandibular joint radiographs were made of each joint and five of these 12 sets were randomly selected for analyses. The quantitative method involved film digitization, computer calculations, and expressed condylar position as a ratio between posterior and anterior joint space distributions. Eight observers viewed the same films and ranked radiographic condylar position from anterior to posterior. The two methods agreed with known rankings 81.8% of the time. Subjective rankings were more variable than quantitative rankings. Intraobserver differences were insignificant and the observers were consistent among themselves as a group.

Cephalometry↗
PubMed1990

Muscle activity patterns and control of temporomandibular joint loads.

The strategy used by the neuromuscular system to distribute reaction forces to the temporomandibular joints on the working and balancing sides has not been fully defined. Theoretical studies and experimental measurements suggest that the two joints are unevenly loaded during unilateral biting or closures for posterior teeth. However, previous electromyographic studies suggest that muscle activity patterns may attempt to balance the distribution of the two joint forces. This study measured bilateral activity in the anterior temporal, posterior temporal, and superficial masseter muscles during isometric bites or closures and chewing at five different positions along the teeth. The resulting ratios of muscle activity on the working/balancing sides were compared with ratios required to maintain equal joint forces. The values of the muscle activity were also used to estimate the ratio of joint forces on the working/balancing side at each tooth position. Results indicate that the muscle activity patterns do not maintain equal joint forces, nor are the muscles responding to joint forces exceeding critical limits. These results suggest that patterns of muscle activity are designed to control the position and magnitude of occlusal forces rather than temporomandibular joint forces. If these same patterns of activity are maintained following repositioning of dental and skeletal elements, adverse temporomandibular joint forces could result.

Adult↗