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At least 721 records · Page 40Linked to original sources
PubMed2004

Joint tenderness, jaw opening, chewing velocity, and bite force in patients with temporomandibular joint pain and matched healthy control subjects.

AIMS: To evaluate the effect of temporomandibular arthralgia on mandibular mobility, chewing, and bite force. METHODS: Twenty female patients (ages 19 to 45 years) with unilateral temporomandibular joint (TMJ) pain during chewing (49 +/- 27 mm on a 100-mm visual analog scale) and provocation, as well as TMJ tenderness, were studied. The TMJ conditions were classified as disc derangement disorders (n = 9), osteoarthritis (n = 7), and inflammatory disorders (n = 4). The patients were compared with matched healthy volunteers without orofacial pain or tenderness. Exclusion criteria were the presence of fewer than 24 teeth or malocclusion. The methods used were (1) algometric assessment of the pressure pain threshold (PPT) over the TMJ; (2) clinical recordings of maximum jaw opening; (3) computerized kinematic assessment of maximum vertical distance, velocity, and cycle duration during chewing of soft gum; and (4) measurement of unilateral molar bite force. RESULTS: The mean (+/- SD) PPT in the patients' painful side (69 +/- 20 kPa; P = .000001) was significantly lower than in the control subjects (107 +/- 22 kPa). Jaw opening was also significantly less (P = .00003) in the patients (42 +/- 9 mm) than in the controls (52 +/- 4 mm). Chewing cycle duration and maximum closing velocity were significantly different (P < or = .03) in the patients (948 +/- 185 milliseconds and 142 +/- 46 mm/s, respectively) versus the controls (765 +/- 102 milliseconds and 173 +/- 43 mm/s, respectively), and bite force was significantly lower (P = .000003) in the patients (238 +/- 99 N) than in the controls (394 +/- 80 N). Both bite force and jaw opening in patients were significantly correlated (P < or = .02) with PPT (r = 0.53 and 0.63, respectively). CONCLUSION: These systematic findings supplement results from acute pain experiments and confirm indications from unspecified patient groups that the clinical presence of long-standing TMJ pain is associated with marked functional impairment. This impairment might be a result of reflex adaptation and long-term hypoactivity of the jaw muscles.

Adult↗
PubMed1995

Disk displacement and temporomandibular joint symptoms in orthognathic surgery patients.

The purpose of this study was to document the prevalence of disk displacement and temporomandibular joint symptoms in orthognathic surgery patients. Fifty-three consecutive patients with different types of dentofacial anomalies were examined clinically and with bilateral arthrography. Disk displacement unilaterally or bilaterally was found in 57% of the patients or 46% of the joints. Displacement with reduction was seen in 38 joints, and displacement without reduction was seen in 11 joints. Fifty-three percent of the patients had pain in the temporomandibular joint or masticatory muscles, 30% of the joints demonstrated clicking, and 4% had crepitation. No association was found between disk displacement and clinical symptoms except for an association between clicking and anterior disk displacement with reduction. Neither could an association between disk displacement and the type of dentofacial anomaly be appreciated. It was concluded that disk displacement was frequent in patients with dentofacial anomalies, but no relationship to temporomandibular joint symptoms and the type of dentofacial anomaly could be clearly demonstrated.

Adolescent↗
PubMed1983

Acute suppurative arthritis of the temporomandibular joint in a patient with rheumatoid arthritis.

Septic arthritis of the temporomandibular joint is a rare condition. A case of acute staphylococcal suppurative arthritis of the temporomandibular joint (TMJ) complicating rheumatoid arthritis (RA) in a 53 year old woman is reported. The aetiology of septic arthritis may be traced to several predisposing factors and many specific agents. It would appear that the case presented is the result of predisposition of patients known to have RA to the complication septic arthritis. Some treatment recommendations are given.

Acute Disease↗
PubMed1987

[Reducible meniscal luxation of the temporomandibular joint].

Normal and pathologic functioning of the temporomandibular joint are summarized and clinical and arthrographic signs of reducible meniscal luxation described. The latter is distinguished clinically and radiologically from irreducible meniscal luxation and the myofacial syndrome. Etiological features are discussed and therapeutic solutions proposed in relation to three clinical cases reported.

Adult↗
PubMed1983

Changes in the temporomandibular joint after oblique sliding osteotomy of the mandibular rami. A longitudinal radiological study.

Changes in the temporomandibular joint following oblique sliding osteotomy of the mandibular rami were studied using axial, frontal and lateral radiographs. The condyle/fossa relationship was also studied with regard to the effect of intraosseous wiring of the proximal fragment. Antero-inferior displacements of the condyles were regularly seen after the osteotomies. The use of intraosseous wiring had no adverse effects on the temporomandibular joint.

Adolescent↗
PubMed1993

Relationship between forward head posture and diagnosed internal derangement of the temporomandibular joint.

The purpose of this study was to determine if a sample of patients with internal derangement of the temporomandibular joint had a significantly greater amount of forward head posture than did an age- and gender-matched control group. Twenty-two patients at a single head, neck, and temporomandibular joint treatment center, who had the diagnosis of internal derangement of the temporomandibular joint, were compared with a control group of volunteers. The angle of each patient's head position was measured from four photographs (two of the patient sitting and two of the patient standing) with a diagonal line drawn from the spinous process of the seventh cervical vertebra to the tragus of the ear and a horizontal line drawn perpendicular to a plumb line suspended from the ceiling. The angles measured from each of the four photographs were averaged, and this figure was paired with that generated from an age- and gender-matched person in the control group. Results indicated that there was not a significantly greater degree of forward head posture in the experimental group.

Adolescent↗
PubMed2006

Complications of temporomandibular joint arthroscopy: a retrospective analytic study of 670 arthroscopic procedures.

PURPOSE: Temporomandibular joint (TMJ) arthroscopy has been considered a safe surgical procedure in the treatment of TMJ derangement. However, it is not exempt from complications. This study evaluates the complications of arthroscopy in patients with internal derangement of TMJ. PATIENTS AND METHODS: Five hundred consecutive patients (670 joints) with TMJ derangement who underwent arthroscopy between 1995 and 2004 were retrospectively analyzed. All the patients were classified as II to V in the Wilkes classification. Lysis and lavage, electrocautery of the posterior ligament, injection of corticoids, injection of ethanolamine, myotomy of lateral pterygoid muscle attachments, myotomy and electrocautery, motor debridement, injection of sodium hyaluronate, and meniscal suture were performed in different patients. RESULTS: Complications were recognized during or immediately after the surgery. They were observed in 5 of 341 (1.26%) arthroscopies of the right TMJ and 4 of 329 (1.21%) arthroscopies of the left TMJ. A 1.34% complication rate was found in the whole series. No blood clots within the external auditory canal were observed. Bleeding within the superior TMJ space was observed in 57 cases (8.5%), 36 of them in the right TMJ and 21 in the left TMJ, but they were not considered as true complications. Lacerations of the external auditory canal were found in 2 cases (0.3%), with no cases of perforation of the tympanic membrane. Lesion of the auriculotemporal nerve was observed in a case. Paresia of the facial nerve was found in 4 cases (0.6%). Alteration of visual accuracy of the ipsilateral eye was also observed in a patient immediately after the surgery. CONCLUSION: Special care must be taken to reduce complications within the upper joint space by means of an adequate instrumentation and by paying attention to essential points of the arthroscopic technique.

Arthroscopy↗
PubMed1979

The relationship between bruxism and temporomandibular joint dysfunction as shown by computer analysis of nocturnal tooth contact patterns.

Whilst there are many causes of temporomandibular joint dysfunction, one of the most frequently encountered is bruxism. The two conditions have many aetiological factors in common and there is a rational physiological reason why bruxism could cause temporomandibular joint dysfunction. In fact, experimental bruxism performed under laboratory conditions has been found to cause such joint dysfunction. This contention is supported by direct measurements of nocturnal tooth contact. Patients with temporomandibular joint dysfunction were found to differ from control subjects to a degree which was statistically significant.

Adolescent↗
PubMed2005

[Effect of elastic pivot stable bite plate on treating irreducible temporal bone displacement of the temporomandibular joint].

OBJECTIVE: To investigate the effect of elastic pivot stable bite plate on treating irreducible temporal bone displacement of the temporomandibular joint. METHODS: Twenty-eight cases of irreducible temporal bone displacement of the temporomandibular joint treated with the elastic pivot stable bite plate from 2000 to 2004 were summarized. The ages of the patients ranged from 15 to 58 years including 11 men and 17 women. RESULTS: All the patients were treated for 1 month and followed up for 3 to 6 months. The effective rate was 87.51%. The patients who had shorter course of diseases obtained better effect than the patients who had longer courses of diseases. CONCLUSION: Elastic pivot stable bite plate is an effective alternative for treating irreducible temporal bone displacement of the temporomandibular joint and it exerts better effect on the patients that have short courses of diseases.

Adolescent↗
PubMed2005

[Transverse spiral tomography with the Cranex-Tome apparatus in diseases of the temporomandibular joint and in implantology].

INTRODUCTION: This study was undertaken to determine the usefulness of transverse spiral tomography with the Cranex-Tome apparatus in diseases of the temporomandibular joint and in implantology. MATERIAL AND METHODS: The temporomandibular joint was studied in 35 patients. Pathologic bony structures, osteophytes, and abnormalities of the joint space were found in 34 patients. A malignant tumor was detected in one patient. In the case of the temporomandibular joint, spiral pantomography appears to offer superior results to conventional radiography by filtering out all structures superimposing on the joint. In addition, 14 patients qualified to receive 60 endosseous implants were studied. Pantomographs of the maxilla and mandible, as well as tomographs were used to measure the height and width of the alveolar process prior to selection of the implant. The precision of imaging of structures important to the implantologist was assessed. RESULTS: Transverse spiral radiographs of the alveolar process gave a clear view of the mandibular canal, mental foramen, and fundus of the maxillary sinus. Measurements of the height and width of the alveolar process appearing on transverse spiral radiographs created a precise basis for the selection of an implant with the right length and diameter.

Adolescent↗
PubMed2000

[The differential diagnosis of avascular necrosis of the temporomandibular joint in systemic lupus erythematosus].

Eight patients with facial skull abnormalities with systemic lupus erythematosus (SLE) and temporomandibular involvement were examined. In 4 patients mandibular deformation was caused by erosive arthritis and in 4 others by aseptic necrosis of the temporomandibular joint. Clinical and x-ray characteristics, magnetic resonance and computer tomography findings in the two groups are compared. A detailed protocol for differential diagnosis of temporomandibular joint involvement in SLE is developed.

Arthritis↗
PubMed1996

Morphology of the lateral ligament in the human temporomandibular joint.

The morphology of the lateral ligament of the human temporomandibular joint is of two types: ligamentous and without distinct structure. Under the scanning electron microscope, a sheath-like structure that contained bundles of collagen was mainly found in the posterior region of the lateral ligament. Analysis of macromolecular components revealed that type III collagen was mainly present on the collagenous framework of the sheath-like structure. Type I collagen, laminin, and tenascin were found in the framework of the sheath-like structure. Supported collagenous bundles and the distribution of macromolecular components might be related to the stability of the temporomandibular joint. The sheath-like structure and other components of the lateral ligaments store energy and protect the capsule from stress and tension during movements of the jaw.

Aged↗
PubMed1992

[Analysis of erroneous diagnosis on temporomandibular joint arthrography].

In the present study, 433 arthrographic cases with temporomandibular joint dysfunction syndrome were included. 30 cases of them underwent operation and 22 cases underwent digital subtraction arthrographic examination after conventional arthrography. It has been found that arthrographic erroneous diagnosis could be made because the artificial manifestations caused by over-dose of contrast medium into the joint cavity, repeated puncture, anterior displacement of the condyle after injecting contrast medium and so on. In addition, the arthrographic manifestations of dis-clock were also analysed.

Adolescent↗
PubMed2007

Guidelines for the replacement of temporomandibular joints in the United Kingdom.

BAOMS has requested that guidelines be formulated for the replacement of the temporomandibular joint (TMJ). This is an expensive and technique sensitive method of TMJ reconstruction and in the current climate warrants an agreed approach. The following document states the indications and contraindications for this technique as discussed and agreed amongst surgeons currently carrying out this procedure in the UK.

Arthroplasty, Replacement↗
PubMed1996

Magnetic resonance imaging of the temporomandibular joint: value of pseudodynamic images.

Magnetic resonance fast scanning technique (gradient recalled acquisition at steady state) has been reported to be useful when evaluating the dynamics of the temporomandibular joint and also to be accurate for determining the disk position. Yet in our clinical experience gradient recalled acquisition at steady state images have frequently been inferior to proton density images for diagnosis of temporomandibular joint internal derangement. The first aim of this study was to compare gradient recalled acquisition at steady state images with proton density images for diagnosis of disk position. The second aim was to identify what additional information could be gathered from gradient recalled acquisition at steady state images when compared with static proton density images. We obtained unilateral images from 20 patients with signs and symptoms of temporomandibular joint internal derangement and from 20 asymptomatic volunteers. Multiple gradient recalled acquisition at steady state images were obtained during mouth opening and closing and proton density images were obtained at the closed and open mouth positions. The results showed that the gradient recalled acquisition at steady state images were in accordance with the proton density images in 32 joints (80%) and were false negative in 8 joints (20%). Six of the joints with false-negative gradient recalled acquisition at steady state images showed sideways disk displacement, and two showed partial anterior disk displacement. Gradient recalled acquisition at steady state images, on the other hand, provided information about movement pattern and also demonstrated impingement of the joint structures on the muscles anterior to the joint at maximal mouth opening. It was concluded that gradient recalled acquisition at steady state images cannot replace proton density images for diagnosis of disk position but they can provide supplementary information for evaluation of joint function.

Adolescent↗
PubMed1994

Histologic characteristics of the lateral pterygoid muscle insertion to the temporomandibular joint.

This study used low-power light microscopy to examine the histologic organization of the lateral pterygoid muscle interface with the temporomandibular joint. The sample included parasagittal sections of 20 intact temporomandibular joints from young adults (mean age 26.2 years) at autopsy. The lateral pterygoid muscle showed no consistent divisions into separate anatomic muscle heads at the insertion. The muscle fibers attached to the pterygoid fovea of the condyle immediately inferior to the articular surface in all cases. Some additional fibers inserted superiorly into the more anterior part of the articular disc in a minority of cases (31%). Fibers inserting into the disc represented only 2.4% to 6% of the total superior-inferior length of the muscle insertion. It is hypothesized that the muscular force exerted by these few fibers inserting into the disc would not be sufficient to displace the disc anteriorly to the condyle. There were two histologic types of insertion of the lateral pterygoid muscle to the condyle. The superior part of the insertion was characterized by an identifiable tendon inserting through fibrocartilage. In the inferior part of the insertion, the muscle attached to periosteum without an obvious tendon. The presence of this tendon must be recognized in interpretation of soft tissue temporomandibular joint imaging.

Adolescent↗
PubMed1994

[Changes in the bioelectrical activity of the masticatory muscles and temporomandibular joint pathology in the myofascial pain dysfunction syndrome].

The authors consider the dependence of changes in the temporomandibular joint on the disease duration, analyze the relations between the clinical pattern of myofascial pain dysfunction syndrome (MPDS) and electromyographic changes in the masticatory muscles. Changes in the temporomandibular joint seemed to be of little importance for MPDS severity.

Adolescent↗