Improved access in minimally invasive temporomandibular joint surgery through a novel endaural template

Abstract Background Digitally designed surgical templates for minimally invasive temporomandibular joint (TMJ) surgery (MITMJS) are a promising tool for improving the safety of these procedures. Given the TMJ anatomy, the template fitting and intraoperative overview are the most important issues for a safe surgery. This article is a technical advance article that aims to describe an endaural surgical template based on the Moses approach as a possible solution in TMJ surgery. Methods Three patients with internal derangement were treated with the guidance of a MITMJS template based on cone beam computed tomography (CBCT) and a surface imprint of the periauricular region. None of the patients needed an additional open surgical procedure. Fitting of the templates was judged in terms of position and rotational stability. Surgical side effects and complications were recorded for each patient. Results The template design and clinical use were satisfactory for MITMJS. The templates showed satisfying fit and good visibility. In the study cohort, no bleeding, facial nerve injury, or other complications occurred after the procedure, and no visible scars were noted postoperatively. Conclusion Our feasibility report on template-guided MITMJS shows a promising new application of templates. It points to improved access in arthroscopy or arthrocentesis of TMJ surgery through endaural access with an increased level of safety during surgery.

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Improved Access in Minimally Invasive Temporomandibular Joint Surgery via A Novel Endaural Template

10.21203/rs.3.rs-68788/v1 ◽

2020 ◽

Author(s):

Matthias Krause ◽

Mohammad Kamal ◽

Daniel Kruber ◽

Dirk Halama ◽

Thomas Hierl ◽

...

Keyword(s):

Minimally Invasive ◽

Temporomandibular Joint ◽

Cone Beam ◽

Rotational Stability ◽

Study Cohort ◽

Promising Tool ◽

Template Design ◽

Open Surgical Procedure ◽

Surgical Templates ◽

Good Visibility

Abstract Background: Digitally designed surgical templates for minimally invasive temporomandibular joint (TMJ) surgery (MITMJS) are a promising tool for improving the safety in these procedures. Given the anatomy of the TMJ, the fitting of the template and intraoperative overview are the most important issues to conduct the surgery safely. This article describes an endaural surgical template based on the Moses approach as a possible solution.Material and Methods: Three patients with internal derangement were treated with guidance of a MITMJS- template based on cone beam computed tomography (CBCT) and a surface imprint of the periauraural region. None of the patients needed an additional open surgical procedure. Fitting of the templates was judged in terms of position and rotational stability. Surgical side effects and complications were recorded for each patient.Results: The template design and clinical use performed the MITMJS satisfactory. The templates showed satisfying fit and good visibility. In the study cohort, no bleeding, facial nerve injury, or other complications occurred after the procedure, and no visible scars were noted postoperatively.Conclusion: Our feasibility report on template-guided MITMJS shows a promising new application of templates. It points an improved access in arthroscopy or arthrocentesis of TMJ- surgery via an endaural access with increased level of safety during surgery.

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Improved Access in Minimally Invasive Temporomandibular Joint Surgery via a Novel Endaural Template

10.21203/rs.3.rs-101466/v1 ◽

2020 ◽

Author(s):

Matthias Krause ◽

Mohammad Kamal ◽

Daniel Kruber ◽

Dirk Halama ◽

Thomas Hierl ◽

...

Keyword(s):

Minimally Invasive ◽

Temporomandibular Joint ◽

Cone Beam ◽

Rotational Stability ◽

Study Cohort ◽

Promising Tool ◽

Template Design ◽

Open Surgical Procedure ◽

Surgical Templates ◽

Good Visibility

Abstract Background:Digitally designed surgical templates for minimally invasive temporomandibular joint (TMJ) surgery (MITMJS) are a promising tool for improving the safety in these procedures. Given the anatomy of the TMJ, the fitting of the template and intraoperative overview are the most important issues to conduct the surgery safely. This article describes an endaural surgical template based on the Moses approach as a possible solution.Methods:Three patients with internal derangement were treated with guidance of a MITMJS- template based on cone beam computed tomography (CBCT) and a surface imprint of the periauraural region. None of the patients needed an additional open surgical procedure. Fitting of the templates was judged in terms of position and rotational stability. Surgical side effects and complications were recorded for each patient.Results:The template design and clinical use performed the MITMJS satisfactory. The templates showed satisfying fit and good visibility. In the study cohort, no bleeding, facial nerve injury, or other complications occurred after the procedure, and no visible scars were noted postoperatively.Conclusion:Our feasibility report on template-guided MITMJS shows a promising new application of templates. It points an improved access in arthroscopy or arthrocentesis of TMJ- surgery via an endaural access with increased level of safety during surgery.

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Improved access in minimally invasive temporomandibular joint surgery through a novel endaural template.

10.21203/rs.3.rs-101466/v2 ◽

2021 ◽

Author(s):

Matthias Krause ◽

Mohammad Kamal ◽

Daniel Kruber ◽

Dirk Halama ◽

Thomas Hierl ◽

...

Keyword(s):

Minimally Invasive ◽

Temporomandibular Joint ◽

Cone Beam ◽

Rotational Stability ◽

Study Cohort ◽

Promising Tool ◽

Template Design ◽

Open Surgical Procedure ◽

Surgical Templates ◽

Good Visibility

Abstract BackgroundDigitally designed surgical templates for minimally invasive temporomandibular joint (TMJ) surgery (MITMJS) are a promising tool for improving the safety of these procedures. Given the TMJ anatomy, the template fitting and intraoperative overview are the most important issues for a safe surgery. This article is a technical advance article that aims to describe an endaural surgical template based on the Moses approach as a possible solution in TMJ surgery.Methods:Three patients with internal derangement were treated with the guidance of a MITMJS template based on cone beam computed tomography (CBCT) and a surface imprint of the periauricular region. None of the patients needed an additional open surgical procedure. Fitting of the templates was judged in terms of position and rotational stability. Surgical side effects and complications were recorded for each patient.Results:The template design and clinical use were satisfactory for MITMJS. The templates showed satisfying fit and good visibility. In the study cohort, no bleeding, facial nerve injury, or other complications occurred after the procedure, and no visible scars were noted postoperatively.Conclusion:Our feasibility report on template-guided MITMJS shows a promising new application of templates. It points to improved access in arthroscopy or arthrocentesis of TMJ surgery through endaural access with an increased level of safety during surgery.

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New Method for Analysis of the Temporomandibular Joint Using Cone Beam Computed Tomography

Sensors ◽

10.3390/s21093070 ◽

2021 ◽

Vol 21 (9) ◽

pp. 3070

Author(s):

Sebastian Iwaszenko ◽

Jakub Munk ◽

Stefan Baron ◽

Adam Smoliński

Keyword(s):

Computed Tomography ◽

Temporomandibular Joint ◽

Cross Section ◽

Cone Beam Computed Tomography ◽

Cone Beam ◽

Section Plane ◽

New Approach ◽

Volume Of Interest ◽

Gap Width

Modern dentistry commonly uses a variety of imaging methods to support diagnosis and treatment. Among them, cone beam computed tomography (CBCT) is particularly useful in presenting head structures, such as the temporomandibular joint (TMJ). The determination of the morphology of the joint is an important part of the diagnosis as well as the monitoring of the treatment results. It can be accomplished by measurement of the TMJ gap width at three selected places, taken at a specific cross-section. This study presents a new approach to these measurements. First, the CBCT images are denoised using curvilinear methods, and the volume of interest is determined. Then, the orientation of the vertical cross-section plane is computed based on segmented axial sections of the TMJ head. Finally, the cross-section plane is used to determine the standardized locations, at which the width of the gap between condyle and fossa is measured. The elaborated method was tested on selected TMJ CBCT scans with satisfactory results. The proposed solution lays the basis for the development of an autonomous method of TMJ index identification.

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Temporomandibular Joint Osseous Morphology of Class I and Class II Malocclusions in the Normal Skeletal Pattern: A Cone-Beam Computed Tomography Study

Diagnostics ◽

10.3390/diagnostics11030541 ◽

2021 ◽

Vol 11 (3) ◽

pp. 541

Author(s):

Xiao-Chuan Fan ◽

Lin-Sha Ma ◽

Li Chen ◽

Diwakar Singh ◽

Xiaohui Rausch-Fan ◽

...

Keyword(s):

Computed Tomography ◽

Temporomandibular Joint ◽

Cone Beam Computed Tomography ◽

Class Ii ◽

Class I ◽

Cone Beam ◽

Glenoid Fossa ◽

Linear Measurements ◽

Significant Difference ◽

Skeletal Pattern

(1) Background—The aim of the present study was to evaluate the correlation between the temporomandibular joint (TMJ) osseous morphology of normal skeletal pattern individuals with different dental malocclusions by using cone-beam computed tomography (CBCT). (2) Methods—The CBCT images of bilateral TMJs in 67 subjects with skeletal class I and average mandibular angle (26 males and 41 females, age range 20–49 years) were evaluated in this study. The subjects were divided into class I, class II division 1, and class II division 2 according to the molar relationship and retroclination of the maxillary incisors. Angular and linear measurements of TMJ were evaluated and the differences between the groups were statistically analyzed. (3) Results—Intragroup comparisons showed statistical differences for articular eminence inclination, the width of the glenoid fossa, the ratio of the width of the glenoid fossa to the depth of the glenoid fossa, the condylar angle, and the intercondylar angle between the malocclusion groups. The measurements of the glenoid fossa shape showed no significant difference between the left and right sides. Females showed more differences in the morphological parameters of TMJ between the three malocclusion groups than the males. (4) Conclusion—The present study revealed differences in the TMJ osseous morphology between dental class I and class II malocclusions in the normal skeletal pattern.

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Long-term Follow-up of Craniofacial Alterations in Juvenile Idiopathic Arthritis

The Angle Orthodontist ◽

10.2319/093008-511r.1 ◽

2009 ◽

Vol 79 (6) ◽

pp. 1057-1062 ◽

Cited By ~ 15

Author(s):

Marinka Twilt ◽

Alcuin J. M. Schulten ◽

Birte Prahl-Andersen ◽

Lisette W. A. van Suijlekom-Smit

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Temporomandibular Joint ◽

Initial Study ◽

Study Cohort ◽

Craniofacial Skeleton ◽

Lateral Cephalograms ◽

Long Term Follow Up ◽

Angular Measurements

Abstract Objective: To investigate changes in the craniofacial skeleton in relation to the changes in condylar alterations that occur during long-term follow-up in patients with juvenile idiopathic arthritis. Materials and Methods: Temporomandibular joint (TMJ) involvement is defined as a condylar alteration that is observed on the orthopantomogram. Lateral cephalograms were used to determine linear and angular measurements. Results: Seventy of 97 patients from the initial study cohort were included, with a mean follow-up of 68 months. The overall prevalence of condylar alterations and posterior rotation of the mandible decreased; however, the prevalence of retrognathia remained the same. Patients showed improvement in the degree of retrognathia and posterior rotation (40% ANB, 51% OP-SN, and 44% GO-GN-SN). Improvement in the degree of retrognathia was seen more often in patients with improved condylar alterations than in patients with persistent alterations and in those without alterations (50%, 33%, and 28%, respectively). The degree of posterior rotation improved almost equally in patients without TMJ involvement and in patients with improved condylar alterations (57% and 50% by OP-SN, and 67% and 38% GO-GN-SN, respectively) and did not improve in patients with stable persistent alterations. Conclusion: Both condylar and craniofacial alterations can improve in patients with juvenile idiopathic arthritis.

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