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Background/Purpose: Newly developed temporary anchorage devices (TADs) serve a strong orthodontic anchorage to intrude molars for correction of anterior open bite (AOB). We measured cephalometric changes in skeletal open bite patients which developed subsequently to temporomandibular joint disorders with bilateral point contacts at terminal molars. Methods: We retrospectively recruited 32 patients who had been treated their TMD before orthodontic correction (overbite: −3.14 ± 1.86 mm). Partial orthodontic appliances were used to intrude posterior teeth using TADs until positive OB obtained (T1). Full fixed appliances were then used to achieve proper overjet and overbite (T2). We collected lateral cephalograms before (T0), during (T1) and after (T2) treatment, and at follow-ups (T3). Using ANOVA, we analyzed the differences among these time points to determine treatment changes and stability of orthodontic results. Results: In this group predominantly comprising young adult women, orthodontic treatment with TADs significantly reduced upper posterior dental heights (T2-T0:-1.84 ± 0.66 mm) and facilitated the retraction and uprighting upper incisors (T2-T0: −9.92 ± 1.72°), to achieve appropriate OJ (T2-T0: −3.21 ± 0.49 mm) and OB (T2-T0: 4.10 ± 0.28 mm) with p

Newly developed temporary anchorage devices (TADs) serve a strong orthodontic anchorage to intrude molars for correction of anterior open bite (AOB). We measured cephalometric changes in skeletal open bite patients which developed subsequently to temporomandibular joint disorders with bilateral point contacts at terminal molars. We retrospectively recruited 32 patients who had been treated their TMD before orthodontic correction (overbite: −3.14 ± 1.86 mm). Partial orthodontic appliances were used to intrude posterior teeth using TADs until positive OB obtained (T1). Full fixed appliances were then used to achieve proper overjet and overbite (T2). We collected lateral cephalograms before (T0), during (T1) and after (T2) treatment, and at follow-ups (T3). Using ANOVA, we analyzed the differences among these time points to determine treatment changes and stability of orthodontic results. In this group predominantly comprising young adult women, orthodontic treatment with TADs significantly reduced upper posterior dental heights (T2-T0:-1.84 ± 0.66 mm) and facilitated the retraction and uprighting upper incisors (T2-T0: −9.92 ± 1.72°), to achieve appropriate OJ (T2-T0: −3.21 ± 0.49 mm) and OB (T2-T0: 4.10 ± 0.28 mm) with p < 0.05. Except upper posterior dental height, most of cephalometric changes including OJ, OB, and upper incisal axis remained significant at follow-ups with retention time of 3.7 ± 2.6 years. Only three out of 30 patients experienced small amount of open bite at T3. Orthodontic correction of OJ remained relatively stable among 90 % of patients with TMJ degeneration by intrusion via TADs. This modern but conservative orthodontic approach can improve occlusal functions in skeletal open bites. [ABSTRACT FROM AUTHOR]

The current study intends to highlight the relationship and, at times, the influence between anxiety disorders and dental dysfunctional syndromes of stomatognathic system(SDSS) in young students from our institution : Basis Of The Dental Care Clinic ,,Mihail Kogalniceanu,, Iasi. These are involved in various stressful intellectual activities and have identified a complex health problem that needed to be solved in light of the constant stress that the present time offers, laying the foundations for a focused and direct approach that will increase the certainty of growth. the quality of life. Be the way, the types of young social cases will be able to be solved, and will gather an extent of the accessible tools and skills. We also rely on the acquisition of skills through the experience conferred in this study to offer optimal solutions in these clinical situations.

Sonoelastography has been increasingly used for non-invasive evaluation of the mechanical features of human tissues. The interplay between orofacial pain and regional muscle activity appears clinically paramount, although only few imaging studies have investigated this association. Using shear wave sonoelastography (SWS), this study ascertained whether orofacial pain induced alterations in the stiffness of superficial and deep masticatory muscles. All participants were systematically evaluated for oral/facial-related conditions, including the area and intensity of pain. SWS was applied to measure the stiffness of the bilateral masseter, temporalis, and lateral pterygoid muscles. The association between orofacial pain and muscle stiffness/thickness was investigated using a generalized estimating equation for adjusting the influence of age, sex, laterality, and body mass index on muscle thickness/stiffness. A total of 98 participants were included in the present study: 48 asymptomatic controls, 13 patients with unilateral pain, and 37 patients with bilateral orofacial pain. The reliability, quantified by the intraclass correlation coefficient for muscle stiffness measurement, ranged from 0.745 to 0.893. Orofacial pain at the individual muscle level was significantly associated with masseter muscle stiffness. A trend of increased stiffness (p = 0.06) was also observed in relation to the painful side of the temporalis muscle. No significant correlation was identified between the numeric rating scales for pain and stiffness measurements. SWS provides reliable stiffness measurements for the superficial and deep masticatory muscles. The ipsilateral masseter and temporalis muscles might be stiffer than those on the side without orofacial pain. Future studies using the present sonoelasotography protocol can be designed to investigate the stiffness changes in the target muscles after interventions. Shear wave sonoelastography (SWS) can reliably assess the stiffness of masticatory muscles. Orofacial pain, particularly affecting the ipsilateral masseter muscles, exhibited increased stiffness, with a similar trend observed in the temporalis muscle as revealed by SWS. However, the stiffness of the lateral pterygoid muscle appeared to remain unaffected. These findings establish a foundational framework for the objective and quantitative assessment of orofacial pain and indicate the potential utility of SWS as a tool for evaluating treatment outcomes. [ABSTRACT FROM AUTHOR]

AbstractIntroduction Sonoelastography has been increasingly used for non-invasive evaluation of the mechanical features of human tissues. The interplay between orofacial pain and regional muscle activity appears clinically paramount, although only few imaging studies have investigated this association. Using shear wave sonoelastography (SWS), this study ascertained whether orofacial pain induced alterations in the stiffness of superficial and deep masticatory muscles.Methods All participants were systematically evaluated for oral/facial-related conditions, including the area and intensity of pain. SWS was applied to measure the stiffness of the bilateral masseter, temporalis, and lateral pterygoid muscles. The association between orofacial pain and muscle stiffness/thickness was investigated using a generalized estimating equation for adjusting the influence of age, sex, laterality, and body mass index on muscle thickness/stiffness.Results A total of 98 participants were included in the present study: 48 asymptomatic controls, 13 patients with unilateral pain, and 37 patients with bilateral orofacial pain. The reliability, quantified by the intraclass correlation coefficient for muscle stiffness measurement, ranged from 0.745 to 0.893. Orofacial pain at the individual muscle level was significantly associated with masseter muscle stiffness. A trend of increased stiffness (p = 0.06) was also observed in relation to the painful side of the temporalis muscle. No significant correlation was identified between the numeric rating scales for pain and stiffness measurements.Conclusions SWS provides reliable stiffness measurements for the superficial and deep masticatory muscles. The ipsilateral masseter and temporalis muscles might be stiffer than those on the side without orofacial pain. Future studies using the present sonoelasotography protocol can be designed to investigate the stiffness changes in the target muscles after interventions.

Ablative surgery of the mandibular condyle poses a unique reconstructive challenge for many reasons. The condyle and it's relationship to the TMJ is a unique, complex, functional and aesthetically relevant piece of human anatomy. Resection may be required for both malignant and benign pathologies; each posing a differing set of surgical variables. Particularly in neoplastic processes, there must remain a certain degree of peri-operative flexibility with regards to the extent of the resection, and forethought to the requirement for post-operative radiotherapy; both of which further complicate choice of reconstructive option and surgical or prosthetic planning. The cases involved can often concern paediatric patients, and an additional aspect to be considered is that of growth potential.In this piece, we will discuss the indications for ablation and the techniques involved. We will elaborate on the reconstructive challenges specific to reconstructing the condyle in post-ablative cases. We will then describe and analyse the established reconstructive techniques; aiming to provide a balanced view on the advantages and disadvantages. Our focus will include autologous options such as vascularised and non-vascularised free tissue transfer, and the non-autologous options of custom and stock implants. We will also touch on distraction osteogenesis and ramus osteotomies. Lastly we will look to the future and consider possible innovative techniques which may become available to the surgeon.

Background: Stabilisation splint therapy (SST) and low‐level laser therapy (LLLT) are effective‐invasive treatment for temporo‐mandibular disorder (TMD) patients. However, the specific efficacy of each therapy in patients with chronic closed lock (CCL) from temporo‐mandibular joints (TMJ) disc displacement without reduction (DDwoR) remains unknown. Objectives: The aim of this study was to assess and compare the efficacy of SST and LLLT alone or in combination in patients with CCL from TMJ DDwoR. Methods: This parallel randomised clinical trial included 42 patients who were diagnosed with CCL from TMJ DDwoR. Patients were allocated equally and randomly into three treatment groups: group I received combined SST and LLLT, group II received LLLT and group III received SST. Maximum mouth opening (MMO), visual analogue scale (VAS), muscle and joint palpation scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software. Results: Regarding MMO and VAS, a statistically significant improvement was found between group I versus group II and versus group III at all evaluation times. Regarding muscle and joint palpation scores, a statistically significant difference was found between group I versus group III, while non‐significant difference was found between group I and group II. A statistically significant faster improvement was found in group I versus group III and versus group II. Conclusion: All treatment modalities can be effective in management of CCL from a TMJ DDwoR cases, but the combined SST and LLLT group seems to provide the best and quickest improvement. Clinical trial registration number: NCT05548894. [ABSTRACT FROM AUTHOR]

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia 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.)

Ablative surgery of the mandibular condyle poses a unique reconstructive challenge for many reasons. The condyle and it's relationship to the TMJ is a unique, complex, functional and aesthetically relevant piece of human anatomy. Resection may be required for both malignant and benign pathologies; each posing a differing set of surgical variables. Particularly in neoplastic processes, there must remain a certain degree of peri-operative flexibility with regards to the extent of the resection, and forethought to the requirement for post-operative radiotherapy; both of which further complicate choice of reconstructive option and surgical or prosthetic planning. The cases involved can often concern paediatric patients, and an additional aspect to be considered is that of growth potential. In this piece, we will discuss the indications for ablation and the techniques involved. We will elaborate on the reconstructive challenges specific to reconstructing the condyle in post-ablative cases. We will then describe and analyse the established reconstructive techniques; aiming to provide a balanced view on the advantages and disadvantages. Our focus will include autologous options such as vascularised and non-vascularised free tissue transfer, and the non-autologous options of custom and stock implants. We will also touch on distraction osteogenesis and ramus osteotomies. Lastly we will look to the future and consider possible innovative techniques which may become available to the surgeon. [Display omitted] [ABSTRACT FROM AUTHOR]

Aim of the study This study aims to determine whether skeletal class and abnormal values of certain variables on cephalometry (cranio-vertebral angle, intervertebral functional spaces, the space between the anterior arch of the atlas and the anterior face of the odontoid process, the C2-7V line and the hyoid triangle) represent possible risk factors for the occurrence of muscle and joint dysfunction. Another objective is represented by the determination of a possible occlusal dysfunction pattern in patients with temporo-mandibular disorder. Material and methods Twenty patients with dysfunction and pain in the temporo-mandibular joint and masticatory muscles were included in the study (TMD group). Subsequently, the control group was chosen, which included 20 patients, who did not have joint and muscle damage, but who had occlusion disorders. In order to collect the data, the patient’s file was used, with records on both static and dynamic occlusion and also the data regarding the analysis of the muscles and the temporomandibular joint. Rocabado cephalometric analysis was used to evaluate cervical spine parameters. In order to determine the skeletal class, the Steiner analysis was used. Results Seventy-five percent of patients in control group were class I, while in TMD group 40% of patients were class I, the others being uniformly divided between class II and III. The mean value of the cervical functional space in C0-C2 area was lower in TMD group compared to control group, while in C1-C2 area presented equal values for both groups. Following the Fisher test analysis of the relationship of the C2-7V line and the hyoid triangle, no statistically significant association was detected between them and groups (p = 1; p = 0.305). Conclusions Skeletal class II is a risk factor for TMD. There is no statistically significant correlation between the values of the variables determined by the Rocabado cranio-cervical cephalometric analysis, and the occurrence of TMD. No pattern has been identified between static occlusion and TMD. Nonfunctional dynamic occlusion does not represent a risk factor for TMD development.

Introduction: The temporo-mandibular joint (TMJ) is a synovial joint between the articular fossa of the temporal bone and the mandibular condyle. It is condylar variety of joint. The most important functions of the TMJ are mastication and speech and are of great interest to anatomists, dentists, orthodontists and oro-maxillo-facial surgeons. The study was conducted with objective to establish the surface projection of Temporo-mandibular joint (TMJ) using tragus of ear as land mark. Materials and methods: Twenty five cadavers dissected in pre auricular area on both right and left side were studied. Out of 25 cadavers, 18 were male and seven were females. The temporo-mandibular joints were exposed on both sides, keeping the tragus of the ear intact. Altogether fifty temporo-mandibular joints were studied. On living persons, condylar head of TMJ were palpated while the subjects were carrying out side to side movement of lower jaw. The distance between the summit of the tragus and the marking on condylar head was measured with the help of divider and scale. Result: The mean distance in millimeter (mm) from midpoint of condylar head to the summit of tragus in all living subjects and cadavers (n=150) was 12.5 ± 3.5 mm and the mean length of distal phalanx of fore finger in all living subjects and cadavers (n=150) was 22 ± 4 mm. Conclusion: The mandibular condyle can be palpated at 12.5 ± 3.5 mm distance from summit of tragus of ear (i.e. Half-length of distal phalanx of fore finger which is 22 ± 4 mm) just below the inferior border of zygomatic arch.

Objectives Assessment of the range of temporomandibular joint and cervical spine mobility in people with bruxism Material and methods The study was conducted on a group of 71 people of both genders, aged between 20 – 45. The control group was the same number of people, without disorders of the stomatognathic system. Both groups were subjected to a physical examination which consisted of measuring the ranges of mobility of the temporo-mandibular joints and the cervical spine Results The mean values of the motion ranges of the temporo-mandibular joints obtained in Group I were: abduction – 28.34 mm (SD=5.91); lateral movement to the right – 5.87 mm (SD=1.67); lateral movement to the left – 6.18 mm (SD=2.30); protrusion – 3.90 mm (SD=1.07). Working ranges of mobility in Group II were: abduction – 41–52 mm; lateral movements to the right and left – 6–10 mm; protrusion – 4–7 mm. Measurements of ranges of mobility of the cervical segment in Group I: bending – 19.39 mm (SD = 4.26); extension – 58.01 mm (SD = 11.45); rotation to the right – 48.38 mm (SD = 9.50); rotation to the left – 46,72 mm (SD = 8.96); flexion to the right – 38.96 mm (SD = 8.26); flexion to the left – 37.79 mm (SD = 7.61). Conclusions 1. The limited range of mobility of the temporomandibular joints in patients with bruxism may affect the reduction of the cervical spine ranges of mobility. 2. The limited range of mobility within the temporomandibular joints and the cervical spine has an impact on pain felt within them. 3. Biomechanical connections of the cervical spine and temporo-mandibular joints indicate the need for functional evaluation of the cervical spine in people with stomatognathic system dysfunction.

Background: Systemic sclerosis (SSc) alterations of the face and of the mouth cause aesthetic modifications and disability, impairing self-esteem and quality of life (QoL). The aim of this study was to verify the effects of two rehabilitation protocols on facial mimic and mouth opening. Methods: A total of 47 SSc patients (40 females and 7 males, mean age ± SD 59.08 ± 10.31 years), were consecutively selected: 22 were randomly assigned to protocol 1 [home exercises for temporomandibular joint (TMJ), mimic, masticatory and cervical spine muscles] and 25 to protocol 2 (home exercises and combined physiotherapeutic procedures performed by a physiotherapist). Each treatment had a duration of 12 weeks with a follow up of 8 weeks. TMJ dysfunction, orofacial involvement, disability, QoL, and safety were assessed at enrollment (T0), at the end of the treatment (T1), and at follow up (T2). Results: Both Protocol 1 and Protocol 2 induced significant improvements of some clinical and clinimetric parameters, but better results were obtained with Protocol 2. In the comparison between the effects of Protocol 1 and Protocol 2 at T1 and T2, a significant difference was observed only for Mouth Handicap in SSc [MHISS; Total (p = 0.00178] and for MHISS Mouth opening (p = 0.0098) at T1. No significant difference of indices of short-form 36 was observed. Conclusion: The present data suggest that TMJ involvement in SSc may be managed by rehabilitation treatments. The action of a physiotherapist prescribing and personalizing exercises may induce better therapeutic effects. [ABSTRACT FROM AUTHOR]

Background: Excessive opening of the mouth has been reported to cause clinical problems such as luxations and traumatic injury to the temporomandibular joint (TMJ). The knowledge of the normal range of mouth opening will help to avoid excessive opening of the mouth which can cause injury to the TMJ of patients during procedures that involve mandibular manipulations. Maximum mouth opening (MMO) has age, race, gender and ethnic variations. Previous studies have looked at normal range of mouth opening among adults, but to the best of our knowledge, no study has looked at this among the paediatric/children population in Nigeria. Thus, this study aimed to determine the normal maximum mouth opening (MMO) among the paediatric population in Ibadan (South Western part of Nigeria) and the effect of gender, age, height and weight of these children on their MMO. Materials and methods: Six hundred and nine primary and secondary school pupils aged 6 – 15 years were included in this study. Patients with any condition affecting the temporomandibular joint (TMJ) function were not included. Measurements of height, weight and two readings of maximum interincisal distance were performed for each participant. Student's t-test, one-way analysis of variance (ANOVA) and Pearson bivariate correlation were used to assess the sample. Results: The mean MMO was 44.0 ± 5.3 mm and 42.6 ± 5.6 mm for males and females respectively. There was no significant difference in the MMO of males and females (t= 0.335, p = 0.563). MMO increases gradually with age irrespective of the gender and this was statistically significant (F= 17.1, p =0.001). Conclusion: The maximum mouth opening established for the paediatric population in this study will help practitioners whose care involves the stomathognathic system to have information about the normal range of mouth opening in this group of patients. The result will also be useful asbaseline for future research.

Osteochondroma is a benign bone tumour which is rarely appreciated in the oral and maxillofacial region. This case report illustrates on a 42‐year‐old male with osteochondroma affecting his left mandibular condyle and presenting with temporo‐mandibular dysfunction‐related symptoms. The authors of this paper hope to emphasise the need for vigilance and the value of using modern imaging techniques in the diagnostic work‐up for pain associated with the temporo‐mandibular joint. [ABSTRACT FROM AUTHOR]

• The temporo-mandibular joint chondrosarcoma is extremely rare, and can be misdiagnosed as parotid gland tumor. • Surgery is standard treatment with the aim of preserving the temporo-mandibular joint function. • Adjuvant radiation is used in certain cases to improve local control. Chondrosarcoma is a malignant tumor originated from cartilage cells. The most common sites of chondrosarcoma are pelvis, femur and ribs. The temporo-mandibular joint (TMJ) chondrosarcoma is extremely rare, with approximately 30 cases reported in worldwide. In this report, we present a case of chondrosarcoma in the left TMJ, which was successfully treated with surgery and radiation therapy. A 47 year-old women was admitted to our hospital with a mass in left pre-auricular region. On examination and para-clinical test results, the initial diagnosis was parotid gland cancer. In operation, the lesion was a mass originating from the left TMJ. Tumor resection was performed with close margin. The post-operative pathological result was well-differentiated chondrosarcoma. She was indicated adjuvant radiation therapy due to inadequate surgical therapy. There was no evidence of recurrence after 6 months follow-up. The TMJ chondrosarcoma is needed to distinguish from other diseases especially parotid gland tumor. Surgery and adjuvant radiation therapy are standard care with the aim of preserving joint function. [ABSTRACT FROM AUTHOR]

• Osteoid osteoma is a benign bone neoplasm, with significant nocturnal pain that responds to NSAIDs. • A case of an intra-articular osteoid osteoma involving the articular eminence and glenoid fossa of TMJ in a 46-years-old female is reported. • CT scan imaging is helpful in displaying the typical radiographic features and localization of the lesion. An osteoid osteoma is a benign bone neoplasm with limited growth potential, characterized by significant nocturnal pain that usually responds to non-steroidal anti-inflammatory drugs (NSAIDs). The tumor may occur in any part of the skeleton, most commonly in the lower extremities and vertebrae. A 46-year-old female was diagnosed with a rare case of an intra-articular variant of osteoid osteoma, involving the articular eminence and glenoid fossa of the temporo-mandibular joint (TMJ). The tumor presented as a painful progressive swelling in the right pre-auricular area that had lasted for more than 2 years and which had been previously treated as a TMJ disorder. Computed tomography revealed a well-defined heterogeneous nidus involving the articular eminence of the TMJ. Surgical excision was performed and histological examination confirmed the diagnosis. In this article, in addition to describing the case, all cases of osteoid osteoma of the jaws and TMJ reported in the English-language literature are reviewed. Osteoid osteoma involving the TMJ is a rare presentation and may exhibit ambiguous symptoms, which could lead to misdiagnosis and delayed treatment. [ABSTRACT FROM AUTHOR]

The aim of the present paper is to carry out a retrospective epidemiological study over a period of ten years on patients with temporo-mandibular disorders (TMD), referred to the TMD and Orofacial Pain Unit, the department of Fixed Prosthodontics, at the Faculty of Dental Medicine of Saint Joseph University, Beirut. This study focuses on the prevalence of sex, age, etiologies and risk factors, as well as the different diagnoses and pathologies of temporomandibular joints (TMJ), and the different treatments considered depending on each case studied. All the patients’ files examined at the TMD and Orofacial Pain Unit between 2006 and 2016 were gathered and reviewed thoroughly. 237 patients of mean age 33.41 ± 14.65 years (amplitude: 11-73 years) participated in the study. The vast majority of participants (79.3%) were women. The purpose of the visit in the entire sample was mainly pain (62.9%), with more women than men consulting because of pain (women: 66.7% v / s men: 47.9%) (p = 0.016). Headache was the most common symptom that was reported (55.7%). Other symptoms included: backache, neckache, posture problems and vertigo. Clenching of the jaws was the most commonly reported risk factor by participants (45.7%). No significant difference was noted between women and men (p> 0.05). Difference in physical examination was also not significant between men and women (p> 0.05). Muscle tension (35.2%), spasm (25.4%) and disc displacement (40.4%) were the most commonly reported diagnoses. The most frequent treatments offered to patients consisted in the stabilization splint (22.4%), medications (18.1%) and the retro-incisal plan (17.7%). Despite its limitations, the present work reflects a general view of our population. Further studies may lead to the creation of a general test that can be adopted systematically for the detection of TMD disorders. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Pain 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.)

Aim: The aim of our study was to analyze magnetic resonance imaging criteria in assessment of TMJ disorders and evaluate the important MRI role in comparison with arthroscopy. Patients and methods: The study was performed on eighty TMJs. TMJs are examined by 1.5 tesla MRI machine using sagittal oblique T1, PD & T2 weighted images & coronal oblique T1 and PD weighted images. The disk position, configuration, presence or absence of joint effusion, osteo-arthritis and mandibular condyle morphology were assessed. Comparison was done with arthroscopy in 49 joints. Results: Disk displacement was found in all cases symptomatic 80 joints, 60% bilateral and 40% unilateral. Joint pain and tenderness were the most clinical symptom followed by joint noise/clicking. Thirty-five joints showed anterior disk displacement with reduction, while forty-five joints showed anterior disk displacement without reduction and one of them shows stuck disk in displaced position. MRI has sensitivity of 95, specificity of 88 and accuracy of 94 in comparison with arthroscopy. Conclusion: MRI is proper diagnostic modality for TMJ disorders due to non invasiveness, excellent soft tissue contrast and multiplaner capabilities.

The article deals with the symmetry of dentofacial abnormality of temporomandibular joint, the position of mandible and rotation edges of temporomandibular joint heads in dentofacial abnormalities. The aim of the investigation is to compare the analysis of temporomandibular joint symmetry, the position of mandible and rotation edges of temporomandibular joint heads in dentofacial abnormalities based on the first and the second type of classification by Angle. The investigation was carried out among 27 patients with dentofacial abnormalities using cone beam computed tomography. The patients were divided into two groups based on types of malocclusion - the first type of occlusion by Angle and the second one by Angle's classification. While studying the distance from the middle of articular heads on the right and on the left to midline, passing through pterygoid processes of sphenoid bone it was determined that in the second class of Angle's classification of dentofacial abnormalities, articular heads are situated posteriorly to cranial basis on 2.45-3.47 mm (p<0.005). The difference between the rotation edges of temporomandibular joint heads is more than 5° of the 1st class according to classification and it occurred in 23.08% of patients; the second class occurred in 64.29%. The range of maximal difference of the rotation edge of the 1st class contains 5.2°, and the 2nd class of Angle's classification includes 15.2°, that determines the severity of dentofacial abnormality of the second classification by Angle. In the second type of Angle's classification articular heads of temporomandibular joint are situated posteriorly that confirms the pathogenesis of distal bite. Proposed methods of measurement can be used for differential diagnosis of skeletal forms of second type dentofacial abnormalities according to Angle's classification. With increase of dentofacial abnormality severity, rotation of temporomandibular joint heads also increases. In the second type of Angle's classification asymmetry of articular heads occurs on the right and left, three times more often in comparison with the first class. [ABSTRACT FROM AUTHOR]

Temporo-mandibular joint (TMJ) metastases are a very rare event and only 73 cases are reported in literature. In about 40% of cases condylar metastases represent the first clinical manifestation of a tumor of elsewhere and may then allow an early diagnosis. However, the identification of this tumoral process can be difficult as in over 50% of the cases it has a nuanced clinical presentation that is very similar to temporo-mandibular disorders. The first case of metastatic neuroendocrine carcinoma (NEC) of the temporo-mandibular joint (TMJ) mimicking a temporo-mandibular joint disorder is presented in this report. Furthermore, an extensive review of the literature has been performed in order to establish a correct diagnostic–therapeutic protocol for these oncologic patients. [ABSTRACT FROM AUTHOR]

Septic arthritis of the temporo-mandibular joint (TMJ) is a rare disease that has been reported infrequently. To the best of the authors' knowledge, only one case of bilateral TMJ septic arthritis has been reported. The contamination may result from direct extension of adjacent infection (dental or ENT), from hematogenous spread of blood-borne organisms or from direct inoculation. The most common presenting are trismus and pain, although swelling, tenderness and erythema have also been described. In addition, patients may develop fever, regional lymphadenopathy and malocclusion. Through a successively bilateral case of TMJ arthritis, without obvious portal of entry of the bacteria, we will analyze characteristics and treatment of this disease.

The human temporomandibular joint, is a ginglymo-arthrodial joint. The articular disk serves as a fibrous, viscoelastic structure that allows force distribution and smooth movement of the joint in its normal arrangement during mandibular movements. Most studies suggest that in the normal disk position the posterior band is located at the 12'o clock position within the glenoid fossa in the closed mouth posture. When the biomechanics of the joint is altered, the disk may be displaced creating an abnormal relationship between the disk, condyle, and the eminence that is often referred to as an internal derangement. This article reviews the various presentations of internal derangements., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Nasopharyngeal carcinoma ( NPC) is endemic in southern China, and its incidence in Hong Kong is relatively high. Radiotherapy is the mainstay treatment for NPC due to its relatively high radiosensitivity and deep-seated anatomical position, which is not readily accessible by surgery. Although the technique of radiotherapy in NPC has been advancing and offers promising treatment outcome, complications around the irradiation areas are inevitable and the quality of life of the post-radiotherapy patients is often compromised. Trismus, which is defined as the restricted mouth opening or jaw movement due to the disorder of temporo-mandibular joint ( TMJ), is one of the possible late complications for radiotherapy of NPC and is found in 5-17% of the post-radiotherapy (post- RT) patients. Trismus at early stage may only affect the speech, but in severe cases nutritional intake and oral hygiene condition may deteriorate seriously. This article reviewed the possible causes of radiation-induced TMJ damage, the various assessments including imaging modalities and possible treatments. The conclusion is that the availability of simple, yet effective examinations for trismus is essential for delaying the progression and restoring TMJ functions. Although there is no absolutely effective treatment for trismus, many supportive, restorative and palliative management are possible under different clinical situations. [ABSTRACT FROM AUTHOR]

Aim The aim of our study was to analyze magnetic resonance imaging criteria in assessment of TMJ disorders and evaluate the important MRI role in comparison with arthroscopy. Patients and methods The study was performed on eighty TMJs. TMJs are examined by 1.5 tesla MRI machine using sagittal oblique T1, PD & T2 weighted images & coronal oblique T1 and PD weighted images. The disk position, configuration, presence or absence of joint effusion, osteo-arthritis and mandibular condyle morphology were assessed. Comparison was done with arthroscopy in 49 joints. Results Disk displacement was found in all cases symptomatic 80 joints, 60% bilateral and 40% unilateral. Joint pain and tenderness were the most clinical symptom followed by joint noise/clicking. Thirty-five joints showed anterior disk displacement with reduction, while forty-five joints showed anterior disk displacement without reduction and one of them shows stuck disk in displaced position. MRI has sensitivity of 95, specificity of 88 and accuracy of 94 in comparison with arthroscopy. Conclusion MRI is proper diagnostic modality for TMJ disorders due to non invasiveness, excellent soft tissue contrast and multiplaner capabilities. [ABSTRACT FROM AUTHOR]

Introduction: A large number of disorders affecting the masticatory system can cause mouthopening restrictions. Among them is Jacob's disease, characterized by restricted jaw movements and caused by pressure of the mandible coronoid process, which is longer than normal in size, on the posterior aspect of the zygomatic arch, together establishing new joint formation. Observation: We present a case report of a 29-year-old male patient presenting limited mouth opening. Inter-incisal maximum mouth opening was 5 mm. On panoramic radiograph an elongated coronoid process of the mandible was evident. Computed tomography (CT) scans showed the relationship between the exophytic mass and the inner surface of the zygomatic arch. An extra-oral coronoidectomy was performed. A mouth opening of 55 mm was achieved intra-operatively. The post-operative period was without complications. The histopathological diagnosis was osteochondroma. Discussion: The clinical, radiological and histopathological characteristics and surgical approach to Jacob's disease are discussed. Conclusion: In a patient with a limitation of mouth opening, and without any temporo-mandibular joint disease, an examination of the coronoid process is required to identify hypertrophy ofthe coronoid process and to diagnose Jacob's disease. [ABSTRACT FROM AUTHOR]

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The study describes a rare clinical case of synovial chondromatosis of the temporo-mandibular joint, in a 53 year-old patient. In the prehospital stage, the patient was examined by additional diagnostic methods - 3D CT and subsequent computer simulation, in view of subsequent surgery. In January 2015, partial synovektomy of the right temporo-mandibular joint with removal of cartilaginous impurities was performed under general anesthesia. After histopathological confirmation of the clinical diagnosis, the patient was discharged in satisfactory condition, with recommendations for further examination and radiological control. Synovial chondromatosis of the temporomandibular joint is a disease characterized by impaired formation of cartilage or of intraarticular, cartilaginous, and relatively rare bone impurities. An important role in the diagnosis of joints' synovial chondromatosis is played by the instrumental research methods, especially X-ray. Surgical treatment is recommended as a function of the prevalence of lesions. [ABSTRACT FROM AUTHOR]

Background: Numerous procedures have been described for the treatment of chronic recurrent dislocation of the temporo-mandibular joint (TMJ), either in the form of enhancement or restriction of the condylar movement, with their obvious merits and demerits. Materials and Method: We present a new technique of using U shaped iliac bone graft to restrict the condylar movement and its advantages over the conventional techniques.We have used this technique successfully in 8 cases where Dautrey's procedure had failed with follow up period of 2 years. Results: No patient complained of recurrent dislocation postoperatively. Conclusion: This a very simple and effective technique where other procedures have failed. [ABSTRACT FROM AUTHOR]

Patients with temporomandibular muscle and joint disorder ( TMJD) increasingly seek and receive treatment for their pain with botulinum toxin (Bo NTA; botulinum toxin A). Used intramuscularly in therapeutic doses, it produces localised paresis. Such paresis creates risk of reduced bone mineral density, or 'disuse osteopenia'. Animal studies have frequently used Bo NTA as a model of paralysis to induce bone changes within short periods. Osteopenic effects can be enduring in animals but have yet to be studied in humans. This is the first study in humans to examine bone-related consequences of Bo NTA injections in the masticatory muscles, comparing oral and maxillofacial radiologists' ratings of trabecular bone patterns in the condyles of patients with TMJD exposed to multiple masticatory muscle injection sessions with Bo NTA to a sample of patients with TMJD unexposed to masticatory muscle injections with Bo NTA. Cone-beam computed tomography ( CBCT)-derived images of bilateral condyles were evaluated in seven patients with TMJD receiving 2+ recent Bo NTA treatment sessions for facial pain and nine demographically matched patients with TMJD not receiving Bo NTA treatment. Two oral and maxillofacial radiologists evaluated CBCT images for evidence of trabecular changes consistent with osteopenia. Both evaluators noted decreased density in all participants exposed to Bo NTA and in none of the unexposed participants ( P < 0·001). No other abnormalities associated with reduced loading were detected. These findings need replication in a larger sample and over a longer time period, to ensure safety of patients with TMJD receiving multiple Bo NTA injections for their pain. [ABSTRACT FROM AUTHOR]