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Results for “TEMPOROMANDIBULAR JOINT”

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At least 757 records · Page 42Linked to original sources

PubMed2006

Image-guided puncture technique for the superior temporomandibular joint space: value of cone beam computed tomography (CBCT).

OBJECTIVE: Temporomandibular joint (TMJ) disk perforation or adhesion requires arthrographic examination. However, puncture of the TMJ may result in damaging penetration of the middle cranial fossa. We investigated the effectiveness of penetrating the superior TMJ space using a safe image-guided puncture technique (IGPT). STUDY DESIGN: Fifty-two patients underwent cone beam computed tomography (CBCT) examination. Optimum angles and distances from the puncture site to the thinnest point of the glenoid fossa to penetrate the superior joint space were measured using three-directional images. RESULTS: Puncturing the superior articular cavity was immediately successful in 50 cases. Image measurements gave an average horizontal angle of 8.0 degrees (standard deviation [SD]: 9.2), an average coronal angle of 16 degrees (SD: 11.3), and an average distance of 27 mm (SD: 2.8). CONCLUSION: Variation in puncture angle among individuals indicated that CBCT examination is necessary preceding TMJ puncture. Preliminary clinical application has demonstrated the safety of IGPT using CBCT.

Adult↗

PubMed1982

Computed tomography of the meniscus of the temporomandibular joint: preliminary observations.

Anterior displacement of the meniscus of the temporomandibular joint (TMJ) was diagnosed in nine patients who had undergone arthrography, and they were later examined with computed tomography (CT) to see if this modality could supplant arthrography in some patients with TMJ dysfunction. The anteriorly displaced menisci were visualized in all nine patients by using sagittal reformations and the blink mode. Four of the nine patients had the diagnosis confirmed at surgery. The precise protocol for the CT examination and how to interpret it are discussed. We are optimistic that CT may replace TMJ arthrography in selected patients.

Adult↗

PubMed2000

Differential diagnosis of calcium pyrophosphate dihydrate deposition of the temporomandibular joint.

Calcium pyrophosphate dihydrate (CPPD) deposition disease (pseudogout) of the temporomandibular joint (TMJ) is rare. It is characterized by the presence of crystal deposits that are birefringent under polarized light. Although these crystals are characteristically weakly birefringent, some other crystals such as those of calcium oxalate, synthetic steroids, and ethylenediaminetetraacetic acid are also birefringent. The differential diagnosis should therefore be based on a quantitative analysis of crystals or observation of the crystal structure in calcified sections. We present a case of CPPD deposition disease of the TMJ and report on the value of such an analysis to substantiate the diagnosis.

Biopsy↗

PubMed1992

Interexaminer comparison of bone scintigraphy and panoramic radiography of temporomandibular joints: correlation with signs and symptoms.

Panoramic radiographs of the temporomandibular joints of patients with orofacial pain were examined for evidence of pathology by three different groups of four dental specialists and by a group of four general dentists. Bone scans of the same joints were used as the "gold standard" for identification of disorder and indicated a low rate of correct readings by the four professional groups. When the symptomatic side of the complaint was used as the gold standard, there was no statistically significant association with the bone scan observations. Comparative analysis of other patient symptoms showed little agreement with panoramic radiographs and scintigraphs. Reliability estimates may be highly variable, even among clinical experts. These results show that neither radiologic technique would be definitive for diagnosis of TM disorders.

Adolescent↗

PubMed2002

Prospective comparative study of the range of movement of temporomandibular joints after mandibular fractures: rigid or non-rigid fixation.

Temporomandibular joints (TMJ) are negatively affected by trauma and disuse. In this prospective study, 103 patients with mandibular fractures were evaluated for the influence of trauma and maxillomandibular fixation on the TMJ. A total of 54 patients were treated by maxillomandibular fixation and 49 by titanium miniplate fixation. Those patients with condylar fractures and multiple mandibular fractures and malocclusion at presentation were not included in the study. The control group consisted of 44 randomly-selected healthy people with no past history of mandibular fracture or symptoms referable to the TMJ. Trauma was a major factor leading to TMJ dysfunction and maxillomandibular fixation increased the incidence and severity of TMJ dysfunction.

Adult↗

PubMedDate not supplied

Normal and abnormal temporomandibular joints as demonstrated by magnetic resonance imaging.

Magnetic resonance imaging of the temporomandibular joint (TMJ) was performed on two normal volunteer subjects and two symptomatic subjects using a 0.15 T resistive magnet. A spin echo pulse sequence with a TE of 38 ms and a TR of 500 ms was employed. The TMJ meniscus is a low signal structure, and the bilaminar zone behind it is a relatively high signal structure. In normal closed mouths, the demarcation between meniscus and bilaminar zone is located at the vertex position above the mandibular condyle. When the condyle translates, the posterior portion of the meniscus bulges into the joint space. Dislocated meniscus can be identified by a gray mass anterior to the condylar head. The joint space is filled with the higher signal of the bilaminar zone. In non-reducible dislocations, the meniscus remains anterior to the condylar head with opening of the mouth. Reduced dislocations appear similar to normal joints in the open mouth.

Cartilage, Articular↗

PubMed1991

[The CT aspects of a case of chondromatosis of the temporomandibular joint].

The CT picture of a case of synovial chondromatosis of the temporomandibular joint is described. The distinctive feature of the case was the presence of ossified loose bodies surrounding the head of the condyle. Three-dimensional image reconstruction was also employed to obtain better overall visualization of the alterations.

Chondromatosis, Synovial↗

PubMed1984

Temporomandibular joint internal derangements: CT diagnosis.

Two hundred patients with suspected displaced temporomandibular joint meniscus were studied with computed tomography. In 75 cases confirmation of the CT diagnosis was subsequently obtained via surgery or arthrography; correlation was found in 73 cases (97%), with one false-negative and one false-positive examination. When meniscus displacement was graded as "mild," "moderate," or "severe," those cases diagnosed as moderate or severe were more likely to require surgery. The technique and interpretation of this technique is described; in most cases CT can replace arthrography in diagnosing displaced temporomandibular joint menisci.

Adolescent↗

PubMed2002

Temporomandibular joint involvement in rheumatoid arthritis: a radiological and clinical study.

Temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) is not uncommon. In this study a questionnaire, clinical assessment, and high resolution computerized tomography (HRCT) were used in 15 patients with rheumatoid arthritis to evaluate the diagnostic criteria of TMJ involvement. Symptoms due to TMJ involvement were present in 33.3% of the patients. Frequency of involvement was 40.0% on clinical assessment but 86.6% with HRCT assessment. The most common HRCT findings were decreases in the joint space (33.3%), mandibular subchondral cysts (23.3%), temporal subchondral cysts (23.3%), degeneration (23.3%), shape (13.3%) and height (13.3%) anomalies of the mandibular condyle, condylar head resorption (13.3%), erosion of the mandibular condyle (13.3%), and demineralization (13.3%). All patients with positive clinical findings also had positive HRCT findings. In seven (46.7%) of the patients, there were no symptoms or clinical findings implying TMJ involvement; however, they had positive results on HRCT evaluation. The HRCT findings may be the initial sign of TMJ involvement in patients with rheumatoid arthritis. In conclusion, it is suggested that RA patients with the suspicion of TMJ involvement should undergo HRCT evaluation, because HRCT findings may precede the clinical findings.

Adult↗

PubMed1985

Diagnosis and reconstruction of the human temporomandibular joint after trauma or internal derangement.

This study reviewed the standardized records of 1100 patients with the symptoms of temporomandibular joint syndrome. Of these patients, only 4.5 percent required surgical intervention. The remaining patients were found to have masticatory muscle spasm and were treated by conservative dental methods. Over half the surgical patients had significant macrotrauma to the jaws in their past history. In addition, electromyographic measurement of the masseteric silent period duration in these patients did not reveal muscle spasm. These factors further serve to differentiate the surgical patient from the patient with myofascial pain dysfunction. The patients selected for surgery demonstrated moderate to severe joint disease and required arthroplasty with partial meniscectomy. A surgical technique is presented demonstrating the reconstruction of the meniscus with silicone implant. This same surgical technique is studied in 10 monkeys, and their joints are examined histologically. The results of surgery reveal that 87 percent of the patients reported improvement 1 year after surgery. In all patients complaining of temporomandibular joint clicking or crepitus, surgery produced complete alleviation of these symptoms. The results of surgery were also associated with a 62 percent increase of jaw opening. Histologic evaluation of the human meniscal resections revealed that in addition to an anatomic displacement of the meniscus, there are also significant cellular changes. These changes consisted of calcification, a decrease in cellularity, hyperemia, and a decrease in elastin content.

Adolescent↗

PubMed2003

Frequency of internal derangement of the temporomandibular joint in elderly individuals.

Elderly patients suffer from various systemic diseases and are likely to neglect their problems with functional disorders in the masticatory system, which are of crucial importance for successful prosthetic treatment. The purpose of the study was to establish the frequency of symptoms, clinical signs and tissue-specific diagnoses of internal derangement of the temporomandibular joint in elderly subjects and their relation with respect to gender and type of prosthetic replacement. The study was conducted on 96 subjects, 48 complete denture wearers and 48 removable partial denture wearers, whose average age was 75.8 years. The diagnostic procedure used in this study was manual functional analysis consisting of specific techniques of dynamic compressions and translations in diagnosing internal derangement of the temporomandibular joint. Chi-square test for independent samples was used for statistical analysis of the results. The symptoms of internal derangement of the temporomandibular joint were found in 9.3% of the subjects, and tissue-specific diagnoses were established in 52.1% of the subjects. The most common diagnoses were osteoarthrosis, total disk displacement with stable reposition and partial anterolateral disk displacement. No statistically significant differences in the frequency of symptoms, clinical signs and tissue-specific diagnoses were found between genders (P>.05) and complete and removable partial denture wearers (P>.05). The frequency of subjective symptoms of internal derangement in the temporomandibular joint of elderly subjects was low in relation to the frequency of intracapsular tissue-specific diagnoses.

Aged↗

PubMed2002

MRI in the assessment of internal derangement and pain within the temporomandibular joint: a pictorial essay.

In this pictorial essay we aim to illustrate the normal temporomandibular joint (TMJ) and the common abnormalities of the osseous, cartilaginous and soft tissue components. These include disc (meniscus) displacement, deformities and perforations, abnormalities of disc and condylar movement, joint effusions, synovial proliferation, condylar deformity and erosions, degenerative change and abnormal retrodiscal enhancement.

Cartilage, Articular↗

PubMedDate not supplied

Trends in temporomandibular joint surgery.

We examined a large population of patients undergoing temporomandibular joint (TMJ) surgery and provide a documentation of the average patient population, frequency of procedures, frequency of repeat procedures, and trends in open (arthrotomy) versus closed (arthroscopy) TMJ surgery. Data on 194 TMJ surgical procedures was extracted from line item claims information collected by Trigon Blue Cross/Blue Shield of Virginia. The frequency of arthroscopy increased during the study, while the incidence of arthrotomies remained relatively low. Approximately half of the hospitals statewide did not perform either procedure. There was a low frequency (3%) of repeat procedures. In the Commonwealth of Virginia, since the advent of TMJ arthroscopy, it has become the preferred surgical technique for treatment of internal derangement. There is a low incidence of repeat procedures for both types of treatment. Analysis of insurance carrier computer records is a valid technique for evaluating trends in surgical care.

Adolescent↗

PubMed1991

Temporomandibular joint after meniscoplasty: appearance at MR imaging.

Twenty-five temporomandibular joints (TMJs) were studied in 20 patients who had undergone meniscoplasty. In all patients, preoperative magnetic resonance (MR) images showed anteriorly dislocated disks; all patients underwent a similar postoperative MR examination an average of 6 months after surgery. The results of these studies were correlated with clinical results of surgery, which were classified as poor, fair, good, or excellent at follow-up MR imaging. In 10 TMJs (eight patients [40%]) the clinical results were excellent or good; in 15 TMJs (12 patients [60%]), fair or poor. The position of the disk relative to its preoperative position was a good discriminator in determination of the clinical success of meniscoplasty. After surgery, in all patients with good or excellent results, the disks appeared to be in a normal or an improved position compared with that prior to surgery; in those with poor or fair results, the TMJs had anteriorly dislocated disks that showed no improvement.

Adolescent↗

PubMed2000

Long-term evaluation of arthrocentesis for the treatment of internal derangements of the temporomandibular joint.

PURPOSE: Arthrocentesis is being used for treatment of patients with temporomandibular joint disorders, including anterior disc displacement with and without reduction. This study was designed to examine the long-term effects of temporomandibular joint arthrocentesis in such patients and to evaluate their overall satisfaction with this treatment. PATIENTS AND METHODS: The study was based on the review of patients' records, a written questionnaire (self-evaluation), and clinical examination. Visual analog scales (VAS) were used for evaluation of pain and dysfunction. Twenty-six patients (39 joints) who had been treated at the Medical College of Virginia Hospital, Virginia Commonwealth University, were included in the study. There were 32 joints with anterior disc displacement without reduction (ADsR) and 7 joints with anterior displacement with reduction (ADcR). Patients all had undergone arthrocentesis as outpatients. Follow-up evaluations ranged from 10 to 96 months, with a mean of 48.7 months. RESULTS: Maximum vertical opening (MVO) prearthrocentesis ranged from 20 to 40 mm, with a mean of 25.3 +/- 5.5 mm. Immediately after arthrocentesis, the MVO ranged from 30 to 55 mm, with a mean of 43.8 +/- 5.6 mm. Maximum vertical opening at long-term follow-up ranged from 15 to 50 mm, with a mean of 37.1 +/- 8.8 mm. There was a significant increase in MVO between prearthrocentesis and postarthrocentesis both short- and long-term (P < .001). The short- and long-term postoperative VAS values for pain and dysfunction showed a significant decrease (P < .001) when compared with the VAS values preoperatively. Fourteen of the 26 patients (54%) no longer experienced pain, and the remaining 9 had less pain than before arthrocentesis as assessed by self-evaluation and clinical examination. Three of 26 patients had improvement for a period, later relapsed, and required subsequent surgery. Twenty-three of the 26 patients (88%) were completely satisfied with their treatment. Overall, an 88% success rate was achieved. CONCLUSION: Arthrocentesis can reduce pain and dysfunction, both short- and long-term, in patients with anterior disc displacement.

Adolescent↗

PubMed2004

Eminectomy and plication of the posterior disc attachment following arthrotomy for temporomandibular joint internal derangement.

AIM: The aim of this study was to assess the success of a single surgical procedure (eminectomy and meniscal plication) in patients with internal derangement of the temporomandibular joint. PATIENTS: A retrospective survey of 119 joints (92 patients), that had undergone eminectomy +/- meniscal plication for internal derangement of the temporomandibular joint, over a 10 year period, was undertaken. METHODS: The same surgeon undertook all surgery and clinical evaluation. Assessment of joint pain, noise/click, and mobility were assessed pre- and post-operatively. Clinical assessment at 24 months postoperatively and patient evaluation (average 59 months postoperatively) formed the basis for the results. RESULTS: Clinical assessment and patient evaluation revealed an improvement in pain (65%), noise (63%) and mobility (71%). The outcome of surgery as assessed by the patients and clinicians showed that both have similar expectations and evaluations of the results of temporomandibular joint surgery, which were reasonably good. Arthrography, which was used as a diagnostic technique prior to surgery, was shown to be unreliable with relatively low sensitivity and specificity.

Adolescent↗

PubMedDate not supplied

Pseudodynamic imaging of the temporomandibular joint: SE versus GE sequences.

Pseudodynamic MR imaging of the temporomandibular joints (TMJs) has been used for the evaluation of the functional aspects of the TMJs. To evaluate the value of T1-weighted spin-echo (SE) and gradient-echo (GE) techniques, both techniques were performed in 9 asymptomatic (mean 25.7 years, 22-23 years), and 25 symptomatic (mean 44.9 years, 20-71 years) subjects with signs and symptoms of internal derangement or osteoarthrosis of the TMJs. The imaging time for the SE (180 ms/15 ms/110 degrees; repetition time/echo time/flip angle) and GE (fast low angle shot; FLASH, 90 ms/12 ms/40 degrees) sequences was 27 and 28 s, respectively. In asymptomatic and symptomatic subjects, the confidence of the identification of the meniscal position was better on SE than GE images (3.6 +/- 0.6 vs. 2.9 +/- 0.9, p < 0.01, 3.2 +/- 0.8 vs. 2.8 +/- 0.8, p < 0.05), respectively and the sizes of the menisci were bigger on SE than GE images. The delineation of the condylar cortex was better on GE than SE images. For pseudodynamic imaging display of the TMJs, the SE images might be better than GE images to provide the stable recognition of the menisci.

Adult↗

PubMed2006

Ultrastructural study of the temporomandibular joint after unilateral meniscectomy in Wistar rats.

Meniscectomy of the temporomandibular joint (TMJ) was frequently performed until a few years ago but now is seldom employed. This procedure induces important articular modifications but the complete extent of ultrastructural changes is still unknown. Twenty-one Wistar rats were submitted to unilateral meniscectomy. Animals were randomly divided into three groups and followed for 15, 35 or 60 days. After killing both meniscectomized and contralateral TMJ specimens were sectioned sagittally and prepared for light and scanning electron microscopy studies. Normal TMJs are characterized by glenoid fossa and condylar process with distinct conjunctive layers in which regularly arranged type 1 collagen fibres predominate. Meniscectomized animals initially exhibit a different tissue covering the eroded articular surface of the condyle with the prevalence of type 3 collagen fibres but type 1 fibres predominate in the late postoperative period. Subchondral cysts are clearly visible. A complex remodelling process of the TMJ after meniscectomy is evident with important ultrastructural modifications that may correlate to unsatisfactory clinical results. The dynamic nature of this process is also observed when specimens from different postoperative periods are compared. Surgeons should always bear in mind these alterations when indicating this procedure.

Animals↗