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Mandibular movement is complex and individual due to variations in the temporomandibular joint (TMJ). Consequently, patient-centered dentistry should incorporate patients’ specific anatomy and condylar function in treatment planning. Real-time magnetic resonance imaging (rt-MRI) visualizes relevant structures and tracks mandibular movement. However, current assessments rely on qualitative observations or time-consuming manual tracking, lacking reliability. This study developed an automatic tracking algorithm for mandibular movement in rt-MRI using least mean square registration (LMS) and compared it to manual tracking (MT) during mouth opening. Ten participants with skeletal class I underwent rt-MRI (10 frames/s). The same operator tracked the condylar pathway for the two methods, setting 2000 landmarks (2 landmarks x100 frames x10 participants) for MT and 210 landmarks (3 landmarks x7 frames x10 participants) for LMS. Time required, superimposition error, and the distance between tracked condylar pathways were compared between methods. LMS tracking was 76% faster and showed significantly better superimposition (0.0289 ± 0.0058) than MT (0.059 ± 0.0145) (p = 0.002). During one-third of the movement, the pathways tracked by both methods were more than 1 mm and 1° apart. These findings highlight the benefits of automatic condylar movement tracking in rt-MRI, laying the groundwork for more objective and quantitative observation of TMJ function. [ABSTRACT FROM AUTHOR]

Objectives: Assess the available scientific literature regarding the direction and extent of condylar positional changes during the first year of post-surgical orthodontics interventions in class III patients. Materials and Methods: PubMed, Cochrane Library, Embase, and Google Scholar databases were searched up to March 2022 for studies involving the measurement of condylar positional changes after surgical treatment of Class III dentofacial deformity in adults with BSSO without or without Le Fort I osteotomies. The methodological index for non-randomized studies (MINORS) was utilized to assess the risk of bias and quality of non-randomized studies. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcome was condyle positional changes between the following time points: T0: before treatment, T1: immediately post treatment, T2: 4, 6, or 9 months post treatment, T3: one year post treatment. Results: Nineteen studies were included in the systematic review. Eleven studies were deemed low quality, and the rest were of medium quality. The meta-analysis included 12 studies and showed statistically significant downward, outward positional changes at T1(Immediately after surgery). Inward Yaw rotation was significant at T1(1–4 month post-surgery) and T2(4–9 months post-surgery). Conclusion: Surgically induced condylar changes tend to go back to normal within the first year after surgery, except for condylar yaw rotations. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: The most popular surgical procedures among orthognathic surgeries for Class II and III patients are Le Fort 1 osteotomy for the maxilla and bilateral sagittal split ramus osteotomy (BSSRO) for the mandible. Keeping the condyle in its proper place during fixation is one of the difficulties of orthognathic surgery. One of the worst post-orthognathic surgery consequences in the temporomandibular joint (TMJ) area may be condylar resorption. Condylar remodeling refers to a group of processes that occur in reaction to forces and stress placed on the temporomandibular joint in order to preserve morphological, functional, and occlusal balance. A systematic review of the literature was performed with the aim of identifying the mandibular condylar component of TMJ changes after orthognathic surgery in class II and III patients. Materials and Methods: An electronic search was carried out using the PubMed, Cochrane Library, and Google Scholar, databases. The inclusion criteria included trials in non-growing patients upon whom orthognathic surgery was performed due to Angle II or Angle III classes malocclusion; in addition, a CT or cone beam computed tomography (CBCT) scan was performed before and after surgery to track the mandibular condylar component of TMJ changes. The quality of the studies was evaluated by two independent authors. The risk of bias was assessed by using the Downs and Black checklist. Results: The electronic and manual literature search yielded 12 studies that fulfilled all necessary inclusion criteria. Observed studies were evaluated as good (3), fair (8), and poor (1) quality. Two studies evaluated class II patients, six studies observed class III patients, and four studies were comparative. Most of the studies evaluated condyle angle and space changes, and the condylar surface and volume changes were also observed. However, the methodology of evaluation in the publications differs. Conclusions: Reduction of bone density, especially in class II patients, and morphological condyle reshaping, with the apposition of the bone, is the main adaptive mechanism after orthognathic surgery. However, all of the studies we examined were conducted using different methods of evaluation, measurement, and reference points. [ABSTRACT FROM AUTHOR]

Background: Mandibular malpositioning may result in an abnormal concentration of stresses within the temporomandibular joint (TMJ) in adult rats, which may further lead to a series of pathological changes, such as articular cartilage wear, subchondral bone sclerosis and osteophyte formation. However, the pathological and adaptive changes in condylar cartilage caused by different stress distributions are still controversial. Objective: The aim of this study was to observe the effect of sagittal changes in mandibular position on condylar cartilage by changing the occlusal vertical dimension (OVD) in adult rats. Methods: Fifteen‐week‐old female rats were divided into three groups: control (CON), increased OVD (iOVD) and loss of occlusion (LO) groups. An occlusal plate and tooth extraction were used to establish the animal model. TMJ samples of the experimental and CON groups were observed and investigated by bone morphological, histomorphological and immunohistochemical staining analyses at 3 days, 1 week, 2 weeks, 4 weeks and 8 weeks. Weight curves were plotted. Results: Micro‐computed tomography showed that, compared with the CON group, cartilage destruction followed by repair occurred in both experimental groups, which was similar to the trend observed in haematoxylin‐eosin staining. All experimental results for the iOVD group showed an approximately similar time trend. Compared with the iOVD group, the toluidine blue and immunohistochemical staining results in the LO group showed no obvious change trend over time. Conclusion: Compared with occlusal loss, an increase in OVD caused faster and more severe damage to condylar cartilage, and subchondral bone repair occurred later. [ABSTRACT FROM AUTHOR]

Objective: To study the correlation between condylar morphology and clinical manifestations in patients with degenerative joint disease (DJD) of the temporomandibular joint (TMJ). Methods: A total of 175 joints of 131 patients with DJD were included. Data on patients' basic information and symptoms were collected and analyzed. Condylar morphology was evaluated using cone beam computed tomography (CBCT). The correlation between the condylar morphology and clinical manifestations was analyzed. Results: The prevalence of joint noises, clicks, and crepitus was 93/175 (53%), 73/175 (42%), and 20/175 (11%), respectively. Condylar anteroposterior diameter and condylar height were correlated with pain. There was a correlation between the shape of the condyle in the sagittal plane and joint noise. Conclusion: Condylar morphology and clinical features of DJD were correlated to some extent. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Prevention & Treatment For Stomatological Diseases is the property of Journal of Prevention & Treatment For Stomatological Diseases Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Objective The objective of this study was to measure and analyze the joint space, condylar morphology, and thickness of the roof of the glenoid fossa (RGF) in patients with unilateral second molar scissor bite using cone beam CT (CBCT). Methods A total of 80 patients were included in this study. Forty patients with a normal posterior occlusal relationship, who attended the Department of Orthodontics at the First Hospital of Shanxi Medical University from December 2021 to August 2023, were selected as the control group. The experimental group consisted of 40 patients with unilateral second molar scissor bite during the same period. All patients underwent CBCT scanning, and the resulting images were analyzed using the NNT viewer software in multiplanar reconstruction (MPR). Axial, coronal, and sagittal adjustments were made for each patient. Results In the control group, the right and left joint spaces (PS, SS, AS), the height of the upper part of the condyle, and the depth of the glenoid fossa did not show statistically significant differences (P > 0.05). When comparing bilateral condylar morphology and joint space in the experimental group, it was found that the posterior joint space on the scissor bite side was greater than that on the normal occlusion side, while the anterior joint space on the scissor bite side was smaller than that on the normal occlusal side. Additionally, the height of the upper condyle and the depth of the glenoid fossa on the scissor bite side were greater than that on the normal occlusal side, with statistically significant differences (P 0.05). The comparison of the minimum thickness of the roof of the glenoid fossa in both the sagittal and coronal directions between the patients in the experimental group and the control group showed no statistically significant difference (P > 0.05). Furthermore, the asymmetry index of the supracondylar height in the control group was significantly smaller than that in the experimental group, displaying a statistically significant difference (P 0.05). When analyzing the position of the condyle in the sagittal direction of the glenoid fossa in the patients of the control group, it was observed that the majority were in the anterior and medial positions, with only 10% and 5% being in the posterior position. However, the analysis of the condyle position in the sagittal direction of the glenoid fossa in the experimental group revealed statistically significant differences (P

Abstract Mandibular movement is complex and individual due to variations in the temporomandibular joint (TMJ). Consequently, patient-centered dentistry should incorporate patients’ specific anatomy and condylar function in treatment planning. Real-time magnetic resonance imaging (rt-MRI) visualizes relevant structures and tracks mandibular movement. However, current assessments rely on qualitative observations or time-consuming manual tracking, lacking reliability. This study developed an automatic tracking algorithm for mandibular movement in rt-MRI using least mean square registration (LMS) and compared it to manual tracking (MT) during mouth opening. Ten participants with skeletal class I underwent rt-MRI (10 frames/s). The same operator tracked the condylar pathway for the two methods, setting 2000 landmarks (2 landmarks x100 frames x10 participants) for MT and 210 landmarks (3 landmarks x7 frames x10 participants) for LMS. Time required, superimposition error, and the distance between tracked condylar pathways were compared between methods. LMS tracking was 76% faster and showed significantly better superimposition (0.0289 ± 0.0058) than MT (0.059 ± 0.0145) (p = 0.002). During one-third of the movement, the pathways tracked by both methods were more than 1 mm and 1° apart. These findings highlight the benefits of automatic condylar movement tracking in rt-MRI, laying the groundwork for more objective and quantitative observation of TMJ function.

The occipitocervical junction (OCJ) is a complex anatomical region crucial for protecting the lower brain stem, upper spinal cord, and lower cranial nerves. Instability in this area can lead to severe outcomes such as chronic pain, neurological deficits, or death. Various surgical techniques have been developed for OCJ stabilization, particularly using occipital condyle screws, which have shown promise in providing stability and preserving neck rotation. This article presents two cases of OCJ instability caused by metastatic involvement of the C2 vertebra, managed successfully with occipital condyle screw fixation. The first case involved a 22-year-old female with Ewing sarcoma metastasis, and the second case involved a 62-year-old male with multiple myeloma. Both patients exhibited significant improvements in neurological function and cervical stability postoperatively, with observable den remodeling. Our findings suggest that occipital condyle screw fixation is not only feasible but also effective in managing OCJ instability due to metastatic disease. Detailed preoperative evaluation and the use of advanced intraoperative imaging technologies, such as the O-arm and neuronavigation, are essential for maximizing safety and ensuring optimal outcomes. This study underscores the potential of occipital condyle screw fixation as a primary surgical method for stabilizing the OCJ in appropriate cases.

The source and process of mandible development are significantly different from those of other bones in the body, and abnormal development can lead to various bone-related diseases, seriously affecting the quality of life of patients. In recent years, the role of the Hedgehog signaling pathway in bone development has received increasing attention. The Hedgehog gene includes three subtypes: Sonic Hedgehog (Shh), Indian Hedgehog (Ihh), and Desert Hedgehog (Dhh). Shh and Ihh can participate in bone metabolism regulation through various pathways, with Shh primarily involved in limb development and Ihh playing a key role in endochondral osteogenesis. The Hedgehog signaling pathway includes Hedgehog signaling protein ligands, Patched (Ptch) receptors, Smoothed (Smo) receptors, nuclear transcription factors, glioma-associated oncogene homologues (Gli), and downstream target genes. The activation of typical Hedgehog signaling pathways requires the involvement of Gli, whereas atypical Hedgehog signaling is mainly regulated by Ptch, Smo, and others. Shh regulates various biological behaviors during early vertebrate embryogenesis, such as organ differentiation, neural stem formation, stem cell differentiation and proliferation, limb bone development, and tooth germ development. During the process of bone cell differentiation, Shh, Ptch1, and Gli1 are expressed in osteoblasts, further promoting the differentiation of bone marrow mesenchymal stem cells into osteoblasts and chondrocytes. IHh plays an indispensable functional role in bone growth, development, and homeostasis and participates in the formation of intramembrane bone collars, proliferation, and maturation of chondrocytes. IHh is expressed in mature skull osteoblasts and can act as a promoter of bone factor regulation of Ptch and bone morphogenetic protein (BMP) expression to induce intramembrane ossification. Brain and muscle ARNT-like protein 1 (BMAL1) can regulate the Hedgehog signaling pathway by binding to Ptch1 and Ihh, playing a crucial role in cartilage formation and endochondral osteogenesis in the temporomandibular joint. Hedgehog signal activators can improve the reduction in mandibular bone mass caused by BMAL1 deficiency. Hedgehog signaling imbalance can have a significant impact on bone development and lead to a series of bone diseases, such as abnormal bone development, fractures, osteoporosis, and osteoarthritis. The mechanism of the Hedgehog signaling pathway in relation to mandibular diseases has not been fully elucidated, and future research should seek to further explore Hedgehog signaling as a potential target for treating mandibular developmental-related diseases.

Ectopic teeth arise from developmental abnormalities and can be supernumerary, deciduous, or permanent teeth. They can cause orofacial pain, swelling, and infection. There is a major paucity in literature about ectopic mandibular third molar (EMTM) and its causes, symptoms, and treatment. We present an unusual case of EMTM in the mandibular subcondylar region and its surgical management. A 58-year-old female reported with complain of pain and swelling in the right preauricular region. On radiographic assessment, the right mandibular third molar was ectopically present in the subcondylar region and associated with a small dentigerous cyst. Complete removal of cystic lining and extraction of EMTM was done under general anesthesia using a retromandibular approach. After surgery, there was a complete resolution of symptoms within 1 month with uneventful healing and no postoperative complications.

The temporomandibular joint is the only joint structure within the craniofacial skeletal system, responsible for performing functions related to opening and closing mouth movements, such as chewing, speaking, and facial expression in daily life. The condyle of the mandible, as a vital component of the temporomandibular joint, originates from the mandibular process formed by the first gill arch and is the key growth center at the end of the mandibular ramus. Condyle is composed of a layer of cartilage as its surface and subchondral bone below, exhibiting unique biological processes during its growth and development. In the articular fossa, the functional movement of the condyle depends on its normal physiological and anatomical structure, which plays a crucial role in establishing occlusion and shaping facial features. Abnormal growth and development can lead to the occurrence of condylar deformities, which affect the vertical height of the patient's maxillofacial region and ultimately lead to secondary skeletal class Ⅱ or Ⅲ craniofacial deformities. During the process of growth and development, the condyle is subject to complex signal regulation. In recent years, with in-depth research on the temporomandibular joint, researchers have begun to discuss the regulatory mechanisms of condyle growth and development from the perspectives of gene expression and molecular level, in order to explain the causes of temporomandibular joint diseases and condylar deformities. This article provides a review on the growth process and structure of condyle, classification and pathological manifestations of condylar deformities, and related regulatory mechanisms of the growth and development of condyle, as well as pathogenesis of condylar deformities. The aim of this article is to provide research ideas for temporomandibular joint diseases and craniofacial malformations caused by abnormal development of the mandibular condyle in clinical practice.

This study aims to compare computed tomography (CT) with magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) by using texture analysis (TA) to detect condylar bone marrow changes associated with the flattening and erosion of cortical bone. A total of 47 patients from the Dentomaxillofacial Radiology Division at São Paulo State University were evaluated. Images from 250 CT and 250 MRI images were assessed by experienced radiologists employing OnDemand3D software. Texture parameters were extracted with MaZda software (version 4.6), and we focused on regions of interest within the condyles. Statistical analysis revealed significant differences in texture parameters between the affected and control groups. CT images showed higher correlation values in cases of flattening, whereas MRI images demonstrated substantial changes in texture parameters for both flattening and erosion. These findings suggest that the texture analysis of CT and MRI images can effectively detect early and advanced degenerative changes in the TMJ, thus providing valuable insights into the underlying pathophysiology and aiding in early intervention and treatment planning. [ABSTRACT FROM AUTHOR]

Background: The goal of treating broken mandibular condyles is to return the affected jaw to its pre-trauma state in terms of masticatory ability, occlusion, symmetry, and function. The two methods can be used to treat the mandibular condylar fracture. These protocols consist of two types: the closed therapy, which employs closed reduction to immobilise the fracture segments, and the open treatment, which involves open reduction of the fracture segments by surgery, followed by internal fixation. Aim: to compare the post-treatment results of closed therapy versus open surgical treatment for mandibular condyle fractures. Methods: 42 individuals were treated with either open reduction with internal fixation or closed reduction utilising IMF in 2 groups (n = 12). The clinical parameters of lateral excursion and protrusion, occlusion, mandibular ramus height, deviation/deflection during jaw opening, and pain evaluation using VAS were measured at 1stand 3rd day and at 1, 3, and 6 weeks. The gathered data were examined statistically. Results: For Group I and Group II, the inter-incisal opening was 8.125±0.3467mm and 6.016±.1528mm, respectively. These values were statistically significant (p ~0.00001). In the surgical groups, it climbed to 17.433±0.3822mm at 3 months and 19.175±0.3696mm at 6 weeks post-operatively. The interincisal opening for the non-surgical group was smaller during the first postoperative week, and subsequently it grew to 9.375±0.2734mm and 12.208±0.1881mm, respectively, at the third and sixth months. Both of these results have statistical significance (p ~<0.00001). At 1, 3, and 6 months recall, the protrusive movement increased in Group I, with means of 0.4667±0.403, 2.275±0.2006mm, and 2.7917±0.0289 mm, respectively. Conclusion: The current study concludes that, in terms of inter-incisal opening, lateral excursion and protrusive mandibular movement range, pain parameters, facial symmetry, occlusion, and ramal height restoration in a 6-week follow-up period, surgical open reduction and internal fixation treatment of the mandibular condylar fracture is superior to non-surgical closed reduction. [ABSTRACT FROM AUTHOR]

The temporomandibular joint is the only joint structure within the craniofacial skeletal system, responsible for performing functions related to opening and closing mouth movements, such as chewing, speaking, and facial expression in daily life. The condyle of the mandible, as a vital component of the temporomandibular joint, originates from the mandibular process formed by the first gill arch and is the key growth center at the end of the mandibular ramus. Condyle is composed of a layer of cartilage as its surface and subchondral bone below, exhibiting unique biological processes during its growth and development. In the articular fossa, the functional movement of the condyle depends on its normal physiological and anatomical structure, which plays a crucial role in establishing occlusion and shaping facial features. Abnormal growth and development can lead to the occurrence of condylar deformities, which affect the vertical height of the patient's maxillofacial region and ultimately lead to secondary skeletal class II or 皿 craniofacial deformities. During the process of growth and development, the condyle is subject to complex signal regulation. In recent years, with in-depth research on the temporomandibular joint, researchers have begun to discuss the regulatory mechanisms of condyle growth and development from the perspectives of gene expression and molecular level, in order to explain the causes of temporomandibular joint diseases and condylar deformities. This article provides a review on the growth process and structure of condyle, classification and pathological manifestations of condylar deformities, and related regulatory mechanisms of the growth and development of condyle, as well as pathogenesis of condylar deformities. The aim of this article is to provide research ideas for temporomandibular joint diseases and craniofacial malformations caused by abnormal development of the mandibular condyle in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Mandibular fractures are frequent in facial trauma. Management of mandibular condylar fractures (MCF) remains an ongoing matter of controversy in maxillofacial injury. A number of techniques, from closed reduction (CR) to open reduction and internal fixation (ORIF), can be effectively used to manage these fractures. The best treatment strategy, that is, closed reduction or open reduction with internal fixation, remains controversial. Aim: The aim of this study is to systematically review the existing scientific literature to determine whether open reduction with internal fixation or closed reduction is a better treatment alternative for the patients with condylar fractures through a meta-analysis. Methods: A systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases like PubMed, google scholar and Ebsco Host were searched from 2000 to December 2021 for studies reporting management of condylar fractures through open reduction with internal fixation against closed reduction and reporting the outcome in terms of mean and standard deviation (SD). Quality assessment of included case control and cohort studies was performed using Newcastle–Ottawa Scale, and randomized studies were evaluated using Cochrane risk-of-bias (ROB)-2 tool through its domains. The risk of bias summary graph and risk of bias summary applicability concern was plotted using RevMan software version 5.3. The standardized mean difference (SDM) was used as summary statistic measure with random effect model and p value <0.05 as statistically significant. Results: Seventeen studies fulfilled the eligibility criteria and were included in qualitative synthesis, of which only nine studies were suitable for meta-analysis. The pooled estimate through the Standardized Mean Difference (SMD) of 0.80, 0.36 and 0.42 for maximum inter incisal opening, laterotrusion and protrusion favours CR compared to ORIF for condylar fracture management. Also, most results of heterogeneity tests were poor and most of the funnel plots showed asymmetry, indicating the presence of possible publication bias. Conclusion: The results of our meta-analysis suggest that CR provides superior outcomes in terms of maximum inter incisal opening, laterotrusion and protrusion compared to ORIF in condylar fractures management. It is necessary to conduct more prospective randomized studies and properly control confounding factors to achieve effective results and gradually unify clinical guidelines. [ABSTRACT FROM AUTHOR]

To determine the level of dental attrition and its relation to signs of TMJ dysfunction adding to condylar alterations analyzed by conventional TMJ Tomography and to propose the correlation between dental attrition and signs of TMJ dysfunction and condylar changes. Patients for the study were selected from the regular outpatient Department of Oral Medicine, Diagnosis and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, with performed criteria. The radiographic examination of TMJ is performed by the PLANMECA OPG machine using the tomographic program. Statistical analysis was performed using a Chi-square test to determine the relation between attrition and temporomandidular disorders [TMD] signs and symptoms. The study group comprises 60 subjects who are having dental attrition, and they are divided into three groups according to their age: Group I, 20-40 age; Group II, 41-60 age; Group III, more than 60 age 80% of the samples had one or more tooth with significant attrition with grades of two or more on a 0-4 scale The prevalence of changes in condylar morphology was more in individuals above 40 yrs (33.33%) as compared to those below the age of 40 with a total prevalence of 41.67%. The most common symptom reported is tooth sensitivity, joint sounds, and muscle tenderness. The last reported are scalloped tongue, buccal mucosa ridging, referred pain, and limitation of mouth opening. Out of the 25 subjects who showed condylar changes, 10 subjects had symptoms of TMD. The symptoms reported are strain in the mouth opening, tenderness in jaw movements, and TMJ clicking sounds. Attrition is not a predictable sign of TMJ dysfunction, yet a finite association was defined between attrition and signs and symptoms of TMJ dysfunction. Studies involving larger samples compared with additional radiographic modalities are recommended.

Abstract Background The aim of this study is to determine the best plate to use as a substitute to fix a medial femoral condyle fracture. Materials and methods The first part is to measure the best fit between several anatomical plates including the Proximal Tibia Anterolateral Plate (PT AL LCP), the Proximal Tibia Medial Plate (PT M LCP), the Distal Tibia Medial Locking Plate (DT M LCP) and the Proximal Humerus (PHILOS) plate against 28 freshly embalmed cadaveric distal femurs. Measurements such as plate offset and number of screws in the condyle and shaft shall be obtained. The subsequent part is to determine the compressive force at which the plate fails. After creating an iatrogenic medial condyle fracture, the cadavers will be fixed with the two plates with the best anatomical fit and subjected to a compression force using a hydraulic press. Results The PT AL LCP offered the best anatomical fit whereas the PHILOS plate offered the maximal number of screws inserted. The force required to create 2 mm of fracture displacement between the two is not statistically significant (LCP 889 N, PHILOS 947 N, p = 0.39). The PT AL LCP can withstand a larger fracture displacement than the PHILOS (LCP 24.4 mm, PHILOS 17.4 mm, p = 0.004). Discussion and conclusion Both the PT AL LCP and the PHILOS remain good options in fixing a medial femoral condyle fracture. Between the two, we would recommend the PT AL LCP as the slightly superior option.

Objective: To check the prevalence and causes of mandibular Fracture in the teaching hospital of Karachi Pakistan. Study Design: Crossectional, Observational, Retrprospective. Setting: Department of Oral & Maxillofacial Surgery, Karachi Medical and Dental College Abbasi Shaheed Hospital Karachi and Department of Oral and Maxillofacial Surgery Baqai Dental College University, Karachi. Period: 1st December 2018 to 30th November 2019. Methods: This study was based on randomly selected cases of one year of work at the Department of Oral and Maxillofacial Surgery Abbasi Shaheed Hospital Karachi and Department of Oral and Maxillofacial Surgery Baqai Dental College Baqai Medical University Karachi. Results: Road traffic accident like Bike accidents were top in position with 69 %, falls were next in position with 12 %, assault were recorded 10%, sports injuries were 7% and fire arm injuries2%. Mandibular fractures were found to occur at a rate of 22.1% in the parasymphysis, 12.8% in the body, 11.42% at the angle of the jaw, 12.1% in the condyle, 12.14% in the dento alveolar area, 6.4% in the symphysis, and 2.85 % in the ramus. Conclusion: To properly reduce and fix the fractures, a variety of treatment methods were employed. It has been determined that most patients were masculine and between the ages of 20 and 50. The most frequent locations for mandibular fractures were the parasymphysis and body, and the most common cause of trauma in the study participants was auto accidents. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to determine the best plate to use as a substitute to fix a medial femoral condyle fracture. Materials and methods: The first part is to measure the best fit between several anatomical plates including the Proximal Tibia Anterolateral Plate (PT AL LCP), the Proximal Tibia Medial Plate (PT M LCP), the Distal Tibia Medial Locking Plate (DT M LCP) and the Proximal Humerus (PHILOS) plate against 28 freshly embalmed cadaveric distal femurs. Measurements such as plate offset and number of screws in the condyle and shaft shall be obtained. The subsequent part is to determine the compressive force at which the plate fails. After creating an iatrogenic medial condyle fracture, the cadavers will be fixed with the two plates with the best anatomical fit and subjected to a compression force using a hydraulic press. Results: The PT AL LCP offered the best anatomical fit whereas the PHILOS plate offered the maximal number of screws inserted. The force required to create 2 mm of fracture displacement between the two is not statistically significant (LCP 889 N, PHILOS 947 N, p = 0.39). The PT AL LCP can withstand a larger fracture displacement than the PHILOS (LCP 24.4 mm, PHILOS 17.4 mm, p = 0.004). Discussion and conclusion: Both the PT AL LCP and the PHILOS remain good options in fixing a medial femoral condyle fracture. Between the two, we would recommend the PT AL LCP as the slightly superior option. [ABSTRACT FROM AUTHOR]

Background: Mandibular fractures are common facial fractures, and contemporary management of mandibular condylar fractures is controversial. The purpose of this study was to compare the outcomes of patients who sustained a mandibular condylar fracture between 2016 and 2020, who were managed by either open or closed techniques. The outcomes of this study were: post‐operative facial nerve function, occlusion, and maximal mouth opening. Methods: This study is a retrospective multicentre cohort study which assessed clinical records for 246 patients with mandibular condyle fractures in three hospitals in Perth, Western Australia. The primary outcome measure was changes in post‐operative facial nerve function. Results: One hundred and thirty‐two patients underwent open reduction and internal fixation (ORIF), and 114 patients had closed management. The overall rate of temporary facial nerve injury following ORIF was 3.28%. The overall rate of permanent facial nerve injury was 0.82%. Sialocoele occurred in 2.46% of all patients who underwent ORIF. 6.14% of patients had persisting malocclusion across both groups. There was a statistically significant association between the degree of fragment shortening and facial nerve injury (P = 0.0063), with more facial nerve changes in the group with 5 mm or greater of fragment shortening. Conclusions: There is still significant debate over the management of mandibular condylar injuries. This study demonstrates a similar rate of temporary and permanent facial nerve injury as previously described, as well as a similar rate of sialocoele occurrence. Further prospective studies may provide clarity about important characteristics that will help guide decision making for mandibular condylar fractures. [ABSTRACT FROM AUTHOR]

To determine the level of dental attrition and its relation to signs of TMJ dysfunction adding to condylar alterations analyzed by conventional TMJ Tomography and to propose the correlation between dental attrition and signs of TMJ dysfunction and condylar changes. Patients for the study were selected from the regular outpatient Department of Oral Medicine, Diagnosis and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, with performed criteria. The radiographic examination of TMJ is performed by the PLANMECA OPG machine using the tomographic program. Statistical analysis was performed using a Chi-square test to determine the relation between attrition and temporomandidular disorders [TMD] signs and symptoms. The study group comprises 60 subjects who are having dental attrition, and they are divided into three groups according to their age: Group I, 20-40 age; Group II, 41-60 age; Group III, more than 60 age 80% of the samples had one or more tooth with significant attrition with grades of two or more on a 0-4 scale The prevalence of changes in condylar morphology was more in individuals above 40 yrs (33.33%) as compared to those below the age of 40 with a total prevalence of 41.67%. The most common symptom reported is tooth sensitivity, joint sounds, and muscle tenderness. The last reported are scalloped tongue, buccal mucosa ridging, referred pain, and limitation of mouth opening. Out of the 25 subjects who showed condylar changes, 10 subjects had symptoms of TMD. The symptoms reported are strain in the mouth opening, tenderness in jaw movements, and TMJ clicking sounds. Attrition is not a predictable sign of TMJ dysfunction, yet a finite association was defined between attrition and signs and symptoms of TMJ dysfunction. Studies involving larger samples compared with additional radiographic modalities are recommended. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint osteoarthritis (TMJOA) is characterized by articular cartilage degeneration and progressive synovitis. How to effectively inhibit TMJOA in the early stage has been a hot topic in the biomedical field. As a non‐invasive physiotherapy, pulsed electromagnetic field (PEMF) treatment has shown great potential in the treatment of osteoarthritis (OA) in extremity joints. Objective: This study aims to investigate the biological effect of PEMF intervention on TMJ cartilage degeneration and synovium inflammation at the early stage of TMJOA. Methods: PEMF (2.0 mT, 15 Hz, 2 h/day) treatment was given to rats in which TMJOA was induced by applying the unilateral anterior crossbite (UAC). Histological and immunohistochemical staining, TUNEL assay, real‐time PCR and western blotting assay were performed to detect the changes of the morphology and the expression of pro‐inflammatory and degradative factors in condylar cartilage and synovium. Results: Obvious condylar cartilage degeneration, characterized by decreased cartilage thickness, degraded cartilage extracellular matrix, increased expression of pro‐inflammatory and degradative factors (TNF‐α, IL‐1β, MMP‐13, ADAMTS‐5, IL‐6, MMP‐3, MMP‐9 and COL‐X) and increased chondrocytes death, was observed in UAC group, accompanied by synovium hyperplasia and up‐regulation of pro‐inflammatory and degradative factors in synovium. PEMF intervention reversed the decreased cartilage thickness at 3 weeks and degraded cartilage extracellular matrix at 6 weeks. Moreover, the up‐regulation of pro‐inflammatory, degradative and hypertrophyic factors and chondrocytes death in condylar cartilage induced by UAC were inhibited to some extent. In addition, the synovium hyperplasia and the up‐regulation of pro‐inflammatory and degradative factors in synovium were inhibited at 3 weeks and 6 weeks. Conclusions: Appropriate PEMF stimulation can reverse the loss of cartilage extracellular matrix, the chondrocytes death, the increased expression of pro‐inflammatory and degradative factors in cartilage, the decreased cartilage thickness and synovium inflammation induced by UAC at the early stage of TMJOA to some extent. PEMF stimulation may be a promising method in clinical TMJOA treatment. [ABSTRACT FROM AUTHOR]

Imaging with bone scans plays an important role in the diagnostic path of patients with unilateral condylar hyperactivity or unilateral condylar hyperplasia (UCH). The aim of this study is to perform a systematic review of the diagnostic performance of the bone SPECT and SPECT/CT scan for the diagnosis of UCH. PubMed, SCOPUS and EMBASE were searched electronically to identify diagnostic accuracy studies that assessed the diagnostic value of bone SPECT and SPECT/CT for the diagnosis of UCH, Meta-analyses were performed with Metadisc 1.4 and 2.0. A total of 14 studies, with a total number of 887 patients, were included in the qualitative analysis and 11 studies qualified for meta-analyses. The pooled sensitivity and specificity for the SPECT scan were 0.814 (95 % CI: 0.639-0.915) and 0.774 (95 % CI: 0.655-0.861), for the SPECT/CT scan these were 0.818 (95 % CI: 0.749-0.874) and 0.901 (95 % CI: 0.840-0.945). The summary receiver operating characteristics of the SPECT scan showed an area under the curve of 0.847 (95 % CI: 0.722-0.972) and that of the SPECT/CT scan was 0.928 (95 % CI: 0.876-0.980). Both bone SPECT scan and SPECT/CT scan provide a high diagnostic accuracy for UCH. The added value of the SPECT/CT scan is questionable and given the potential disadvantages of the SPECT/CT scan, including the increased radiation dose and costs, the diagnostic modality of first choice in patients with UCH should be a SPECT scan. [ABSTRACT FROM AUTHOR]

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Objective: This study aims to evaluate differences in the morphological and morphometric features of hard tissue components of the temporomandibular joint (TMJ) in the cone beam computed tomography (CBCT) images of children with different skeletal models in the sagittal and vertical plane. Methods: Condyle dimensions, horizontal condylar angle, the distance of the condyle center to the midsagittal plane, condyle position, eminence height, eminence inclination, condyle, and fossa shape and symmetry were evaluated in CBCT images in 190 TMJs in 95 pediatric patients. Patients were classified as Class 1–2–3 in the sagittal direction, as hypodivergent, normodivergent, and hyperdivergent in the vertical direction. Children were divided into 10–13 and 14–17 age groups. Results: The left superior joint space in children with a different skeletal model in the sagittal plane was lower and found to be statistically significant in Class 3 children (p < 0.05). A statistically significant difference was found lower in the left articular eminence inclination and height in Class 3 children (p < 0.05). The most common oval fossa form was seen in Classes 2–3 children (p < 0.05). It was determined that the anterior joint space was lower in hyperdivergent children and the condyle was located more anteriorly. The mediolateral length of the condyle and the height of the articular eminence were positively correlated with age. Conclusions: The results revealed that the difference in skeletal models seen in sagittal and vertical planes in children may cause morphological and morphometric changes in the hard tissue components of TMJ. [ABSTRACT FROM AUTHOR]

Introduction: Temporomandibular joint (TMJ) osteoarthritis (OA) is a common TMJ degenerative disease with an unclear mechanism. Synovial fluid (SF), an important component of TMJ, contains various proteins and metabolites that may directly contribute to OA. The present study aimed to investigate the influence of SF in TMJOA at the metabolite level. Methods: Untargeted and widely targeted metabolic profiling were employed to identify metabolic changes in SF of 90 patients with different TMJOA grades according to TMJ magnetic resonance imaging. Results: A total 1498 metabolites were detected. Most of the metabolites were amino acids and associated metabolites, benzene and substituted derivatives, and lipids. Among patients with mild, moderate and severe TMJOA, 164 gradually increasing and 176 gradually decreasing metabolites were identified, indicating that biosynthesis of cofactors, choline metabolism, mineral absorption and selenocompound metabolism are closely related to TMJOA grade. Combined metabolomics and clinical examination revealed 37 upregulated metabolites and 16 downregulated metabolites in patients with pain, of which 19 and 26 metabolites were positively and negatively correlated, respectively, with maximum interincisal opening. A model was constructed to diagnose TMJOA grade and nine biomarkers were identified. The identified metabolites are key to exploring the mechanism of TMJOA. Discussion: In the present study, a metabolic profile was constructed and assessed using a much larger number of human SF samples from patients with TMJOA, and a model was established to contribute to the diagnosis of TMJOA grade. The findings expand our knowledge of metabolites in human SF of TMJOA patients, and provide an important basis for further research on the pathogenesis and treatment of TMJOA. [ABSTRACT FROM AUTHOR]

Ectopic teeth arise from developmental abnormalities and can be supernumerary, deciduous, or permanent teeth. They can cause orofacial pain, swelling, and infection. There is a major paucity in literature about ectopic mandibular third molar (EMTM) and its causes, symptoms, and treatment. We present an unusual case of EMTM in the mandibular subcondylar region and its surgical management. A 58-year-old female reported with complain of pain and swelling in the right preauricular region. On radiographic assessment, the right mandibular third molar was ectopically present in the subcondylar region and associated with a small dentigerous cyst. Complete removal of cystic lining and extraction of EMTM was done under general anesthesia using a retromandibular approach. After surgery, there was a complete resolution of symptoms within 1 month with uneventful healing and no postoperative complications. [ABSTRACT FROM AUTHOR]

Introduction: The multitude of definitions for the centric relation (CR) has sparked extensive scientific debates, marking significant milestones in the evolution of concepts in these fields. The discourse surrounding CR has remained contentious for over a century, and there is still a persistent divergence of perspectives. Aim: This narrative review aims to unravel the evolutionary trajectory of CR definitions, seeking to untangle the existing confusion prevalent within specialized literature. Moreover, it endeavors to provide guiding principles within this contentious domain, offering valuable insights to practitioners, students, educators, and researchers. Discussion: Dentistry has not arrived at a consensus definition and concept of CR. Even in the era of evidence-based dentistry, CR still leaves room for controversy. Conclusion: The evolution of the CR concept and its definition, progressing from the exact specification of the maxillomandibular relationship, temporomandibular joint elements, and hinge axis and to its partial “abandonment” due to the individuality and particularities of the patients, should be contextualized within the functional and adaptable nature of the stomatognathic system.

Background and Objectives: The most popular surgical procedures among orthognathic surgeries for Class II and III patients are Le Fort 1 osteotomy for the maxilla and bilateral sagittal split ramus osteotomy (BSSRO) for the mandible. Keeping the condyle in its proper place during fixation is one of the difficulties of orthognathic surgery. One of the worst post-orthognathic surgery consequences in the temporomandibular joint (TMJ) area may be condylar resorption. Condylar remodeling refers to a group of processes that occur in reaction to forces and stress placed on the temporomandibular joint in order to preserve morphological, functional, and occlusal balance. A systematic review of the literature was performed with the aim of identifying the mandibular condylar component of TMJ changes after orthognathic surgery in class II and III patients. Materials and Methods: An electronic search was carried out using the PubMed, Cochrane Library, and Google Scholar, databases. The inclusion criteria included trials in non-growing patients upon whom orthognathic surgery was performed due to Angle II or Angle III classes malocclusion; in addition, a CT or cone beam computed tomography (CBCT) scan was performed before and after surgery to track the mandibular condylar component of TMJ changes. The quality of the studies was evaluated by two independent authors. The risk of bias was assessed by using the Downs and Black checklist. Results: The electronic and manual literature search yielded 12 studies that fulfilled all necessary inclusion criteria. Observed studies were evaluated as good (3), fair (8), and poor (1) quality. Two studies evaluated class II patients, six studies observed class III patients, and four studies were comparative. Most of the studies evaluated condyle angle and space changes, and the condylar surface and volume changes were also observed. However, the methodology of evaluation in the publications differs. Conclusions: Reduction of bone density, especially in class II patients, and morphological condyle reshaping, with the apposition of the bone, is the main adaptive mechanism after orthognathic surgery. However, all of the studies we examined were conducted using different methods of evaluation, measurement, and reference points.

OBJECTIVE: Temporomandibular joint disorders (TMD) are a type of disorder that affects the temporomandibular joint, muscles, and nerves leading to persistent facial pain. Transcutaneous electrical nerve stimulation (TENS) therapy is an alternative treatment for pain relief in TMD patients. The aim of the study was to assess the condylar position changes and pain levels occurring in TMD patients after TENS therapy. MATERIALS AND METHODOLOGY: According to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) criteria, a total of seven patients with TMD were included in this study. Routine diagnostic investigations were taken for each patient along with joint vibration analysis (JVA), electromyography (EMG), and a cone beam computed tomography (CBCT) at rest position. Using the Dolphin software (version 11.95), the temporomandibular joint spaces were measured on the CBCT for the right and left sides individually for each patient. These patients were then subjected to TENS therapy, and an EMG reading was taken post-TENS therapy to evaluate the effect on muscle strain. A CBCT was taken after the TENS therapy to assess its effect on the condylar position. The statistical significance of the pre- and post-temporomandibular joint spaces and the EMG readings post-TENS therapy were assessed using paired t-tests, respectively. RESULTS: There was a change in the anterior, middle, and posterior dimensions observed radiographically, before and after TENS. However, the results were found to be statistically significant only in the anterior region on the right joint space (P = 0.03) and posterior region of the left joint space (P = 0.04). CONCLUSION: TENS therapy has been found to bring about a change in the condylar position and pain intensities by relieving inadvertent muscle activity in the temporomandibular region. Therefore, further studies with larger sample sizes and control are required to fully ascertain the role of inadvertent muscle activity on the TMJ.

Objective: The purpose of this study is to assess the impact of Sagittal Split Ramus Osteotomy (SSRO) on the alignment of the condyle and orientation of the Ramal segment following surgery in patients operated for the correction of mandibular asymmetry. Methods: A total of 27 patients who underwent SSRO were enrolled in this study, and study groups were defined as asymmetric (study group) and symmetric (control group) using linear measurements from the dental midline based on a three-dimensional coordinate system. Differences on preoperative and postoperative values of anterior (AJS), posterior (PJS) and superior joint spaces (SJS), condylar axial angle (CAA), Sagittal Ramal Angle (SRA), and Coronal Ramal Angles (CRA) of study and control groups were measured and compared. The data was analyzed using the “Wilcoxon signed-ranks test” to identify differences between groups. Results: Differences between preoperative and postoperative values of CRA and SRA of the contralateral group showed statistically significant results with p-values of 0.007 and 0.005, respectively. A statistically significant change in CAA angle was found in the control and deviation groups (p = 0.018 and p = 0.010, respectively). Conclusions: SSRO has inevitable effects on the condylar and ramal orientation. Individuals with asymmetry require particular attention throughout the planning process and beyond. Conjunctive modalities and modifications should be considered and utilized when necessary. Future studies with larger sample sizes, homogenous follow-up periods, and more comprehensive clinical data are needed to substantiate understanding of the response of the condylar segment. Clinical relevance: Orthognathic surgeries inevitably alter the alignment and harmony of temporomandibular structures and may result in change of AJS, PJS, SJS, CAA, SRA, and LRA, which may change the biomechanics of joint and lead to several complications like temporomandibular disorders. Especially in cases with midline asymmetry needs special consideration from planning till the end of the treatment to achieve best results. In severe cases, conjunctive modalities and modifications and other alternatives such as inverted-L osteotomies should be considered. [ABSTRACT FROM AUTHOR]

Abstract Background Mandibular condyle remodeling and displacement are post-orthognathic surgery concerns that can potentially lead to occlusal issues after bilateral sagittal split ramus osteotomy. This retrospective study examined the relationship between condylar volume changes and position alterations after surgery in patients with skeletal class II and III malocclusions using cone-beam CT. Methods The study included 16 patients (6 with Class II malocclusion, 10 with Class III malocclusion) who underwent bilateral sagittal split ramus osteotomy at Chonnam National University Hospital. Cone-beam CT data were collected at three specific time points: before surgery, immediately after surgery, and approximately 6 months post-surgery. Mandibular movement was measured using InVivoDental 5.4.6. ITK-SNAP 3.8.0 was used to assessed condylar volume changes post-surgery. Condyle positions were evaluated in four parts with RadiAnt DICOM Viewer 4.6.9. Statistical analyses were performed using the SPSS version 23. Results Considering both Class II and III malocclusion, a 2.91% volume reduction was noted immediately and at 6 months after surgery. Both Class II and III cases demonstrated a decrease in superior joint space by -0.59 mm and medial joint space by -1.09 mm. No significant correlation was found between this process and condylar volume change. Conclusions The mandibular condyle volume decreased, and superior-medial movement of the condyle was detected in patients with Class II and III malocclusion immediately and at 6 months after surgery with no volume-position correlation.

Introduction: Knee joint problems, such as Osteoarthritis (OA), primarily affect the upper weight-bearing end of the tibia. Total and unicompartmental knee arthroplasty are commonly performed as treatment options. However, existing studies on morphometric assessment of the knee joint mainly focus on the Western population, with a lack of data among the Indian population. Obtaining such data is crucial for designing tibial components of knee prostheses tailored to the Indian population. Aim: To compare the morphometric data of the upper end of the tibia between the North and East Indian populations. Materials and Methods: A cross-sectional observational study was conducted in the Department of Anatomy at FMHS Medical College, SGT University, Gurugram, Haryana, North India, involving 41 dry tibias, and at Medical College and Hospital Kolkata in East India, involving 43 dry tibias. Measurements of the Anteroposterior (AP) and Transverse Diameters (TD) of the Medial Tibial Condyle (MTC), Lateral Tibial Condyle (LTC), and Total Tibial Condyles (TTC) were performed using digital Vernier callipers with a least count of 0.01 mm. The data was statistically analysed using Statistical Package for Social Sciences (SPSS) (version 21.0), and Student’s t-test was applied, with p

This study aims to compare computed tomography (CT) with magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) by using texture analysis (TA) to detect condylar bone marrow changes associated with the flattening and erosion of cortical bone. A total of 47 patients from the Dentomaxillofacial Radiology Division at São Paulo State University were evaluated. Images from 250 CT and 250 MRI images were assessed by experienced radiologists employing OnDemand3D software. Texture parameters were extracted with MaZda software (version 4.6), and we focused on regions of interest within the condyles. Statistical analysis revealed significant differences in texture parameters between the affected and control groups. CT images showed higher correlation values in cases of flattening, whereas MRI images demonstrated substantial changes in texture parameters for both flattening and erosion. These findings suggest that the texture analysis of CT and MRI images can effectively detect early and advanced degenerative changes in the TMJ, thus providing valuable insights into the underlying pathophysiology and aiding in early intervention and treatment planning.

Idiopathic Condylar Resorption (ICR) has been frequently reported in patients undergoing orthodontic treatment especially in young adolescent females, so as dentists we could be the first ones to diagnose this condition. This condition represents an aggressive and fast-moving form of degenerative disease of the Temporomandibular Joint (TMJ) and the pathognomonic features of this condition include a deficit of condylar volume, furthermore reducing the ramus height and length of mandible and causing a clockwise rotation of the mandible leading to absence of anterior bite. The accurate cause of this condition is not known, however, there are multiple aetiological factors that could be contributing to this disease. ICR is a poorly understood disease and it could be a very difficult condition to treat because of its various expression and the large number of treatment options that are available. Over the past years a number of cases with ICR have been reported in the orthodontic literature. The aim of this review article is to present a compiled data to better understand the pathophysiology and aetiological factors contributing to ICR and provide an insight about the various clinical features and radiographic findings of this condition which will help us diagnose this condition better in our day-to-day practice. Various treatment modalities like splint therapy, orthognathic surgery, joint replacement have also been mentioned and discussed. A case of ICR that reported to our department with a chief complaint of progressive opening of the bite has also been included in this review article.

Abstract Background The ossification mechanism of the temporomandibular joint (TMJ) condyle remains unclear in human embryo. The size and structure of TMJ, shape of articular disc and the characteristics of omnivorous chewing in the pig are similar to those of humans. The pig is an ideal animal for studying the mechanism of ossification of the TMJ condyle during the embryonic period. Method In a previous study by our group, it was found that there was no condylar ossification on embryonic day(E) 45, but the ossification of condyle occurred between E75 and E90. In this study, a total of 12 miniature pig embryos on E45 and E85 were used. Six embryos were used for tissue sections (3 in each group). The remaining six embryos were used for transcriptomic and proteomic studies to find differential genes and proteins. The differentially expressed genes in transcriptome and proteomic analysis were verified by QPCR. Results In total, 1592 differential genes comprising 1086 up‐regulated genes and 506 down‐regulated genes were screened for fold changes of ≥2 to ≤0.5 between E45 and E85. In the total of 4613 proteins detected by proteomic analysis, there were 419 differential proteins including 313 up‐regulated proteins and 106 down‐regulated proteins screened for fold changes of ≥2 to ≤0.5 between E45 and E85. A total of 36 differential genes differing in both transcriptome and proteome analysis were found. QPCR analysis showed that 14 of 15 selected genes were consistent with transcriptome analysis. Conclusion Condylar transcriptome and proteomic analysis during the development of TMJ in miniature pigs revealed the regulatory genes/proteins of condylar ossification.

Abstract Purpose The purpose of this article is to discuss the effective management of mandibular fractures in pediatric patients during the growing phase of the mandible using splint fiber and ligature wire. Methods A retrospective study examined pediatric patients with mandibular fractures who were treated using the splint (Quartz) fiber and ligature wire technique at the Stomatology Hospital of Xi’an Jiaotong University from August 2021 to January 2023. Data on gender, age, location or site of the fracture, and development of tooth stage were collected from the patient’s medical records. Descriptive statistics were used to analyze the data and evaluate the effectiveness of the splint (Quartz) fiber technique for treating mandibular fractures in pediatric patients. Results Out of 256 subjects, 6 pediatric patients with mandibular fractures were selected, resulting in an incidence rate of 2.34% with an equal sex ratio. Mental or symphysis fracture was the most common site for fracture in children, accounting for 100% of cases. Right mandibular angle fracture was observed in 16.7% of patients, while 50% of the group (3 individuals) suffered from left condylar fracture and 16.7% had a bilateral condylar fracture. Treatment with Quartz splint fiber and circumdental arch wiring using ligature wire was successful with no observed post-treatment complications or malocclusion. The splint fiber was worn for 30 days and the circumdental arch wiring was for the same. Healing of bone fracture yields good results after 12 weeks. Follow-up care is crucial to monitor for complications, in this study, no post-treatment complications were observed. Conclusion The treatment of pediatric mandibular fractures is complex and requires careful consideration of various factors. Conservative management should be the first choice, with open reduction and internal fixation reserved for specific cases. The use of quartz splint fiber and ligature wire is an effective treatment option for stabilizing the mandible and providing occlusal stability in growing children. A fiber splint along with ligature wire can also be used as an alternative treatment to avoid any adverse effects on the growth and development of the mandible and permanent teeth. A multidisciplinary approach is essential to achieving the best outcomes for pediatric patients with mandibular fractures.

Abstract Background This study aimed to compare the skeletal structures between mandibular prognathism and retrognathism among patients with facial asymmetry. Results Patients who had mandibular asymmetry with retrognathism (Group A) in The Netherlands were compared with those with deviated mandibular prognathism (Group B) in Korea. All the data were obtained from 3D-reformatted cone-beam computed tomography images from each institute. The right and left condylar heads were located more posteriorly, inferiorly, and medially in Group B than in Group A. The deviated side of Group A and the contralateral side of Group B showed similar condylar width and height, ramus-proper height, and ramus height. Interestingly, there were no inter-group differences in the ramus-proper heights. Asymmetric mandibular body length was the most significantly correlated with chin asymmetry in retrognathic asymmetry patients whereas asymmetric elongation of condylar process was the most important factor for chin asymmetry in deviated mandibular prognathism. Conclusion Considering the 3D positional difference of gonion and large individual variations of frontal ramal inclination, significant structural deformation in deviated mandibular prognathism need to be considered in asymmetric prognathism patients. Therefore, Individually planned surgical procedures that also correct the malpositioning of the mandibular ramus are recommended especially in patients with asymmetric prognathism.

Ankylosis of the temporomandibular joint (TMJ) is characterized by the intracapsular union of the condyle-disc complex to the surface of the temporal bone, which can cause restriction of the mandibular movements and a limitation of a mouth opening. Alterations are also described as a restriction of masticatory capacity, difficulty in phonation and suitable oral hygiene, as well as difficulty in social interaction. A 27-year-old female patient with a bilateral history of parasymphysis and mandibular condyle fracture after a trauma in 2014, which evolved to an ankylosis of the right TMJ, with a maximum mouth opening of 13.27 mm. For the treatment of the described case, it was used the Al-Kayat approach, ipsilateral coronoidectomy and resection of the ankylotic mass in gap with interposition of temporalis muscle fascia flap on the right side. After six months of the surgical procedure, it was made a new computed tomography of the face in which it was possible to notice the absence of lesions and signs of recurrence of the ankylosis. It was also observed the maintenance of the gap space made by the bone resection. The satisfactory result of the technique was attributed to the achievement and stabilization of an adequate mouth opening, improved chewing ability and phonation. Besides the clinical success, an advantage of the technique used was the low cost of the procedure by using only temporal muscle interposition without the use of alloplastic materials. In addition, the associated ipsilateral coronoidectomy was sufficient to help maintaining the achieved mouth opening, and the contralateral coronoidectomy was not necessary, as a result it was minimized the surgical time and morbidity of one more accessed surgical site.

Introduction: Maxillofacial trauma in children is uncommon, accounting for between 1 % and 14 % of all facial trauma in the general population. Objective: To describe the epidemiological and anatomical-clinical aspects of mandibular fractures in children. Material and method: This was a retrospective descriptive cross-sectional study with non-probabilistic accidental sampling. It took place in the maxillofacial surgery and stomatology department of Cocody University Hospital in the Republic of Côte d'Ivoire, over a 20-year period (2000–2019). The study population consisted of patients aged 0–16 years admitted to our department for a mandibular fracture. At the end of this study, we identified 58 patients. Data was entered using Excel 2016. Tables and graphs were processed using Excel version 2016. Results: we have identified 58 patients. The mean age of patients was 9.35 ± 2.1 years, with extremes of 1 and 16 years, and a sex ratio of 2,22 in favouring men. The 6–12 age group was the most affected (n: 34 cases or 60.35 %). Soft tissue wounds were present in all our patients, followed by peri-mandibular swelling (n: 37 cases or 63.79 %) and disorders of the dental articulation (n: 28 cases or 48.2 %). Condylar fractures were the most frequent (46.87 %).Mandibular fracture lines were uni-focal in 75 % of cases. These fractures were associated with other facial lesions in 48.28 % of cases and with extra-facial lesions in 34.48 % of cases. Conclusion: Mandibular fractures are common in maxillofacial trauma in children. Condylar fractures are the most common, almost always associated with chin injuries. Hence the importance of a systematic examination of the mandibular condyles.

The bilateral sagittal split osteotomy (BSSO) is the established workhorse in mandibular orthognathic surgery. Despite the frequency at which this procedure is performed, alterations in condylar position from the surgery remain a concern to the operating surgeon. Such changes in condylar positioning have long been associated with relapse. A systematic literature review was carried out to address the question: ‘condylar re-positioning devices in orthognathic surgery – is there a benefit to their use?'. As of yet there is no robust scientific evidence to suggest that these devices confer any clinical benefit over traditional manual re-positioning in orthognathic surgery cases. It would seem appropriate that future research focus on cost effective methods for intra-operative identification of a mal-positioned condyle with the aim of preventing later relapse.

Background: Mandibular condyle remodeling and displacement are post-orthognathic surgery concerns that can potentially lead to occlusal issues after bilateral sagittal split ramus osteotomy. This retrospective study examined the relationship between condylar volume changes and position alterations after surgery in patients with skeletal class II and III malocclusions using cone-beam CT. Methods: The study included 16 patients (6 with Class II malocclusion, 10 with Class III malocclusion) who underwent bilateral sagittal split ramus osteotomy at Chonnam National University Hospital. Cone-beam CT data were collected at three specific time points: before surgery, immediately after surgery, and approximately 6 months post-surgery. Mandibular movement was measured using InVivoDental 5.4.6. ITK-SNAP 3.8.0 was used to assessed condylar volume changes post-surgery. Condyle positions were evaluated in four parts with RadiAnt DICOM Viewer 4.6.9. Statistical analyses were performed using the SPSS version 23. Results: Considering both Class II and III malocclusion, a 2.91% volume reduction was noted immediately and at 6 months after surgery. Both Class II and III cases demonstrated a decrease in superior joint space by -0.59 mm and medial joint space by -1.09 mm. No significant correlation was found between this process and condylar volume change. Conclusions: The mandibular condyle volume decreased, and superior-medial movement of the condyle was detected in patients with Class II and III malocclusion immediately and at 6 months after surgery with no volume-position correlation. [ABSTRACT FROM AUTHOR]

Introduction: Knee joint problems, such as Osteoarthritis (OA), primarily affect the upper weight-bearing end of the tibia. Total and unicompartmental knee arthroplasty are commonly performed as treatment options. However, existing studies on morphometric assessment of the knee joint mainly focus on the Western population, with a lack of data among the Indian population. Obtaining such data is crucial for designing tibial components of knee prostheses tailored to the Indian population. Aim: To compare the morphometric data of the upper end of the tibia between the North and East Indian populations. Materials and Methods: A cross-sectional observational study was conducted in the Department of Anatomy at FMHS Medical College, SGT University, Gurugram, Haryana, North India, involving 41 dry tibias, and at Medical College and Hospital Kolkata in East India, involving 43 dry tibias. Measurements of the Anteroposterior (AP) and Transverse Diameters (TD) of the Medial Tibial Condyle (MTC), Lateral Tibial Condyle (LTC), and Total Tibial Condyles (TTC) were performed using digital Vernier callipers with a least count of 0.01 mm. The data was statistically analysed using Statistical Package for Social Sciences (SPSS) (version 21.0), and Student's t-test was applied, with p<0.05 considered significant. Results: The mean TD and AP diameters of the tibial plateau were found to be greater in the East Indian population (TD: 65.47±5.46, AP: 44.29±4.36). In both samples, the AP diameter of MTC (North Indians: 38.30±3.54, East Indians: 40.63±3.46) was greater than that of LTC (North samples: 35.30±3.51, East samples: 35.70±3.96). When comparing parameters between the North and East samples using Student's t-test, significant differences were found on the right-side for the mean AP (p-value=0.0065) and TD (p-value=0.0213) of TTC, mean AP (p-value=0.0006) and TD (p-value=0.0219) of MTC, mean TD of LTC (p-value=0.0002), mean AP (p-value=0.0005) and TD (p<0.0001) of the Intercondylar area at anterior ends, and mean AP (p<0.0001) and TD (p-value=0.0017) of the Intercondylar area at posterior ends. On the left-side, significant differences between the North and East population were found for mean TD of LTC (p-value=0.0348), AP (p<0.0001) and TD (p-value=0.0207) of the Intercondylar area posterior end. When comparing the areas between the North and East populations, significant differences were found on the right-side only for the MTC (p-value=0.0013), LTC (p-value=0.0083), and TTC (p-value=0.0055). Conclusion: There are significant regional variations in the anthropometric measurements of the North and East Indian populations, emphasising the need to develop populationspecific tibial prostheses for improved surgical outcomes. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the characteristics of condylar resorption in craniofacial microsomia (CFM) patients following mandibular distraction osteogenesis (MDO). Patients with unilateral type-IIa and type-IIb CFM, who had completed MDO and mandibular distractor extraction (MDE), were recruited. The height and volume of the condyle were measured on three-dimension models created by the analysis of computed tomography (CT) data. Normality analysis was performed using the Shapiro-Wilk test. Data for the affected and unaffected sides were compared using the paired t -test or Wilcoxon signed-rank test. Data for both type-IIa and type-IIb CFM were compared using the independent-samples t -test or Mann-Whitney U test. The Pearson or Spearman correlation was used to determine the correlations of condylar resorption rate with related measurements. In total, 48 type-IIa and 48 type-IIb CFM patients were included. The condylar resorption rate in type-IIa CFM (0.35 ± 0.32) was significantly associated with the height of the condyle (r = 0.776, p < 0.001) and distraction distance (r = 0.447, p = 0.001), while the condylar resorption rate in type-IIb CFM (0.49 ± 0.46) was significantly associated with the height of the condyle (r = 0.924, p < 0.001). However, there was no significant difference in condylar resorption rate between type-IIa and type-IIb CFM (p = 0.075). In addition to occlusal changes, no other negative symptoms of the TMJ were observed with condylar resorption. Condylar resorption was evident in CFM patients following mandibular distraction osteogenesis, and the condylar resorption rate showed a relationship with distraction distance and condylar height. [ABSTRACT FROM AUTHOR]