Diagnostics

Research

13 pages, 1268 KiB

Open AccessArticle

Evaluation of Rheumatic Diseases Affecting the Temporomandibular Joint: A Cone Beam Computed Tomography Study and Literature Review

by Zeliha Merve Semerci and Sevcihan Günen Yılmaz

Diagnostics 2024, 14(1), 4; https://doi.org/10.3390/diagnostics14010004 - 19 Dec 2023

Viewed by 1610

Abstract

Introduction: Due to the silent manifestation of temporomandibular joint (TMJ), dentists and rheumatologists may neglect treatment for this joint. Aims: The aim of this study was to investigate the TMJ components in patients with various rheumatic diseases and to compare them with a [...] Read more.

Introduction: Due to the silent manifestation of temporomandibular joint (TMJ), dentists and rheumatologists may neglect treatment for this joint. Aims: The aim of this study was to investigate the TMJ components in patients with various rheumatic diseases and to compare them with a control group based on cone beam computed tomography (CBCT) images. Materials and Methods: This study comprised an assessment of the CBCT images of 65 patients (130 temporomandibular joints) with various rheumatic diseases (mostly rheumatoid arthritis) affecting the TMJ. Moreover, 65 patients (130 temporomandibular joints) with a similar age and gender distribution were examined as the control group. Pathologies were classified into a total of 12 types for the presence of any osseous changes in the condylar head or articular fossa or for joint space narrowing. Statistical analysis of all data was performed with SPSS version 18. The conformity of continuous variables to a normal distribution was examined by the Kolmogorov–Smirnov test. The Mann–Whitney U test was used to compare the means of two independent groups. The Pearson Chi-square test, Yates correction and Fisher’s exact test were used in the analysis of categorical variables. Results: The mean age of the patient and control groups was 50 ± 13 and 48 ± 16, respectively, and no statistically significant difference was found between the patient and control groups in terms of age distribution (p = 0.123). Condylar erosion, condylar flattening, subcondylar sclerosis, osteophytes, subcortical cysts, articular eminence resorption and articular eminence flattening rates were found to be statistically significantly higher in the patient group than in the control group (p < 0.05). Conclusions: Dentomaxillofacial radiologists should examine the bony components of the TMJ in patients with rheumatic diseases, and a multidisciplinary approach involving a dental specialist and rheumatologist is required. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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16 pages, 1609 KiB

Open AccessArticle

The Effect of TMJ Intervention on Instant Postural Changes and Dystonic Contractions in Patients Diagnosed with Dystonia: A Pilot Study

by Ayse Selenge Akbulut

Diagnostics 2023, 13(20), 3177; https://doi.org/10.3390/diagnostics13203177 - 11 Oct 2023

Viewed by 1087

Abstract

(1) Background: The aim of the present study is to analyze the instant postural changes and changes in the dystonic contractions among patients with dystonia following the use of an intraoral device called a key integrative dynamic TMJ treatment appliance (KIDTA). (2) Methods: [...] Read more.

(1) Background: The aim of the present study is to analyze the instant postural changes and changes in the dystonic contractions among patients with dystonia following the use of an intraoral device called a key integrative dynamic TMJ treatment appliance (KIDTA). (2) Methods: Twelve subjects, previously diagnosed with dystonia were enrolled. Their existing records were utilized to assess the changes in their posture and dystonic contractions. The posture analysis was conducted using a mobile application (APECS). The initial records (T0) and records acquired after the delivery of the KIDTA (T1) were utilized in the analysis. The Wilcoxon signed-rank test was performed to compare parameters between T0 and T1, with a significance level set at p < 0.05. (3) Results: Based on the Wilcoxon signed-rank test, statistically significant differences in T1 compared to T0 were observed in the severity of dystonic spasms, body alignment, head shift, head tilt, shoulder alignment, shoulder angle, axillae alignment, ribcage tilt, pelvic tilt, knee angle, and tibia angle (p < 0.05). (4) Conclusions: Within the limitations of the present pilot study, an intervention to the TMJ through a KIDTA appliance seems to mitigate the severity of dystonic contractions and improve the posture with respect to certain postural parameters. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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11 pages, 1491 KiB

Open AccessArticle

Temporomandibular Disorders at the Preoperative Time of Orthognathic Surgery

by Alice Vanzela Miotto, Danielle Veiga Bonotto, Jessica Sarha Cavalheiro Silva, Juliana Feltrin De Souza, Aline Monise Sebastiani and Rafaela Scariot

Diagnostics 2023, 13(18), 2922; https://doi.org/10.3390/diagnostics13182922 - 12 Sep 2023

Viewed by 992

Abstract

Individuals seeking orthodontic treatment combined with orthognathic surgery (OS) have a high prevalence of temporomandibular disorders (TMDs), but the relationship between TMD diagnoses and dentofacial deformities (DFDs) is still controversial. Therefore, this cross-sectional study with a comparison group aimed to analyze the association [...] Read more.

Individuals seeking orthodontic treatment combined with orthognathic surgery (OS) have a high prevalence of temporomandibular disorders (TMDs), but the relationship between TMD diagnoses and dentofacial deformities (DFDs) is still controversial. Therefore, this cross-sectional study with a comparison group aimed to analyze the association between dentofacial deformities and TMDs. Methodology: Eighty patients undergoing OS were consecutively selected from the stomatology department of the Federal University of Paraná between July 2021 and July 2022. Forty patients who would undergo OS composed the group of participants with DFD, and forty who received other types of attention and did not present changes in the dental bone bases formed the group without DFDs (DFDs and no DFDs groups). The groups were matched for sex, age, and self-reported ethnicity. The diagnostic criteria for TMDs (DC/TMDs) were used to diagnose TMD based on the Axis I criteria. The psychosocial aspects, oral behaviors in wakefulness, and sleep bruxism were evaluated through the Axis II criteria. The data were analyzed with a 5% significance level. Results: The presence of DFDs was significantly associated with arthralgia (p = 0.01). The other types of TMDs were not associated with DFDs. Comorbidities, habits, and psychosocial variables were not associated with DFDs at a level of 0.05. (p > 0.05). In analyzing the participants with arthralgia, the ones with this condition presented higher frequencies of sleep bruxism (p = 0.046). Conclusions: Participants with DFDs presented a significantly higher frequency of arthralgia when compared to no DFDs ones. Sleep bruxism was associated with the occurrence of joint TMDs in these participants. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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12 pages, 30959 KiB

Open AccessArticle

The Role of Temporomandibular Joint Arthroscopy for Diagnosis and Surgical Management of Synovial Chondromatosis

by Salvatore Sembronio, Luca Raccampo, Alessandro Tel, Michele Di Cosola, Stefania Troise, Giovanni Dell’Aversana Orabona and Massimo Robiony

Diagnostics 2023, 13(17), 2837; https://doi.org/10.3390/diagnostics13172837 - 1 Sep 2023

Viewed by 1107

Abstract

Objective: We report the experience of our maxillo-facial surgery unit into the diagnostic and the therapeutic role of arthroscopy of temporomandibular joint (TMJ) synovial chondromatosis (SC). Materials and Methods: A series of sixteen patients with an imaging, arthroscopical, and histological diagnosis of SC [...] Read more.

Objective: We report the experience of our maxillo-facial surgery unit into the diagnostic and the therapeutic role of arthroscopy of temporomandibular joint (TMJ) synovial chondromatosis (SC). Materials and Methods: A series of sixteen patients with an imaging, arthroscopical, and histological diagnosis of SC treated with arthroscopy was selected. The surgeries were conducted in the Department of Maxillo-facial surgery, Academic hospital of Udine, from January 2016 to December 2022. Medical history, clinical examination, imaging, arthroscopical, and histological characteristics were recorded and then reviewed and discussed. Results: Clinical improvement, both in pain and in maximum incisal opening (MIO), were noticed in whole patients. Histologically, according to Milgram’s classification, the sample was fairly homogeneous. Arthroscopic treatment was successful in 87.5% of the patients. Only two cases of SC relapse were registered and were then submitted to open surgery to perform a total sinovectomy. The data collected were used to develop an SC classification proposal based on clinical, radiological (magnetic resonance imaging), arthroscopical, and histopathological characteristics. Conclusions: TMJ arthroscopy must be considered the first line of treatment for SC, leaving open surgery to relapses cases and those cases with extraarticular extension. A univocal classification is essential to best stage and prognostically characterise this pathology. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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13 pages, 1480 KiB

Open AccessArticle

Evaluation of Temporomandibular Joint in Patients with Parkinson’s Disease: A Comparative Study

by Ayse Selenge Akbulut and Aysun Hatice Akca Karpuzoglu

Diagnostics 2023, 13(15), 2482; https://doi.org/10.3390/diagnostics13152482 - 26 Jul 2023

Viewed by 1086

Abstract

(1) The aim of this study was to perform an evaluation of the temporomandibular joint (TMJ) in patients with Parkinson’s disease (PD) and present the morphological differences of the TMJ between healthy subjects and patients with PD. (2) A total of 102 Caucasian [...] Read more.

(1) The aim of this study was to perform an evaluation of the temporomandibular joint (TMJ) in patients with Parkinson’s disease (PD) and present the morphological differences of the TMJ between healthy subjects and patients with PD. (2) A total of 102 Caucasian subjects were divided equally into two groups. The study group consisted of patients with PD, while the control group comprised healthy subjects. Ten parameters, including anterior joint space (AJS), superior joint space (SJS), posterior joint space (PJS), condyle head length (CHL), condylar neck width (CNW), minor axis of the condyle (MAC), long axis of the condyle (LAC), condylar axis inclination (CI), medial joint space (MJS), and lateral joint space (LJS), were measured using magnetic resonance images. The data were statistically analyzed using paired samples t-test and Student’s t-test, with a significance level set at p < 0.05. (3) In the PD group, all TMJ parameters showed a statistically significant difference between both sides of the face (p < 0.05). However, in the control group, AJS, SJS, PJS, CHL, CNW, MAC, CI, MJS, and LJS did not show a statistically significant difference between both sides of the face (p > 0.05), except for LAC (p < 0.05). The asymmetry index values of AJS, SJS, PJS, CHL, CNW, MAC, CI, MJS, and LJS demonstrated a statistically significant difference between the study and control groups (p < 0.05), except for LAC (p > 0.05). (4) Within the limitations of this retrospective study, the findings suggest that TMJ morphology and asymmetry could be associated with PD. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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12 pages, 6162 KiB

Open AccessArticle

Positional Features of the Mandibular Condyle in Patients with Facial Asymmetry

by Diego Fernando López, Valentina Rios Borrás and Rodrigo Cárdenas-Perilla

Diagnostics 2023, 13(6), 1034; https://doi.org/10.3390/diagnostics13061034 - 8 Mar 2023

Viewed by 1689

Abstract

Objective: To describe the position of the mandibular condyle, the size of the joint spaces and the condylar angulation in patients with facial asymmetry (FA), and to classify these results according to the type of FA and compare them with a reference group [...] Read more.

Objective: To describe the position of the mandibular condyle, the size of the joint spaces and the condylar angulation in patients with facial asymmetry (FA), and to classify these results according to the type of FA and compare them with a reference group without FA. Materials and Methods/Patients: An observational, cross-sectional, descriptive study using computed tomography (CT) was conducted on a sample of 133 patients with a clinical diagnosis of FA derived from the following entities: hemimandibular elongation (HE) (n = 61), hemimandibular hyperplasia (HH) (n = 11), condylar hyperplasia in its hybrid form (HF) (n = 19), asymmetric mandibular prognathism (AMP) (n = 25), glenoid fossa asymmetry (GFA) (n = 9) and functional laterognathism (FL) (n = 8). Likewise, a group of 20 patients without clinical or tomographic characteristics of FA was taken and their complete cone beam tomography (CBCT) scans were analyzed. The quantified variables were joint spaces (anterior, middle and posterior), angle of the condylar axis and condylar position. All measurements were performed using the free, open-source Horos software. Results: Most of the subjects without FA had a right middle condylar position (55%), while in the patients with FA the anterior condylar position predominated. On the left side, the most frequent condylar position was anterior, including the group without FA, except in the HH group. Considering the measurements of the anterior, middle and posterior joint space (mm) on the right side (anterior JS: 1.9 mm, middle JS: 2 mm and posterior JS: 2.8 mm) and on the left side (anterior JS: 2.7 mm, middle JS: 2.1 mm and posterior JS: 2.6 mm) of the subjects without FA, compared to those with FA, the latter presented smaller distances in all diagnoses and only for the right posterior JS (1.9 mm) in HH, was not significant. The condylar axis of the AF group showed significant differences with smaller angles for the left side in those diagnosed with HE (65.4°) and HH (56.5°) compared to those without AF (70.4°). Conclusions: The condylar position of patients with FA tends to be anterior, both on the right and left sides, while for cases without FA it is middle and anterior, respectively. Patients with FA have smaller joint spaces (mm) compared to patients without FA, with the exception of HH for the right posterior JS. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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11 pages, 1018 KiB

Open AccessArticle

Myogenous Temporomandibular Disorders: Diagnostic Concepts and Prospective Pilot Study on Extracorporeal Shockwave Therapy

by Dion Tik Shun Li, Kar Yan Li and Yiu Yan Leung

Diagnostics 2023, 13(1), 51; https://doi.org/10.3390/diagnostics13010051 - 24 Dec 2022

Cited by 6 | Viewed by 1586

Abstract

The aims of this article are to discuss the current, and potential future directions, in the diagnosis of myogenous temporomandibular disorders (M-TMD), as well as to report a pilot study to investigate the feasibility and clinical outcomes of extracorporeal shockwave therapy (ESWT) in [...] Read more.

The aims of this article are to discuss the current, and potential future directions, in the diagnosis of myogenous temporomandibular disorders (M-TMD), as well as to report a pilot study to investigate the feasibility and clinical outcomes of extracorporeal shockwave therapy (ESWT) in the treatment of M-TMD. Forty-one adult patients presented with M-TMD were recruited into the study and randomized into two groups: Group 1 received ESWT treatment, whereas Group 2 received placebo treatment. The variables investigated were pain, measured by a numerical rating scale (NRS) and mouth opening. Twenty-six patients (Group 1: n = 14, mean age = 45.3 (16.7) years; Group 2: n = 12, mean age = 46.8 (19.7) years) completed 1-year follow up and were included into the final analysis. In both groups, reduction in pain and increase in MO (unassisted maximum, assisted maximum, and pain-free) were seen at post-treatment 1 year. There were more reduction in pain and increase in all MO in Group 1 than Group 2, but statistical significance was not detected. No major complications were encountered in this study. Although significant differences were not seen between groups, this prospective pilot study provided preliminary evidence that ESWT is safe and potentially beneficial in the treatment of M-TMD. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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Review

Jump to: Research, Other

16 pages, 1670 KiB

Open AccessReview

Diagnosis and Treatment of Myogenous Temporomandibular Disorders: A Clinical Update

by Natalie Hoi Ying Chan, Ching Kiu Ip, Dion Tik Shun Li and Yiu Yan Leung

Diagnostics 2022, 12(12), 2914; https://doi.org/10.3390/diagnostics12122914 - 23 Nov 2022

Cited by 15 | Viewed by 3918

Abstract

Myogenous temporomandibular disorders (M-TMDs) are the most common chronic orofacial pain, affecting the masticatory muscles and, thus, jaw movement. While a concise diagnosis is crucial to formulate a rational treatment plan, the similarities in clinical presentations that M-TMDs share with other neuromuscular disorders [...] Read more.

Myogenous temporomandibular disorders (M-TMDs) are the most common chronic orofacial pain, affecting the masticatory muscles and, thus, jaw movement. While a concise diagnosis is crucial to formulate a rational treatment plan, the similarities in clinical presentations that M-TMDs share with other neuromuscular disorders affecting the temporomandibular joint (TMJ) could easily confuse physicians. In addition to the basics, such as thorough history taking and meticulous clinical examinations, different imaging techniques are useful adjuncts to facilitate the diagnostic process. This review presents an overview of the current understanding on a variety of diagnostic and treatment modalities for M-TMD patients. It is essential to highlight that there is not a single treatment for all, and the benefits of multidisciplinary strategies have been noted for the effective management of myogenous TMD pain. Treatment modalities ranging from conservative to minimally invasive options are discussed in this review. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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Other

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23 pages, 3245 KiB

Open AccessSystematic Review

Psychological Outcomes on Anxiety and Depression after Interventions for Temporomandibular Disorders: A Systematic Review and Meta-Analysis

by Lai Ying Luo, Johyun Lee, Kar Yan Li, Yiu Yan Leung and Dion Tik Shun Li

Diagnostics 2023, 13(4), 653; https://doi.org/10.3390/diagnostics13040653 - 9 Feb 2023

Cited by 7 | Viewed by 1679

Abstract

Many studies have shown mutual interaction between temporomandibular disorders (TMD) and psychological distress. However, evidence on the effectiveness of therapeutic interventions for TMD on psychological outcomes is scarce. This review aimed to summarise the best evidence on the association between interventions for TMD [...] Read more.

Many studies have shown mutual interaction between temporomandibular disorders (TMD) and psychological distress. However, evidence on the effectiveness of therapeutic interventions for TMD on psychological outcomes is scarce. This review aimed to summarise the best evidence on the association between interventions for TMD and psychological outcomes regarding symptoms of anxiety and depression. Electronic search was carried out in databases, including Pubmed, Web of Science, Medline, Cochrane Library, and Scopus. All eligible studies were included for narrative synthesis. Eligible randomised controlled trials (RCTs) were included for the meta-analysis. The overall effect size of interventions for TMD was analysed in standardised mean difference (SMD) in levels of anxiety and depression. Ten studies were included in the systematic review. Of these, nine were included in the narrative analysis and four were included in the meta-analysis. All included studies and the result of the narrative analysis showed a statistically significant beneficial effect of interventions for TMD on improving symptoms of anxiety and depression (p < 0.0001); however, a statistically significant overall effect was not found in the meta-analyses. Current evidence is in favour of the interventions for TMD in improving symptoms of depression and anxiety. However, the effect is statistically uncertain and warrants future studies to enable the best synthesis of the evidence. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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15 pages, 2917 KiB

Open AccessSystematic Review

Lavage Volume of Arthrocentesis in the Management of Temporomandibular Disorders: A Systematic Review and Meta-Analysis

by Hei Christopher Tsui, Chun Mo Lam, Yiu Yan Leung, Kar Yan Li, Natalie Sui Miu Wong and Dion Tik Shun Li

Diagnostics 2022, 12(11), 2622; https://doi.org/10.3390/diagnostics12112622 - 28 Oct 2022

Cited by 4 | Viewed by 1910

Abstract

The aim of this study was to investigate the most effective lavage volume of arthrocentesis in the management of temporomandibular disorders. A comprehensive electronic search, based on the PRISMA guidelines, was performed, which included a computer search with specific keywords, a reference list [...] Read more.

The aim of this study was to investigate the most effective lavage volume of arthrocentesis in the management of temporomandibular disorders. A comprehensive electronic search, based on the PRISMA guidelines, was performed, which included a computer search with specific keywords, a reference list search and a manual search. The inclusion criteria were the following: a randomized controlled trial, at least 20 subjects who underwent arthrocentesis, mention of the irrigation materials used for the arthrocentesis, mention of the irrigation volumes used for the arthrocentesis, MMO and pain measured as VAS or NRS, were reported as outcome figures, mention of a specific diagnosis or signs and symptoms, and inclusion of the data on the MMO or VAS/NRS at 6-month follow-up. Sixteen publications were enrolled in the meta-analysis, comparing arthrocentesis with a lavage volume <150 mL and arthrocentesis with a lavage volume ≥150 mL, in the efficacy of the improvement in the mouth opening and pain reduction. The results revealed the group with a lavage volume <150 mL had a greater improvement in the mouth opening and pain reduction. However, results are to be interpreted with caution, due to the paucity of the randomized controlled literature and other confounding factors. Further high-quality studies are required to provide a better conclusion to the treatment outcomes of the different lavage volumes. Full article

(This article belongs to the Special Issue Advances in the Diagnosis and Management of Temporomandibular Joint Diseases 2.0)

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