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Ren L, Chen P, Musa M, Zhao Y, Awad R, Xiao Z, Li C, Li D, Chen X. Quantitative and qualitative condylar changes Post-Stabilization splint in patients with temporomandibular disorder and chewing side preference. Sci Rep 2025; 15:10996. [PMID: 40164653 PMCID: PMC11958744 DOI: 10.1038/s41598-025-94746-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2025] [Accepted: 03/17/2025] [Indexed: 04/02/2025] Open
Abstract
This study aimed to explore the quantitative (joint spaces, condylar position, morphology, and fossa) and qualitative (bone mineral density (BMD), condylar volume (CV), and condylar surface area (CSA)) therapeutic outcomes following a stabilization splint (S.S.) therapy in adult patients diagnosed with temporomandibular disorder (TMD) (Arthralgia) with/without chewing side preference (CSP) using cone-beam computed tomography (CBCT). This retrospective study included 64 patients divided into two groups: 32 with TMD + CSP and 32 with TMD only. TMD was diagnosed using the Diagnostic Criteria for TMD (DC/TMD) AXIS I. The Observed Preferred Chewing Side (OPCS) and State Preferred Chewing Side (SPCS) methods assessed CSP status. CBCT scanned the temporomandibular joint (TMJ) before (T0) and after (T1) treatment for three-dimensional (3D) analysis. Statistical comparisons were made using the Wilcoxon signed ranks and Mann-Whitney U tests. The treatment duration ranged from 6 to 12 months, with an average of 9.5 months. In the TMD + CSP group, significant differences were observed between pre-treatment (T0) and post-treatment (T1) for joint space measures, including (SJS, PJS, and CLS) on the preferred side (p-value = 0.04; 0.00; 0.02, respectively), with significant differences for the balancing side in (SJS, PJS, and CMS) (p-value = 0.01; 0.03; 0.016 respectively). The TMD group showed significant changes in (AJS) on both symptomatic and contralateral sides (p-value = 0.015; 0.01 respectively). Morphologically, significant differences were noted in condyle width (CL2) in the TMD + CSP group on the preferred side between T0 and T1, along with significant differences in intra-group comparison in fossa height (FH), fossa width (FW), and articular eminence (θ) at T0, with FW and θ remaining significant at T1 (p-value = 0.01; 0.02; 0.01; 0.00, and 0.04 respectively). The TMD group exhibited significant changes in condylar length (CL1) on both sides between T0 and T1 (p-value = 0.03; 0.01 respectively). Qualitatively, BMD disturbance was significant in the TMD + CSP on the preferred side group across the majority of slopes when compared to the balancing side between T0 and T1 and for intragroup comparison at T0 and T1, while in TMD group showed changes on the symptomatic side in (AS) only when compared to the contralateral side between T0 and T1and for intragroup comparison at T0 (p-value = 0.035; 0.045; and 0.01 respectively). Additionally, significant differences in CV and CSA were observed in the TMD + CSP group on the preferred side between T0 and T1 (p-value = 0.04; 0.03 respectively), with intra-group comparisons highlighting significant differences in both CV and CSA at T0 and T1 (p-value = 0.01; 0.02; < 0.001; 0.03, respectively). The co-occurrence of TMD + CSP exacerbates TMD severity and affects both quantitative and qualitative measures. This condition leads to asymmetrical condylar positions, distinct morphological changes, and imbalance in BMD, increasing the risk of degenerative changes over time.
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Affiliation(s)
- Le Ren
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Pengyu Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Mazen Musa
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Orthodontics, Faculty of Dentistry, Al Tegana Dental Teaching Hospital, University of Science and Technology Omdurman, Khartoum, Sudan
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Riham Awad
- Department of Pediatrics Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
- Department of Pediatrics Dentistry, Faculty of Dentistry, International University of Africa, Khartoum, Khartoum, Sudan
| | - Zhongyi Xiao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Chen Li
- Xi'an Shanhang Science and Industry Co., Ltd, Xi'an, China
| | - Daxu Li
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
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Ye X, Li X, Qiu J, Kuang Y, Hua B, Liu X. Alpha-ketoglutarate ameliorates age-related and surgery induced temporomandibular joint osteoarthritis via regulating IKK/NF-κB signaling. Aging Cell 2024; 23:e14269. [PMID: 38992995 PMCID: PMC11561675 DOI: 10.1111/acel.14269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/03/2024] [Accepted: 06/18/2024] [Indexed: 07/13/2024] Open
Abstract
Recent studies have shed light on the important role of aging in the pathogenesis of joint degenerative diseases and the anti-aging effect of alpha-ketoglutarate (αKG). However, whether αKG has any effect on temporomandibular joint osteoarthritis (TMJOA) is unknown. Here, we demonstrate that αKG administration improves condylar cartilage health of middle-aged/aged mice, and ameliorates pathological changes in a rat model of partial discectomy (PDE) induced TMJOA. In vitro, αKG reverses IL-1β-induced/H2O2-induced decrease of chondrogenic markers (Col2, Acan and Sox9), and inhibited IL-1β-induced/ H2O2-induced elevation of cartilage catabolic markers (ADAMTS5 and MMP13) in condylar chondrocytes. In addition, αKG downregulates senescence-associated (SA) hallmarks of aged chondrocytes, including the mRNA/protein level of SA genes (p16 and p53), markers of nuclear disorders (Lamin A/C) and SA-β-gal activities. Mechanically, αKG decreases the expressions of p-IKK and p-NF-κB, protecting TMJ from inflammation and senescence-related damage by regulating the NF-κB signaling. Collectively, our findings illuminate that αKG can ameliorate age-related TMJOA and PDE-induced TMJOA, maintain the homeostasis of cartilage matrix, and exert anti-aging effects in chondrocytes, with a promising therapeutic potential in TMJOA, especially age-related TMJOA.
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Affiliation(s)
- Xiaoping Ye
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of StomatologySouthern Medical UniversityGuangzhouChina
| | - Xinping Li
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of StomatologySouthern Medical UniversityGuangzhouChina
| | - Jin Qiu
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of StomatologySouthern Medical UniversityGuangzhouChina
| | - Yiwen Kuang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of StomatologySouthern Medical UniversityGuangzhouChina
| | - Bingqiang Hua
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of StomatologySouthern Medical UniversityGuangzhouChina
| | - Xianwen Liu
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of StomatologySouthern Medical UniversityGuangzhouChina
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Tăut M, Barbur I, Hedeșiu M, Ban A, Leucuța D, Negucioiu M, Buduru SD, Ilea A. Condylar Remodeling and Skeletal Changes Following Occlusal Splint and Manual Therapy: A Cone Beam Computed Tomography Study in Temporomandibular Disorders. J Clin Med 2024; 13:5567. [PMID: 39337052 PMCID: PMC11433483 DOI: 10.3390/jcm13185567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 09/09/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Temporomandibular disorders (TMD) may be associated with degenerative disease of temporomandibular joint (TMJ), such as condyle erosion and subchondral cysts. Occlusal splint and cranio-mandibular manual therapy, or combined therapy, is recommended as a conservative treatment to alleviate pain-related signs and symptoms in TMD. This study aimed to assess osseous condylar changes and skeletal changes following occlusal splint and cranio-mandibular manual therapy in TMD using cone beam computed tomography (CBCT). Methods: A retrospective cohort study included 24 patients diagnosed with TMD. Combined therapy was performed until pain-related signs and symptoms disappeared. CBCT scans were performed before and after therapy. Osseous structure of condyles and their subsequent modifications were analyzed on CBCT images: flattening, erosion, and subchondral cyst. Sella-Nasion-A point (SNA), Sella-Nasion-B point (SNB), A point-Nasion-B point (ANB), Sella-Articulare-Gonion (Condylar angle), and anterior and posterior facial height (AFH, PFH) were measured on CBCT-generated lateral cephalograms. A paired t-test, Wilcoxon rank-sum test, McNemar test, and Stuart-Maxwell test were used for the statistical analyses. Results: The treatment period with combined therapy was 7.42 ± 3.27 months, and 21 out of 33 TMJ presenting degenerative disease (63.6%) had significant complete remodeling (p < 0.05). Following therapy, SNB significantly decreased from 75.61 ±3.47° to 74.82 ± 3.41° (p = 0.02), ANB significantly increased from 4.05° (3.35-4.9°) to 4.8° (3.3-6.12°) (p < 0.001), AFH significantly increased from 112.85 mm (109.28-118.72) to 115.3 mm (112.58-118.88) (p < 0.001), PFH/AFH significantly decreased from 64.17 (61.39-66.1) to 63 (59.68-64.51) (p = 0.012), and condylar angle significantly increased from 140.84 ± 8.18° to 144.42 ± 8.87° (p = 0.007). Conclusion: Combined therapy promoted significant condylar remodeling in TMJ degenerative disease, along with skeletal changes (mandibular retrusion and increase in facial height). Therapeutic strategies should consider condylar remodeling in TMD. Skeletal and dental parameters should be evaluated prior to occlusal splint therapy.
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Affiliation(s)
- Manuela Tăut
- Department of Oral Rehabilitation, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Department of Prosthetic Dentistry and Dental Materials, Prosthetic Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Ioan Barbur
- Department of Maxillo-Facial Surgery and Radiology, Surgery and Maxillo-Facial Implantology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400029 Cluj-Napoca, Romania
| | - Mihaela Hedeșiu
- Department of Maxillo-Facial Surgery and Radiology, Dental Radiology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400029 Cluj-Napoca, Romania
| | - Alina Ban
- Department of Maxillo-Facial Surgery and Radiology, Dental Radiology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400029 Cluj-Napoca, Romania
| | - Daniel Leucuța
- Department of Medical Education, Medical Informatics and Biostatistics, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Marius Negucioiu
- Department of Prosthetic Dentistry and Dental Materials, Prosthetic Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Smaranda Dana Buduru
- Department of Prosthetic Dentistry and Dental Materials, Prosthetic Dentistry, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Aranka Ilea
- Department of Oral Rehabilitation, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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Valladares-Neto J, Acioli GMR, Teodoro AB, Evangelista K, Furquim BD', Silva MAG. Conservative and minimally invasive approaches to control idiopathic condylar resorption: a scoping review. Int J Oral Maxillofac Surg 2023; 52:1188-1196. [PMID: 37271625 DOI: 10.1016/j.ijom.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023]
Abstract
Idiopathic condylar resorption (ICR) is an uncommon disease with multiple names that challenges orthodontic and surgical treatments. The aim of this study was to investigate the existing conservative and minimally invasive approaches to controlling ICR. A scoping literature review was conducted. Inclusion criteria were young patients with degenerative joint disease based on the Research Diagnostic Criteria for Temporomandibular Disorders or Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocols, or ICR based on the DC/TMD expanded taxonomy protocol. Six electronic databases and the grey literature were searched, without restriction on year or language. Two reviewers independently performed the study selection and data extraction. Ten studies were selected from the 13,953 records identified. The total sample size was 424 patients; the female-to-male ratio was 7:1 and the mean age of the patients was 25.7 years. The main primary outcomes were pain, mandibular dysfunction, and condylar resorption. There is no guarantee of definitive success in the early management of ICR, despite the promising approaches studied, and there is no specific protocol to be followed. Therefore, close post-surgical follow-up is still required. This study highlights the need to standardize the nomenclature and diagnostic criteria, and assess the status of condylar activity/severity in future research.
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Affiliation(s)
- J Valladares-Neto
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | - G M R Acioli
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - A B Teodoro
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - K Evangelista
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - M A G Silva
- Department of Stomatology, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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Ju HM, Kim HW, Choi SY, Jeon HM, Jeong SH, Ahn YW, Ok SM. A Comparison of the Condyle and Articular Eminence in Asian Juvenile Idiopathic Osteoarthritis Patients with Unilateral and Bilateral TMJ Involvement: A Retrospective Case-Control Study. J Clin Med 2023; 12:5566. [PMID: 37685631 PMCID: PMC10489145 DOI: 10.3390/jcm12175566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
This study compared the condylar volume, length, and articular eminence (AE) characteristics of normal individuals to those with unilateral and bilateral juvenile idiopathic osteoarthritis (JOA). The 116 patients were divided into four groups: Control (n = 16), affected condyle of unilateral JOA (Aff-Uni) (n = 36), non-affected condyle of JOA (NonAff-uni) (n = 36), and bilateral JOA (Bilateral) (n = 28). The differences in condyle volume and length and AE were analyzed using ANOVA and Bonferroni post-hoc tests. The results showed that Bilateral had a significantly different condylar volume, especially in the condylar head (p < 0.01), specifically the middle, anterior, and medial parts (p < 0.05). Condylar length also differed among the groups, with differences observed between the control group and the other three groups, as well as between the bilateral group and the other three groups (p < 0.01). AE total volume differed between the control group and Aff-Uni. In the detailed comparison, Aff-Uni and NonAff-Uni were smaller than the control group in the posterior, lateral, and medial sections (p < 0.05). In conclusion, depending on the involvement of unilateral or bilateral JOA, there were differences in condylar volume and AE when compared to the normal control group. Therefore, a prognosis should be evaluated by distinguishing between patients with unilateral and bilateral JOA.
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Affiliation(s)
- Hye-Min Ju
- Department of Oral Medicine, School of Dentistry, Pusan National University, Dental and Life Science Institute, Yangsan-si 50612, Republic of Korea; (H.-M.J.); (S.-H.J.); (Y.-W.A.)
| | - Hee-Won Kim
- Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan-si 50612, Republic of Korea; (H.-W.K.); (S.-Y.C.)
| | - Seo-Young Choi
- Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan-si 50612, Republic of Korea; (H.-W.K.); (S.-Y.C.)
| | - Hye-Mi Jeon
- Dental Clinic Center, Pusan National University Hospital, Busan 49241, Republic of Korea;
| | - Sung-Hee Jeong
- Department of Oral Medicine, School of Dentistry, Pusan National University, Dental and Life Science Institute, Yangsan-si 50612, Republic of Korea; (H.-M.J.); (S.-H.J.); (Y.-W.A.)
| | - Yong-Woo Ahn
- Department of Oral Medicine, School of Dentistry, Pusan National University, Dental and Life Science Institute, Yangsan-si 50612, Republic of Korea; (H.-M.J.); (S.-H.J.); (Y.-W.A.)
| | - Soo-Min Ok
- Department of Oral Medicine, School of Dentistry, Pusan National University, Dental and Life Science Institute, Yangsan-si 50612, Republic of Korea; (H.-M.J.); (S.-H.J.); (Y.-W.A.)
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Musa M, Zhang Q, Awad R, Wang W, Ahmed MMS, Zhao Y, Almashraqi AA, Chen X, Alhammadi MS. Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders. Clin Oral Investig 2023; 27:2299-2310. [PMID: 37039959 DOI: 10.1007/s00784-023-04963-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/19/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE This study aimed to explore the quantitative and qualitative condylar changes following stabilization splint (S.S) therapy, including condylar position, morphology, and bone mineral density (BMD) in subjects with temporomandibular disorders (TMD). MATERIALS AND METHODS In this retrospective clinical study, we enrolled 40 TMD subjects (80 joints) aged 18 to 35 years, for whom a S.S was used to treat TMD. The 80 TMD consists of 32 masticatory muscle disorders (myalgia) and 48 TMJ disorders (arthralgia). Cone beam computed tomography (CBCT) was used to scan the TMJs of subjects pre- and post-treatment for three-dimensional analysis (3D). Using Mimics software v.21.0, quantitative (3D condylar and joint spaces dimensions parameters were measured using linear measurements in millimeters, according to the Kamelchuk method and Ikeda method, while the assessment of anteroposterior condyle position within the glenoid fossa was based on the method of Pullinger and Hollender), and qualitative (a round bone tissue with an area of 2 mm2 in three representative areas according to the Kamelchuk method to measure condylar BMD) pre- and post-treatment. Intra- and inter-group statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal-Wallis test, respectively. RESULTS The course of treatment was 6-12 months, with an average of 9.1 months. For the pre- and post-treatment quantitative comparisons, there was a statistically significant difference in the anterior joint space (AJS) and coronal medial space, as well as the condyle length in the myalgia group and condylar width in the arthralgia group. For qualitative measurements, a significant difference was observed in the posterior slope of the myalgia group and the arthralgia group's anterior, superior, and posterior slopes. The inter-group comparisons revealed significant differences in AJS, condylar length, and anterior slope density. CONCLUSION In short-term follow-up, the S.S influenced patients with TMD from different origins; it changes anterior and coronal medial joint space, condyle length in myalgia, and width in arthralgia. Furthermore, it improved the condyle bone density more evidently in arthralgia. CLINICAL RELEVANCE This study highlights the influence of S.S on symptomatic populations with TMD of different origins from a qualitative and quantitative perspective.
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Affiliation(s)
- Mazen Musa
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Orthodontics, Al Tagana Dental Teaching Hospital, Faculty of Dentistry, University of Science and Technology Omdurman, Omdurman, 11111, Khartoum, Sudan
| | - Qianqian Zhang
- Department of Stomatology, Shaan'xi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Riham Awad
- Department of Pediatrics Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Wenfang Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Orthodontics, Faculty of Dentistry, Aden University, Aden, Yemen
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Abeer A Almashraqi
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Maged S Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Assessment of Morphologic Change of Mandibular Condyle in Temporomandibular Joint Osteoarthritis Patients with Stabilization Splint Therapy: A Pilot Study. Healthcare (Basel) 2022; 10:healthcare10101939. [PMID: 36292386 PMCID: PMC9601680 DOI: 10.3390/healthcare10101939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/04/2022] Open
Abstract
(1) Background: The purpose of this study was to evaluate the 3-dimensional bony changes of the mandibular condyle in temporomandibular joints-osteoarthritis (TMJ-OA) patients treated with stabilization splint (SS) therapy using shape correspondence analysis. (2) Methods: A total of 27 adult patients (2 men and 25 women) with a mean age of 24.6 ± 3.9 years were included in this study. All patients were diagnosed with TMJ-OA and were treated with an SS. Cone-beam computed tomography data of the condylar head before and after SS therapy from 42 condyles (15 bilateral and 12 unilateral TMJ-OA) were used for the analysis. For the performance shape correspondence analysis (SPHARM-PDM), statistical differences were performed using the one-way analysis of variance and Scheffe post hoc tests. (3) Results: After SS treatment in TMJ-OA patients, bone resorption of the condyle head surface was predominant in the anterosuperior, superolateral, and superior areas, and bone formation was superior in the lateral, medial, posterosuperior, and posteromedial areas. The change in the condylar volume between the two groups was not statistically significant. (4) Conclusions: After SS treatment in TMJ-OA patients, there was both bone resorption and bone formation on the mandibular condyle head surface, which induced morphological changes in the condyle head.
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Zhang J, Pi C, Cui C, Zhou Y, Liu B, Liu J, Xu X, Zhou X, Zheng L. PTHrP promotes subchondral bone formation in TMJ-OA. Int J Oral Sci 2022; 14:37. [PMID: 35853862 PMCID: PMC9296483 DOI: 10.1038/s41368-022-00189-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 02/08/2023] Open
Abstract
PTH-related peptide (PTHrP) improves the bone marrow micro-environment to activate the bone-remodelling, but the coordinated regulation of PTHrP and transforming growth factor-β (TGFβ) signalling in TMJ-OA remains incompletely understood. We used disordered occlusion to establish model animals that recapitulate the ordinary clinical aetiology of TMJ-OA. Immunohistochemical and histological analyses revealed condylar fibrocartilage degeneration in model animals following disordered occlusion. TMJ-OA model animals administered intermittent PTHrP (iPTH) exhibited significantly decreased condylar cartilage degeneration. Micro-CT, histomorphometry, and Western Blot analyses disclosed that iPTH promoted subchondral bone formation in the TMJ-OA model animals. In addition, iPTH increased the number of osterix (OSX)-positive cells and osteocalcin (OCN)-positive cells in the subchondral bone marrow cavity. However, the number of osteoclasts was also increased by iPTH, indicating that subchondral bone volume increase was mainly due to the iPTH-mediated increase in the bone-formation ability of condylar subchondral bone. In vitro, PTHrP treatment increased condylar subchondral bone marrow-derived mesenchymal stem cell (SMSC) osteoblastic differentiation potential and upregulated the gene and protein expression of key regulators of osteogenesis. Furthermore, we found that PTHrP-PTH1R signalling inhibits TGFβ signalling during osteoblastic differentiation. Collectively, these data suggested that iPTH improves OA lesions by enhancing osteoblastic differentiation in subchondral bone and suppressing aberrant active TGFβ signalling. These findings indicated that PTHrP, which targets the TGFβ signalling pathway, may be an effective biological reagent to prevent and treat TMJ-OA in the clinic.
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Affiliation(s)
- Jun Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Yunnan Key Laboratory of Stomatology, Kunming, China.,Department of, Affiliated Stomatological Hospital, Kunming Medical University, Kunming, China
| | - Caixia Pi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chen Cui
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yang Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bo Liu
- Yunnan Key Laboratory of Stomatology, Kunming, China
| | - Juan Liu
- Yunnan Key Laboratory of Stomatology, Kunming, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liwei Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Lan KW, Chen JM, Jiang LL, Feng YF, Yan Y. Treatment of condylar osteophyte in temporomandibular joint osteoarthritis with muscle balance occlusal splint and long-term follow-up: A case report. World J Clin Cases 2022; 10:4264-4272. [PMID: 35665098 PMCID: PMC9131237 DOI: 10.12998/wjcc.v10.i13.4264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/16/2021] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Condylar osteophytes, a remodeling form of temporomandibular joint osteoarthritis (TMJ OA), mainly manifest as marginal angular outgrowths of the condyle. Previous researchers have advocated surgical removal of condylar osteophytes. Reports on the effect of occlusal splint on TMJ OA patients’ joints have mostly focused on treatment with this splint, which can reduce the absorption of the affected condyle and promote repair and regeneration. However, the effect of the splint on the dissolution of condylar osteophytes has not yet been reported.
CASE SUMMARY A 68-year-old female patient suffered from occlusal discomfort with left facial pain for 2 years. Cone beam computed tomography showed a rare osteophyte on top of her left condyle. She was finally diagnosed with TMJ OA. The patient refused surgical treatment and received conservative treatment with a muscle balance occlusal splint. The pain experienced by the patient on the left side of her face was relieved, and her chewing ability recovered after treatment. The osteophyte dissolved, and the condylar cortex remained stable during long-term follow-up observations.
CONCLUSION The muscle balance occlusal splint could be a noninvasive means of treating condylar osteophytes in TMJ OA patients.
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Affiliation(s)
- Kai-Wen Lan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Jia-Min Chen
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou 510182, Guangdong Province, China
| | - Liu-Lin Jiang
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Yi-Fan Feng
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Ying Yan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
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Jung W, Lee KE, Suh BJ. Comparison of Clinical and Radiological Characteristics of Temporomandibular Joint Osteoarthritis in Older and Young people. Open Dent J 2022. [DOI: 10.2174/18742106-v15-e2112290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives:
The relatively high prevalence of temporomandibular joint (TMJ) osteoarthritis (OA) in older people increases the necessity to investigate the specific characteristics of TMJ-OA in this particular population. This study aimed to analyze the longitudinal changes in clinical and radiological characteristics of TMJ-OA in older people.
Methods:
We retrospectively analyzed the clinical features and cone-beam computed tomography (CBCT) images of 76 participants with TMJ-OA. Participants were classified into two groups according to age. The older people group included 33 participants over 50 years of age, and the control group included 43 participants in their 15-29 years. We analyzed the differences in clinical features and the distribution of destructive bony changes on CBCT images between groups.
Results:
The duration of pain was significantly shorter in the older people group (P = .046); however, the treatment duration was significantly longer in the older people group (P = .001). There was a significant difference in the distribution of destructive bony features between groups (P = .005). In the older people group, “three or more features” (36.3%) were the most common, whereas in the control group, “erosion” (44.2%) was the most common. After treatment, there was little improvement in the frequency of “erosion” in the older people group. There was a significant difference in the proportion of erosion after treatment between the groups (P = .033).
Conclusion:
In older people with TMJ-OA, active treatment to effectively induce condylar remodeling should be considered.
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11
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Jung W, Lee KE, Suh BJ. Comparison of Clinical and Radiological Characteristics of Temporomandibular Joint Osteoarthritis in Older and Young people. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2112290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives:
The relatively high prevalence of temporomandibular joint (TMJ) osteoarthritis (OA) in older people increases the necessity to investigate the specific characteristics of TMJ-OA in this particular population. This study aimed to analyze the longitudinal changes in clinical and radiological characteristics of TMJ-OA in older people.
Methods:
We retrospectively analyzed the clinical features and cone-beam computed tomography (CBCT) images of 76 participants with TMJ-OA. Participants were classified into two groups according to age. The older people group included 33 participants over 50 years of age, and the control group included 43 participants in their 15-29 years. We analyzed the differences in clinical features and the distribution of destructive bony changes on CBCT images between groups.
Results:
The duration of pain was significantly shorter in the older people group (P = .046); however, the treatment duration was significantly longer in the older people group (P = .001). There was a significant difference in the distribution of destructive bony features between groups (P = .005). In the older people group, “three or more features” (36.3%) were the most common, whereas in the control group, “erosion” (44.2%) was the most common. After treatment, there was little improvement in the frequency of “erosion” in the older people group. There was a significant difference in the proportion of erosion after treatment between the groups (P = .033).
Conclusion:
In older people with TMJ-OA, active treatment to effectively induce condylar remodeling should be considered.
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12
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Zhou J, Fu Y, Yu L, Li Z, Chen S. A novel three-dimensional morphological analysis of idiopathic condylar resorption following stabilisation splint treatment. J Oral Rehabil 2021; 48:560-567. [PMID: 33539541 DOI: 10.1111/joor.13154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 12/30/2022]
Abstract
Bone modelling evaluation is important for monitoring idiopathic condylar resorption (ICR) progress. To compare condylar modelling in ICR patients treated with or without stabilisation splints (SSs). Eighty-four condyles from 84 ICR patients were studied: 42 received SS therapy (SS group); 42 received conventional therapy (control group). Cone-beam computed tomography images at diagnosis (T0) and after at least 6 months (T1) were used for three-dimensional reconstruction. Volume differences between T0 and T1 (δV) were used to evaluate the amount of modelling. Percentage of growth area (PCT) was used to assess the condylar surface growth tendency. No significant change in condylar volume was found in the SS group, whereas that in the control group was significantly decreased at T1 (P <.0001). The amount of modelling differed among condylar subregions within the SS group: among 6 subregions (P =.0137), between anterior and posterior regions (P =.0336) and between lateral, intermediate and medial regions (P =.0275). Control group condylar subregions showed no significant differences in the amount of modelling. The anabolic modelling tendency of the total condylar surface in the SS group was greater than that in the control group (P =.0251); however, there were no statistical differences in PCTs among condylar subregions in either group. SS therapy effectively reduced further bone destruction and promoted condylar modelling. Three-dimensional morphological analysis is a novel method that can accurately evaluate the amount of bone modelling and growth tendency in ICR patients.
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Affiliation(s)
- Jialiang Zhou
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yujie Fu
- School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Lixia Yu
- State Key Laboratory of Oral Disease, Department of Temporomandibular Joint, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ziyu Li
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Oh JW, Ahn YW, Jeong SH, Ju HM, Song BS, Ok SM. Prediction of anterior open-bite development after stabilization splint treatment in patients with temporomandibular disorder. Cranio 2020; 40:324-333. [DOI: 10.1080/08869634.2020.1792220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jae-Won Oh
- Department of Oral Medicine, Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, Republic of Korea
| | - Yong-Woo Ahn
- Department of Oral Medicine, Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, Republic of Korea
- Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Sung-Hee Jeong
- Department of Oral Medicine, Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, Republic of Korea
- Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Hye-Min Ju
- Department of Oral Medicine, Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, Republic of Korea
- Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Byong-Sop Song
- Department of Statistics, Graduate School of the Pusan National University, Busan, Republic of Korea
| | - Soo-Min Ok
- Department of Oral Medicine, Dental and Life Science Institute, Pusan National University School of Dentistry, Yangsan, Republic of Korea
- Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
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Derwich M, Mitus-Kenig M, Pawlowska E. Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis-Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E225. [PMID: 32397412 PMCID: PMC7279162 DOI: 10.3390/medicina56050225] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/28/2020] [Accepted: 05/06/2020] [Indexed: 02/07/2023]
Abstract
Background and objectives: There are an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause of the pain in the area of temporomandibular joints, but its course may also be absolutely asymptomatic. The aim of this study was to present an interdisciplinary approach to TMJOA, including current diagnostics and treatment modalities on the basis of the available literature. Materials and Methods: PubMed and Scopus databases were analyzed using the keywords: ((temporomandibular joint AND osteoarthritis) AND imaging) and ((temporomandibular joint AND osteoarthritis) AND treatment). The bibliography was supplemented with books related to the temporomandibular joint. After screening 2450 results, the work was based in total on 98 publications. Results and Conclusions: Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists. Sometimes additional pharmacotherapy is indicated. Thorough examination of TMJ function and morphology is necessary at the beginning of any orthodontic or dental treatment. Undiagnosed TMJ dysfunction may cause further problems with the entire masticatory system, including joints, muscles and teeth.
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Affiliation(s)
- Marcin Derwich
- Department of Orthodontics, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Maria Mitus-Kenig
- Department of Prophylaxis and Experimental Dentistry, Jagiellonian University in Krakow, 31-007 Krakow, Poland;
| | - Elzbieta Pawlowska
- Department of Orthodontics, Medical University of Lodz, 90-419 Lodz, Poland;
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Long-term Changes of Temporomandibular Joint Osteoarthritis on Computed Tomography. Sci Rep 2020; 10:6731. [PMID: 32317672 PMCID: PMC7174364 DOI: 10.1038/s41598-020-63493-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 03/30/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to understand long-term changes of the osteoarthritic temporomandibular joint (TMJ) condyle using computed tomography (CT) and to verify its correlation with clinical characteristics of temporomandibular disorders. Eighty-nine patients (152 joints; 76 female, 13 male) who had taken follow-up CTs (mean follow-up period: 644.58 ± 325.71 days) at least once in addition to their initial evaluation were selected. Cross-sectional demographic and clinical data and longitudinal CT images were collected. Data were analyzed by analysis of variance and logistic regression. Overall destructive change index (number of TMJ condyle sections in which destructive change was observed) decreased from 1.56 to 0.66. Improvement was seen in 93 joints (61.2%) and 27 joints (17.8%) worsened. In the pain positive group, both initial and final destructive change index were significantly higher compared to the pain negative group (p = 0.04). Occlusal stabilization splint therapy and nonsteroidal anti-inflammatory drug administration showed a significant effect on improving the prognosis of TMJ osteoarthritis (p = 0.015 and 0.011). In conclusion, TMJ osteoarthritis showed long-term improvement in the majority of cases. TMJ osteoarthritis accompanied by pain showed unfavorable prognosis with additional bone destruction. Occlusal stabilization splint and nonsteroidal anti-inflammatory drug administration were beneficial on the prognosis of TMJ osteoarthritis.
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Hong SW, Kang JH. Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults. Sci Rep 2020; 10:3623. [PMID: 32107437 PMCID: PMC7046747 DOI: 10.1038/s41598-020-60554-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 02/10/2020] [Indexed: 02/06/2023] Open
Abstract
This study aimed to clarify how masticatory muscle atrophy induced by botulinum toxin (BTX) injection affects cortical bone quality of the mandible using 3D modeling technology. A total of 39 young (26.9 ± 6.0 years) and 38 post-menopausal (55.3 ± 6.3 years) females were included. Computed tomography (CT) images were obtained before and after 12 months of treatment. Predictor variables were application of a stabilization splint, and/or two times of BTX injection in the bilateral temporalis and masseter muscles within a six-month interval. Outcome variables were changes in average Hounsfield units (HU) and cortical thickness of region of interest (ROI). 3D mandibular models were reconstructed using CT images, and models were used to calculate average HU and cortical thickness of ROIs, including inferior half of the lateral surface of ascending ramus, coronoid process, and temporomandibular joint condyle. Cortical bone quality at muscle insertion site was influenced by decreased muscle thickness but seemed not to be affected by decreased functional loading. Reduced functional loading seemed to influence cortical bone quality of the condyles. These effects were more remarkable in post-menopausal females. Hence, decreased masticatory muscle thickness may lead to alterations of the mandibular cortical structures, especially in post-menopausal females.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul, 03181, Korea
| | - Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea.
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17
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Li L, Shi H, Xie H, Wang L. MRI assessment and histopathologic evaluation of subchondral bone remodeling in temporomandibular joint osteoarthritis: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:355-362. [PMID: 30122441 DOI: 10.1016/j.oooo.2018.05.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 05/22/2018] [Accepted: 05/30/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of the study was to characterize subchondral bone remodeling by using magnetic resonance imaging (MRI) and histopathologic assessment of temporomandibular joint osteoarthritis (TMJOA) and to analyze the correlations between them. STUDY DESIGN The retrospective study was based on 153 joints of 100 patients. These patients had undergone MRI and had been diagnosed with temporomandibular joint internal derangement Wilkes stage IV-V, followed by the failure of conservative or arthroscopic/anchorage treatment. We evaluated and compared 136 joints based on MRI and histopathologic observation. According to the modified Osteoarthritis Research Society International system and the Diagnostic Criteria for Temporomandibular Disorders system, the scores of histopathology and MRI were compared by using kappa categorical agreement analysis. RESULTS MRI showed subchondral bone changes in 153 joints, 136 of which had been subjected to surgical treatment and histopathologic assessment. Statistical tests revealed substantial agreement between MRI and histopathology (κ value: 0.779). CONCLUSIONS MRI is an effective technique to evaluate the pathologic changes of TMJOA. Our histopathologic grading criteria contributed to the clarification of the occurrence and developmental process of TMJOA. Therefore, the evidence of MRI should be seen as a reference standard for the choice of nonsurgical or surgical therapy in the management of TMJOA.
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Affiliation(s)
- Lingzhi Li
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Huimin Shi
- Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Han Xie
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lizhen Wang
- Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China.
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Suh MS, Park SH, Kim YK, Yun PY, Lee WW. 18F-NaF PET/CT for the evaluation of temporomandibular joint disorder. Clin Radiol 2017; 73:414.e7-414.e13. [PMID: 29223613 DOI: 10.1016/j.crad.2017.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 11/05/2017] [Indexed: 10/18/2022]
Abstract
AIM To investigate the usefulness of a quantitative parameter (maximum standardised uptake value [SUVmax]) of 18F-sodium fluoride (NaF) positron-emission tomography (PET)/computed tomography (CT) for the evaluation of temporomandibular joint (TMJ) disorder (TMD). MATERIALS AND METHODS Seventy-six TMD patients (male: female=14:62, age=40.3±17.1 years, bilateral: unilateral=40:36) with 152 TMJs were enrolled. The 18F-NaF PET/CT parameter (SUVmax) was compared with the presence of TMJ arthralgia (arthralgic=86, non-arthralgic=66) and clinical subtypes based on the Research Diagnostic Criteria for TMD Axis I (TMD osteoarthritis=49, non-TMD osteoarthritis=67, and asymptomatic TMJ=36). Splint therapy was applied to 48 patients for 6 months without considering 18F-NaF PET/CT findings. Post-splint therapy 18F-NaF PET/CT was performed in 32 patients and clinical responses to the therapy were classified into improvement (n=33), no change (n=10), or aggravation (n=7) for 50 TMJs excluding asymptomatic TMJs (n=14). RESULTS SUVmax was significantly greater in arthralgic TMJs than in non-arthralgic TMJs (6.62±3.56 versus 4.32±1.53, p<0.0001). SUVmax was also significantly greater in TMD osteoarthritis (6.75±3.85) than in non-TMD osteoarthritis (5.21±2.70) and asymptomatic TMJs (4.86±1.99; p=0.0386). After splint therapy, SUVmax was significantly increased in aggravated TMJs (from 7.80±3.72 to 11.00±5.74, p=0.0156), whereas no significant change in SUVmax was observed in improved (from 6.16±2.68 to 6.09±2.60, p=0.4915) and unchanged (from 6.46±4.19 to 6.77±4.32, p=0.3223) TMJs. CONCLUSIONS 18F-NaF PET/CT is a useful imaging tool for TMD evaluation because SUVmax showed a fair diagnostic performance for arthralgic TMJ and TMD osteoarthritis, and a correlation with the therapeutic response.
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Affiliation(s)
- M S Suh
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Republic of Korea
| | - S H Park
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Republic of Korea
| | - Y-K Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Republic of Korea; Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Republic of Korea
| | - P-Y Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Republic of Korea
| | - W W Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Republic of Korea; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Republic of Korea.
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