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PubMedDate not supplied

Pigmented villonodular synovitis of the temporomandibular joint.

Pigmented villonodular synovitis (PVNS) rarely occurs in the temporomandibular joint. The bony changes are easily assessed by tomography. Pluridirectional tomography cannot, however, evaluate the soft tissue component of the lesion especially that medial to the mandibular condyle. This area is accessible to CT scan evaluation. A case is presented in which the medial extent of the lesion was determined by CT scan. The radiologic findings of PVNS of the temporomandibular joint are discussed.

Female↗
PubMedDate not supplied

Computed tomography of the temporo-mandibular joint.

Computed tomography (CT) of the temporo-mandibular joint (TMJ) has only been occasionally reported. As CT techniques improve, more detailed information is available. Though conventional radiography of the TMJ can supply sufficient diagnostic detail, it may well be replaced by CT as a preliminary examination, as it is able to offer more information with less radiation and minimal patient discomfort.

Adolescent↗
PubMedDate not supplied

Internal derangement of the temporomandibular joint: radiologic staging with clinical, surgical, and pathologic correlation.

The radiologic findings from 60 patients with 86 internally deranged temporomandibular joints (TMJ) upon whom sequential imaging procedures had been performed over a period of two months to ten years were analyzed and correlated with clinical, surgical (72 joints), and pathological observations. Internal derangement of the TMJ disc (meniscus) and osseous structures was found to be an irreversible and progressive disorder with characteristic stages. Internal derangements of the TMJ were divided into early (stage one), intermediate (stages two and three) and late stage (stages four and five) categories based upon radiologic findings obtained with radiography, lateral TMJ tomography and either two compartment arthrography or high field, surface coil MR. After sequential imaging studies, each patient and 72 deranged joints underwent surgical joint exploration and meniscectomy because of progressive joint disease and clinical disability. Surgically removed tissues underwent routine histological evaluation. Surgical and pathologic observations included disc displacement, deformity, hyalination, myxomatous degeneration, perforation of the disc attachments, capsular adhesions, synovitis and mandibular condyle lesions including osteochondritis dissecans (OCD), avascular necrosis (AVN), osseous remodeling and degenerative arthritis. There was excellent correlation between imaging studies and surgical observations. Internal derangement of the TMJ is an irreversible, generally progressive disorder which may be staged and followed with radiography, tomography and either two-compartment arthrography or high field, surface coil MR.

Adolescent↗
PubMed1986

Influence of excision of the facial and inferior dental nerves on mandibular growth and development.

The purpose of this study was to evaluate the role of the facial and inferior dental nerves on mandibular growth and development. A sample of 10 mongrel dogs was randomly divided into two equal groups. Avulsion of the right inferior dental nerve was carried out on the first group. Surgical cutting of the extracranial portion of the right facial nerve was performed on the second group. Sham operations were made for the left sides of the mandibles of all animals. The animals were killed 3 months later and their mandibles visually and radiographically examined. Measurements were recorded in a double-blind experimental design. The data were statistically analyzed. The results obtained from this study indicate that surgical cutting of the extracranial portion of the facial nerve resulted in unilateral facial paralysis of the muscles of expression. However, after the animals were killed, no significant statistical differences were found between the nerve-devoid and sham sides of the mandible for both the facial nerve group and the inferior dental nerve group. Nevertheless, for the inferior dental nerve group, visual and radiographic examinations revealed various morphologic differences at the angular process regions of the mandibles. The impact of neural deprivation on mandibular growth and development was thus determined.

Animals↗
PubMed2003

Jaw kinematics during mastication after unilateral fractures of the mandibular condylar process.

This study compared the mandibular kinematics during mastication of patients treated for unilateral fractures of the mandibular condylar process with those of control subjects. We used a Sirognathograph (Siemens, Bensheim, Germany) to record the chewing cycles of 81 male patients with unilateral condylar process fractures while they chewed a constant bolus unilaterally on the same side as the fracture and on the opposite side. Recordings were made at 6 weeks, 6 months, 1 year, and 2 years after treatment. Similar chewing cycles were recorded for 15 male controls (Class I dental and Class I skeletal occlusion) without fractures of the condylar process. The chewing cycles of both groups were analyzed with a custom computer program, and the duration, excursive ranges, and 3-dimensional cycle shape were compared at each time interval with multilevel linear modeling statistics. Fracture patients had significantly slower chewing cycles, with significantly less maximum excursion toward the working side during the closing phase and significantly greater excursion toward the balancing side during the opening phase than the controls. The opening pathway of the incisors showed greater differences between patients and controls than the closing pathways. Differences in chewing cycle shape persisted for up to 2 years, especially when chewing was on the side opposite the fracture. Unilateral condylar process fractures produce long-lasting changes in chewing cycle duration and chewing cycle shape of adults.

Adult↗
PubMed2006

Image analysis and superimposition of 3-dimensional cone-beam computed tomography models.

Three-dimensional (3D) imaging techniques can provide valuable information to clinicians and researchers. But as we move from traditional 2-dimensional (2D) cephalometric analysis to new 3D techniques, it is often necessary to compare 2D with 3D data. Cone-beam computed tomography (CBCT) provides simulation tools that can help bridge the gap between image types. CBCT acquisitions can be made to simulate panoramic, lateral, and posteroanterior cephalometric radioagraphs so that they can be compared with preexisting cephalometric databases. Applications of 3D imaging in orthodontics include initial diagnosis and superimpositions for assessing growth, treatment changes, and stability. Three-dimensional CBCT images show dental root inclination and torque, impacted and supernumerary tooth positions, thickness and morphology of bone at sites of mini-implants for anchorage, and osteotomy sites in surgical planning. Findings such as resorption, hyperplasic growth, displacement, shape anomalies of mandibular condyles, and morphological differences between the right and left sides emphasize the diagnostic value of computed tomography acquisitions. Furthermore, relationships of soft tissues and the airway can be assessed in 3 dimensions.

Cephalometry↗
PubMed2005

Subclassification of fractures of the condylar process of the mandible.

We present the definitions of various types of fracture of the condylar process, which have been adopted for the Strasbourg Osteosynthesis Research Group (SORG), in their Pan-European prospective randomised controlled trial into the management of such fractures. We think that this will assist people in their description of the various types of fracture of the condylar process.

Humans↗
PubMed2005

Transmasseteric antero-parotid approach for open reduction and internal fixation of condylar fractures.

The morbidity that results from surgical approaches to the condylar neck, and the time-consuming nature of the operation inhibits many surgeons from using open reduction and internal fixation for the treatment of condylar fractures. The many approaches that have been described stand testimony to the disadvantages of the individual techniques. The most common problems are limited access and injury to the facial nerve. We describe the transmasseteric antero-parotid (TMAP) technique, which offers swift access to the condylar neck while substantially reducing the risk to the facial nerve and eliminating the complications associated with transparotid approaches.

Bone Plates↗
PubMed2006

Review of 509 mandibular fractures treated at the University Hospital, Alexandria, Egypt.

Mandibular fracture is one of the most common facial skeletal injuries. Although its main causes are road crashes and violence, the relation between these causes varies from one country to another. We made a retrospective study of the medical records and radiographs of 509 patients treated for mandibular fracture at the University of Alexandria Hospital between 1991 and 2000. The data that we collected included age, sex, aetiology, date of injury, anatomical site of the fracture, associated maxillofacial trauma, and treatment. The prevalence of mandibular fractures was higher in male subjects in all age groups, and the male:female ratio was 3.6:1. Most fractures were sustained by men in the age group 21-30 years and girls between 0 and 10 years, and the monthly incidence was constant. Road crashes were the main cause, followed by falls and assaults. Fractures of the angle were the most common (22%) followed by parasymphyseal fractures (21%) and the lowest was in the coronoid region (1%).

Accidents, Traffic↗
PubMed2006

Treatment of post-traumatic open bite by radiofrequency.

An 18-year-old man with a fracture of the mandibular symphysis and both condylar heads was treated by open reduction of the fractured symphysis and closed reduction of the fractures of the condylar heads. As the open-bite was not resolved by the operation, elastic traction was applied for three weeks, but there was no improvement. Finally, we gave radiofrequency treatment to the anterior bellies of the digastric muscle, after which the open-bite disappeared and at the follow-up examinations there was no recurrence.

Adult↗
PubMed2006

Resorbable poly(D,L)lactide plates and screws for osteosynthesis of condylar neck fractures in sheep.

We made osteotomies in the condylar neck in 12 adult sheep to simulate fractures, and joined the two ends with 2 poly(D,L)lactide (PDLLA) plates and 8 PDLLA screws 2mm in diameter. The animals were killed after 2, 6, and 12 months and bony healing was assessed macroscopically and histologically. The plates and screws remained intact and there was no displacement of the bony ends. The degrading plates, which were still visible in the specimens after 6 months, had been replaced by bone. At 12 months the PDLLA had been resorbed with no foreign body reaction and no resorption of underlying bone. The articular discs showed no signs of degeneration.

Absorbable Implants↗
PubMed2003

Connective tissue growth factor mRNA expression pattern in cartilages is associated with their type I collagen expression.

Connective tissue growth factor (CTGF) has been identified as a secretory protein encoded by an immediate early gene and is a member of the CCN family. In vitro CTGF directly regulates the proliferation and differentiation of chondrocytes; however, a previous study showed that it was localized only in the hypertrophic chondrocytes in the costal cartilages of E 18 mouse embryos. We described the expression of CTGF mRNA and protein in chondrocytes of different types of cartilages, including femoral growth plate cartilage, costal cartilage, femoral articular cartilage, mandibular condylar cartilage, and cartilage formed during the healing of mandibular ramus fractures revealed by in situ hybridization and immunohistochemistry. To characterize the CTGF-expressing cells, we also analyzed the distribution of the type I, type II, and type X collagen mRNA expression. Among these different types of cartilages we found distinct patterns of CTGF mRNA and protein expression. Growth plate cartilage and the costal cartilage showed localization of CTGF mRNA and protein in the hypertrophic chondrocytes that expressed type X collagen mRNA with less expression in proliferating chondrocytes that expressed type II collagen mRNA, whereas it was also expressed in the proliferating chondrocytes that expressed type I collagen mRNA in the condylar cartilage, the articular cartilage, and the cartilage appearing during fracture healing. In contrast, the growth plate cartilages or the costal cartilages were negative for type I collagen and showed sparse expression of CTGF mRNA in the proliferating chondrocytes. We found for the first time that CTGF mRNA could be differentially expressed in five different types of cartilage associated with those expressing type I collagen. Moreover, the spatial distribution of CTGF mRNA in the cartilages with type I collagen mRNA suggested its roles in the early differentiation, as well as in the proliferation and the terminal differentiation, of those cartilages.

Animals↗
PubMed2006

Condylar fracture repair: use of the endoscope to advance traditional treatment philosophy.

Traditional treatment of subcondylar fractures with maxillomandibular fixation often results in a malreduction and significant functional and aesthetic sequelae, including facial asymmetry, decreased jaw opening, and potential for late derangements of the temporomandibular joint. When used selectively, based on preoperative CT scans, the endoscopic technique will reliably restore condylar anatomy in nearly 95% of patients, thus obviating the consequences of malunion. Furthermore, unlike traditional open techniques no significant facial scarring or permanent facial nerve palsies have resulted. Thus, the authors strongly advocate endoscopic repair of adult condylar neck and subcondylar fractures that demonstrate displacement or dislocation and have adequate proximal bone stock to accept miniplate fixation.

Endoscopy↗
PubMed2005

Temporomandibular joint morphology following post-traumatic ankylosis in 26 patients.

This study evaluated the joint morphology on coronal computed tomography of ankylosed temporomandibular joints in 26 patients. All patients developed ankylosis following blunt trauma. Post-ankylosis joint morphology was assessed to determine if the precursor condylar fracture could be identified and this was compared to the condylar fracture prevalence to determine if any condylar fractures have an increased risk factor for ankylosis. Mean age at presentation was 20.9+/-14.41 years (range 6-58) and mean age at injury was 13.84+/-13.81 years (range 3-53). Thirty-seven joints were ankylosed in 26 patients (11 bilateral, 15 unilateral) with 27 joints in 19 patients showing vestiges of a medially dislocated condylar fracture (72.9% of joints). The prevalence of MDCF at our unit over a period of 6 months was 16.8% (16 of 95 condylar fractures). This suggests that a medially dislocated condylar fracture is more likely to ankylose than other condylar fractures. A hypothesis is proposed to explain this increased risk.

Adolescent↗