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Nielsen TW, Holte MB, Berg-Beckhoff G, Thorn JJ, Ingerslev J, Pinholt EM. Three-dimensional assessment of temporomandibular joint changes following maxillomandibular advancement surgery: a five-year follow-up study. Int J Oral Maxillofac Surg 2025; 54:617-623. [PMID: 39721908 DOI: 10.1016/j.ijom.2024.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 12/09/2024] [Accepted: 12/11/2024] [Indexed: 12/28/2024]
Abstract
This study aimed to evaluate changes of the temporomandibular joint (TMJ) following maxillomandibular advancement surgery (MMA), long-term postoperative skeletal relapse, and progressive condylar resorption (PCR) development. Preoperative and postoperative cone beam computed tomography(2 weeks, 5 years) of 50 patients (33 female, 17 male; mean age 25.6 years) were assessed three-dimensionally. Compared to the preoperative state, the largest long-term changes of the TMJ were observed in the condyles: mean volume decrease of 9.94% for the right condyle and 8.35% for the left. Condylar volume changes contributed most to the changes in condylar height (effect size right/left, η2 = 0.71/0.72) and horizontal postoperative skeletal relapse (η2 = 0.22/0.20). In contrast, glenoid fossa and joint space changes were modest and unassociated with skeletal relapse. Five female patients (10%) showed signs of PCR, with a mean reduction in condylar volume of 32%, a significant loss of condylar height and skeletal relapse. In conclusion, at 5 years following MMA, mainly condylar volume changes were observed, which had the largest effect on long-term postoperative skeletal relapse when compared to glenoid fossa and joint space changes. PCR occurred in 10% of the patients and was related to a significant loss of condylar height and skeletal relapse.
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Affiliation(s)
- T W Nielsen
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Esbjerg, Denmark; Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - M B Holte
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Esbjerg, Denmark; Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - G Berg-Beckhoff
- Research Unit for Health Promotion, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Esbjerg, Denmark; Department of Research, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - J J Thorn
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - J Ingerslev
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - E M Pinholt
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Esbjerg, Denmark; Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark.
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Prado BN, Pereira LC, Prado JNI. Aggressive idiopathic condylar reabsorption after orthognathic surgery: A complex Imaging diagnosis. Radiol Case Rep 2025; 20:2940-2945. [PMID: 40207031 PMCID: PMC11979931 DOI: 10.1016/j.radcr.2025.02.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 02/21/2025] [Accepted: 02/23/2025] [Indexed: 04/11/2025] Open
Abstract
Idiopathic condylar resorption (ICR) is a pathological condition of unknown origin that affects the temporomandibular joint (TMJ) and can lead to malocclusion, facial asymmetry, TMJ dysfunction and orofacial pain. Imaging examinations are essential for diagnosis and planning of future treatment. To diagnose ICR, it will always be necessary to perform imaging tests and associate them with predisposing risk factors to understand the level of bone remodeling and mechanical trauma performed to propose the best type of treatment. The objective of this study was to elucidate the clinical case of a patient who underwent orthodontics and orthognathic surgery and after 2 years, occlusion recurrence was diagnosed with a severe and active ICR. In addition, it demonstrates the importance of requesting postoperative imaging examinations and clinical radiographic monitoring.
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Qu G, Bu L, Li X, You Q, Luo Y, Ma Z, Yang C. Malocclusion Associated With Temporomandibular Joint Anterior Disc Displacement and Condylar Resorption in Adolescents: A Cross-Sectional Study. J Oral Rehabil 2025; 52:760-768. [PMID: 39734269 DOI: 10.1111/joor.13924] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Revised: 12/09/2024] [Accepted: 12/12/2024] [Indexed: 12/31/2024]
Abstract
BACKGROUND Anterior disc displacement (ADD) is the most common type of temporomandibular joint (TMJ) internal derangement and may lead to condylar resorption (CR) during the adolescence period, but the specific malocclusion associated with ADD and CR remains unclear. OBJECTIVE This study aimed to investigate the malocclusion associated with TMJ ADD and CR in adolescents. METHODS This cross-sectional study included a clinical examination of adolescent patients aged 11-19 years. Magnetic resonance imaging (MRI) was used to diagnose both TMJ ADD and CR. Occlusal measurements were obtained and analysed using 3D scanning models. RESULTS A total of 242 adolescent patients (53 males and 189 females) underwent TMJ MRI examination and dental occlusion scanning. The prevalence of anterior disc displacement without reduction (ADDwoR) was higher in females than that in males (OR > 1, p < 0.05). Deep overbite and posterior scissor bite were significantly associated with anterior disc displacement with reduction (ADDwR), while Angle Class II malocclusion, anterior open bite and posterior scissor bite were significantly associated with ADDwoR (OR > 1, p < 0.05). Adolescents with excessive overjet and anterior open bite were at a higher risk of CR (OR > 1, p < 0.05), whereas those with deep overbite and individual crossbite had a lower risk of CR (OR < 1, p < 0.05). CONCLUSION Our study offers valuable insights into the association between deep overbite, posterior scissor bite, Angle Class II malocclusion, anterior open bite, excessive overjet and the ADD and CR in adolescents. Orthodontic treatment for adolescent patients should prioritise the health of the TMJ, particularly for these types of malocclusion.
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Affiliation(s)
- Guanlin Qu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Lingtong Bu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xifeng Li
- Department of Stomatology, Heze Municipal Hospital, Shandong, China
| | - Qingling You
- Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Luo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Zhigui Ma
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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Ueki K, Gomi K, Yoshizawa K, Moroi A, Shin YM. Changes in computed tomography values and morphology of the condyle and glenoid fossa before and after orthognathic surgery in female jaw deformity patients. J Craniomaxillofac Surg 2025; 53:446-453. [PMID: 39855982 DOI: 10.1016/j.jcms.2025.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 01/15/2025] [Accepted: 01/17/2025] [Indexed: 01/27/2025] Open
Abstract
This study aimed to investigate the computed tomography (CT) values and morphology of the temporomandibular joint (TMJ), specifically the condyle and glenoid fossa, in female patients with jaw deformities before and after orthognathic surgery. The maximum CT values were measured on the condylar and glenoid fossa surfaces. In addition, the height, length, and area of the glenoid fossa in the sagittal plane were evaluated for the bilateral TMJs, preoperatively and one year postoperatively. The ramus height, condylar square, ramus angle, and gonial angle were also measured. A total of 148 TMJs from 74 patients were analyzed. Both condylar and ramus heights decreased one year after surgery in class II and class III patients (P < 0.05). The glenoid fossa area significantly increased one year after surgery in class II (P = 0.0005). Significant postoperative increases in CT values were observed at the 0°, 135°, and 180° points on the condylar surface and at the 135° and 180° points on the glenoid fossa surface in class II patients (P < 0.05). These findings suggest that in class II patients, substantial morphological and CT value changes occurred in the condyle and glenoid fossa one year following orthognathic surgery.
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Affiliation(s)
- Koichiro Ueki
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3893, Japan.
| | - Karen Gomi
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3893, Japan
| | - Kunio Yoshizawa
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3893, Japan
| | - Akinori Moroi
- Department of Oral and Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, 1110 Shimokato Chuo, Yamanashi, 409-3893, Japan
| | - Young-Min Shin
- Department of Dentistry (Oral & Maxillofacial Surgery), Dongsan Medical Center, Keimyung University, School of Medicine, Dalgubeoldaero 1035, Dalseogu, Daegu, 42601, Republic of Korea.
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Nogami S, Kajita T, Yanagisawa Y, Suzuki H, Takeda Y, Ito K, Kumasaka A, Steiner C, Gaggl A, Iikubo M, Kumamoto H, Yamauchi K. Effects of antigen-induced arthritis and compressive mechanical stress on condylar head of mandible. J Oral Biosci 2025:100654. [PMID: 40118180 DOI: 10.1016/j.job.2025.100654] [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: 01/16/2025] [Revised: 03/14/2025] [Accepted: 03/18/2025] [Indexed: 03/23/2025]
Abstract
OBJECTIVE Compressive mechanical stress was applied to the temporomandibular joints (TMJ) affected by antigen-induced arthritis to assess the etiological factors of idiopathic condylar resorption. METHODS Following ovariectomy in 27 female rabbits, 12 received ovalbumin (OVA), 12 received phosphate-buffered saline, and three formed the control group. Each treated rabbit underwent an osteotomy, and a custom device was employed for one week postoperatively, with the length increased by 0.25 mm every 12 h to provide compressive mechanical stress to the TMJ. Thereafter, samples were obtained from the treated groups, subjected to histological staining and immunohistochemistry, and examined using micro-computed tomography. RESULTS At each examination, the OVA group showed a greater area and depth of bone resorption, with bone resorption continuing for three weeks following distraction. Additionally, subcondylar bone resorption was noted significantly earlier and had a greater prevalence in the OVA group and greater numbers of tartrate-resistant acid phosphatase-positive cells. Immunostaining for metalloproteinase (MMP)-3 and MMP-13 of the anterior condylar head in the OVA group after two and three weeks revealed high levels of both proteins from the surface to the deep cartilage layer. CONCLUSION Therefore, coexisting TMJ pathology factors, such as antigen-induced arthritis, promote a significantly greater amount of condylar head anterior surface bone resorption.
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Affiliation(s)
- Shinnosuke Nogami
- Division of Oral and Maxillofacial Reconstructive Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan.
| | - Tomonari Kajita
- Division of Oral and Maxillofacial Oncology and Sciences, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
| | - Yuta Yanagisawa
- Division of Oral and Maxillofacial Reconstructive Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
| | - Hikari Suzuki
- Division of Oral and Maxillofacial Reconstructive Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
| | - Yuri Takeda
- Division of Oral and Maxillofacial Reconstructive Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
| | - Ko Ito
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, 38 Morohongo, Moroyama, 350-0495, Saitama, Japan
| | - Akira Kumasaka
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
| | - Christoph Steiner
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Alexander Gaggl
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Masahiro Iikubo
- Division of Oral Diagnosis, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
| | - Hiroyuki Kumamoto
- Division of Oral Pathology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
| | - Kensuke Yamauchi
- Division of Oral and Maxillofacial Reconstructive Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
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Endo S, Niimi K, Kato Y, Nohno K, Hasebe D, Hayashi T, Saito I, Kobayashi T. Examination of factors affecting condylar bone changes following surgical-orthodontic treatment. Cranio 2025; 43:214-224. [PMID: 36101940 DOI: 10.1080/08869634.2022.2118263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To identify factors affecting condylar bone changes following surgical-orthodontic treatment. METHODS A total of 200 patients with dentofacial deformities were classified into skeletal Classes I, II, and skeletal Class III groups consisting of 61 and 139 subjects, respectively. Temporomandibular joints (TMJs) were evaluated using clinical findings and computed tomography images before treatment, immediately before surgery, and 6 months after surgery. RESULTS Condylar bone changes occurred at a significantly higher rate after surgery in both groups. Factors related to condylar bone changes following surgical-orthodontic treatment included skeletal Class I or II, disc displacement, and condylar bone changes before treatment. There were three cases with condylar bone changes after surgery that were diagnosed with condylar resorption and skeletal Class II and anterior disc displacement before surgery. CONCLUSION Condylar resorption could occur when the load on the condyle increases after orthognathic surgery and exceeds the permissible limit.
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Affiliation(s)
- Satoshi Endo
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Japan
| | - Kanae Niimi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Japan
- Oral Management Unit for Medical Cooperation, Niigata University Medical and Dental Hospital, Niigata City, Japan
| | - Yusuke Kato
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Japan
- Department of Oral and Maxillofacial Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma City, Japan
| | - Kaname Nohno
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Japan
| | - Daichi Hasebe
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Japan
| | - Takafumi Hayashi
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Japan
| | - Isao Saito
- Division of Orthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Japan
| | - Tadaharu Kobayashi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata City, Japan
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7
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Shibusaka K, Negishi S, Sakai N, Kim Y, Okada H, Yano F. Synergistic effects of estrogen deficiency and articular disk derangement on condylar bone loss. J Oral Biosci 2025; 67:100616. [PMID: 39855426 DOI: 10.1016/j.job.2025.100616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 01/15/2025] [Accepted: 12/23/2024] [Indexed: 01/27/2025]
Abstract
OBJECTIVES Temporomandibular joint osteoarthritis (TMJ-OA) with condylar resorption is a multifactorial condition involving hormonal imbalance and articular disk dysfunction, often leading to severe TMJ degeneration. This study investigated the combined effects of estrogen deficiency and anterior articular disk derangement (ADD) on condylar bone resorption in a mouse model. METHODS Female C57BL/6J mice underwent ovariectomy (OVX) to induce estrogen deficiency and ADD was surgically induced for stress. The animals were divided into the control, OVX, ADD, and OVX + ADD groups. Microcomputed tomography and histological analyses were conducted to evaluate condylar bone structure, trabecular architecture, and osteoclast activity. RESULTS OVX and ADD caused significant condylar bone loss, characterized by reduced bone volume per tissue volume (BV/TV) and abnormal trabecular architecture. The OVX + ADD group exhibited exacerbated bone resorption, with decreased BV/TV and increased trabecular separation compared to OVX or ADD alone. Histological analyses revealed increased osteoclast activity in the OVX + ADD group, suggesting a synergistic effect of estrogen deficiency and ADD on condylar degradation. CONCLUSION Estrogen deficiency amplifies the bone-resorptive and inflammatory effects of ADD, accelerates temporomandibular joint (TMJ) degeneration, and underscores the interplay between hormone imbalance and articular disk dysfunction in the pathophysiology of TMJ-OA. There is a need for integrated treatment strategies, such as effective hormone replacement therapy and articular disk repositioning, to effectively manage temporomandibular joint disorders, particularly in postmenopausal women or those with hormonal imbalances. Further research is required to elucidate these molecular pathways and evaluate long-term therapeutic interventions.
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Affiliation(s)
- Kazuhiro Shibusaka
- Department of Biochemistry, Graduate School of Dentistry, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-0064, Japan; Department of Orthodontics, Graduate School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Soichiro Negishi
- Department of Biochemistry, Graduate School of Dentistry, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-0064, Japan; Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Nobuhiro Sakai
- Division of Dental Education, School of Dentistry, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-0064, Japan
| | - Youngkwan Kim
- Department of Biosystems Science, Institute for Life and Medical Sciences, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroyuki Okada
- Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Fumiko Yano
- Department of Biochemistry, Graduate School of Dentistry, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-0064, Japan.
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Iwasaki T, Takahara N, Duc VV, Tomomatsu N, Tabata MJ, Yoda T. Effect of anterior disc displacement and estrogen deficiency on rabbit mandibular condyle. J Oral Biosci 2025; 67:100599. [PMID: 39681195 DOI: 10.1016/j.job.2024.100599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 12/10/2024] [Accepted: 12/11/2024] [Indexed: 12/18/2024]
Abstract
OBJECTIVE In this study, we aimed to establish an experimental model of idiopathic condylar resorption by combining surgically induced anterior disc displacement and estrogen deficiency in growing rabbits. This study aimed to investigate the individual and combined effects of these factors on condylar resorption. MATERIALS AND METHODS Seventeen female Japanese White rabbits were divided into four groups: control, ovariectomy, anterior disc displacement surgery, and combination of ovariectomy and anterior disc displacement surgery. Micro-computed tomography and histological evaluations were performed to analyze changes in the trabecular bone structure and cartilage thickness of the condyle. RESULTS The combined group exhibited the most significant changes in trabecular bone parameters, including the lowest bone volume per tissue volume and trabecular number and the highest trabecular separation and spacing. Histologically, the fibrous layer thinned and the hypertrophic layer thickened in the anterior and central parts of the condyle in the anterior disc displacement and combined groups. The Modified Mankin Score indicated the highest level of degenerative change in the combined group. CONCLUSION The combination of surgically induced anterior disc displacement and estrogen deficiency in growing rabbits effectively modeled idiopathic condylar resorption, demonstrating the synergistic impact of disc displacement and estrogen deficiency on condylar resorption. This model provides valuable insight into the pathogenesis of idiopathic condylar resorption.
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Affiliation(s)
- Takuya Iwasaki
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
| | - Namiaki Takahara
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
| | - Vu Viet Duc
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
| | - Nobuyoshi Tomomatsu
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
| | - Makoto J Tabata
- Faculty of Nutrition, Kyushu Nutrition Welfare University, Kitakyushu, Japan
| | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
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Can S, Kıraç Can SB, Varol A. Success of custom total joint replacement simultaneous with orthognathic surgery in patients with idiopathic condylar resorption. Int J Oral Maxillofac Surg 2025; 54:157-165. [PMID: 39256068 DOI: 10.1016/j.ijom.2024.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 08/18/2024] [Accepted: 08/22/2024] [Indexed: 09/12/2024]
Abstract
The aim of this study was to evaluate the aesthetic and functional outcomes of custom alloplastic total joint replacement combined with orthognathic surgery (cTJR + OS) in patients with idiopathic condylar resorption. Thirteen patients who underwent cTJR + OS between 2015 and 2022 were analysed retrospectively. Primary outcomes were maximum inter-incisal opening (MIO), scores for joint pain, jaw function, diet, sleep apnoea, and aesthetics. Secondary outcomes were cranial nerve VII deficits, infection, heterotopic ossification, prosthesis failure with need for reoperation, and bleeding. Clinical data were collected for a minimum 24 months post-surgery; postoperative data were compared with the preoperative data. Mean follow-up was 39.6 months. Significant improvements were observed in joint pain (P = 0.026), jaw function (P = 0.004), diet (P = 0.004), sleep apnoea (P = 0.001), and aesthetics (P = 0.001) scores, as well as in MIO (P = 0.006). The greatest improvements (preoperative to postoperative) were obtained for aesthetics and sleep apnoea, and the smallest for joint pain and MIO. Early and mid-term results were very satisfactory in terms of the patients' perceptions of the outcomes investigated. Optimization of the prosthesis design and increasing surgical experience may contribute to significant improvements in patient outcomes.
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Affiliation(s)
- S Can
- Private Practice, Istanbul, Turkey.
| | - S B Kıraç Can
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
| | - A Varol
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bahçeşehir University, Istanbul, Turkey.
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Verhelst PJ, Janssens S, Matthews H, Begnoni G, Claes P, Shaheen E, Peeters H, Politis C, Jacobs R. Analysis and prediction of condylar resorption following orthognathic surgery. Sci Rep 2025; 15:664. [PMID: 39753589 PMCID: PMC11699120 DOI: 10.1038/s41598-024-81148-w] [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: 07/18/2024] [Accepted: 11/25/2024] [Indexed: 01/06/2025] Open
Abstract
Condylar resorption is a feared complication of orthognathic surgery. This study investigated condylar resorption in a cohort of 200 patients This allowed for a powerful update on incidence and risk factors. 9.5% of patients developed resorption. These patients had on average, 17% volume loss with 3.9 mm ramal height loss and 3.1 mm posterior mandibular displacement. 2% of patients had bilateral resorption. Univariable analysis identified a younger age, a bimaxillary + genioplasty procedure, larger mandibular advancements, upward movements of the distal segment, a higher counterclockwise pitch of the distal segment, smaller preoperative condylar volumes and a higher anterior/posterior lower facial height ratio as risk factors on a patient level. Univariable analysis on a condylar level also identified compressive movements of the ramus and a higher mandibular plane angle as risk factors. Using machine learning for the multivariable analysis, the amount of mandibular advancement was the most important predictor for condylar resorption. There were no differences in preoperative mandibular, ramal or condylar shape between patients with or without resorption. These findings suggest condylar resorption may be more common than thought. Identifying risk factors allows surgical plans to be adjusted to reduce the likelihood of resorption, and patients can be more selectively screened postoperatively.
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Affiliation(s)
- Pieter-Jan Verhelst
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Sigrid Janssens
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium
| | - Harold Matthews
- Department of Human Genetics, KU Leuven, Leuven, Belgium
- Medical Imaging Research Center, University Hospitals Leuven, Leuven, Belgium
- Facial Sciences Research Group, Murdoch Children's Research Institute, Parkville, Australia
| | - Giacomo Begnoni
- Orthodontics Research Unit, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Orthodontics, University Hospitals Leuven, Leuven, Belgium
| | - Peter Claes
- Department of Human Genetics, KU Leuven, Leuven, Belgium
- Medical Imaging Research Center, University Hospitals Leuven, Leuven, Belgium
- Facial Sciences Research Group, Murdoch Children's Research Institute, Parkville, Australia
- Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Hilde Peeters
- Department of Human Genetics, KU Leuven, Leuven, Belgium
- Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
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11
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Boos-Lima FBDJ, Guastaldi FPS, Nielsen GP, Kaban LB, Peacock ZS. Histopathology of Idiopathic Condylar Resorption Differs From Temporomandibular Joint-Only Juvenile Idiopathic Arthritis. J Oral Maxillofac Surg 2025; 83:26-36. [PMID: 39476870 DOI: 10.1016/j.joms.2024.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 10/05/2024] [Indexed: 11/10/2024]
Abstract
BACKGROUND Idiopathic condylar resorption (ICR) is a rare condition of unknown etiology characterized by progressive decrease in volume and pathologic remodeling of a previously normal mandibular condyle. Juvenile idiopathic arthritis (JIA) affecting only the temporomandibular joint (TMJ-only JIA) is characterized by synovitis and destruction of TMJ tissues without involvement of other joints. It is often difficult to differentiate the 2 conditions because they exhibit similar phenotypes. PURPOSE To compare histology of resected condylar specimens from patients with ICR and TMJ-only JIA. Specific aims were as follows: 1) to correlate longitudinal clinical data with histopathology of resected condyle specimens and 2) to compare resorption patterns between the 2 disease processes. STUDY DESIGN, SETTING, SAMPLE This was a retrospective cohort study of patients treated at the Massachusetts General Hospital from 1999 through 2023. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE Primary predictor variable was the diagnosis (ICR or JIA). Secondary predictor variables included age, gender, race, putative contributing factors, and laboratory studies. MAIN OUTCOME VARIABLE(S) Primary outcome variable was presence or absence of inflammatory infiltrates in bone and synovial specimens. Secondary outcome variables were structural integrity and morphologic characteristics of the condylar cartilage and bone. ANALYSES Spearman correlation was used to assess the relationship between histological scores and age, gender, and possible associated contributing factors. A P value < .05 was considered statistically significant. RESULTS Thirty-five subjects (67 specimens) were included in group 1 (ICR). Eight subjects (15 specimens) were included in group 2 (TMJ-only JIA). The histopathologic findings in ICR consisted of severe and irregular cartilage surface disruption, fibrocartilage degeneration, and subchondral bone with no inflammatory infiltrate. Degeneration was observed to begin at the anterior pole of the condyle and progress eventually to total resorption to the sigmoid notch. TMJ-only JIA was notable for more severe condylar degeneration and inflammation in the bone and synovia. There was no specific pattern of degeneration. For both groups, the subject's age, gender, or putative contributing factors did not correlate with the histopathologic scores. CONCLUSION AND RELEVANCE These results support the hypothesis that ICR and TMJ-only JIA are distinct clinical entities and can be distinguished by histopathologic findings in the mandibular condyles and synovia.
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Affiliation(s)
| | - Fernando Pozzi Semeghini Guastaldi
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA; Director, Division of Oral and Maxillofacial Surgery, Skeletal Biology Research Center, Massachusetts General Hospital, Boston, MA
| | - Gunnlaugur P Nielsen
- Professor of Pathology, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Leonard B Kaban
- Walter C. Guralnick Distinguished Professor of Oral & Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA; Chief Emeritus, Division of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
| | - Zachary S Peacock
- Chair, Department of Oral & Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA; Chief, Division of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA.
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12
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Liu S, Cai B, Fan S, Zhang Y, Lu S, Xu L. Effects of patient education on the oral behavior of patients with temporomandibular degenerative joint disease: a prospective case series study. Cranio 2025; 43:100-109. [PMID: 35678722 DOI: 10.1080/08869634.2022.2085410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the effects of patient education and related factors on oral behaviors (OBs) in patients with temporomandibular joint degenerative diseases. METHODS Sixty-three patients were included. Temporomandibular joint specialists conducted clinical examinations, provided patient education, and administered the Oral Behavior Checklist (OBC) questionnaire at baseline. Patients were followed up at 6 months. RESULTS Eight OBs showed a high incidence among patients. At the 6-month follow-up, the incidence of 6 of the OBs decreased, all of which were high incidence OBs. The frequency of 9 OBs decreased, of which 8 were high incidence OBs. The average OBC score decreased from 22.97 ± 9.30 to 17.90 ± 9.28. Age, education level, and original OBC score had a significant effect on OB improvement. CONCLUSION Patient education and the corresponding treatment are conducive to OB improvement. The related factors affecting the improvement in patients' OBs were age, education level, and OB severity.
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Affiliation(s)
- Shasha Liu
- Department of Rehabilitation Medicine, the Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Beijing, SH, China
- Department of Rehabilitation Medicine, Sijing Hospital of Songjiang District of Shanghai, Beijing, SH, China
| | - Bin Cai
- Department of Rehabilitation Medicine, the Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Beijing, SH, China
| | - Shuai Fan
- Department of Rehabilitation Medicine, the Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Beijing, SH, China
| | - Yuxin Zhang
- Department of Rehabilitation Medicine, the Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Beijing, SH, China
| | - Shenji Lu
- Department of Rehabilitation Medicine, the Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Beijing, SH, China
- Department of Rehabilitation Medicine, Sijing Hospital of Songjiang District of Shanghai, Beijing, SH, China
| | - Lili Xu
- Department of Rehabilitation Medicine, the Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Beijing, SH, China
- Department of Rehabilitation Medicine, Sijing Hospital of Songjiang District of Shanghai, Beijing, SH, China
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13
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Turgut Altay H, Ertem SY. The Stress Effects of Mandibular Movements on the Temporomandibular Joint With Sagittal Split Ramus Osteotomy. J Craniofac Surg 2025; 36:206-210. [PMID: 39360968 DOI: 10.1097/scs.0000000000010712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2024] [Accepted: 09/09/2024] [Indexed: 10/05/2024] Open
Abstract
PURPOSE The aim of this study was to evaluate the stress changes in the temporomandibular joint (TMJ) after sagittal split ramus osteotomy (SSRO) with finite element analysis (FEA). MATERIAL AND METHODS 5 and 10 mm mandibular setback and advancement were applied to models by using SSRO and a control model without osteotomy evaluated. The articular disc was modeled as superelastic, and the stresses on the articular fossa, disc, and condyle were evaluated. RESULTS The stresses on the cartilage were 1.150 MPa on the 5 mm advancement model and 1.506 MPa on the 10 mm advancement model. The stresses on the disc were 11.56 MPa on the 5 mm advancement model, 7.94 MPa on the 10 mm advancement model and the amount were significantly higher than other models. The stress, especially in the cartilage, increased with the amount of advancement. In the setback models, the stresses on the condylar cartilage and the disc were higher than in the control model, and the stress in the condylar cartilage increased with the amount of setback. CONCLUSION SSRO increases the stresses in the TMJ components and stresses increase depending on the amount of advancement and setback and may cause the development of joint problems.
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Affiliation(s)
- Hilal Turgut Altay
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ankara Yildirim Beyazit University, Ankara, Turkey
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14
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Önsüren AS, Temur KT. Evaluation of fractal analysis and radiomorphometric measurements of mandibular bone structure in bruxism and non-bruxism paediatric patients. Oral Radiol 2025; 41:60-68. [PMID: 39375282 DOI: 10.1007/s11282-024-00776-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 09/25/2024] [Indexed: 10/09/2024]
Abstract
OBJECTIVES The goal of this examination was to compare the impact of probable sleep/awake bruxism on the mandibular trabecular bone structure by fractal analysis (FA) with digital panoramic radiograph (DPR) and radiomorphometric measurements in paediatric patients with bruxism. METHODS The examination included 130 participants with 63 patients with probable sleep/awake bruxism and 67 control groups. Bilateral regions of interest (ROI) in three regions were examined as ROI1: mandibular ramus, ROI2: mandibular angulus, ROI3: anterior to the molar teeth. Radiomorphometric measurements were taken of the mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI). p < 0.05 was approved for statistical significance. RESULTS The ROI-1, ROI-2, and ROI-3 values were defined to be statistically significantly high in the bruxism group (p < 0.05). No significant difference was found between the groups in the other values (p > 0.05). There was no difference in the age and gender for any of the parameters (p > 0.05). CONCLUSION In children and adolescents, the mandibular trabecular bone can be affected by bruxism. FA can be used as an auxiliary method for finding the mandibular trabecular differences of patients with bruxism in paediatric dentistry just as it can for adults.
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Affiliation(s)
| | - Katibe Tuğçe Temur
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Omer Halisdemir University, Niğde, Turkey
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15
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Gong Y, Zhu J, Zheng F, Zhu Y, Sui S, Liu Y, Yin D. Associations between condylar height relative to occlusal plane and condylar osseous condition and TMJ loading based on 3D measurements and finite element analysis. Sci Rep 2024; 14:28919. [PMID: 39572697 PMCID: PMC11582652 DOI: 10.1038/s41598-024-80442-x] [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: 09/23/2024] [Accepted: 11/19/2024] [Indexed: 11/24/2024] Open
Abstract
To investigate the relationship between condylar height relative to occlusal plane (CHO) and condylar osseous condition and the changes of condylar stress loading before and after CHO modifications. The condylar osseous conditions of 434 temporomandibular joints (TMJ) were assessed and grouped. Measurements of anatomical parameters were performed on CT-based reconstructed 3D stomatognathic models. Differences in anatomical parameters of the jaws in the different groups were compared, and the correlation between the Angle α (representing the CHO ratio) and related parameters was investigated. A finite element model (FEM) was constructed using 3D finite element analysis (FEA). The Angle α was altered by modifying condylar position and the inclination of mandibular plane (MP) and occlusal plane (OP) based on the FEM to analyze condylar stress loading under different working conditions. There were differences in anatomical parameters among the different groups, with the smaller Angle α in the osseous destruction group. Angle α was negatively correlated with the inclination of MP and OP. The FEA illustrated condylar stress loading changed after modifying the Angle α by both two modalities. After modifying condylar position, the stress increased with the proximal movement of the condyle toward the OP. After changing the inclination of MP and OP, the stress increased with increasing inclinations. Changes in CHO correlate with condylar osseous condition, and distal movement of the condyle to the OP and reduction of MP and OP inclination may reduce TMJ stress overload. In clinical practice, it is advisable to assess patients for sufficient CHO ratio, as insufficiency in CHO may elevate the risk of TMJ stress overload. The CHO ratio could be modulated by changing the inclination of the OP.
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Affiliation(s)
- Yanji Gong
- National Clinical Research Center for Oral Disease, Department of Jinjiang Outpatient, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jinyi Zhu
- National Clinical Research Center for Oral Disease, Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Fangjie Zheng
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Yunfan Zhu
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Shangyan Sui
- National Clinical Research Center for Oral Disease, Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Yang Liu
- National Clinical Research Center for Oral Disease, Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
| | - Deqiang Yin
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China.
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16
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Holte MB, Nielsen TW, Cattaneo PM, Pinholt EM. Stability of proximal mandibular anatomical structures following bilateral sagittal split osteotomy. Int J Oral Maxillofac Surg 2024; 53:925-933. [PMID: 38702201 DOI: 10.1016/j.ijom.2024.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 04/05/2024] [Accepted: 04/19/2024] [Indexed: 05/06/2024]
Abstract
The aim of this study was to investigate the stability of the proximal mandibular reference structures that have been proposed in the literature for superimposition. Forty proximal mandibular segments of 20 patients who underwent bilateral sagittal split osteotomy (BSSO) for advancement were reconstructed from a pair of pre- and postoperative (2 years) cone beam computed tomography scans, and spatially divided into the mandibular condyle, the coronoid process, and 20 mandibular ramus regions. To assess the stability of the anatomical regions, the volumetric and surface discrepancy between the superimposed pre- and postoperative regions were calculated. One-sample t-tests were applied to analyse the statistical stability of the individual regions. Two statistically stable (P < 0.05) structures in the proximal segment of the mandible following BSSO were identified: (1) the posterior part of the mandibular ramus above the gonial angle and below the condylar neck, and (2) the sub-coronoid area below the coronoid process/mandibular notch. Using these stable structures for superimposition resulted in an assessment discrepancy in the condylar displacement of up to 1.1 mm and in the volumetric change of up to 2.8%. Hence, it is suggested that these two identified stable structures are used as reference areas when assessing condylar displacement and change using superimposition.
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Affiliation(s)
- M B Holte
- 3D Lab Denmark, Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Esbjerg, Denmark
| | - T W Nielsen
- 3D Lab Denmark, Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Esbjerg, Denmark
| | - P M Cattaneo
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Victoria, Australia
| | - E M Pinholt
- 3D Lab Denmark, Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Esbjerg, Denmark.
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17
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Zhu Y, Zheng F, Gong Y, Zhu J, Yin D, Liu Y. Effect of occlusal contact on TMJ loading during occlusion: An in silico study. Comput Biol Med 2024; 178:108725. [PMID: 38878405 DOI: 10.1016/j.compbiomed.2024.108725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/08/2024] [Accepted: 06/07/2024] [Indexed: 07/24/2024]
Abstract
Alterations in occlusal features may have significant consequences, ranging from dental aesthetics to health issues. Temporomandibular joint disorders (TMDs) are often associated with joint overload, and the correlation between occlusal features and TMDs has been thoroughly discussed. In current work, we introduced a novel stomatognathic model that aligns well with in vivo experimental measurements, specifically designed to decouple the impact of occlusal contact and periodontal ligament (PDL) negative feedback on temporomandibular joint (TMJ) loading. Utilizing an in-silico approach, the simulation analysis included six symmetric occlusal contact scenarios. Furthermore, a biomechanical lever model was employed to clarify the mechanical mechanism and investigate the multi-factorial effects of TMJ overload. These findings indicate that anterior shifts in the occlusal centre lead to increased TMJ loading, particularly in occlusal contact cases with anteroposterior changes. Considering the symmetrical distribution of occlusal contact, mediolateral alterations had a more modest effect on TMJ loading. Additionally, potential negative feedback activated by principal strain of periodontal could not only alleviate joint load but also diminish occlusal force. These investigations enhance our understanding of the intricate interactions between masticatory muscles, occlusal forces, and joint contact forces, thereby providing motivation for future comprehensive studies on TMJ biomechanical overload.
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Affiliation(s)
- Yunfan Zhu
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Fangjie Zheng
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Yanji Gong
- State Key Laboratory of Oral Disease, National Center for Stomatology &National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jinyi Zhu
- State Key Laboratory of Oral Disease, National Center for Stomatology &National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Deqiang Yin
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China.
| | - Yang Liu
- State Key Laboratory of Oral Disease, National Center for Stomatology &National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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18
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Boos-Lima FBDJ, Guastaldi FPS, Kaban LB, Peacock ZS. Accuracy of skeletal scintigraphy for the evaluation of mandibular growth disorders: a systematic review. Int J Oral Maxillofac Surg 2024; 53:482-495. [PMID: 38158243 DOI: 10.1016/j.ijom.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
Bone scans, reflecting blood flow and metabolic activity in a region of interest, are frequently used to evaluate mandibular growth disorders. Increased uptake is a non-specific finding and can occur as a result of multiple causes. The correlation between radioactive tracer uptake and growth activity has not been consistently demonstrated. The aim of this study was to assess the accuracy of planar skeletal scintigraphy (SS), single-photon emission computed tomography (SPECT), and SPECT with computed tomography (CT) images (SPECT/CT) in detecting abnormal mandibular growth activity compared to clinical and radiographic/tomographic methods (reference standard) and histologic findings. A systematic review was conducted following the PRISMA guidelines. Sensitivity, specificity, and accuracy were calculated for planar SS, SPECT, and SPECT/CT. Compared to the reference standard, SPECT/CT had the best diagnostic accuracy (76.5% sensitivity, 90.4% specificity, 83.2% accuracy), followed by planar SS (81.8% sensitivity, 84.5% specificity, 83.0% accuracy) and SPECT (77.7% sensitivity, 72.4% specificity, 74.5% accuracy). The results of this study indicate that SPECT/CT has the best clinical correlation, but the certainty of the evidence is low. The differences in sensitivity and specificity between the three index tests were not clinically significant. The three tests can be useful, with only a small difference in their diagnostic value. Histopathology was found not to be satisfactory as a reference standard.
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Affiliation(s)
- F B D J Boos-Lima
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA
| | - F P S Guastaldi
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA
| | - L B Kaban
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA
| | - Z S Peacock
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.
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19
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Al-Watary MQ, Telha WA, Ge H, Wu Y, Sun X, Qing Z, Li J. Does adjunctive fixation in conjunction with miniplate affect condylar position and morphology after mandibular advancement through bilateral sagittal split ramus osteotomy? A retrospective 3-dimensional CT comparative study. J Craniomaxillofac Surg 2024; 52:778-785. [PMID: 38627189 DOI: 10.1016/j.jcms.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/30/2024] [Indexed: 06/16/2024] Open
Abstract
To minimize condylar positional and morphological changes after mandibular advancement through bilateral sagittal split ramus osteotomy (BSSRO), surgeons add either a bicortical screw or a two-hole plate distal to the conventional single miniplate. Since there have been no previous studies investigating the effect of this combination, our study aimed to evaluate the short- and long-term effects of these adjunctive fixation methods (AFM) on condylar positional and morphological changes after mandibular advancement through BSSRO. This retrospective cohort study included consecutive patients with retruded mandibles who were treated in the Department of Orthognathic and TMJ Surgery at West China Hospital of Stomatology, Sichuan University. The patients were divided into two groups based on the primary predictor variable, which was the addition of AFM - either a single bicortical screw or a two-hole plate in addition to the single miniplate. The primary outcome variable was the condylar positional and morphological changes after mandibular advancement through BSSRO. Three-dimensional facial CT scans were obtained at three different time points (preoperatively - T0, 1 week postoperatively - T1, and 1 year postoperatively - T2) and analyzed using ITK-SNAP, 3D Slicer, and SlicerSALT software. Intergroup comparisons were conducted with an independent t-test, with a p-value of <0.05 considered significant. Correlations between the variables were estimated by Pearson correlation. The study comprised 51 patients (32 females, 19 males; mean age 25.13 ± 4.24 years), involving a total of 81 condyles (21 unilateral and 60 bilateral). There was a significant difference in long-term condylar displacement in favor of AFM along with a single miniplate (p < 0.001). The bicortical screw group recorded less condylar displacement than the two-hole plate group horizontally (0.11 mm vs 0.22 mm) and sagittally (0.03 mm vs 0.17 mm), but more vertically (0.85 mm vs 0.03 mm). Bone formation associated with AFM occurred on all condylar surfaces, compared with only three surfaces in the single miniplate group. The adjunctive method in addition to the single miniplate fixation method showed less condylar displacement and more bone apposition after mandibular advancement through BSSRO. The follow-up duration variable was the only significant determinant for volumetric changes in the condyle.
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Affiliation(s)
- Mohammed Qasem Al-Watary
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center for Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Wael Ahmed Telha
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center for Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Han Ge
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center for Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yifan Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center for Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Xiaoshuang Sun
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center for Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Zhao Qing
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center for Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jihua Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center for Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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20
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Yang C, Teng H, Shao B, Liu Z. Biomechanical study of temporomandibular joints of patients with temporomandibular disorders under incisal clenching: A finite element analysis. J Biomech 2024; 166:112065. [PMID: 38555778 DOI: 10.1016/j.jbiomech.2024.112065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/01/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
Temporomandibular disorders (TMD) encompass a collection of pathologies. Within the multitude of etiological factors contributing to TMD, mechanical factors hold significant importance. The aim of this investigation was to assess the magnitude and distribution of stresses encountered by the temporomandibular joints (TMJs) during incisal clenching among TMD patients while also elucidating the mechanical pathogenesis underlying TMD. Ten asymptomatic subjects and ten TMD patients were recruited. The Control, Bilateral, and Unilateral groups were set. The contact stress, maximum principal stress, and minimum principal stresses of TMJ structures among the groups were compared. In addition, comparisons of the contact stress distribution among the groups were adopted. In the Control and Bilateral groups, the magnitudes of stresses (contact stress, maximum and minimum principal stresses) between the right and left sides showed no significant difference (P > 0.05). For unilateral TMD patients,the minimum principal stress on the condyle in the Uni-N group (the normal side) was significantly greater than thatin the Uni-T group (the TMD side)(P = 0.016, mean difference 9.99 MPa [95 %CI: 3.11 to 16.87]). Furthermore, stresses on the condyle and fossa of the patients were significantly greater than those of asymptomatic subjects (P < 0.05). The contact stress distributions were concentrated in the Control group while irregular in the TMD groups. In conclusion, asymmetrical contact stress distributions were observed in unilateral TMD, with excessive stresses on the healthy side. The protection of the healthy TMJ during treatment is recommended for patients with unilateral TMD.
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Affiliation(s)
- Chunxin Yang
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology/Sichuan University, Yibin Park, Yibin 644600, China
| | - Haidong Teng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology/Sichuan University, Yibin Park, Yibin 644600, China
| | - Bingmei Shao
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology/Sichuan University, Yibin Park, Yibin 644600, China
| | - Zhan Liu
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology/Sichuan University, Yibin Park, Yibin 644600, China.
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21
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Nomoto S, Ota T, Sekine H. Two Cases of Idiopathic Condylar Resorption Due to Temporomandibular Joint (TMJ) Osteoarthritis Remodeled by Different Treatment Modalities. Cureus 2023; 15:e49322. [PMID: 38143608 PMCID: PMC10748828 DOI: 10.7759/cureus.49322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Condylar resorption is a condition of progressive and significant mandibular head resorption. We treated two patients with condylar resorption caused by temporomandibular joint (TMJ) osteoarthritis. The first patient was a 22-year-old female at the time of the initial examination. She had a history of orthodontic treatment and came to the clinic with a number of symptoms, including difficulty opening the mouth. Idiopathic condylar resorption was diagnosed, an occlusal splint was placed for approximately one year, and the patient was followed up for 12 years. The second patient was a 20-year-old female who had completed non-extraction orthodontic treatment by the age of 17 years. She came to the clinic with esthetic issues, such as an anterior open bite. Implant anchor screws were placed in the alveolar bone of the anterior teeth and intermaxillary fixation was performed. Case 1 had 12 years of follow-up, with CT scan results showing remodeling of the condylar. Case 2 is expected to shorten treatment time. However, the CT scan showed remodeling and improvement in the chief complaint.
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Affiliation(s)
- Syuntaro Nomoto
- Department of Fixed Prosthodontics, Tokyo Dental College, Tokyo, JPN
| | - Takuya Ota
- Department of Fixed Prosthodontics, Tokyo Dental College, Tokyo, JPN
| | - Hideshi Sekine
- Department of Fixed Prosthodontics, Tokyo Dental College, Tokyo, JPN
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22
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Tanaka E. Etiology and Diagnosis for Idiopathic Condylar Resorption in Growing Adolescents. J Clin Med 2023; 12:6607. [PMID: 37892745 PMCID: PMC10607317 DOI: 10.3390/jcm12206607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
This article has been written in honor of the late professor emeritus Kazuo Tanne, who passed away on 4 March 2023 [...].
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Affiliation(s)
- Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8504, Japan
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23
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Telha W, Bi R, Abotaleb B, Al-Watary M, Sakran K, Zhu S, Jiang N. Condylar positional changes and remodeling following bimaxillary anterior segment osteotomy with and without Le Fort I osteotomy: a three-dimensional comparative analysis. Clin Oral Investig 2023; 27:5121-5130. [PMID: 37474831 DOI: 10.1007/s00784-023-05132-w] [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: 04/17/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To evaluate 3D condylar displacement and long-term remodeling following the correction of bimaxillary protrusion by anterior segment osteotomy (ASO) with and without Le Fort I surgery. MATERIALS AND METHOD This retrospective study included 32 adults with bimaxillary protrusion who underwent ASO alone (group 1) or with concomitant Le Fort I osteotomy (group 2). Subject's computed tomography scans at basic (T0), immediate postoperatively (T1), and at 1 year or more follow-up (T2) were collected. The condyle displacement was measured at superior-inferior, lateromedially, and anteroposterior surfaces, while condyle remodeling was measured at the superior, lateral, anterior, medial, and posterior surfaces. All 3D analyses were performed using 3D Slicer software (4.11.2). RESULTS At T1, 52.7%, 86.7%, and 94.4% of condyles in group 1 were displaced inferiorly, laterally, and posteriorly, respectively, as well as 75%, 89.2%, and 53.5% of condyles in group 2, which had not fully returned to the original preoperative positions at T2. Condylar remodeling was observed in both groups at T2, and no significant difference was found in the overall condylar volume between T1 and T2 in both groups. Patients in group 2 exhibited significant bone resorption at both lateral and anterior surfaces compared to group 1 (P = 0.000 and 0.01, respectively). CONCLUSION This study's results demonstrated that ASO is associated with a degree of condylar changes even if the posterior mandible is not osteomized. The positional changes vary between bimaxillary ASO alone and those with simultaneous Le Fort I osteotomy. However, both groups' condyle volume remained stable at the long-term follow-up.
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Affiliation(s)
- Wael Telha
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Rui Bi
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Bassam Abotaleb
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Mohammed Al-Watary
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Karim Sakran
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China.
| | - Nan Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China.
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24
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Lekroengsin B, Tachiki C, Takaki T, Nishii Y. Relationship between Changes in Condylar Morphology and Masticatory Muscle Volume after Skeletal Class II Surgery. J Clin Med 2023; 12:4875. [PMID: 37510990 PMCID: PMC10381303 DOI: 10.3390/jcm12144875] [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: 06/26/2023] [Revised: 07/20/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
The treatment of dentofacial deformities generally includes orthognathic surgery in which mandibular condyle changes following surgery are a common cause of relapse. This study investigated the changes in the mandibular condyle and related muscles to identify the factors that affected the changes in the mandibular condyle after orthognathic surgery in skeletal class II patients. This research studied 60 joints in 30 patients with skeletal class II dentofacial deformities who received surgical orthodontic treatment, including bilateral sagittal split ramus osteotomy, and underwent computed tomography before and after orthodontic treatment. The mandibular condyle, masseter, and medial pterygoid muscles were reconstructed and measured in 3D. Condylar positional and morphology changes, masseter and medial pterygoid muscle volume, temporomandibular joint (TMJ) pain, and distal segment movement were analyzed. The study observed that both the masseter and medial pterygoid muscle volumes decreased with statistical significance. The changes in the horizontal direction were positively correlated with the amount of movement. The findings indicated that mandibular condyle changes were significantly affected by the movement of the distal segment, the medial pterygoid muscle volume, and the direction of the distal segment, which influenced the treatment's long-term stability after orthognathic surgery.
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Affiliation(s)
| | - Chie Tachiki
- Department of Orthodontics, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Takashi Takaki
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Yasushi Nishii
- Department of Orthodontics, Tokyo Dental College, Tokyo 101-0061, Japan
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25
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Ertty E, Méndez-Manjón I, Haas OL, Hernández-Alfaro F, Meloti F. Definition of New Three-Dimensional Cephalometric Analysis of Maxillomandibular Sagittal Relationship for Orthodontics and Orthognathic Surgery: Normative Data Based on 700 CBCT Scans. J Craniofac Surg 2023; 34:1291-1295. [PMID: 36922378 DOI: 10.1097/scs.0000000000009267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/05/2022] [Indexed: 03/18/2023] Open
Abstract
The objective of the study was to define the norm of new 3-dimensional cephalometric analysis of maxillomandibular sagittal relationship with the patient in Natural Head Position. A cross-sectional study was performed using 700 consecutives cone beam computed tomography datasets of pre-orthodontic patients received for three-dimensional craniofacial analysis. To stablish the clinical norm of the new sagittal reference (linear distance A-B), the correlation with the gold standard (ANB angle) was estimated with the Pearson's correlation coefficient. Subsequently, the prognostic values of the linear distance A-B was calculated to define the clinical norm. The sample was composed by 463 women (66.1%) and 237 men (33.9%). The mean age was 30 ± 14,5 years old (range 6-71 y old). According to the skeletal class classification (ANB), 46.1% (323) were class I, 42% (294) class II, and 11.9% (83) class III. The regression model found that each additional grade of the ANB angle imply a mean increase of 1.24 mm of the distance A-B ( P <0.001). The normative value of the linear distance A-B was obtained through the prognostic values of the distance for the limits of the ANB norm 0 to 4. These values were on the range of 0.52 to 5.48 mm. Therefore, the clinical norm for cephalometric maxillomandibular sagittal relationship using linear distance from point A-B is: 3±2.48 mm. With this new approach, we can define the skeletal sagittal relationship of the patient in natural head position overcoming the limitations of using intracranial or occlusal plane references improving the diagnosis and orthognathic surgical planning process.
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Affiliation(s)
- Ertty Ertty
- Department of Orthodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo (SP)
- Ertty Ortodontia, Ertty Ortodontia, Brasília. Distrito Federal (DF), Brazil
| | - Irene Méndez-Manjón
- Ertty Ortodontia, Ertty Ortodontia, Brasília. Distrito Federal (DF), Brazil
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Orion Luiz Haas
- Department of Oral and Maxillofacial Surgery, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Federico Hernández-Alfaro
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
- Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain
| | - Fernanda Meloti
- Department of Orthodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo (SP)
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26
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Yang W, Chen Y, Li J, Jiang N. Assessment of condylar positional changes in severe skeletal class II malocclusion after surgical-orthodontic treatment. Clin Oral Investig 2023:10.1007/s00784-023-04984-6. [PMID: 37017754 DOI: 10.1007/s00784-023-04984-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVES This study aimed to determine the positional changes in the condyle in the temporomandibular joint (TMJ) of severe skeletal class II malocclusion patients treated with surgical-orthodontics. MATERIALS AND METHODS The measurements of TMJ space in 97 severe skeletal class II malocclusion patients (20 males, 77 females, mean age, 24.8 years, mean ANB = 7.41°) were assessed using limited cone-beam computed tomography (LCBCT) images acquired before orthodontics (T0) and 12 months after surgery (T1). 3D remodeling of the TMJ and measurements of the anterior space (AS), superior space (SS), and posterior space (PS) were performed to determine the position of the condyle for each joint. All data were analyzed by t test, correlation analysis, and Pearson correlation coefficient. RESULTS The mean AS, SS, and PS values after the therapy changed from 1.684 to 1.680 mm (0.24%), 3.086 to 2.748 mm (10.968%), and 2.873 to 2.155 mm (24.985%), respectively. The decreases in SS and PS were statistically significant. Positive correlations were found in the mean AS, SS, and PS values between the right and left sides. CONCLUSIONS The combination of orthodontic and surgical treatment makes the condyle move counterclockwise in the TMJ in severe skeletal class II patients. CLINICAL RELEVANCE Studies of temporomandibular joint (TMJ) intervals changes in patients with severe skeletal class II after sagittal split ramus osteotomy (SSRO) are limited. The postoperative joint remodeling, resorption, and related complications remain unstudied.
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Affiliation(s)
- Wen Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China, 14 Third Section, Renmin South Road, Chengdu, 610041, Republic of China
| | - Yanbin Chen
- Sichuan University, 14 Third Section, Renmin South Road, Chengdu, 610041, Republic of China
| | - Jiaxuan Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China, 14 Third Section, Renmin South Road, Chengdu, 610041, Republic of China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China, 14 Third Section, Renmin South Road, Chengdu, 610041, Republic of China.
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27
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Khurana S, Pahadia M, Parasher P, Creanga AG. Magnetic Resonance Imaging Features of Progressive Condylar Resorption: A Case Report. Cureus 2023; 15:e36261. [PMID: 37073208 PMCID: PMC10105648 DOI: 10.7759/cureus.36261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/18/2023] Open
Abstract
Progressive condylar resorption is a dysfunctional remodeling of the temporomandibular joint of unknown origin. It usually manifests in young girls and causes reduced ramus height, loss of condylar volume, steep mandibular angle, limited jaw motion, and pain. On magnetic resonance imaging, the condition is associated with anterior disc displacement with or without reduction. This article discusses imaging features of progressive condylar resorption that cause severe temporomandibular joint degenerative changes, emphasizing the careful evaluation of imaging changes of the temporomandibular joint in young female patients. The early diagnosis of progressive condylar resorption helps to reduce the further progression of the condition.
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28
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Sun CK, Li YB, Ma HS, Li G, Sun ZP, Sun LS. Natural course of severe temporomandibular joint osteoarthrosis evaluated by a novel condylar remodelling scoring system and quantitative volumetric analysis. Int J Oral Maxillofac Surg 2023; 52:227-236. [PMID: 35970695 DOI: 10.1016/j.ijom.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 01/11/2023]
Abstract
Temporomandibular joint osteoarthrosis (TMJ-OA) frequently causes mild, moderate, or severe condylar morphological changes. A novel condylar remodelling scoring system (CRSS) based on three-dimensional cone beam computed tomography images is proposed, which is used to grade condylar morphological changes. In the CRSS, the condyle is divided into 10 regions by 11 reference points. For each increase in the number of regions involved in TMJ-OA, one point is subtracted from the full score of 10. The intra-class correlation coefficients for intra- and inter-observer agreement (range 0.656-0.898 and 0.841-0.906, respectively) indicated that the CRSS had good reliability. Cephalometric analysis showed that the condyles with severe morphological changes were prone to present with a retrognathic and clockwise rotating mandible, shorter ramus height, reduced mandibular length, larger mandibular angle, and maxillary retrusion. Qualitative CRSS evaluation and quantitative volumetric analysis were performed to evaluate the stability of severe TMJ-OA in its natural course (343 condyles). The continuous cortex group showed no remarkable changes with an average follow-up of 2 years. In the discontinuous cortex group, most (74.4%) converted into a continuous cortex during follow-up (mean 2 years).
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Affiliation(s)
- C-K Sun
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - Y-B Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - H-S Ma
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - G Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - Z-P Sun
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - L-S Sun
- National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China; Key Laboratory of Oral Pathology, School and Hospital of Stomatology, Peking University, Haidian District, Beijing, PR China.
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29
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Ma H, Teng H, Li A, Zhang Z, Zheng T, Chong DYR, Shao B, Liu Z. The pressure in the temporomandibular joint in the patients with maxillofacial deformities. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101285. [PMID: 36087916 DOI: 10.1016/j.jormas.2022.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Temporomandibular disorder (TMD) symptoms were found to be common in the patients with maxillofacial deformities. The mandibular structure was in relation with the stress within temporomandibular joint (TMJ). However, the current studies on the TMJ stresses in the patients with different maxillofacial deformities are not comprehensive enough. PURPOSE The aim of this study was to investigate the compression and morphology of the TMJ in the patients with different maxillofacial deformities under central occlusion. METHODS 24 patients and 10 asymptomatic individuals were included in this study and divided into patient groups and control group. The 3D models were reconstructed. Muscle forces and boundary conditions corresponding to the central occlusion were applied. Nine morphological parameters of mandible were evaluated. RESULTS The minimum principal stresses in the articular disc and condyle were significantly greater than those of the control group (P<0.05). For the articular disc, the compression on the non-deviation side was greater than those on the deviation side in patients with asymmetrical mandibles. There was difference between both sides in the mandibular prognathism and retrusion groups. The joint space of patients was significantly lower than that of the control group (P<0.05). CONCLUSIONS Maxillofacial deformities might change the condylar position within the articular fossa, which decreased the joint space and increased the compression within TMJ. The patients with asymmetry mandible suffered greater pressure within TMJ on the non-deviation side. The bilaterally over-developed and under-developed mandible in patients might also increase the compression within TMJ.
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Affiliation(s)
- Hedi Ma
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Haidong Teng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Annan Li
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Zhifei Zhang
- Department of Statistics, School of Mathematics, Southwest Jiaotong University,611756, China
| | - Tinghui Zheng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Bingmei Shao
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China; Basic Mechanics Lab, Sichuan University, Chengdu, 610065, China
| | - Zhan Liu
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China.
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30
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Genetic overlap between temporomandibular disorders and primary headaches: A systematic review. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:69-88. [PMID: 35242249 PMCID: PMC8881721 DOI: 10.1016/j.jdsr.2022.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/18/2021] [Accepted: 02/07/2022] [Indexed: 12/14/2022] Open
Abstract
Primary headache disorders (PHD), specifically migraine, are strongly associated with temporomandibular disorders (TMD), sharing some patterns of orofacial pain. Both disorders have significant genetic contributions already studied. PRISMA guidelines were followed to conduct this systematic review, which comprehensively summarize and discuss the genetic overlap between TMD and PHD to aid future research in potential therapy targets. This review included eight original articles published between 2015 and 2020, written in English and related to either TMD and/or PHD. The genes simultaneously assessed in PHD and TMD studies were COMT, MTHFR, and ESR1. COMT was proved to play a critical role in TMD pathogenesis, as all studies have concluded about its impact on the occurrence of the disease, although no association with PHD was found. No proof on the impact of MTHFR gene regulation on either TMD or PHD was found. The most robust results are concerning the ESR1 gene, which is present in the genetic profile of both clinical conditions. This novel systematic review highlights not only the need for a clear understanding of the role of ESR1 and COMT genes in pain pathogenesis, but it also evaluates their potential as a promising therapeutic target to treat both pathologies.
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31
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Ferrillo M, Gallo V, Lippi L, Bruni A, Montrella R, Curci C, Calafiore D, Invernizzi M, Migliario M, de Sire A. The 50 most-cited articles on temporomandibular disorders: A bibliometric analysis. J Back Musculoskelet Rehabil 2022; 36:279-297. [PMID: 36189581 DOI: 10.3233/bmr-220152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are musculoskeletal conditions involving masticatory muscles and temporomandibular joints. Bibliometric analysis has been introduced as a new method for collecting and analyzing information on scientific articles. OBJECTIVE The aim of this study was to identify the 50 most cited articles on TMD, performing a bibliometric analysis of the identified papers to favor research and clinical practice. METHODS On December 17, 2021 a systematic research was performed to find all papers on TMD published in the literature. The Incites Journal Citation Reports dataset and Scopus database was used to obtain bibliometric indexes of the authors and metrics data of the journals, including Impact Factor, Eigenfactor Score, and Normalized Eigenfactor. VOSviewer was used to visualize the keyword mapping networking, with the nodes standing for keywords and the edges for keyword relationships. RESULTS Out of 24372 papers obtained by the search strategy, the 50 most cited articles on TMD were analyzed. The paper with the highest number of citations (n= 3020) was on TMD research diagnostic criteria. Rate of citations per year collected by the 50 most cited articles on TMD has been increasing over time (from 627 in 2006 to 1483 in 2021). Most of them were cross-sectional studies (n= 20; 40.0%) and narrative reviews (n= 14; 28.0%). CONCLUSION This bibliometric study showed an increasing number of citations for articles on TMD, testifying a high interest in the last years. Starting from this analysis, future studies might provide high-quality evidence on TMD management.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.,Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Vittorio Gallo
- CIR Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy.,Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.,Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandro Bruni
- CIR Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Roberta Montrella
- CIR Dental School, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Claudio Curci
- Physical and Rehabilitative Medicine Unit, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Dario Calafiore
- Physical and Rehabilitative Medicine Unit, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy.,Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Mario Migliario
- Dental Clinic, Department of Translational Medicine, University of Eastern Piedmont "A. Avogadro", Novara, Italy
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Lee YH, Tsai CY, Wang LC, Lai UK, Lai JP, Lin SS, Chang YJ. Comparison of the Post-Surgical Position of the Temporomandibular Joint after Orthognathic Surgery in Skeletal Class III Patients and Patients with Cleft Lip and Palate. J Pers Med 2022; 12:jpm12091437. [PMID: 36143222 PMCID: PMC9506436 DOI: 10.3390/jpm12091437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Objective: The purpose of our research is to compare the post-surgical position of the temporomandibular joint in skeletal Class III patients and patients with cleft lip and palate treated with two-jaw orthognathic surgery using a three-dimensional computer tomography image. Materials and Methods: Twenty-three skeletal Class III patients with mandibular prognathism associated with maxillary retrognathism in group 1 and twenty cleft mid-face retrusion skeletal Class III patients in group 2 were enrolled in this study. All subjects were treated with two-jaw orthognathic surgery. Computed tomography scans were taken in all subjects at 3 weeks preoperatively and 6 months postoperatively. Three-dimensional craniofacial skeletal structures were build-up, and assessed the temporomandibular joint position changes before and after surgery. Results: Forty-three selected patients were separated into two groups. The mean age of patients was 22.39 ± 4.8 years in group 1 and 20.25 ± 3.8 years in group 2. The range of mean three-dimensional discrepancy of the selected condylar points was 0.95–1.23 mm in group 1 and 2.37–2.86 mm in group 2. The mean alteration of intercondylar angle was 2.33 ± 1.34° in group 1 and 6.30 ± 2.22° in group 2. The significant differences in the discrepancy of TMJ and changes in intercondylar angle were confirmed within the intra-group and between the two groups. Conclusions: Significant changes in postoperative TMJ position were present in both groups. Furthermore, the cleft group presented significantly more postoperative discrepancy of TMJ and more changes in intercondylar angle after surgery. This finding may be a reason leading to greater postoperative instability in cleft patients compared with skeletal Class III non-cleft patients. Clinical Trial Registration Number: IRB No: 202201108B0.
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Affiliation(s)
- Yi-Hao Lee
- Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Chi-Yu Tsai
- Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Ling-Chun Wang
- Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - U-Kei Lai
- Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Jui-Pin Lai
- Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Shiu-Shiung Lin
- Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Yu-Jen Chang
- Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
- Correspondence: ; Tel.: +886-7-7317123 (ext. 8291)
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Signs and Symptoms of Temporomandibular Dysfunction and Radiographic Condylar Morphology in Patients with Idiopathic Condylar Resorption. J Clin Med 2022; 11:jcm11154289. [PMID: 35893380 PMCID: PMC9331313 DOI: 10.3390/jcm11154289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Little is known about the clinical characteristics of idiopathic condylar resorption (ICR). The aim of this study was to examine the signs and symptoms of temporomandibular dysfunction (TMD) and evaluate the morphological characteristics of the condyles in patients with ICR. Methods: Sixty patients with ICR (41 in the bilateral ICR group and 19 in the unilateral ICR group) and forty-one healthy controls were examined. Signs and symptoms of TMD were described, and three-dimensional models of the condyles were measured and analyzed. Results: In total, 81.7% of ICR patients had self-reported symptoms and 78.3% of ICR patients had objective-found signs. The anteroposterior diameter, transverse diameter, height, maximal sectional area, volume of the condyles, axial angle, and the distance from the posterior point of the condyle to the Saggittal standard line were significantly smaller in the ICR condyles compared with the controls (p < 0.05). The condylar neck angle was significantly larger in the ICR condyles compared with the controls (p < 0.05). Conclusions: Most patients with ICR had signs and symptoms of TMD. The prevalence of clicking and opening−closing deviation was significantly different between the bilateral and the unilateral ICR groups. In patients with ICR, the size of the condyles decreased significantly; the condyles also rotated inward, moved forward, and inclined posteriorly.
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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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Signs, Symptoms, and Morphological Features of Idiopathic Condylar Resorption in Orthodontic Patients: A Survey-Based Study. J Clin Med 2022; 11:jcm11061552. [PMID: 35329876 PMCID: PMC8952278 DOI: 10.3390/jcm11061552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Idiopathic condylar resorption (ICR) is an aggressive degenerative disease of the temporomandibular joint that is most frequently observed in teenage girls. However, no specific cause of ICR has been identified. To explore the specific causes of the onset and progression of ICR, we performed a survey-based study on ICR in orthodontic patients and described its subjective symptoms, clinical signs, and condylar morphological features. Methods: A total of 1735 participants were recruited from 2193 orthodontic patients. For each participant, subjective symptoms and clinical signs of temporomandibular disorders (TMDs) were evaluated through clinical examination and a questionnaire. Furthermore, three-dimensional computed tomography (CT) was performed to diagnose ICR. Results: Among the 1735 patients evaluated, ICR was present in two male and ten female patients. All 12 patients had maxillary protrusion and an anterior open bite. Four patients with ICR underwent orthodontic treatment. Based on CT findings, patients with ICR had significantly different condylar sizes and shapes from patients with TMDs alone. Conclusions: The coexistence of intrinsic and extrinsic factors, such as sex-hormone imbalance and a history of orthodontic treatment, might lead to the onset of ICR. We suggest that growing patients suspected of having ICR should undergo CT evaluation because CT findings may precede clinical symptoms and signs.
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Arnett GW, Trevisiol L, Grendene E, McLaughlin RP, D'Agostino A. Combined orthodontic and surgical open bite correction. Angle Orthod 2022; 92:161-172. [PMID: 34986216 PMCID: PMC8887413 DOI: 10.2319/101921-779.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVES To examine the stability of combined surgical and orthodontic bite correction with emphasis on open-bite closure. All study patients were treated with strict and consistent orthodontic and surgical protocols. MATERIALS AND METHODS Study inclusion required all patients to have anterior open bites, maxillary accentuated curve of Spee, 36-month minimum follow-up, and no temporomandibular joint pathology. Thirty patients met the inclusion/exclusion criteria. Importantly, segmental upper arch orthodontic preparation (performed by EG) was used. Surgery consisted of a multisegment Le Fort I (MSLFI) combined with a bilateral sagittal osteotomies (BSSO). Surgery was performed (by ADA and LT) at the Department of Dentistry and Maxillofacial Surgery of the University of Verona, Italy. RESULTS The long-term open bite and overjet relapse were not statistically significant. The mean transverse relapse of the upper and lower molars was statistically significant. Of great importance, the upper and lower arch widths narrowed together, maintaining intercuspation of the posterior dentition which prevented anterior open bites from developing. CONCLUSIONS This study revealed stability of three-dimensional occlusal correction including anterior open bite. Stable open bite closure was achieved by using rigid protocols for orthodontic preparation, surgical techniques, surgical follow-up, and orthodontic finishing.
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Holte M, Diaconu A, Ingerslev J, Thorn J, Pinholt E. Virtual surgical analysis: long-term cone beam computed tomography stability assessment of segmental bimaxillary surgery. Int J Oral Maxillofac Surg 2022; 51:1188-1196. [DOI: 10.1016/j.ijom.2022.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/21/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
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Skeletal and Dental Outcomes after Facial Allotransplantation: The Cleveland Clinic Experience and Systematic Review of the Literature. Plast Reconstr Surg 2022; 149:945-962. [DOI: 10.1097/prs.0000000000008949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Characteristics of the Maxillofacial Morphology in Patients with Idiopathic Mandibular Condylar Resorption. J Clin Med 2022; 11:jcm11040952. [PMID: 35207225 PMCID: PMC8878818 DOI: 10.3390/jcm11040952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 11/17/2022] Open
Abstract
Idiopathic mandibular condylar resorption (ICR) is a pathological condition characterized by idiopathic resorption of the mandibular condyle, resulting in a decrease in the size and height of the mandibular condyle. The purpose of this study was to characterize the maxillofacial morphology of ICR patients. Subjects were selected from patients that attended our orthodontic clinic between 1991 and 2019. Twenty-five patients were diagnosed with ICR by magnetic resonance imaging; however, growing patients were excluded. In total, 18 patients were finally selected. The control group comprised 18 healthy volunteers. Lateral and frontal cephalograms were also used. The ICR group had significantly more severe skeletal class II malocclusions than the control group, mainly due to retrusion of the mandible. In the ICR group, there was a tendency for a skeletal open bite due to a significantly larger clockwise rotation of the mandible than in the control group. There was no significant difference between the two groups in the inclination of the upper and lower central incisors or protrusion of the upper and lower central incisors and first molars. ICR patients have been suggested to exhibit skeletal open bite and maxillary protrusion with changes in maxillofacial morphology due to abnormal resorption of the mandibular condyle.
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GÖRÜRGÖZ C, KURT H, ŞEKER Ç, İÇEN M, AKSOY S, ORHAN K. RELATIONSHIP BETWEEN THE DEGENERATIVE CHANGES IN THE MANDIBULAR CONDYLE AND ARTICULAR EMINENCE INCLINATION, HEIGHT, AND SHAPE: A CBCT STUDY. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.949926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Mashkina AA, Chkadua TZ, Ermolin VI, Isaichikova OV, Romanovsky MA. [Condylar displacement following orthognathic surgery]. STOMATOLOGIIA 2022; 101:77-84. [PMID: 36268926 DOI: 10.17116/stomat202210105177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The overview of the current literature in the research of mandibular condyle displacement after orthognathic surgeries was done. The correct postoperative mandibular condyle position is considered as one of the determinants of the stability of treatment results.
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Affiliation(s)
- A A Mashkina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - T Z Chkadua
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - V I Ermolin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | | | - M A Romanovsky
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Yuan W, Wu Y, Zhou X, Zheng Y, Wang J, Liu J. Comparison and applicability of three induction methods of temporomandibular joint osteoarthritis in murine models. J Oral Rehabil 2021; 49:430-441. [PMID: 34936115 DOI: 10.1111/joor.13300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/07/2021] [Accepted: 12/16/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Temporomandibular joint osteoarthritis (TMJ-OA) causes severe symptoms such as chewing difficulties, acute pain and even maxillofacial deformity. However, there is hardly any effective disease-curing strategy because of uncertainty in aetiology. Animal model is an excellent tool to investigate the mechanism, prevention and treatment on diseases. Currently, although several TMJ-OA animal models have been established, there are almost no comparative studies on different models, which poses a great challenge for selecting suitable models. OBJECTIVE To compare three TMJ-OA induction methods and assess their applicability considering pathological changes in the cartilage, subchondral bone, osteoclasts, and synovium. METHODS Murine models were employed and followed for 3 and 6 weeks after experimental procedures (surgery, injection, crossbite). The TMJ changes were evaluated by Safranin-O/Fast green staining, immunofluorescence staining, micro-CT, TRAP staining, and HE staining. RESULTS In the Surgery group, a pronounced drop in bone volume fraction was observed. In the Injection group, chondrocytes were mostly disordered or arranged in clusters and a substantial increase in the OARSI score and osteoclasts was found. The OARSI score and osteoclasts also increased significantly in the Crossbite group, although to a lower extent compared with injection. CONCLUSION Osteoarthritis-like changes were observed in all models. Concerning the applicability of the different induction methods, surgery might be an important resource for the assessment of post-traumatic TMJ-OA and subchondral bone changes in early stages. Injection induces a severe end-stage osteoarthritis in a short time and provides model basis for advanced TMJ-OA. Crossbite might be more reasonable model to explore the pathogenesis mechanism of temporomandibular arthritis due to occlusal disorders.
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Affiliation(s)
- Wenxiu Yuan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Lab for Aging Research, State Key Laboratory of Biotherapy and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yange Wu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Lab for Aging Research, State Key Laboratory of Biotherapy and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xueman Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Lab for Aging Research, State Key Laboratory of Biotherapy and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yingcheng Zheng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Lab for Aging Research, State Key Laboratory of Biotherapy and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jin Liu
- Lab for Aging Research, State Key Laboratory of Biotherapy and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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van Luijn R, Baan F, Shaheen E, Bergé S, Politis C, Maal T, Xi T. Three-dimensional analysis of condylar remodeling and skeletal relapse following LeFort-I osteotomy: A one-year follow-up bicenter study. J Craniomaxillofac Surg 2021; 50:40-45. [PMID: 34654618 DOI: 10.1016/j.jcms.2021.09.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 07/28/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022] Open
Abstract
The aim of the study was to quantify the postoperative condylar remodeling after Le Fort I surgery. Patients treated with a Le Fort I osteotomy were investigated. CBCT scans were acquired preoperatively, one week and one year postoperatively. A preoperative 3D cephalometric analysis was performed on the preoperative CBCT. Surgical movements were quantified using a voxel-registration based method (OrthoGnaticAnalyser). After rendering of the condyles from the CBCT, a volumetric analysis was performed. The correlation between the surgical movement of the maxilla and the postoperative condylar volume changes was determined with analysis of variance. RESULTS: A total of 45 subjects were included in this study. 47 of 90 condyles (52%) showed a mean volume reduction of 93 mm3 (4.9 volume-%) postoperatively. The maxilla was impacted in 12 patients (2.44 ± 2.49 mm) and extruded in 33 patients (1.78 ± 1.29 mm). The maxillary impaction group showed a volume reduction of 50 ± 122 mm3 and the extrusion group showed a mean volume gain of 21 ± 139 mm3 (p = 0.028). CONCLUSION: Clinicians should be aware of potential condylar remodeling following solitary Le Fort I osteotomies, particularly in female patients with maxillary impaction.
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Affiliation(s)
- Rik van Luijn
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525, GA, Nijmegen, the Netherlands; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Frank Baan
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525, GA, Nijmegen, the Netherlands.
| | - Eman Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525, GA, Nijmegen, the Netherlands.
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Thomas Maal
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525, GA, Nijmegen, the Netherlands.
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525, GA, Nijmegen, the Netherlands.
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Reed DA, Zhao Y, Han M, Mercuri LG, Miloro M. Mechanical Loading Disrupts Focal Adhesion Kinase Activation in Mandibular Fibrochondrocytes During Murine Temporomandibular Joint Osteoarthritis. J Oral Maxillofac Surg 2021; 79:2058.e1-2058.e15. [PMID: 34153254 PMCID: PMC8500914 DOI: 10.1016/j.joms.2021.05.001] [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: 03/16/2021] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Mechanical overloading is a key initiating condition for temporomandibular joint (TMJ) osteoarthritis (OA). The integrin-focal adhesion kinase (FAK) signaling axis is implicated in the mechanobiological response of cells through phosphorylation at Tyr397 (pFAK) but poorly defined in TMJ health and disease. We hypothesize that mechanical overloading disrupts TMJ homeostasis through dysregulation of FAK signaling. MATERIALS AND METHODS To assess if FAK and pFAK are viable clinical targets for TMJ OA, peri-articular tissues were collected from patients with TMJ OA receiving a total TMJ replacement. To compare clinical samples with preclinical in vivo studies of TMJ OA, the joints of c57/bl6 mice were surgically destabilized and treated with and without inhibitor of pFAK (iFAK). FAK signaling and TMJ OA progression was evaluated and compared using RT-PCR, western blot, immunohistochemistry, and histomorphometry. To evaluate mechanical overloading in vitro, primary murine mandibular fibrochondrocytes were seeded in a 4% agarose-collagen scaffold and loaded in a compression bioreactor with and without iFAK. RESULTS FAK/pFAK was mostly absent from the articular cartilage layer in the clinical sample and suppressed on the central condyle and elevated on the lateral and medial condyle in murine TMJ OA. In vitro, compressive loading lowered FAK/pFAK levels and elevated the expression of TGFβ, NG2, and MMP-13. iFAK treatment suppressed MMP13 and Col6 and elevated TGFβ, NG2, and ACAN in a load independent manner. In vivo, iFAK treatment moderately attenuated OA progression and increased collagen maturation. CONCLUSION These data illustrate that FAK/pFAK is implicated in the signaled dysfunction of excessive mechanical loading during TMJ OA and that iFAK treatment can moderately attenuate the progression of cartilage degeneration in the mandibular condyle.
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Affiliation(s)
- David A. Reed
- Department of Oral Biology, University of Illinois at Chicago, Chicago IL,Corresponding author: David A. Reed,
| | - Yan Zhao
- Department of Oral Biology, University of Illinois at Chicago, Chicago IL
| | - Michael Han
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago IL
| | - Louis G. Mercuri
- Department of Orthopaedic Surgery, Rush University, Chicago IL, Adjunct Professor, Department of Bioengineering, University of Illinois at Chicago, Chicago, IL
| | - Michael Miloro
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago IL
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Liu SS, Xu LL, Fan S, Lu SJ, Jin L, Liu LK, Yao Y, Cai B. Effect of platelet-rich plasma injection combined with individualised comprehensive physical therapy on temporomandibular joint osteoarthritis: A prospective cohort study. J Oral Rehabil 2021; 49:150-159. [PMID: 34562321 DOI: 10.1111/joor.13261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/03/2021] [Accepted: 09/21/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND The effectiveness of platelet-rich plasma (PRP) injection combined with physical therapy for the treatment of temporomandibular joint osteoarthritis (TMJ-OA) has not been studied. OBJECTIVES To assess the effectiveness of PRP injection combined with individualised comprehensive physical therapy for the treatment of TMJ-OA. METHODS This prospective cohort study included 40 patients with TMJ-OA who received PRP injection or PRP injection combined with individualised comprehensive physical therapy. Pain intensity, maximum mouth opening, temporomandibular joint sounds, and the Jaw Functional Limitation Scale (JFLS) scores and imaging findings were compared before treatment and during follow-up. RESULTS The pain intensity, maximum mouth opening, and temporomandibular joint sounds of the two groups significantly improved with an increase in treatment time (p < .05). The pain improvement in the combined treatment group was greater than that in the PRP injection group at 3 and 6 months (p < .05). The improvement of mouth opening was better in the combined treatment group, whereas the improvement of joint sounds was better in the PRP injection group. The improvement in JFLS scores in the combined treatment group was greater than that in the PRP injection group at 6 months (p < .05). The imaging improvement rates of the two groups were similar. CONCLUSIONS Platelet-rich plasma injection can significantly improve pain, mouth opening, abnormal joint sound, and mandibular function in patients with TMJ-OA and has good repair effect on condylar bone defects. PRP injection combined with individualised comprehensive physical therapy can effectively control the medium- and long-term pain of patients.
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Affiliation(s)
- Sha-Sha Liu
- Department of Rehabilitation Medicine, The Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Li-Li Xu
- Department of Rehabilitation Medicine, The Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Shuai Fan
- Department of Rehabilitation Medicine, The Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Shen-Ji Lu
- Department of Rehabilitation Medicine, The Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Lei Jin
- Department of Rehabilitation Medicine, The Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Li-Kun Liu
- Department of Rehabilitation Medicine, The Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Yuan Yao
- Department of Rehabilitation Medicine, The Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Bin Cai
- Department of Rehabilitation Medicine, The Ninth People's Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
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Short-Term Stability After Segmental Le Fort I Maxillary Impaction Surgery With Mandibular Autorotation in Seven High-Angle Class II Patients: A Case Series. J Craniofac Surg 2021; 33:e135-e138. [PMID: 34456281 DOI: 10.1097/scs.0000000000008112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To retrospectively evaluate skeletal stability after Le Fort I maxillary impaction surgery and mandibular autorotation without bilateral sagittal split osteotomy (BSSO) in high-angle class II patients. MATERIALS AND METHODS Seven female high-angle class II patients who underwent maxillary impaction surgery and mandibular autorotation without bilateral sagittal split osteotomy were included in this study. Surgical changes and relapse were measured on lateral cephalograms taken preoperatively and at 1 month, 6 months and 1 year postoperatively. RESULTS The horizontal movement of the maxilla at point A was 5.8 ± 3.3 mm backward, and the upward movement at the posterior nasal spine was 3.3 ± 1.4 mm. The mean horizontal change at point A during the 1-year follow-up period was 0.1 ± 0.2 mm, and the vertical change at posterior nasal spine was 0.2 ± 1.3 mm, which were not statistically significant. The horizontal surgical change at point B was 4.0 ± 1.8 mm forward and the vertical surgical change at point B was 4.7 ± 1.8 mm upward. Postoperative relapse was 10.9% and 13.7% in the horizontal and vertical directions, respectively. CONCLUSIONS Le Fort I maxillary impaction surgery with mandibular autorotation may be 1 of the suitable procedures for high-angle class II patients.
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Postsurgical Stability of Temporomandibular Joint of Skeletal Class III Patients Treated with 2-Jaw Orthognathic Surgery via Computer-Aided Three-Dimensional Simulation and Navigation in Orthognathic Surgery (CASNOS). BIOMED RESEARCH INTERNATIONAL 2021; 2021:1563551. [PMID: 34409098 PMCID: PMC8367535 DOI: 10.1155/2021/1563551] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/30/2021] [Accepted: 07/20/2021] [Indexed: 11/23/2022]
Abstract
Objective The aim of this study is to clarify the postsurgical stability of temporomandibular joints in skeletal class III patients treated with 2-jaw orthognathic surgery which was performed utilizing computer-aided three-dimensional simulation and navigation in orthognathic surgery (CASNOS) protocol. Materials and Methods 23 consecutive nongrowing skeletal class III patients with mandibular prognathism associated with maxillary retrognathism treated with 2-jaw orthognathic surgery between 2018 and 2019 were enrolled in this study. The surgery was planned according to the standardized protocol of CASNOS (computer-aided three-dimensional simulation and navigation in orthognathic surgery). Computed tomography (CT) scans were performed in all patients 3 weeks presurgically and 6 months postsurgically. ITKSNAP and 3D Slicer software were used to reconstruct three-dimensional facial skeletal images, to carry out image segmentation, and to superimpose and quantify the TMJ position changes before and after surgery. Amount of displacement of the most medial and lateral points of the condyles and the change of intercondylar angles were measured to evaluate the postsurgical stability of TMJ. Results A total amount of 23 skeletal class III patients (female : male = 12 : 11) with age ranged from 20.3 to 33.5 years (mean: 24.39 ± 4.8 years old) underwent Le Fort I maxillary advancement and BSSO setback of the mandible. The surgical outcome revealed the satisfactory correction of their skeletal deformities. The mean displacement of the right most lateral condylar point (RL-RL′) was 1.04 ± 0.42 mm and the mean displacement of the left most lateral condylar point (LL-LL′) was 1.19 ± 0.41 mm. The mean displacement of the right most medial condylar point (RM-RM′) was 1.03 ± 0.39 mm and the left most medial condylar point (LM-LM′) was 0.96 ± 0.39 mm. The mean intercondylar angle was 161.61 ± 5.08° presurgically and 159.28 ± 4.92° postsurgically. Conclusion The postsurgical position of TM joint condyles in our study only presented a mild change with all the landmark displacement within a range of 1.2 mm. This indicates the bimaxillary orthognathic surgery via 3D CASNOS protocol can achieve a desired and stable result of TMJ position in treating skeletal class III adult patients with retrognathic maxilla and prognathic mandible.
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Phi L, Albertson B, Hatcher D, Rathi S, Park J, Oh H. Condylar degeneration in anterior open bite patients: A cone beam computed tomography study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:221-228. [PMID: 34503937 DOI: 10.1016/j.oooo.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/16/2021] [Accepted: 07/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the prevalence of condylar degeneration in patients with anterior open bites (AOB). STUDY DESIGN Cone beam computed tomography (CBCT) scans of 194 patients with AOB (108 with skeletal open bites and 86 with dental open bites) and 100 patients serving as controls were included in this retrospective study. Two oral and maxillofacial radiologists categorized each of the 588 condyles as normal, degenerative-active, or degenerative-repair. The χ2 analysis with Bonferroni adjustment was used to evaluate the relationship of condylar status (normal vs degenerative) to anterior open bites. RESULTS Of the 103 degenerative condyles, there were 59 in the group with skeletal open bites, 14 in the group with dental open bites, and 30 in the control group. Condylar degeneration occurred twice as frequently in patients with skeletal open bites as it did in the control group (P < .0001). Conversely, a greater frequency of normal condyles was found in the group of patients with dental open bites (P = .0002). The group with skeletal open bites also showed a significantly higher frequency of bilateral degenerative condyles (P = .0001). The frequency of condylar degeneration did not differ significantly between female and male individuals. CONCLUSIONS Degenerative condylar change was significantly more likely in patients with skeletal open bites and less likely in patients with dental open bites.
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Affiliation(s)
- Linda Phi
- Adjunct Assistant Professor, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Brad Albertson
- Private practice, Austin, Texas, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - David Hatcher
- Adjunct Associate Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Shikha Rathi
- Adjunct Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Joorok Park
- Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Heesoo Oh
- Professor and Chair, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
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Yun JM, Choi YJ, Woo SH, Lee UL. Temporomandibular joint morphology in Korean using cone-beam computed tomography: influence of age and gender. Maxillofac Plast Reconstr Surg 2021; 43:21. [PMID: 34224004 PMCID: PMC8257806 DOI: 10.1186/s40902-021-00307-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/19/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The purpose of this study was to investigate the condylar morphology and position of Koreans using cone-beam computed tomography (CBCT) images. Analyzing the mean values of this study with reference to left and right sides, gender, and age will help to understand the size of the condyle and glenoid fossa, condylar morphology, and temporomandibular joint (TMJ) symmetry for establishing the standard temporomandibular joint structures of Koreans and then design the standard temporomandibular joint prosthesis for Koreans. RESULTS There was no significant result in the condyle size, condyle axis angle, joint space, fossa depth, and mandibular body size between the left and right sides (p > 0.05). On the other hand, the mediolateral width of the condyle and mandibular body size show significantly different with the gender (P < 0.05). Also, significant differences were found in condyle size, joint space, fossa depth, and mandibular body size according to age groups (p < 0.05). CONCLUSIONS Condylar position and morphology vary according to side, age, and gender. The results of this study are expected to help in customizing a treatment for the patients who need TMJ reconstruction by predicting the TMJ morphology according to age and gender and design the standard temporomandibular joint prosthesis for the Koreans.
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Affiliation(s)
- Ji-Min Yun
- Department of Orthodontics, Dental Center, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Young-Jun Choi
- Department of Oral & Maxillofacial Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Su-Heon Woo
- R&D Center, Medyssey Co, Ltd., Jecheon, Republic of Korea
| | - Ui-Lyong Lee
- Department of Oral & Maxillofacial Surgery, Dental Center, Chung-Ang University Hospital, 224-1 Heukseok-dong, Dongjak-gu, Seoul, Republic of Korea.
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Initial radiological signs of dentofacial deformity in juvenile idiopathic arthritis. Sci Rep 2021; 11:13142. [PMID: 34162967 PMCID: PMC8222246 DOI: 10.1038/s41598-021-92575-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 06/08/2021] [Indexed: 01/12/2023] Open
Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood and the temporomandibular joint (TMJ) is often involved. TMJ arthritis in growing individuals can cause deformation of facial skeleton (dentofacial deformity) and TMJ components (TMJ deformity). Treatment outcome hinges on early initiation of anti-inflammatory treatment and orthopaedic treatment with dental splints. The aim of the present study was to characterize the radiological signs of dentofacial deformity in patients with a JIA-induced need for orthopaedic treatment. We retrospectively studied 96 patients with JIA and 20 non-JIA controls to identify the initial radiological signs of JIA-induced dentofacial deformity leading to initiation of orthopaedic treatment. We found that initial radiological signs of dentofacial deformities were subtle and characterized by minor mandibular asymmetry and occlusal plane steepening. Radiological findings of TMJ deformity associated with initial dentofacial deformity were frequent and characterized by condylar articular surface flattening (OR 8.42), condylar subcortical cyst (OR 5.94), condylar surface erosion (OR 5.38) and condylar deviation in form (OR 25.39). Radiological signs of TMJ deformity were also documented in TMJs considered “healthy” during initial clinical and radiological examination. This study presents new knowledge of importance for early diagnosis of dentofacial deformity in JIA. Early diagnosis of dentofacial deformity is important as treatment outcome is greatly influenced by timely initiation.
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