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Agenesis of the temporomandibular condyle is a congenital/developmental disorder that can present with the absence of the condyle and an incomplete development of the articular fossa and eminence, resulting in facial asymmetry as well as masticatory dysfunction. The purpose of this report is to present the case of a three-year-old girl with absence of the left temporomandibular condyle. The patient presented with pain and dysfunction in the left masseter muscle, pre-auricular area and ear as well as mild chin deviation to the left. The most common treatment modality is to wait and treat this condition with surgical intervention once the patient is grown. However, oral orthopedic appliances can be considered to promote bone formation prior to surgery. Prompt recognition and early treatment is advisable to take advantage of the child's growth and avoid further facial asymmetry, pain and dysfunction. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint osteoarthritis (TMJOA) is an end-stage disease that seriously affects the patients’ quality of life. Molecular insights in advancing our understanding of TMJOA are the need of the hour. Methods: We performed RNA high-throughput sequencing and bioinformatics analysis of differentially expressed (DE) long non-coding RNA (lncRNAs), microRNAs (miRNAs), and messenger RNA (mRNAs) in human synovial TMJOA tissues. Firstly, synovium samples of TMJOA patients and non-TMJOA controls were collected for highthroughput sequencing of lncRNAs, miRNAs, and mRNAs. We then performed biological function analysis of the top 100 mRNAs with more than 2-fold differential expression, and their upstream regulated miRNAs and lncRNAs were predicted separately. Intersections between predicted miRNAs/lncRNAs and differentially expressed miRNAs/ lncRNAs were determined, respectively. Regulatory networks among the selected lncRNAs, miRNAs, and mRNAs were constructed. Finally, Western Blotting and reverse transcription-quantitative polymerase chain reaction (RTqPCR) were used to explore the function of selected lncRNA and mRNAs. Results: Our analysis showed that the only upregulated lncRNAxist, was involved in intracellular protein degradation, cartilage matrix degradation, and osteoclast differentiation through four regulatory axes: miR-1271-5p/ctsb, miR-365a-3p/mmp3, miR-199a-3p/fos, and miR-27b-3p/ miR-1271-5p/grb2. RT-qPCR results showed that xist expression increased in both TMJOA synovial tissue and inflammatory-stimulated synovial cells. Inhibition of xist could promote the proliferation of synovial cells upon inflammatory stimulation, and xist could positively regulate the expression of GRB2. Targeting GRB2 could inhibit the expression of matrix degrading enzymes in synovial cells, thereby attenuating the inflammatory environment. Conclusion: Given the current lack of reports of lncRNA regulation in TMJOA synovitis, our results revealed that xist was significantly differentially expressed in human synovial TMJOA and could regulate the expression of GRB2, which may play a role in the progression of TMJOA. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective cohort study in an asymptomatic nonpatient population evaluated the prevalence of specific morphologic changes usually associated with the presence of degenerative joint diseases (DJD) using cone beam computed tomography (CBCT) and examined the associations between DJD and age, sex, and number of teeth present.Materials and Methods: CBCT images (268 TMJs) of 134 asymptomatic patients were studied. Patient data were obtained from clinical records, and calibrated examiners interpreted the CBCT images. The presence or absence of traditional radiographic signs of DJD (erosion, generalized sclerosis, osteophytes, and subchondral cysts) in the condyle and articular eminence of each TMJ were evaluated. The data were submitted to bivariate (chi-square and Fisher exact tests) and multivariate (Poisson regression) analyses (α = .05).Results: The sample was primarily composed of men (52.24%) and individuals aged ≥ 61 years (55.64%); 61.94% were partially edentulous with ≤ 12 teeth in the oral cavity. The most common DJD diagnoses were mandibular condyle osteophytes (30.22%) and erosion (12.69%), followed by articular eminence erosion (8.58%) and mandibular condyle subchondral cysts (7.09%). The bivariate analysis showed a statistically significant association between women and subchondral cysts (P = .007), between edentulous individuals and subchondral cysts (P = .008), and between individuals with ≤ 12 teeth and mandibular condyle erosion (P = .005). In the adjusted Poisson regression analysis, a significant association was found between DJD and gender (P = .015).Conclusion: Despite the limitations of this study, the results show a high prevalence of morphologic changes usually associated with the presence of DJD in asymptomatic subjects. Osseous TMJ abnormalities were most present in women, individuals with a lower number of teeth, and older individuals. [ABSTRACT FROM AUTHOR]

Purpose: To determine a possible association between asymptomatic temporomandibular joint (TMJ) condylar erosion and the number of missing posterior teeth and their location, as well as the number of dental quadrants with missing posterior teeth.Materials and Methods: This case-control study involved 210 patients (male to female ratio = 98:112) aged 16-74 years, with 105 asymptomatic patients with TMJ condylar erosion and a control group of 105 patients without TMJ condylar erosion. Cone beam computed tomography images were evaluated to classify the severity of TMJ condylar erosion as grade 0 (absence of erosion), grade I (slight erosion), grade II (moderate erosion), or grade III (extensive erosion).Results: The number of missing posterior teeth (mean ± standard deviation [SD]; 2.7 ± 2.4 vs 0.7 ± 1.2) (P < .001), number of dental quadrants with missing posterior teeth (1.5 ± 1.3 vs 0.6 ± 0.9) (P < .001), and bilateral location of missing posterior teeth (41 ± 39.0 vs 10 ± 9.5) (P < .001) were all significantly higher in patients with erosion than in those without erosion. The condylar erosion grade was significantly associated with the number of missing posterior teeth (odds ratio [OR] = 1.24; P = .006), the number of dental quadrants with missing posterior teeth (OR = 1.36; P = .006), and the bilateral occurrence of missing posterior teeth (OR = 3.03; P = .002).Conclusion: The findings from this study suggest a possible association between TMJ condylar erosion grades and the number of missing posterior teeth, the number of quadrants with missing posterior teeth, and the bilateral occurrence of missing posterior teeth. [ABSTRACT FROM AUTHOR]

Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management. In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed. Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery. Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food. This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child. [ABSTRACT FROM AUTHOR]

Temporomandibular joint osteoarthritis (TMJOA) is one of the most common diseases causing chronic pain in the oral and maxillofacial region. So far, there are few ways to relieve the pain of TMJOA. Melatonin (MT) has a good analgesic effect in many diseases, including fibromyalgia, neuropathic pain, chronic headache, and burn pain, with very low acute toxicity and side effects. This study was to investigate the role and mechanism of MT in TMJOA chronic pain. In rats TMJOA chronic pain occurred at day 14 after an intra–temporomandibular joint injection of monosodium iodoacetate, which we previously reported. The enzyme-linked immunosorbent assay results showed that MT levels were higher in the synovial fluid from patients and rats with TMJOA as compared with those from control. Fluorescent retrograde tracing (Dil) identified that upregulation of MT type 2 receptor (MT2R) in trigeminal ganglion (TG) neurons innervating rat temporomandibular joints was accompanied by TMJOA chronic pain. Nociceptive behavior as assessed by von Frey and the Rat Grimace Scale demonstrated that exogenous administration of MT relieved chronic pain in TMJOA rats, whereas blocking MT2R with 4P-PDOT reversed the analgesic effect of MT. Immunofluorescence analysis also confirmed that MT inhibited CGRP and IB4 expression of TG neurons, and this inhibition was reversed by administering the MT2R antagonist in TMJOA rats. By using Fluo-3 AM-based calcium imaging in vitro, MT elicited calcium transients in Dil+ TG neurons, which were significantly abolished by 4P-PDOT. Collectively, this study suggested that MT relieves the TMJOA chronic pain of rats through downregulation of sensitized CGRP+ and IB4+ neurons in TG via MT2R. This will be helpful for health care professionals utilizing MT as an option against TMJOA chronic pain. [ABSTRACT FROM AUTHOR]

The authors aim to present an updated protocol for mandibular reconstruction in nongrowing patients with Pruzansky/Kaban type IIb/III congenital craniofacial microsomia with customized temporomandibular joint (TMJ) prosthesis to reduce facial nerve (FN) damage and improve surgical accuracy. This is illustrated (using 3 cases) and is based on preoperative mapping of the FN using MRI for better virtual surgical planning of custom-made TMJ prosthesis. Intraoperative FN mapping and monitoring, as well as verification of the final result with intraoperative cone-beam computed tomography (CBCT) and 3D-reconstructed images is also achieved. All 3 patients presented mild transient postoperative facial palsy due to surgical soft tissue stretching which resolved within 2 months of surgery. All patients presented proper occlusion and mouth opening without pain, with an average incisal opening of 38.8 mm (range 35.5-42 mm) at two months of follow-up. Moreover, superposition of intraoperative and preoperative 3D reconstruction images ensured surgical accuracy and avoided the need for a potential reintervention. In conclusion, the proposed surgical protocol for mandibular reconstruction with customized alloplastic TMJ prosthesis in nongrowing patients with type IIb/III Pruzansky-Kaban congenital mandibular hypoplasia may reduce FN morbidity, improve surgical accuracy and final outcomes., (Copyright © 2024. Published by Elsevier Ltd.)

Total joint reconstruction (TJR) has become the most preferred method of reconstruction in recent years for hemifacial microsomia (HFM). This requires meticulous planning for the glenoid fossa and ramus prosthesis along with the arch in certain indications. TJR in a type V HFM is extremely challenging due to agenesis/hypolasia of the zygoma and arch which compromises anchorage of the glenoid prosthesis. Conventional options used for such indications incorporate extended designs for the fossa. However, the two designs used commonly are associated with limitations; (i) the temporal extension is overtly large and cannot be anchored in patients with thin temporal bone and (ii) the glenoid fossa incorporated into the arch prosthesis, where the fossa is not positioned on stable bone and occlusal loading is non-physiological; transmitted onto the arch prosthesis rather than the skull base. The authors propose the use of the mastoid process as an alternative for anchorage of fossa prosthesis. This technique offers stable anchorage while facilitating ideal positioning on the skull base for optimal masticatory load transmission. The case illustration depicts reconstruction of the TMJ, zygoma and the zygomatic arch in a 31-year-old man with type V HFM, with a three-year follow-up, with good clinical outcomes sans complications., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

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Agenesis of the temporomandibular condyle is a congenital/developmental disorder that can present with the absence of the condyle and an incomplete development of the articular fossa and eminence, resulting in facial asymmetry as well as masticatory dysfunction. The purpose of this report is to present the case of a three-year-old girl with absence of the left temporomandibular condyle. The patient presented with pain and dysfunction in the left masseter muscle, pre-auricular area and ear as well as mild chin deviation to the left. The most common treatment modality is to wait and treat this condition with surgical intervention once the patient is grown. However, oral orthopedic appliances can be considered to promote bone formation prior to surgery. Prompt recognition and early treatment is advisable to take advantage of the child's growth and avoid further facial asymmetry, pain and dysfunction.

Abnormal subchondral bone remodeling plays important roles during osteoarthritis (OA) pathology. Recent studies show that bone marrow mesenchymal stem cells (BMSCs) in osteoarthritic subchondral bones exhibit a prominent pro-osteoclastic effect that contributes to abnormal subchondral bone remodeling; however, the pathologic mechanism remains unclear. In the present study, we used a mouse model with OA-like change in the temporomandibular joint (TMJ) induced by an experimentally unilateral anterior crossbite (UAC) and found that the level of microRNA-29b (miR-29b), but not miR-29a or miR-29c, was markedly lower in BMSCs from subchondral bones of UAC mice as compared with that from the sham control mice. With an intra-articular aptamer delivery system, BMSC-specific overexpression of miR-29b by aptamer-agomiR-29b rescued subchondral bone loss and osteoclast hyperfunction in UAC mice, as demonstrated by a significant increase in bone mineral density, bone volume fraction, trabecular thickness, and the gene expression of osteocalcin and Runx2 but decreased trabecular separation, osteoclast number and osteoclast surface/bone surface, and the gene expression of cathepsin K, Trap, Wnt5a, Rankl, and Rank as compared with those in the UAC mice treated by aptamer-NC (all P < 0.05). In addition, BMSC-specific inhibition of miR-29b by aptamer-antagomiR-29b exacerbated those responses in UAC mice. Notably, although it primarily affected miR-29b levels in the subchondral bone (but not in cartilage and synovium), BMSC-specific overexpression of miR-29b in UAC mice largely rescued OA-like cartilage degradation, including decreased chondrocyte density, cartilage thickness, and the percentage areas of proteoglycans and type II collagen, while BMSC-specific inhibition of miR-29b aggravated these characteristics of cartilage degradation in UAC mice. Moreover, we identified Wnt5a, but not Rankl or Sdf-1, as the direct target of miR-29b. The results of the present study indicate that miR-29b is a key regulator of the pro-osteoclastic effects of BMSCs in TMJ-OA subchondral bones and plays important roles in the TMJ-OA progression. [ABSTRACT FROM AUTHOR]

Background: Idiopathic condylar resorption (ICR) is a well-documented but poorly understood condition, characterised by the progressive degeneration of the temporomandibular joint without an identifiable cause. ICR most commonly presents as a spontaneous, self-limiting episode of bilateral condylar resorption in the absence of pathology, injury or systemic disease. The condition most commonly affects physically active adolescent females, and has a strong predilection for individuals with a Class II skeletal relationship. Some ICR patients exhibit symptoms such as discomfort and/or functional limitations during the active phase of resorption, though some may be completely asymptomatic. Aim: This case report describes the ICR management of a 20-year-old female with asymptomatic bilateral condylar resorption, resulting in a rapid development of mandibular retrognathia. The retrognathic appearance was of concern to the patient and treatment was desired for this reason. Methods and results: Combined orthodontic-orthognathic treatment was undertaken. Pre-surgical orthodontics was completed following ICR stabilisation, and surgical correction consisted of a mandibular advancement plus a genioplasty. The resorbed condyles were accepted given the temporomandibular joints remained asymptomatic and there were no functional limitations. Following treatment, the patient remained asymptomatic, functioning without restrictions, and satisfied with the aesthetic outcome. Conclusion: The combined orthodontic-orthognathic approach addressed the aesthetic and functional concerns of the patient. The condyles were not reconstructed with prostheses and were left in their resorbed anatomical form and relationship. This illustrates the adaptive capabilities of the mandible and associated musculature, and that more complex condylar restorative procedures are not always required. [ABSTRACT FROM AUTHOR]

AIMS: The goal of this study was to compare the treatment outcome after two different treatment modalities in cases of disc displacement of the temporomandibular joint diagnosed via magnetic resonance technique, namely surgical procedure in form of arthroscopic lysis and lavage vs. hyaluronic acid superior joint space application. MATERIALS AND METHODS: Magnetic resonance imaging was performed before and one year after treatment. Simultaneously, pre- and post-treatment visual analogue scales and maximal mouth opening distance were documented. RESULTS: In our study, out of the total of 145 patients who were initially diagnosed with magnetic resonance imaging to have internal derangements and treated with arthroscopic lysis and lavage or hyaluronic acid application, we observed progression of internal derangement in 27 cases (18.6%), improvement in 37 cases (25.5%) and stationary state in 81 patients (55.9%). Both treatment methods significantly improved the followed maximal mouth opening distance and visual analogue scale, as confirmed upon the 12-month follow-up examination. Maximal mouth opening was 4.7mm for hyaluronic acid application and 12.2mm for arthroscopic lysis and lavage (p<0.005). The mean visual analogue scale values decreased from 6.2 to 2.1 for hyaluronic acid application and from 6.9 to 1.2 for arthroscopic lysis and lavage (p<0.005). Our study shows that both arthroscopic lysis and lavage and hyaluronic acid injections are effective and safe in the treatment of disc displacement in the temporomandibular joint (Tab. 3, Ref. 30). Text in PDF www.elis.sk. [ABSTRACT FROM AUTHOR]

Objective: To investigate the course of temporomandibular joint (TMJ) inflammation, osseous deformation, and mandibular ramus growth in children with juvenile idiopathic arthritis (JIA) during systemic therapy.Methods: Longitudinal study of 38 consecutive patients with JIA (29 female, median age 9.0 yrs, interquartile range 6.2-10.7 yrs) receiving systemic therapy with TMJ involvement, with 2 TMJ magnetic resonance imaging (MRI) examinations ≥ 2 years apart and no TMJ corticosteroid injection. Clinical and MRI findings were compared between initial and followup examinations and between TMJ with and without active inflammation at baseline.Results: Over a median period of 3.6 years (range, 2.0-8.7 yrs), MRI grade of TMJ inflammation improved (p = 0.009) and overall osseous deformity tended to become less severe (p = 0.114). In TMJ with arthritis at baseline (46 TMJ), both the grades of inflammation (p < 0.001) and deformity (p = 0.011) improved. In TMJ with no arthritis at baseline (30 TMJ), the frequency and grade of condylar deformation remained stable. Mandibular ramus growth rates were not significantly different between TMJ with and without arthritis at baseline (1.3 mm/yr vs 1.5 mm/yr, p = 0.273), and were not correlated with the degree of inflammation at baseline or followup. The frequency of facial asymmetry tended to be lower at followup than at initial examination (24% vs 45%, p = 0.056).Conclusion: Our results suggest that systemic treatment of TMJ arthritis in children with JIA decreases the degree of inflammation seen on MRI, preserves osseous TMJ morphology, and maintains normal mandibular ramus growth. [ABSTRACT FROM AUTHOR]

Aim: The aim of this systematic review was to compile the latest evidence to assess the effectiveness of nonsteroidal anti‐inflammatory drug(s) (NSAID) in patients with temporomandibular joint disorders (TMDs) in relieving pain. TMDs are a group of musculoskeletal disorders that affect the temporomandibular joint and/or masticatory muscles. Methods: After a literature review, a comprehensive search was conducted via Pubmed, Scopus, Google Scholar, and Cochrane databases with a systematic search strategy. The inclusion criteria were randomised controlled trials in humans, published in the last 50 years evaluating the effect of NSAIDs on TMDs. Although this duration chosen would potentially identify studies that have utilised outdated treatments, research methodology, and TMDs diagnostic criteria, and this has been considered before making clinical recommendation, it was used to advise future methodological changes necessary. The included studies were subjected to full‐text review. Results: Out of 646 studies initially identified through searches, 12 were selected for full‐text review of which 11 were included in the data synthesis. All 11 studies were randomised controlled trials. In total, 424 patients were included in this review. The earliest study included was 1996. Diagnostic criteria varied among all studies, and some did not specify enough signs and symptoms to construct a diagnosis. Intervention varied among all studies, as did the control. Nonspecific diagnosis, variable control groups, and heterogenous intervention protocols affected the outcome of this review. Despite the reduction of pain in the joint and/or masticatory muscles as well as improved range of motion, conclusive clinical recommendation could not be made. Conclusion: Heterogeneity did not allow for definitive conclusion; however, there was some evidence to support the use of NSAIDs in patients with TMDs for relief of pain. Further studies with strict, consistent diagnostic criteria and treatment are required. [ABSTRACT FROM AUTHOR]

Aim: To determine if glutamate injected into the healthy temporomandibular joint (TMJ) evokes pain through peripheral N-methyl- D-aspartate (NMDA) receptors and if such pain is influenced by sex or sex steroid hormones. Methods: Sixteen healthy men and 36 healthy women were included and subjected to two randomized and double-blind intra-articular injections of the TMJ. Experimental TMJ pain was induced by injection of glutamate (1.0 mol/L) and NMDA block was achieved by co-injection of the NMDA antagonist ketamine (10 mmol/L). The TMJ pain intensity in the joint before and during a 25-minute postinjection period was continuously recorded on an electronic visual analog scale (0 to 10). Estradiol, progesterone, and testosterone levels in serum were analyzed. Results: Glutamate-induced pain showed a median (25/75 percentile) duration of 8.3 (5.2/12.2) minutes. The peak pain intensity was 6.1 (4.2/8.2), the time to peak was 50 (30/95) seconds, and the area under the curve was 59 (29/115) arbitrary units. The women reported higher maximum pain intensity than the men and shorter time to peak. The sex hormone levels were not significantly related to the glutamate-induced TMJ pain. NMDA block significantly reduced the glutamate-induced TMJ pain, mainly in the women. There were no significant correlations between sex hormone levels and the effects of NMDA block for any pain variable. Conclusion: Glutamate evokes immediate pain in the healthy human TMJ that is partly mediated by peripheral NMDA receptors in the TMJ. [ABSTRACT FROM AUTHOR]

This study investigated the prevalence of signs and symptoms of temporomandibular disorders (TMD) in 1,134 orthodontically untreated children and adolescents (593 boys, 541 girls; age range 5 to 15 years) with and without crossbites. The sample with crossbites was further grouped according to the type (anterior, posterior, unilateral, or bilateral). The TMD symptoms bruxism (obvious active attrition/myalgia), joint sounds (clicking/crepitation), deviation during opening, reduced functional movements (maximum opening < 40 mm), and myopain (originating in the masticatory muscles/related to masticatory functions) were evaluated based on the standardized RDC/TMD protocol (Research Diagnostic Criteria for Temporomandibular Disorders) and compared among the various groups. Girls had a significantly higher prevalence of myopain than boys (χ2= 3.882, P < .05). Furthermore, individuals with posterior unilateral crossbites showed a significantly higher prevalence of TMD symptoms (χ2 = 33.877, P < .001) and reduced functional movements (χ2= 10.800, P < .05) than any other group. In conclusion, sex and type of crossbite play a role in the prevalence of TMD signs and symptoms. [ABSTRACT FROM AUTHOR]

Objective: To quantify the relative risk of multiple occlusal variables for muscular disorders of the stomatognathic system. Method and Materials: Thirteen occlusal features were clinically assessed by the same three operators: partial unilateral posterior reverse articulation, anterior open occlusal relationship, vertical anterior overlap (normal value < 4 mm), complete unilateral posterior reverse articulation, anterior overjet (normal value < 5 mm), incisor midline discrepancy (normal value < 2 mm), Angle Class I canine and molar relationship; plus dynamic occlusion features such as length and symmetry of retruded contact position-intercanine position (RCP/ICP) slides (normal value < 2 mm), occlusal guidance patterns, and mediotrusive and laterotrusive interferences. The sample consisted of 156 women with only muscular disorders according to the Group I Research Diagnostic Criteria for temporomandibular disorders and 82 healthy women (control group). A stepwise multiple logistic regression model was used to identify the significant correlation between occlusal features and disease. Results: The odds ratio for myofascial pain was 2.6 for absence of canine guidance, 2.0 for laterotrusive interference, 2.3 for mediotrusive interference, and 1.9 for reverse articulation. Other occlusal variables did not reveal statistical significance. The percentage of the total log likelihood for myofascial pain explained by the significant occlusal factors was acceptable with a Nagelkerke R² = 0.2. The final model including the significative occlusal features revealed an optimal discriminant capacity to predict patients with myofascial pain with a sensitivity of 62.2%, or healthy subjects with a specificity of 93.6%, and an accuracy of 82.8%. Conclusions: Few occlusal features show a significative predictive value for myofascial pain. [ABSTRACT FROM AUTHOR]

Objective: This study treated patients with temporomandibular disc displacement with reduction (with pain, limited mandibular movement, and clicking sound symptoms) using a combination of analgesics, injection, mandibular exercise, and occlusal splints. Method and materials: Twenty-five patients with temporomandibular joint (TMJ) disorders were evaluated for pretreatment complaints and clinical findings, such as TMJ sounds, mandibular deviation, limited mouth opening, and bilateral magnetic resonance imaging results. Diagnostic treatment was then planned; all patients received occlusal splints, and 10 patients received injections. Results: Evaluations were conducted 1 year after the initial diagnosis and treatment. Complaints (especially of pain} by the patients who received injections had reduced significantly. After 6 months of occlusal splinting, clinical findings of patients with TMJ disc displacement had greatly improved. To manage parafunctional habits of the patients, night plate usage was continued. Therefore, clinical symptom reduction was maintained. Conclusion: The use of mandibular manipulation technique can decrease the anterior disc displacement of the TMJ. (Quintessence MS004:35-B11-814) [ABSTRACT FROM AUTHOR]

Purpose: This study observed occlusal contacts and determined their areas on the mandibular teeth, especially the molars, during voluntary lateral excursions. Materials and Methods: Occlusal contact areas were estimated with a measurement system combining 3-D tracking of mandibular movements with 3-D digitization of tooth shape. Sixteen women with sound permanent dentitions participated. Results: At the intercuspal position, estimated occlusal contact areas of the first and second mandibular molars were on average 12.6 mm2 and 9.0 mm2, respectively. However, after 3.0 mm of lateral excursion, their areas were sharply reduced to 2.2 mm2 and 1.5 mm2 on the working side, and 0.4 mm2 and 1.1 mm2 on the nonworking side, respectively. Conclusion: These results suggest that the occlusal contact areas on working- and nonworking-side molars differ from each other as lateral excursion proceeds. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated whether tooth wear status can predict bruxism level. Materials and Methods: Sixteen Japanese subjects (eight bruxers and eight age- and gender-matched controls; mean age 30 years) participated in this study. From dental casts of these subjects, the tooth wear was scored by Murphy's method. Bruxism level in these subjects was also recorded for 5 consecutive nights in the subject's home environment using a force-based bruxism detecting system. The relationship between the tooth wear score and bruxism data was evaluated statistically. Results: Correlation analysis between the Murphy's scores of maxillary and mandibular dental arch and bruxism event duration score revealed no significant relationship between tooth wear and current bruxism. Conclusion: Tooth wear status is not predictive of ongoing bruxism level as measured by the force-based bruxism detection system in 30-year-old Japanese subjects. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the prevalence of signs and symptoms associated with temporomandibular disorders (TMD) in adults with shortened dental arches in Tanzania. Materials and Methods: The shortened dental arch group comprised 725 subjects with an intact anterior region and zero to eight occluding pairs of teeth posteriorly. They were categorized into five groups according to length and symmetry of the dental arches. A control group of 125 subjects with complete dental arches was included. The subjects were interviewed with questions related to pain and sounds within the temporomandibular joints and restricted mobility of the mandible. Clinical examination consisted of registration of clicking or crepitation of the joints, measuring maximum mouth opening, and assessing occlusal tooth wear. Results: Joint sounds were reported significantly more frequently by subjects with posterior support only unilaterally (17%) and by subjects with no posterior support (10%) compared to other categories of dental arches (3% to 5%). No significant differences were found between categories of dental arches with respect to pain (2% to 9%), restricted mobility of the mandible (0% to 1%), maximum mouth opening < 40 mm (0% to 3%), or clicking or crepitation of the joints (12% to 23%). For the younger age group (≥ 20 and < 40 years), tooth wear occurred significantly more often in subjects with no posterior support. For the older age group (≥ 40 years), tooth wear increased significantly with decrease of posterior support. Conclusion: No evidence was found that shortened dental arches provoke signs and symptoms associated with TMD. However, when all posterior support is unilaterally or bilaterally absent, the risk for pain and joint sounds seems to increase. [ABSTRACT FROM AUTHOR]

The presence of a temporomandibular joint dysfunction is a decisive factor in the treatment plan of a malocclusion. This article discusses an adult patient with a Class II, Division 2 malocclusion, referred to the authors by a maxillofacial surgeon for orthodontic treatment prior to surgical advancement of the mandible. A previously undiagnosed temporomandibular joint dysfunction led to different and less invasive treatment planning. [ABSTRACT FROM AUTHOR]

Aims: Temporomandibular joint (TMJ) discs displaced simultaneously, dorsoventrally, and mediolaterally are assumed to be rotated. However, a pilot study performed with individualized oblique-axial scans on supposedly rotated discs did not show disc rotation consistently. The aim of this study was the quantitative evaluation of disc rotation on a larger sample size, assessing the mediolateral disc geometry and position by the use of a reference system determined by the condylar long axis. Methods: Eighty-five TMJs from 50 subjects were analyzed. One series of sagittal and 1 of 14 individualized oblique-axial magnetic resonance (MR) scans were taken for each joint. The dorsoventral disc position was diagnosed by means of the sagittal scans. The mediolateral disc width and position were then measured on every oblique-axial scan. The width and midline was computed for each disc and its deviation from the perpendicular to the condylar long axis was calculated. Finally, a statistical analysis was performed to study whether the disc width and the direction of the disc midline varied between discs normally positioned and anteriorly displaced. Results: The disc width varied significantly more within the anteriorly displaced discs than within the normal ones. The midline of the anteriorly displaced discs deviated more from the perpendicular to the condylar long axis than that of normally positioned discs and was mostly in a lateral direction. The disc midline also deviated more in the ventral than in the dorsal part of the disc. Conclusion: Most anteriorly displaced discs were laterally displaced and showed a larger width variation than normally positioned discs. This fact seems to indicate disc deformation. [ABSTRACT FROM AUTHOR]

Aims: A new individualized oblique-axial orientation of magnetic resonance imaging scans of the temporomandibular joint (TMJ), corrected to be perpendicular to the tangent of the posterior slope of the articular eminence, has been proposed to improve the representation of the disc. The aim of this study was to evaluate the quality of the images obtained with this new type of scanning plane and to assess the factors that can affect the scans. Methods: Twenty-nine TMJs were scanned by the use of sagittal, conventional coronal, and individualized oblique-axial scanning planes. On the sagittal images, the angle α between the tangent of the posterior slope of the articular eminence and the vertical was measured, and the disc position was evaluated. For both imaging planes, 2 examiners, blind to the scanning techniques, counted the number of conventional coronal and oblique-axial scans in which the disc was visible and in which the medial and lateral disc borders were well demarcated and evaluated the mediolateral disc position. Results: The individualized oblique-axial technique was superior to the conventional coronal technique in depicting the disc and its medial and lateral demarcations (paired t test. P < 0.05). The possibility of correct diagnosis of the mediolateral disc position and the agreement between the observers in this evaluation were better with the oblique-axial technique than with the conventional technique (P c 0.05). This was particularly evident when the disc was anteriorly displaced. Conclusion: The individualized oblique-axial scanning planes should be used for a better representation of the discicondyle complex mediotaterally if the disc is anteriorly displaced. [ABSTRACT FROM AUTHOR]

The processes by which the human face develops in the embryo are exceedingly complex, but they work out perfectly—almost every time. Occasionally, however, the development of structures such as those comprising the temporomandibular articulation is disturbed leading to an anomalous morphology in later life. It is important to note that an anomaly is not necessarily an undesirable condition requiring treatment. It may be benign, with no associated problems, and therefore of no consequence; in fact, it may never be identified. Ross and Johnston have published a review of the developmental processes and etiology of undesirable conditions affecting the temporomandibular joint (TMJ). Craniofacial anomalies may be caused by genetic faults (eg, Treacher Collins syndrome) or caused by a teratogenic agent (eg, thalidomide), but most often it appears the cause is multifactorial (eg, cleft lip and palate). When the entire human genome is available and studied in persons with congenital anomalies, there may well be indicators for, or at least a demonstrable predisposition to, developmental problems. Problems involving the TMJ can be acquired or congenital (developmental). The vast majority seen in a dental office are acquired dysfunctions, traumatic injuries, or pathologic conditions. Developmental anomalies appear to be rare because most of them are asymptomatic and never come to the patient's or dentist's attention. Others are associated with syndromes, and the patients are referred to centers where treatment is provided by multidisciplinary teams of specialists. [ABSTRACT FROM AUTHOR]

Down syndrome (DS) is the most often diagnosed chromosomal disorder in newborns. The incidence is 1:792 live births. The article describes the irregularities and characteristics found in trisomy 21, which greatly affect the functioning of the stomatognathic system. The most significant disorders include the following: false macroglossia, muscular hypotonia and gothic palate. These abnormalities affect articulation, breathing, food intake, and swallowing. We analyzed the morphological characteristics of the craniofacial region in children with DS based on the current literature review. The following databases were used for the analysis: MEDLINE (via PubMed), Scopus, Infona, and Dentistry & Oral Sciences Source. In the course of the study, 199 pieces of literature were analyzed; the analysis also included 18 articles on children and adults with DS. It also took into account the structure of the palate, dental and skeletal defects, size of the tongue, muscular hypotonia, and temporomandibular joint dysfunction. Down syndrome is still a current subject of research. Although macroglossia, hypotonia, malocclusion, and temporomandibular joint abnormalities are not features exclusive to DS, numerous dysfunctions and parafunctions as well as retarded psychomotor development greatly complicate the treatment. Therefore, interdisciplinary treatment of patients with trisomy 21 and early treatment in the first months of life with the use of the Castillo-Morales plate are very important, as they ensure better adaptation to the subsequently used apparatus and reduce the risk of disorders of the stomatognathic system. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to investigate the relationship between TMJ disc displacement and chondylar degenerative changes. Material and Methods: The MRIs of 182 TMJs belonging to 91 patients with TMD were evaluated. TMJs were distributed into three groups according to the disc positions as normal disc position (Group 1, n=39), disc displacement with reduction (Group 2, n=49) and disc displacement without reduction (Group 3, n=94). Condylar degenerative change is diagnosed according to presence or absence of erosion, sclerosis, flattening and osteophyte encountered in MRI. When more than one type of degenerative change was observed, the joint was determined to have degenerative changes. Results: The results of MRI evaluation of 182 TMJs revealed Group 1, Group 2 and Group 3 in 39 (21.4%), 49 (26.9%) and 94 (51.6%) joints, respectively. No degenerative condyle was found in 107 (58.8%) joints whereas degenerative condylar changes were encountered in 75 (41.2%) of 182 TMJs by the MRI evaluation. Condyle degeneration was detected in 2 (5.1%) of the joints with normal disc position whereas 6 (12.2%) and 67 (71.3%) of the joints with reducing and non-reducing disc displacement revealed condyle degeneration, respectively. Conclusion: A statistically significantly higher rate of condyle degeneration was encountered in the joints with disc displacement without reduction than the joints with disc displacement with reduction and normal disc position. Advancing disc displacement causes condylar degenerative changes. [ABSTRACT FROM AUTHOR]

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension 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.)

This study's objectives were to test correlations among groups of biomarkers that are associated with condylar morphology and to apply artificial intelligence to test shape analysis features in a neural network (NN) to stage condylar morphology in temporomandibular joint osteoarthritis (TMJOA). Seventeen TMJOA patients (39.9 ± 11.7 y) experiencing signs and symptoms of the disease for less than 10 y and 17 age- and sex-matched control subjects (39.4 ± 15.2 y) completed a questionnaire, had a temporomandibular joint clinical exam, had blood and saliva samples drawn, and had high-resolution cone beam computed tomography scans taken. Serum and salivary levels of 17 inflammatory biomarkers were quantified using protein microarrays. A NN was trained with 259 other condyles to detect and classify the stage of TMJOA and then compared to repeated clinical experts' classifications. Levels of the salivary biomarkers MMP-3, VE-cadherin, 6Ckine, and PAI-1 were correlated to each other in TMJOA patients and were significantly correlated with condylar morphological variability on the posterior surface of the condyle. In serum, VE-cadherin and VEGF were correlated with one another and with significant morphological variability on the anterior surface of the condyle, while MMP-3 and CXCL16 presented statistically significant associations with variability on the anterior surface, lateral pole, and superior-posterior surface of the condyle. The range of mouth opening variables were the clinical markers with the most significant associations with morphological variability at the medial and lateral condylar poles. The repeated clinician consensus classification had 97.8% agreement on degree of degeneration within 1 group difference. Predictive analytics of the NN's staging of TMJOA compared to the repeated clinicians' consensus revealed 73.5% and 91.2% accuracy. This study demonstrated significant correlations among variations in protein expression levels, clinical symptoms, and condylar surface morphology. The results suggest that 3-dimensional variability in TMJOA condylar morphology can be comprehensively phenotyped by the NN. [ABSTRACT FROM AUTHOR]

First Bite Syndrome (FBS) is a painful condition which classically presents as severe pain in the pre‐auricular region, initiated on the first bite of a meal. It is usually associated with a history of upper neck surgery or tumour of the parotid salivary gland or parapharyngeal space (PPS). Some propose that FBS arises from damage to, or resection of, the cervical sympathetic trunk resulting in loss of sympathetic innervation to the parotid salivary gland. Idiopathic FBS has been reported only a handful of times in the literature. We present the case of a 51‐year‐old male, urgently referred to the Department of Oral Medicine, with a 3‐week history of severe, sharp, unilateral pain from the right angle of mandible, intensity described as '20/10', occurring only on the first bite of eating. This would diminish over 2 min. Clinical examination revealed tenderness over the right condylar neck and angle of mandible only. FBS was suspected and the patient immediately started on carbamazepine. An urgent MRI displayed no abnormalities of the temporomandibular joints, PPS, trigeminal nerve or parotid gland. Restorative Dentistry review confirmed no odontogenic or occlusal cause and on review, 4 months later the patient reported complete resolution of symptoms on 200 mg of carbamazepine three times daily. This case highlights the importance of taking a thorough pain history. Patients with symptoms of FBS and no history of surgery to the neck should have an MRI to rule out parotid gland or PPS tumour. Carbamazepine can be successful in treating idiopathic FBS and can resolve symptoms completely. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint (TMJ) anterior disc displacements with reduction (ADDR) are commonly found in the young population and often found to be associated with biomechanical and anatomical factors. Until now, most knowledge on ADDR among children and adolescents comes from studies performed on Caucasian subjects. Aims: To assess the clinically determined prevalence rates of ADDR among the young Indonesian population and to evaluate its risk indicators. Design: In this cross‐sectional study, 1562 pupils and students of 7‐21 years old completed a questionnaire and underwent a clinical examination. Results: The prevalence rates of ADDR were 7.0% among children (7‐12 years), 14.4% among adolescents (13‐18 years), and 12.3% among young adults (19‐21 years). Logistic regression analyses revealed that increasing age and lip biting were associated with ADDR in children, whereas pen biting was associated with ADDR in the adolescent population. None of the included factors were found to be associated with ADDR in the young adult population. Conclusions: The present findings indicate that prevalence of ADDR increases with age, with a peak during the years of adolescence. Biomechanical factors seem to play a significant role in ADDR development. [ABSTRACT FROM AUTHOR]

In recent years many advances have developed in the field of temporomandibular joint (TMJ) imaging. The newest of these involves the use of magnetic resonance imaging (MRI) to evaluate internal derangements of the TMJ. Improvements in imaging techniques now provide excellent anatomical images of the TMJ. The superior soft tissue contrast of MR enables the inteipreter to accurately determine meniscal position. This article describes MR features of the normal TMJ and findings in patients with internal derangements. The impact of MIR on the field of TMJ imaging may be quite substantial. It offers many advantages including superior evaluation of soft tissue structures without the use of ionizing radiation or intraarticular injections. Lack of dynamic evaluation, cost, and availability remain tile major shortcomings of the procedure. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Craniomandibular Disorders is the property of Quintessence Publishing Company Inc. 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 Journal of Craniomandibular Disorders is the property of Quintessence Publishing Company Inc. 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 Journal of Craniomandibular Disorders is the property of Quintessence Publishing Company Inc. 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 Journal of Craniomandibular Disorders is the property of Quintessence Publishing Company Inc. 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 Journal of Craniomandibular Disorders is the property of Quintessence Publishing Company Inc. 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 Journal of Craniomandibular Disorders is the property of Quintessence Publishing Company Inc. 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.)

This article deals with those aspects of oral muscle physiology that are relevant in the clinical situation. Some suggestions made in the literature for using electrornyography to evaluate the oral muscle function are discussed. Electromyography for routine use in the first screening of craniomandibular disorders is also discussed. [ABSTRACT FROM AUTHOR]

It has been suggested that skeletal malocclusions and deep bites may play a major role in the development of temporomandibular joint dysfunction. This study finds no strong relationships between horizontal and vertical overlap of the incisors and molar classification as compared to condylar position and arthrographic diagnosis. There was a predominence of patients with Class I occlusions and more normal horizontal and vertical over-lap of the incisors. Linear models demonstrated a relationship between distal condylar position, meniscus displacement without reduction, and less vertical overlap. This study suggests there may not be a strong relationship between the occlusal factors described and condyle position. [ABSTRACT FROM AUTHOR]

The use and efficacy of Doppler auscultation in assessing the status of the temporomandibular joint meniscus is described. The advantages of being noninvasive, readily available, portable, cost effective, and accurate make this a valuable adjunct to the present armamentarium. [ABSTRACT FROM AUTHOR]

One clinical observation made during acupuncture treatment of patients with mandibular disorders and facial pain was that acupuncture pothts often seem to coincide with those parts of the masticatory muscles exhibiting tenderness on palpation. The aim of this study was to determine more systematically to what degree acupuncture points correspond with the location of the tender zones in the masseter muscle. Twenty-six individuals with tenderness in the left masseter muscle were included in the study. In the majority of the cases (97%), one or more acupuncture points were localized within the tender zone in the muscle. An agreement between the location of the acupuncture point and tender muscle zones does appear to exist. [ABSTRACT FROM AUTHOR]

Internal derangements of the temporomandibular joint can lead to changes in condylar movements. These movements were recorded in the parasagittal plane, lateral to the condyles, with simple mechanical recorders. Several different patterns were found. A figure-eight-shaped pattern may be an indicator for an anteriorly displaced disk with reduction. Condylar movement patterns did not allow prediction of the outcome of anterior repositioning splint therapy. [ABSTRACT FROM AUTHOR]

A subgroup of six women aged 21 to 39 years were studied for their responses to treatment for craniornandibular disorders of neuromuscular origin. Severe clinical symptoms were ameliorated over a 5- to 8-week period. A standardized recording of their chewing movements in response to treatment was done with an optoelectronic measuring system. Comparison of chewing cycle variables, before treatment began, with those obtained after the 5- to 8-week period of treatment showed that changes in speed and duration of the opening stroke in comminution were indirect indicators of recovery from dysfunctional symptoms in the masticatory system. These two parameters effected a significant change in the overall rhythmicity of chewing for these subjects. [ABSTRACT FROM AUTHOR]

Results of 1.5-year posttreatment outcomes for TMJ clinic patients are described for three conservative reversible physical medicine procedures. Prior to treatment, the patients were diagnosed to one of these categories: (1) clicking; (2) joint pain and/or restriction (3) muscle pain without significant evidence of (1) or (2). Patient treatment was one of: (I) repositioning appliance; (2) stabilization appliance and physical therapy; (3) physical therapy alone; (4) no treatment. The choice of treatment was based on both clinician recommendations and patient choice. The most improvement was observed in those patients receiving the stabilization appliance and/or physical therapy; less improvement Was seen in the TA/If clicking patients who received the repositioning appliance therapy. [ABSTRACT FROM AUTHOR]

The outcome of this study showed that therapeutic laser treatment was effective in a short time and still stable after one year in patients with an arthrogenous origin of craniomandibular pain. The maximum, mouth opening increased significantly within four days of treatment (P < 0.001). Although unsuccessful pre-laser treatment time through several professions ranged from 6 to 66 months, a total relief of pain was found in 80% of the arthrogenous patients after a mean period of six days. Further studies have to be developed regarding infrared laser therapy in patients with a myogenous origin of pain, and to compare the effect of various durations of exposure. [ABSTRACT FROM AUTHOR]

An association between condylar position of the TMJ during centric occlusion and the presence of internal derangements related to meniscal position has been suggested. In this study, 143 patients (128 women and 15 men) were evaluated. From this patient group, 170 multidirectional hypocycloidal tomograms and arthrograms were obtained and evaluated. Temporo mandibular joint space measurements (linear and area) were obtained and compared to the arthrographic findings in 38 symptomatic normal patients, 72 patients with meniscus displacement with reduction, and 60 patients with Ineniscus displacement without reduction. Condylar position was divided into three subgroups: posterior, concentric, and anterior. A high variability of condylar position was noted in the three study groups. Using linear measurements, a tendency for posterior condylar position was found in patients with meniscus displacement with reduction, but not in symptomatic normals or patients with menisculs displacement without reduction. [ABSTRACT FROM AUTHOR]

Arthroscopy can be an important diagnostic and therapeutic modality in the treatment of some intracapsular temporomandibular joint (TMJ) disorders. Internal derangement with persistent closed lock and arthrosis with adhesive capsulitis are examples of problems where arthroscopy can be utilized. Therapeutic (surgical) arthroscopy is an alternative to arthrotomy ("open" TMJ surgery) and can be very effective in eliminating symptoms of preauricular pain and mandibular hypomobility secondary to internal derangement with persistent closed lock (acute and chronic) and arthrosis with adhesive capsulitis where nonsurgical therapy has been unsuccessful. [ABSTRACT FROM AUTHOR]