Replacement of temporomandibular condylar head in a patient suffering from ankylosing spondylitis with severe ankylosis of the temporomandibular joints and whole spine

2019 ◽  
Vol 31 (1) ◽  
pp. 31-37
Author(s):  
Kazumichi Yonenaga ◽  
Kazuto Hoshi ◽  
Takao Uchiyama ◽  
Asako Taniguchi ◽  
Hideyuki Suenaga ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Temporomandibular Joints ◽  
Condylar Head ◽  
Whole Spine

scholarly journals Development of the CT Syndesmophyte Score (CTSS) in patients with ankylosing spondylitis: data from the SIAS cohort

2017 ◽  
Vol 77 (3) ◽  
pp. 371-377 ◽  
Author(s):  
Freek de Bruin ◽  
Anoek de Koning ◽  
Rosaline van den Berg ◽  
Xenofon Baraliakos ◽  
Juergen Braun ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Structural Damage ◽  
Change Score ◽  
Spinal Segment ◽  
Change Scores ◽  
Status Score ◽  
Smallest Detectable Change ◽  
Baseline Status ◽  
Spinal Segments ◽  
Whole Spine

ObjectivesTo develop the CT Syndesmophyte Score (CTSS) for low-dose CT (ldCT) to assess structural damage in the spine of patients with ankylosing spondylitis (AS) and test its reliability.MethodsPatientswith AS in the SIAS cohort had whole spine ldCT at baseline and 2 years. Syndesmophytes were scored in coronal and sagittal planes in eight quadrants per vertebral unit (VU) as absent=0, <50% of the intervertebral disc space (IDS)=1, ≥50%=2 or bridging the IDS=3 (range 0–552). Images were scored by two readers, paired by patient, blinded to time order. Whole spine and spinal segment status and change scores were calculated. Inter-reader reliability was assessed by intraclass correlation coefficient (ICC), smallest detectable change (SDC) and frequency of scores per VU.Results49 patients (mean age 50 years (SD 9.8), 84% men, 88% human leucocyte antigen B27 positive) were included. Mean (SD) scores of reader 1 were: whole spine baseline status score 163 (126) and change score 16 (21), spinal segment baseline status scores 30 (41), 97 (77) and 36 (36) and change scores 2 (7), 12 (18) and 3 (4) for the cervical, thoracic and lumbar spine, respectively. Scores of reader 2 were similar. Whole spine status score ICC was 0.99 and 0.97–0.98 for spinal segments. Whole spine change score ICC was 0.77 and 0.32–0.75 for spinal segments. Whole-spine SDC was 14.4. Score distribution pattern per VU was similar between readers.ConclusionsUsing the CTSS, new bone formation in the spine of patients with AS can be assessed reliably. Most progression was seen in the thoracic spine.

scholarly journals Dautrey's Procedure Revisited in Management of Recurrent Mandibular Dislocation

2017 ◽  
Vol 18 (1) ◽  
pp. 78-79
Author(s):  
Joanna Baptist ◽  
Mohan Baliga
Keyword(s):  
Articular Eminence ◽  
Surgical Experience ◽  
Intermaxillary Fixation ◽  
Traumatic Injuries ◽  
Psychiatric Disturbances ◽  
Dental Procedures ◽  
Temporomandibular Joints ◽  
Condylar Head ◽  
Articulating Surface ◽  
Manual Manipulation

ABSTRACT Introduction Mandibular dislocation occurs when the condylar head glides out of the glenoid fossa with the condyle positioned in such a way that its posterior articulating surface lying ahead of the articular eminence. Recurrent mandibular dislocation is relatively uncommon. Patient is extremely distressed and goes through a lot of discomfort. Varied etiologies have been cited in the literature, such as keeping the mouth wide open for long periods of time during dental procedures, yawning, laughing, traumatic injuries to the mandible, psychiatric disturbances, and certain drugs. Acute dislocations are best managed immediately by reduction and intermaxillary fixation. However, dislocations that have remained over a period of a month are considered to be chronic and these cannot be reduced successfully by manual manipulation of the mandible. Such chronic recurrent dislocations are surgically managed with eminectomy, meniscectomy, and condylotomies. A downward and forward osteotomy of the zygomatic arch in front of the articular eminence so as to produce a mechanical obstruction was recommended by Dautrey and Gosserez. This article will highlight the surgical experience of managing six patients with chronic recurrent dislocations of the temporomandibular joints (TMJs) bilaterally employing Dautrey's procedure. How to cite this article Baptist J, Baliga M. Dautrey's Procedure Revisited in Management of Recurrent Mandibular Dislocation. J Contemp Dent Pract 2017;18(1):78-79.

Ankylosing spondylitis and spinal trauma – with an emphasis on the role of radiology

Trauma ◽  
2017 ◽  
Vol 19 (1_suppl) ◽  
pp. 33-45
Author(s):  
Prudencia Tyrrell ◽  
J Roy Chowdhury
Keyword(s):  
Ankylosing Spondylitis ◽  
Spinal Injury ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Neck Extension ◽  
Limited Mobility ◽  
Spine Imaging ◽  
High Index Of Suspicion ◽  
Whole Spine

Diagnosis of spinal injury in a patient with chronic ankylosing spondylitis can be challenging. Minor insult can result in an unstable three-column injury which may be subtle. Spinal deformity, osteoporosis and limited mobility are associated with difficulty in positioning patients for imaging studies, including radiography and both computed tomography and magnetic resonance imaging. It is important to maintain a high index of suspicion of fracture, avoid forced neck extension during radiological imaging, and to consider whole spine imaging in these patients. Other causes of neurological symptoms simulating potential spinal injury are also briefly addressed.

scholarly journals Temporomandibular Joints’ Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking—A Case Control Study

2020 ◽  
Vol 17 (10) ◽  
pp. 3428
Author(s):  
Marcin Derwich ◽  
Maria Mitus-Kenig ◽  
Elzbieta Pawlowska
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Orthodontic Treatment ◽  
Statistical Significance ◽  
Cone Beam ◽  
Glenoid Fossa ◽  
Computed Tomography Images ◽  
Temporomandibular Joints ◽  
Condylar Head ◽  
Reciprocal Clicking

Background: Patients referred for orthodontic treatment often present symptoms of temporomandibular joints’ disorders (TMD), predominantly clicking. The objective was to analyze the morphology of the temporomandibular joints in cone-beam computed tomography (CBCT) images based on the presence of reciprocal clicking before orthodontic treatment. Methods: 105 participants took part in the study. 210 temporomandibular joints (TMJs) were allocated into one of two groups regarding the presence of reciprocal clicking. Morphology of condyle’s head, glenoid fossa, and articular eminence as well as condylar head position in the glenoid fossa and osteoarthritic changes in the area of the condylar head were examined for each TMJ in the CBCT images. Statistical analysis was performed with STATISTICA version 12.0. The following tests were performed: U-Mann Whitney, Kruskal-Wallis, t-Student, and chi-square. The statistical significance level was p = 0.05 for all the measurements included. Results: Significantly smaller condylar A-P dimension (p = 0.040) characterized temporomandibular joints with reciprocal clicking. Condyles were substantially more often positioned posteriorly (p = 0.043) and were significantly more often accompanied by subcortical cysts and pathologic osteoarthritic bone changes (p < 0.001). Conclusions: The early stages of internal derangements stay with alterations in morphology and position of TMJs as well as with the presence of osteoarthritic changes.

Flexible Fiberoptic Endoscopy in Difficult Intubations

1981 ◽  
Vol 90 (4) ◽  
pp. 307-309 ◽  
Author(s):  
Enje Th. Edens ◽  
Roberto L. Sia
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Anatomical Landmarks ◽  
Short Neck ◽  
Fiberoptic Endoscopy ◽  
Temporomandibular Joints ◽  
Laryngeal Tumors ◽  
History Of ◽  
Conscious Patient

Intubation problems sometimes occur very suddenly and can be divided into two groups. The expected ones include the patients with a short neck and long teeth, cellulitis of the tongue, large oropharyngeal tumors, obstructing laryngeal tumors, congenital and acquired maxillofacial deformities, ankylosis of the temporomandibular joints, fractures or ankylosing spondylitis of the cervical spine, and all patients with a history of previous intubation problems. Unexpected problems can arise in patients who combine large incisors and canines with an inability to open the mouth wide, or when the glottis is invisible because the epiglottis is immobile. The first concern in these cases is to restore consciousness, for the conscious patient shows tonus and this facilitates identification of anatomical landmarks. A 60 cm bronchofiberscope provided with a tube and a freely movable end of 30 cm is suitable. Shorter flexible scopes are not adequate.

scholarly journals Computed Tomography-based Assessment of Radiographic Progression in Spine and Sacroiliac Joints After Pregnancy in Women With Ankylosing Spondylitis

2021 ◽  
Author(s):  
Kyung-Ann Lee ◽  
So Yun Lee ◽  
Se Hee Kim ◽  
Hyun-Sook Kim ◽  
Hae-Rim Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ankylosing Spondylitis ◽  
Radiographic Progression ◽  
Joint Space ◽  
Gravid Uterus ◽  
Control Group ◽  
Sacroiliac Joints ◽  
Pregnancy And Delivery ◽  
Whole Spine

Abstract Background: Mechanical stress are one of the pathogenesis of ankylosing spondylitis (AS). During pregnancy, the mechanical overload on the spine and pelvis increases due to gravid uterus. We aimed to investigate whether pregnancy affects radiographic progression in patients with ankylosing spondylitis (AS) based on computed tomography (CT) evaluations.Methods: This retrospective study included women with AS aged 19-49 years who underwent at least two CT evaluations of the whole spine or sacroiliac joints (SIJs) at intervals of 2-4 years. To compare radiographic progression after delivery, we classified the patients into two groups: delivery group and controls. The delivery group was restricted to women who had the first CT ~2 years before delivery and the second CT ~2 years after delivery. The CT Syndesmophyte Score (CTSS) (0-522) and SIJ scores (0-40) were used to evaluate spinal syndesmophytes and erosion, joint space narrowing, and sclerosis of the SIJs.Results: A total of 21 women in the delivery group and 38 women in the control group were included. The median (Q1-Q3) CTSS at baseline in the delivery group and controls was 19 (16-23) and 20 (13.25-27.75), and the median progression was 1 (0-3) and 0 (0-1) during the median 2.9-year follow-up, respectively. The median (Q1-Q3) SIJ score at baseline in the delivery group and controls was 13 (8-22) and 11 (6-22), and the median progression was 1.5 (0-3) and 1 (0-2), respectively. The CTSS and SIJ scores significantly increased in both groups; however, no difference in absolute score changes per time point was observed. The SIJ score changes were comparable according to the delivery method.Conclusion: Pregnancy and delivery do not affect the radiographic progression of the spine and SIJs in women with AS.

scholarly journals Computed tomography-based assessment of radiographic progression in spine and sacroiliac joints after pregnancy in women with ankylosing spondylitis

2021 ◽  
Author(s):  
Kyung-Ann Lee ◽  
So Yun Lee ◽  
Se Hee Kim ◽  
Hyun-Sook Kim ◽  
Hae-Rim Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Ankylosing Spondylitis ◽  
Radiographic Progression ◽  
Sacroiliac Joints ◽  
Whole Spine ◽  
Time Point

Abstract We aimed to investigate whether pregnancy affects radiographic progression in patients with ankylosing spondylitis (AS) based on computed tomography (CT) evaluations. This retrospective study included women with AS aged 19–49 years who underwent at least two CT evaluations of the whole spine or sacroiliac joints (SIJs) at intervals of 2–4 years. The delivery group was restricted to women who had the first CT ~ 2 years before delivery and the second CT ~ 2 years after delivery. The CT Syndesmophyte Score (CTSS) (0-522) and SIJ scores (0–40) were used to radiographic progression. A total of 21 women in the delivery group and 38 women in the controls were included. The median (Q1-Q3) CTSS at baseline in the delivery group and controls was 19 (16–23) and 20 (13.25–27.75), and the median progression was 1 (0–3) and 0 (0–1) during the median 2.9-year follow-up, respectively. The median SIJ score at baseline in the delivery group and controls was 13 (8–22) and 11 (6–22), and the median progression was 1.5 (0–3) and 1 (0–2), respectively. The CTSS and SIJ scores significantly increased in both groups; however, no difference in absolute score changes per time-point was observed. Pregnancy do not affect the radiographic progression in AS.

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