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At least 649 records · Page 36Linked to original sources
PubMed1997

The effect of occlusal appliances and clenching on the temporomandibular joint space.

It has been suggested that stabilization appliances and mandibular anterior repositioning appliances work by decompressing the temporomandibular joint. To indirectly test this assumption, tomograms of right temporomandibular joints of seven subjects were taken during comfortable closure and maximum clenching in maximum intercuspation and on the two types of occlusal appliances. Outlines of the condyle and the temporal fossa were automatically determined by an edge detection protocol. Upon comfortable closure, the anterior joint space dimension was reduced with stabilization appliances and mandibular anterior repositioning appliances. Upon maximum clenching, the minimum joint space dimension on stabilization appliances was equivalent to that seen in maximum intercuspation, while that on mandibular anterior repositioning appliances was substantially less (P < .05). Findings do not indicate that these appliances induce an increase in joint space during clenching.

Adult↗
PubMed2001

Experimental validation of a finite element model of the temporomandibular joint.

PURPOSE: A 2-dimensional finite model of the temporomandibular joint (TMJ) was previously developed to provide a way of studying the specific roles of individual components as well as the overall dynamics of joint motion. This study was undertaken to show that the previously reported finite element model provides results that are consistent with the experimentally obtained results. MATERIALS AND METHODS: The upper compartment of a TMJ of a fresh cadaver specimen was exposed to allow the insertion of a small strip of pressure-sensitive film. Measured loads were applied to the chin and angle of the mandible, pressing the condyle into the glenoid fossa. The resulting stresses in the joint stained the film, providing a way to determine their magnitude. Similar loads were applied to the finite element model and the stresses in the TMJ were mathematically calculated. RESULTS: Experimental results were successfully obtained in 4 separate attempts, recording maximum stresses of 5.6, 8.6, 6.4, and 9.9 MPa (megapascals), respectively. The corresponding finite element model predictions were 7.3, 6.9, 6.4, and 8.2 MPa, respectively. CONCLUSIONS: This study indicates that the results of the previously reported finite element model of the TMJ provide a reasonable approximation of the actual physical situation.

Aged↗
PubMed1988

Spontaneous temporomandibular joint arthropathy in MRL-lpr/lpr mice.

The temporomandibular joint (TMJ) in spontaneously arthritic MRL lpr/lpr (MRL/l) mice has been histologically analysed. After decalcification and standardized preparation of the joint tissue, histological sections were examined for presence of synovial hypertrophy, synovial villi, pannus tissue, erosions, cysts and signs of periarticular inflammation. In 12 of 13 TMJs examined, histopathological changes indicating a state of arthropathy were found. The most prevalent finding was synovial proliferation, which was frequently detected at the insertion of the synovial membrane to the bone. Two or more signs of inflammatory involvement including synovial proliferation, pannus tissue and bone erosion were seen in 5 mice with a predominance among the oldest mice (greater than or equal to 5 months of age). No lymphocytic cell infiltration was found in the analyzed synovial tissues of the TMJ. In contrast, lymphocytes were observed in the vicinity of periarticular blood vessels and tendons. It is concluded that the TMJ is frequently involved in the arthritic disease of autoimmune MRL/l mice.

Animals↗
PubMed1990

Rheumatic disease of the temporomandibular joint: MR imaging and tomographic manifestations.

Thirty-six temporomandibular joints (TMJs) in 28 symptomatic patients (aged 14-40 years) with rheumatic disease (mostly rheumatoid arthritis) were studied with magnetic resonance (MR) imaging and hypocycloidal tomography. MR images of four TMJs were normal. Another four TMJs showed internal derangement. Of the 28 TMJs presumed to show rheumatic disease involvement (26 with condylar destruction or deformation), 23 showed abnormal disk structure--five showing severe disk destruction and 18 showing less severe abnormalities (inhomogeneous structure, fragmentation, poor delineation, and severe flattening). MR images showed bone abnormalities in 27 of the 36 TMJs, and tomography showed abnormalities in 25 of the 36 TMJs. Good agreement between the two imaging modalities regarding surface irregularities was found. However, MR imaging demonstrated more extensive bone abnormalities than did tomography in 11 TMJs. The potential of MR imaging for depicting bone and soft-tissue abnormalities associated with rheumatic TMJ involvement was clearly demonstrated.

Adolescent↗
PubMed1998

Ultrasonic imaging of the temporomandibular joint: a clinical trial for diagnosis of internal derangement.

Kinematic imaging of the temporomandibular joint (TMJ) was applied for diagnosis of TMJ disorders using an ultrasonic diagnostic imaging system. Patients with a normal TMJ (male, 24 y 1 mon) and a symptomatic TMJ (female, 20 y 2 mon) were selected for imaging. The transducer must be placed in a specific location in order to propagate ultrasound through soft tissue because it is difficult for ultrasound to penetrate bone such as the condyle and the eminence. Therefore the ultrasonic images were not taken in sagittal cross-section, as is the case with magnetic resonance images. The ultrasonic diagnostic imaging system showed a transverse cross-section and no hard tissue images. It was difficult to become accustomed to these images, thus making it difficult to find differences between the normal TMJ and the symptomatic TMJ on the basis of static ultrasonic images alone. However a difference between the kinematic images of the normal and symptomatic TMJ was observed during jaw opening. Irregularity in the striated pattern of the soft tissue surrounding the condyle was observed in the image of the symptomatic TMJ. In order to make a precise diagnosis using ultrasonic imaging, it may be useful to understand the kinematics of the soft tissue surrounding the TMJ during jaw opening and closing.

Adult↗
PubMed1983

Temporomandibular joint involvement in systemic lupus erythematosus.

Temporomandibular joint involvement was studied in 37 systemic lupus erythematosus patients not selected with regard to this involvement. One-third had current complaints and two-thirds had a history of severe symptoms. Objective findings indicating systemic lupus erythematosus arthritis were locking or dislocation, tenderness to palpation, and pain on movement of the mandible. Such changes were found in 8 patients (22%) but in none of the healthy controls. Radiographic changes of the condyles, including flattenings, erosions, osteophytes, and sclerosis, were seen in 11 patients (30%), 4 of whom had deformity of other joints as well.

Adult↗
PubMed1990

Condylar position in superior maxillary repositioning and its effect on the temporomandibular joint.

Twenty-nine patients (58 joints) were tomographically evaluated for condylar position and assessed for temporomandibular joint function following superior maxillary repositioning with mandibular autorotation. Seventy-six percent of the condyles showed postoperative posterior repositioning, whereas tomographic measurement of the joint spaces revealed significantly posterior condylar position (P less than .01) relative to the preoperative position. Pre- and postoperative comparative values of condylar displacement from absolute concentricity based on the Pullinger index also showed posterior condylar repositioning postoperatively (P less than .001). However, there was no correlation between condylar position and the presence of temporomandibular joint symptoms in both the asymptomatic and symptomatic groups.

Adolescent↗
PubMed1999

Immunolocalization of gelatinase-A (matrix metalloproteinase-2) in damaged human temporomandibular joint discs.

The fibrous tissue of the articular disc of the dysfunctional temporomandibular joint undergoes deep and variable structural modifications. Here the concurrence of morphological changes and the expression of matrix metalloproteinase-2 (MMP-2) in damaged discs from individuals suffering joint dysfunction was investigated. Microscopic, ultrastructural and immunocytochemical investigations were made on variously damaged articular discs and on one control sample. Disaggregation of collagen fibres, an increase in cellular components and calcification of large areas of tissue were observed in the damaged discs. These modifications were accompanied by a positive immunoreaction pattern for MMP-2. Fibroblast-, chondroblast- and osteoblast-like cells displayed a positive cytoplasmic reaction. In samples displaying evidence of synovial hyperplasia, some cells of the synovial protrusions were MMP-2 immunoreactive. No MMP-2 staining was observed in the control sample. These findings demonstrate that structural modifications of the articular disc could be specific responses to changes in the function of the temporomandibular joint. Variations in extrinsic stimuli may activate intrinsic factors, such as MMPs, that induce structural modifications in the discal tissue.

Adult↗
PubMed1980

Arthrotomographic diagnosis of meniscus perforations in the temporomandibular joint.

A method of diagnosis of temporomandibular joint (TMJ) meniscus perforation is described along with the clinical incidence and significance. Meniscus perforations are believed to accelerate degenerative disease of the TMJ. Perforations were diagnosed in 12% of the patient series by arthrography. Arthrography of the TMJ offers an important diagnostic method relevant to current diagnosis and treatment of joint pain and dysfunction.

Adult↗
PubMed1997

Ganglion cyst and synovial cyst of the temporomandibular joint. Two case reports.

Ganglion cysts and synovial cysts are lesions rarely associated with the temporomandibular joint. Ganglion cysts arise from myxoid degeneration of the connective tissue of the joint capsule, are filled with viscoid fluid or gelatinous material, and have a fibrous lining. Synovial cysts also contain gelatinous fluid and are lined with cuboidal to somewhat flattened cells consistent with a synovial origin. One case of a ganglion cyst and one case of a synovial cyst of the temporomandibular joint are presented, and their differential diagnosis and management are discussed.

Adult↗
PubMed1998

Intra-articular injection of hyaluronic acid reduces total amounts of leukotriene C4, 6-keto-prostaglandin F1alpha, prostaglandin F2alpha and interleukin-1beta in synovial fluid of patients with internal derangement in disorders of the temporomandibular joint.

This prospective randomised study was designed to assess the effect of an intra-articular injection of sodium hyarulonate on internal derangement in disorders of the temporomandibular joint. Fifteen patients (4 men, 11 women, mean (SEM) age 33(3) years) with unilateral internal derangement of the temporomandibular joint without radiographic evidence of the condylar degeneration who were randomly allocated to have arachidonic acid metabolites (n = 9) or cytokines (n = 6) measured in synovial fluid. The preauricular area was disinfected and anaesthetised locally with 1% lignocaine hydrochloride. Synovial fluid was collected by rinsing the joint with saline 5 ml. Sodium hyaluronate 1 ml (10 mg) was then injected into the superior compartment of the temporomandibular joint. The treatment was repeated after two weeks. The effects of sodium hyaluronate on total amounts of arachidonic acid metabolites and cytokines and on symptoms was measured. Injection of sodium hyaluronate caused significant reductions in the mean (SEM) of total amounts of leukotriene C4 (4.68 (2.27) to 0.48 (0.24) ng/joint), 6-keto-prostaglandin F1alpha (12.12 (2.78) to 5.19 (1.90) ng/joint), prostaglandin F2alpha (12.63 (5.51) to 4.21 (2.20) ng/joint), and interleukin-1beta (100.5 (14.2) to 50.8 (13.9) pg/joint), respectively (P<0.05 in each case). The mean (SEM) pain score was significantly reduced from 2.56 (0.18) to 0.89 (0.26) (P<0.01), the noise score from 2.18 (0.23) to 1.18 (0.18) (P<0.05), and degree of mouth opening from 28.2 (2.5) to 34.9 (2.0) mm (P<0.01). However, no improvement in symptoms was recorded in 1/9, 5/11, and 1/9 patients, respectively. These findings suggest that inflammation plays a part in internal derangement of the temporomandibular joint, and injection of an anti-inflammatory substance may be beneficial to such patients.

6-Ketoprostaglandin F1 alpha↗
PubMed1982

Microsurgical approach to the temporomandibular joint. A new horizon.

The operating microscope has revolutionized many surgical procedures. To my knowledge, this article records for the first time, pioneering microtechniques for exploring and reconstructing the temporomandibular joint. Determination of pathologic conditions and observation of temporomandibular joint function-dysfunction are dramatic and rewarding. Precision surgery using microinstruments, microneedles, microdrills, and bipolar cautery allows accuracy of technique that previously was impossible. Two representative case presentations illustrate patient treatment, microsurgical technique employed, and clinical results obtained.

Adult↗
PubMed1993

Relation between intra-articular temperature of the arthritic temporomandibular joint and presence of calcitonin gene-related peptide in the joint fluid. A clinical study.

Arthritic temporomandibular joints were investigated for intra-articular temperature and joint fluid content of calcitonin gene-related peptide. Eleven patients (16 joints) with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or chronic unspecific polyarthritis or monarthritis participated in the study. The intra-articular temperature varied between 35.5 and 37.5 degrees C, with a mean of 36.5 degrees C. The concentration of calcitonin gene-related peptide varied between 7.5 and 749.0 pmol/l, with a mean of 108.6 pmol/l. There was a positive correlation between the intra-articular temperature and the joint fluid concentration of calcitonin gene-related peptide. The plasma level of the peptide was on an average 5% of the joint fluid level.

Adult↗
PubMed1990

Computerized axial tomography in the diagnosis of internal derangements of the temporomandibular joint.

Fourteen patients with a history of pain, clicking and locking of the temporomandibular joint were assessed clinically and by using computerized axial tomography (CAT). The findings of the clinical and CAT scan assessment were correlated and compared with surgical observations. Computerized axial tomography scanning proved to be a highly accurate method of assessing meniscal position. With the advent of more sophisticated methods of CAT scanning, it provides an accurate, non-invasive method of assessing the temporomandibular joint and providing a basis for more effective treatment planning of problems related to internal derangements.

Adolescent↗
PubMed1987

Morphology of the meniscotemporal part of the temporomandibular joint and its biomechanical implications.

The temporomandibular joint is a diarthrosis. It has classically been referred to as being a condylar, and functionally as a double condylar joint. We have used the moiré topographical technique to study the morphology of the pars suprameniscalis or meniscotemporalis of the joint. The findings show that this pars suprameniscalis could be classified as a saddle joint. The biomechanical implications are also discussed.

Humans↗
PubMed1981

Temporomandibular joint space in children without joint disease.

Bilateral assessment of the temporomandibular joint space in children without joint disease is reported. Twenty-eight children were examined with conventional radiography and 23 with tomography. High prevalence of asymmetric joint spaces with both techniques indicated that great care should be taken when using narrowing or widening of the joint space as a diagnostic criterion in children with juvenile rheumatoid arthritis. Other signs, such as restricted translation of the mandibular head, and clinical symptoms should be evaluated.

Adolescent↗