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Results for “TEMPOROMANDIBULAR JOINT”

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PubMed1990

The indications of arthroscopic sweep for the patient with internal derangements of the temporomandibular joint (T.M.J.).

The arthroscopy of the temporomandibular joint (TMJ) is recently recognized as the useful diagnostic manner as well as the alternative surgical procedures in the treatment of TMJ internal derangements. Arthroscopic surgery of the TMJ, which consists of arthroscopic sweep with lysis of adhesion and lavage of the upper joint compartment, is simple and less surgical invasive manner for the patient with closed lock. The instrumentation, procedure, patient management, and clinical evaluation are described.

Adolescent↗

PubMed1992

Prevalence of temporomandibular joint internal derangement in patients with craniomandibular disorders.

To determine the prevalence of temporomandibular joint internal derangement in patients with signs and symptoms of craniomandibular disorders, bilateral imaging was performed in a consecutive series of 115 patients with signs and symptoms of craniomandibular disorders. Ninety patients (78%) had different stages of unilateral or bilateral internal derangement, and 25 patients (22%) had normal temporomandibular joints bilaterally. Out of 230 joints, 60 showed disk displacement with reduction, 8 showed disk displacement without reduction, and 29 showed disk displacement without reduction associated with anthrosis. The study indicates that almost 80% of patients with signs and symptoms of craniomandibular disorders have different forms of internal derangement.

Adolescent↗

PubMed1979

The use of hypnosis in treating the temporomandibular joint pain dysfunction syndrome. Report of two cases.

This article, jointly authored by an oral and maxillofacial surgeon and a psychiatrist, presents two case studies of conjoint treatment of the temporomandibular joint pain dysfunction syndrome. The authors present a short review from the literature that supports the multifactorial etiology of temporomandibular joint dysfunction and provide, in two case studies, a combination of conservative dental treatment and hypnotherapy. The two case studies show a successful resolution of temporomandibular joint dysfunction with hypnosis in one case and failure of hypnotherapy to relieve the pain in a second case. Reasons for the success and failure are discussed. The article closes with some thoughts and ideas that dental practitioners can use in treating temporomandibular joint pain via hypnosis.

Adolescent↗

PubMed1999

Clinical and magnetic resonance findings in the temporomandibular joints of patients before and after orthognathic surgery.

It is difficult to achieve the correct position of the condyle in the temporal fossa during orthognathic surgery in angle class II patients with disorders of the temporomandibular joint. This led us to examine the TMJ of 25 of our own patients before and shortly after orthognathic operations. We recorded the clinical and magnetic resonance imaging findings of the temporomandibular joint preoperatively and three months postoperatively. The patients had skeletal class II dysgnathia and had been treated with fixed orthodontic appliances for a mean of two years and three months before operation. Operation resulted in a mean reduction of maximal incisor distance of 12 mm. In five of the 25 patients, the pattern of mouth-opening changed. Nine patients had less pain than before surgery, and nine had fewer abnormal joint sounds. The magnetic resonance imaging showed displacement of the articular disc in 38 of the 50 joints preoperatively and in 28 postoperatively. Degenerative joint changes were not improved by operation. Improvement of the disc position was achieved by repositioning of the condylar-disc complex during orthognathic surgery in angle class II patients. Clinical and magnetic resonance imaging findings regarding the temporomandibular joint in class II patients correlated significantly both preoperatively and postoperatively.

Adult↗

PubMed1995

Total reconstruction of the temporomandibular joint with cryogenically preserved allograft mandibular condyle, meniscus, and fossa in the adult goat.

OBJECTIVE: The purpose of this study was to determine the feasibility of total temporomandibular joint reconstruction with the use of cryogenically preserved allograft mandibular condyle, disk, and fossa in the adult goat. STUDY DESIGN: This study consisted of an experimental group of 10 adult goats that underwent total resection of their temporomandibular joints. These animals were immediately reconstructed with cryogenically preserved mandibular condyles, disks, and fossa. These allograft were harvested from 10 donor animals matched to the recipient animal with respect to age, sex, and head dimensions. These grafts were harvested and stored at -185 degrees C for several months before implantation. At 2 years after surgery, the animals were killed. They were evaluated, clinically, radiographically, and histologically. RESULTS: Fifty percent of the eight surviving animals had a normal clinically functional joint with an intact superior joint space and viable articular surfaces. CONCLUSION: The authors conclude that this temporomandibular joint reconstruction technique is feasible in the adult goat model and is deserving of further research.

Animals↗

PubMed1995

Gradient-echo MR imaging of the temporomandibular joint: diagnostic pitfall caused by the superficial temporal artery.

OBJECTIVE: In routine MR imaging of the temporomandibular joints, a low-signal structure posterosuperior to the mandibular condyle is occasionally seen on the two-dimensional gradient-echo sequence. The structure is ovoid and may have a higher-signal core, simulating a loose body within the joint. We undertook a clinical and cadaveric study to determine the cause of this finding. MATERIALS AND METHODS: In a clinical study, we reviewed the MR images of 100 temporomandibular joints. We scored each joint for the presence and appearance of a low-signal structure posterosuperior to the mandibular condyle: type 1 was ovoid with a low-signal rim and a higher-signal core, type 2 was ovoid with uniformly low signal, type 3 was a low-signal structure inseparable from the posterior wall of the glenoid fossa, and type 4 was normal. Using this scoring system, we determined the appearance and frequency of the finding on two-dimensional gradient-echo, T1-, T2-, and proton density-weighted images. To determine the cause of the finding, we correlated the imaging and anatomic findings in a cadaveric specimen. RESULTS: Of the 100 MR images of joints reviewed, 22 showed a type 1 structure, 24 a type 2 structure, 11 a type 3 structure, and 43 were normal. The finding was seen only on the two-dimensional gradient-echo sequences, never on the spin-echo sequences. Correlation between the imaging and anatomic findings in the cadaveric specimen showed that the finding was caused by the superficial temporal artery. The variability in its appearance is thought to result from the complex manifestations of flowing blood within this artery. CONCLUSION: The finding posterosuperior to the mandibular condyle seen on two-dimensional gradient-echo MR images is a flow phenomenon within the superficial temporal artery. Recognition of the nature of this finding will avoid mistaking it for disease, such as an intraarticular loose body.

Adult↗

PubMed2001

[Clinical research on the relationship between the orthondontic treatment and the temporomandibular joint noises].

The sign of the temporomandibular joint(TMJ) noise was assessed through the comparison among seventy orthodontic patients before and after orthondontic treatment. The results showed, after orthondontic treatment the TMJ noise was less than before, no significant correlation was found between TMJ noise and the orthondontic treatment with or without tooth extraction.

Adolescent↗

PubMed1999

Age and gender differences in temporomandibular joint radiographic findings before orthodontic treatment in adolescents.

OBJECTIVE: The purpose of this study was to determine whether there is a relationship between abnormal temporomandibular joint radiographic findings and age or gender in a sample of young preorthodontic patients. STUDY DESIGN: A total of 491 consecutive patients, aged 9 to 15 years, were referred for orthodontic records. Routine preorthodontic radiographs, including corrected sagittal tomographs, were taken for each patient and viewed by an observer blinded to clinical records. Temporomandibular joint radiographic findings were classified as normal or abnormal. For comparative purposes, the study population was divided into 2 age groups (9-11 years and 12-15 years). RESULTS: Frequency of abnormal findings ranged from 2.4% to 11.5% and was similar for both sides. Temporal component abnormalities correlated with abnormalities of condylar position, joint space, and condylar osseous morphology. The frequency of osseous abnormalities was higher in girls and highest in older girls. CONCLUSIONS: There are significant differences between genders for some temporomandibular joint radiographic abnormalities, and in our study sample the frequency of abnormalities was highest in 12-to-15-year-old girls.

Adolescent↗

PubMed2000

Synovial chondromatosis of the temporomandibular joint.

We report two cases of temporomandibular joint (TMJ) synovial chondromatosis, one of which was in the early stage and treated arthroscopically. The second was more advanced and recurred after removal of the free bodies, and so required condylectomy and synovectomy.

Adult↗

PubMed1987

Chondrocalcinosis of the temporomandibular joint. Calcium pyrophosphate dihydrate deposition disease.

A case of calcium pyrophosphate dihydrate (CPPD) arthropathy of the temporomandibular joint, seen in a 54-year-old woman, is reported. The patient presented an eight-year history of diffuse swelling with tenderness over the right preauricular region. Surgical exploration of the right temporomandibular joint disclosed calcified masses that were identified as CPPD crystalline materials by histologic and infrared spectrophotometric studies. The occurrence of CPPD arthropathy of the temporomandibular joint is very rare, and this is only the fourth report of such a case, to our knowledge.

Calcium Pyrophosphate↗

PubMed1986

Changes in temporomandibular joint pain-dysfunction after surgical correction of dentofacial anomalies.

20 patients with dentofacial anomalies were investigated with respect to signs and symptoms of temporomandibular joint pain-dysfunction, which was a common reason for requesting treatment. After surgical correction of the malocclusions, the patients were re-examined 1 week after removal of intermaxillary fixation (IMF), 6 months after surgery and, finally, after 1 to 2 1/2 years. Several of the patients complained of recurrent headaches before surgery and also reported several other subjective symptoms of temporomandibular joint pain-dysfunction. At final control, a statistically significant reduction in headache frequency, as well as for the anamnestic dysfunction index as a whole, was noted. An impairment of clinical signs of temporomandibular joint pain-dysfunction was noted 1 week after removal of IMF, but the situation then returned to that found preoperatively. At final control, a statistically significant reduction of the clinical dysfunction index used was noted. In line with other previous investigations, the patients were satisfied with the aesthetic result of the treatment. A statistically significant increase in number of occluding pairs of teeth was recorded postoperatively and the patients reported an improvement of chewing ability. It is concluded that surgical correction of dentofacial anomalies has a beneficial effect not only on aesthetic and dental occlusion but also upon signs and symptoms of temporomandibular joint pain-dysfunction.

Adolescent↗

PubMed1999

Postoperative ionizing radiation in the management of heterotopic bone formation in the temporomandibular joint.

PURPOSE: The purpose of this study was to evaluate the effectiveness and possible morbidity of postoperative low-dose ionizing radiation in the treatment of recurrent temporomandibular joint ankylosis. PATIENTS AND METHODS: From 1987 to 1996, 14 patients with a history of multiple surgeries and recurrent temporomandibular joint ankylosis were treated postsurgically with radiation therapy. The treatment regimen initially selected was a postoperative dose of 2,000 rads in 10 fractions. Subsequently, 1,000 rads was found to be as effective. The success of therapy was assessed by means of serial radiographic studies and clinical examination, with the longest follow-up being 9 years. RESULTS: Thirteen of 14 patients (93%) showed radiographic evidence of decreased heterotopic bone formation. No patient redeveloped ankylosis. A transient xerostomia appeared to be the only significant complication. CONCLUSION: Low-dose ionizing radiation therapy, consisting of 1,000 rads given in five fractionated doses soon after surgical treatment, reduces recurrent heterotopic bone formation and appears to be a useful adjunct to the surgical management of temporomandibular joint ankylosis.

Adult↗

PubMed2004

[Whiplash lesions and temporomandibular joint disorders].

Attributing dysfunction of the temporomandibular joint (TMJ) to whiplash injury is a difficult problem to solve. TMJ disorders do not seem to be secondary to direct articular trauma but rather caused by a postural disorder of the cervical spine. Occlusal disorders and stress further complicate the picture. Four clinical cases illustrate a new hypothetical approach.

Adult↗

PubMed1993

Relation between the intra-articular temperature of the temporomandibular joint and the presence of neuropeptide Y-like immunoreactivity in the joint fluid. A clinical study.

Arthritic temporomandibular joints were examined for the joint fluid content of neuropeptide Y-like immunoreactivity (NPY-LI) and the intra-articular temperature at two separate sessions. Sixteen patients (23 joints) with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and unspecific polyarthritis or monarthritis were investigated in this study. The intra-articular temperature ranged between 35.6 and 37.5 degrees C. The concentration of NPY-LI ranged between 72.1 and 4466.0 pmol/l and was above the normal plasma level in all patients. The intra-articular temperature was negatively correlated with the joint fluid concentration of NPY-LI. Moreover, patients with low intra-articular temperature and high concentration of NPY-LI had a shorter duration of TMJ symptoms than those with high intra-articular temperature and low concentration of NPY-LI.

Adult↗

PubMed1990

Conservative management of temporomandibular joint disease: a case study.

Although temporomandibular joint (TMJ) problems are difficult to diagnose and evaluate, treatment today centers on conservative methods, not surgery. Many dentists lack the knowledge to adequately diagnose and treat TMJ, and many insurers as well as managed care plans have often refused to pay for conservative therapy, now known as Phase 1 TMJ treatment. This treatment consists of appliance or intraoral splint placement, along with physical therapy. Ultimately, this therapy is far less expensive than either joint or orthognathic surgery. Since there is no recognized specialty in TMJ disease, managed care programs need to establish discernible criteria for the selection of providers to diagnose and treat their TMJ patients. By carefully selecting providers and monitoring the outcome of treatment rendered to patients, costs and time of treatment could be drastically reduced, benefiting the patient and the managed care program.

Adolescent↗

PubMed1997

Pigmented villonodular synovitis of the temporomandibular joint.

Pigmented villonodular synovitis is a proliferative disorder affecting the synovium and may be an aggressive local process with bone destruction and invasion of contiguous structures. Involvement of the temporomandibular joint is very rare. We report a rare case of pigmented villonodular synovitis of the temporomandibular joint that invaded the infratemporal fossa with bone destruction of the mandibular condyle. Magnetic resonance imaging was effective in delineating the extent of the lesion in the infratemporal fossa. Fine-needle aspiration cytology showed multinucleated giant cells and round or spindle-shaped cells with hemosiderin deposits. The tumor was resected en bloc through a combined temporocervical and infratemporal fossa approach. The postoperative histological diagnosis was a variant of pigmented villonodular synovitis. Fine-needle aspiration cytology and magnetic resonance imaging proved to be useful in the preoperative diagnosis of pigmented villonodular synovitis of the temporomandibular joint and in the preoperative planning that is required to obtain adequate surgical margins.

Biopsy, Needle↗

PubMed1992

Temporomandibular joint diskectomy. No positive effect of temporary silicone implant in a 5-year follow-up.

The purpose of this study was to evaluate the long-term clinical and radiologic effects of a temporary silicone implant after diskectomy of the temporomandibular joint. Forty-three temporomandibular joints in 43 patients with painful disk displacement underwent a diskectomy. A sheet of medical-grade silicone was temporarily placed in 22 patients; 21 patients did not receive an implant. The patients were clinically and radiologically examined 5 years after surgery. On the basis of symptoms and jaw function, they were classified as having good (30 patients), acceptable (8 patients), and bad (5 patients) results. All the patients with bad results and five of the eight patients with acceptable results had received implants. Erosive changes of the condyle or fossa were seen radiographically at follow-up in eight patients, each of whom had received an implant. No positive clinical or radiologic effects of the implants could be identified. The use of a temporary silicone implant after diskectomy of the temporomandibular joint in patients with internal derangement should be seriously questioned.

Adult↗

PubMed1994

Medical devices; classification of temporomandibular joint implants--FDA. Final rule.

The Food and Drug Administration (FDA) is classifying four temporomandibular joint (TMJ) implants, the total temporomandibular joint prosthesis, the glenoid fossa prosthesis, the mandibular condyle prosthesis, and the interarticular disc prosthesis (interpositional implant), into class III (premarket approval). These actions are being taken under the Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device Amendments of 1976 (the 1976 amendments) and the Safe Medical Devices Act of 1990 (the SMDA).

Dental Prosthesis↗