scholarly journals The Value of SPECT CT in Patient Management of Osteoarthritis of the Temporomandibular Joint

2018 ◽  
Vol 1 (1) ◽  
pp. 18-22
Author(s):  
Bernard Bonte ◽  
Kristoff Muylle ◽  
Nigel Shaun Matthews
Keyword(s):  
Temporomandibular Joint ◽  
Total Joint Replacement ◽  
Mouth Opening ◽  
Stage Iv ◽  
Stage Disease ◽  
Diagnostic Arthroscopy ◽  
Custom Made ◽  
The Right ◽  
End Stage ◽  
Masseter Muscles

A 30 year old female patient presented in 2009 with severe bilateral temporomandibular joint (TMJ) pain, restricted mouth opening and tenderness over the masseter muscles. She was initially diagnosed with Wilkes Stage IV of the right and left TMJ. A diagnostic arthroscopy performed bilaterally failed to releave her pain. She was diagnosed with an isolated spondyloarthropathy of TMJ based on a positive test for HLA B. Further medicamentous treatment was unsuccesfull over subsequent months and years. CBCT of the TMJ showed discrete sclerosis of the right TMJ. Based on an additional SPECT-CT with 99 Tcm hydroxymetylene diphosphonate with significant increased uptake of the tracer in the right TMJ, the right TMJ was considered as end stage disease and a right total joint replacement (TJR) using a Zimmer Biomet custom made prosthesis was performed. A left TJR was performed 3 years.

scholarly journals Experience of using an integrated approach in the diagnosis of temporomandibular joint dysfunction

2022 ◽  
pp. 98-100
Author(s):  
A. A. Sultanov ◽  
Y. Y. Pervov ◽  
A. K. Yatsenko ◽  
M. A. Sultanova ◽  
D. O. Drozdova
Keyword(s):  
Physical Examination ◽  
Temporomandibular Joint ◽  
Orthodontic Treatment ◽  
Clinical Case ◽  
Mouth Opening ◽  
Integrated Approach ◽  
Masticatory Muscles ◽  
Temporomandibular Joint Dysfunction ◽  
The Right ◽  
Masseter Muscles

The article presents a clinical case of the diagnostics and treatment of the temporomandibular joint dysfunction (TMJ) in patient after orthodontic treatment. The hypertonia of masticatory muscles, limit of mouth opening and deviation of the jawbone to the right were observed during physical examination. Adhesion of the disk to the articular tubercle of the right temporal bone was detected on MRI. Hyperrotation of the articular head and the deviation of the jawbone to the right were observed on the charts during axiography. Disappearing of the feeling of heaviness in the right TMJ, free mouth opening, absence of deviation symptom, and the reduction of the rigidity of the masseter muscles were observed on the basis of diagnostic examinations after treatment. Presented clinical experience lets us make a conclusion that it is necessary to prescribe taking axiography and MRI during diagnosing and treating temporomandibular joint dysfunction.

scholarly journals Stability of the Natural Joint Side in Unilateral Alloplastic Total Temporomandibular Joint Replacement Using a Ready-Made System

2021 ◽  
Vol 11 (9) ◽  
pp. 3935
Author(s):  
Jin-Hong Kim ◽  
Byung-Ho Park ◽  
Myoung-Sang Yoo ◽  
Bu-Kyu Lee
Keyword(s):  
Temporomandibular Joint ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Mouth Opening ◽  
Clinical Results ◽  
Pain Scale ◽  
The Other ◽  
Mandibular Movement ◽  
Average Maximum ◽  
End Stage

An alloplastic total joint replacement (TJR) is an effective and reliable treatment option in non-salvageable end-stage temporomandibular joint (TMJ) disease. However, unilateral alloplastic TJR of the TMJ (TMJ TJR) could affect the other side natural joint because the physiologic action of both condyles is quite different during mandibular movement. In this study, we examined whether the unilaterally replaced alloplastic TMJ TJR affects the other side natural joint condition over long periods of time. Eight patients who received alloplastic TJR on one side were subjects in this study. All alloplastic TJR implants were stable in situ. The average maximum mouth opening was 37.5 mm (range 19–49 mm) pre-operatively and 44.1 mm (range 34–57 mm) post-operatively. This parameter gradually increased and reached the maximum at about twelve months after surgery. The post-operative change of pain level was significantly reduced from 3.5 to 0 on a pain scale of zero to ten. No significant complications in any joints were observed within the follow-up period. The shape of the natural joint sides showed slight changes but were functionally stable during the observation period. In this study, unilateral alloplastic TJR showed stable and reliable clinical results, either alloplastic TJR or healthy joint sides for quite long period of time.

scholarly journals A Protocol for the Use of a Combined Microvascular Free Flap with Custom-Made 3D-Printed Total Temporomandibular Joint (TMJ) Prosthesis for Mandible Reconstruction in Children

2021 ◽  
Vol 11 (5) ◽  
pp. 2176
Author(s):  
Krzysztof Dowgierd ◽  
Rafal Pokrowiecki ◽  
Maciej Borowiec ◽  
Marcin Kozakiewicz ◽  
Dominika Smyczek ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Soft Tissues ◽  
Total Joint Replacement ◽  
Speech Development ◽  
Functional Requirements ◽  
Immediate Reconstruction ◽  
Congenital Deformities ◽  
Custom Made ◽  
Masticatory System

Extended postoperative mandibular reconstructions due to orofacial disease involving the temporomandibular joint (TMJ) in immature patients remain a challenge as a result of ongoing growth, which is usually affected by the disease and treatment. Current reconstructive techniques based fully on alloplastic total joint replacement fail to meet fully the anatomical and functional requirements for the masticatory system and speech development. Fourteen children aged 12.6 ± 2.6 with tumors or congenital deformities affecting the mandible and TMJ were included in the study. Radical surgical treatment according to our own protocol was performed through microvascular anastomotic flap reconstruction of the soft tissues and bones, together with total TMJ custom replacements. Follow-up lasted 2–6 years. During the follow-up, increases in the mandible body (13% growth) and ramus (12% growth) were observed, both of which were related (p < 0.001). This is the first report concerning the immediate reconstruction of the mandible with ramus and total TMJ in children and adolescents that combines a free vascularized graft and total individual prosthesis of the TMJ. The presented technique enabled optimal function of the TMJ, growth of the mandible, and further rehabilitation of the patients. The technique was demonstrated to be safe, reliable, and provide good functional and cosmetic outcomes.

scholarly journals Clinical staging in psychiatry: a cross-cutting model of diagnosis with heuristic and practical value

2013 ◽  
Vol 202 (4) ◽  
pp. 243-245 ◽  
Author(s):  
Jan Scott ◽  
Marion Leboyer ◽  
Ian Hickie ◽  
Michael Berk ◽  
Flavio Kapczinski ◽  
...  
Keyword(s):  
Developmental Psychopathology ◽  
General Medicine ◽  
Stage Iv ◽  
Clinical Staging ◽  
Stratified Medicine ◽  
Stage Disease ◽  
Physical Disorders ◽  
Disease Extension ◽  
End Stage ◽  
Cutting Model

SummaryStaging models are used routinely in general medicine for potentially serious or chronic physical disorders such as diabetes, arthritis and cancers, describing the links between biomarkers, clinical phenotypes and disease extension, and promoting a personalised or stratified medicine approach to treatment planning. Clinical staging involves a detailed description of where an individual exists on a continuum of disorder progression from stage 0 (an at-risk or latency stage) through to stage IV (late or end-stage disease). The approach is popular owing to its clinical utility and is increasingly being applied in psychiatry. The concept offers an informed approach to research and the active promotion of indicated prevention and early intervention strategies. We suggest that for young persons with emerging bipolar disorder, such transdiagnostic staging models could provide a framework that better reflects the developmental psychopathology and matches the complex longitudinal inter-relationships between subsyndromal and syndromal mood, psychotic and other disorders.

scholarly journals Treatment of Atypical Bifid Mandibular Condyle Associated with Ankylosis of the Temporomandibular Joint

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Katheleen Miranda ◽  
André Sander Carneiro ◽  
Jennifer Tsi Gerber ◽  
Suyany Gabriely Weiss ◽  
Leandro Eduardo Klüppel ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Treatment Plan ◽  
Mandibular Condyle ◽  
Mouth Opening ◽  
Facial Asymmetry ◽  
Lateral Deviation ◽  
Tmj Ankylosis ◽  
History Of ◽  
The Right

Introduction. The bifid mandibular condyle (BMC) is an unusual temporomandibular joint (TMJ) disorder with controversial etiology. The association of this entity with ankylosis is rare. Objective. The objective of the present study is to report a case of BMC with associated TMJ ankylosis in a patient with no history of trauma and/or infection. Case Report. A 17-year-old male patient sought care reporting pain on the right TMJ region and mastication difficulty due to a severe limitation of mouth opening. In the clinic and imaging examinations, a 15 mm mouth opening and BMC associated with ankylotic mass of the right TMJ were observed, besides a facial asymmetry with chin deviation to the right. The proposed treatment plan was condylectomy on the right side, bilateral coronectomy, and genioplasty, so the chin lateral deviation could be corrected, under general anesthesia. The patient remains under clinical and imaging follow-up of two years with functional stability and no signs of relapse of the ankylosis. Conclusion. The association of BMC with ankylosis is an atypical entity which must be diagnosed and treated early to prevent aesthetic and functional damages to the patient.

scholarly journals Evaluation of Temporomandibular Joint Total Replacement with Alloplastic Prosthesis: Observational Study of 27 Patients

2013 ◽  
Vol 6 (3) ◽  
pp. 171-177 ◽  
Author(s):  
Fernando Briceño ◽  
Ronmell Ayala ◽  
Karlina Delgado ◽  
Sabrina Piñango
Keyword(s):  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Subjective Data ◽  
Replacement Surgery ◽  
Total Replacement ◽  
Custom Made ◽  
Significant Difference ◽  
General Data ◽  
Mandibular Movements ◽  
Diet Consistency

Background Temporomandibular joint (TMJ) total replacement with alloplastic prostheses has been performed since 1960s. Research in these last two decades has achieved important improvement in the development of biomaterials, design, adaptation, and fixation of the prosthesis components. Objective To evaluate total TMJ replacement with alloplastic prostheses. Methods We studied 27 patients, between 19 and 73 years old, who had total TMJ uni- or bilateral replacement surgery with custom-made alloplastic prostheses manufactured by TMJ Concepts, Inc. (Ventura, CA) between 1996 and 2011. The general data and preoperative measurements were taken from medical records. Subjective data related to pain, diet consistency, and current quality of life were collected with a questionnaire answered by the patients; measures of maximum interincisal opening and lateral mandibular movements were obtained from direct examination. Results We found significant difference ( p < 0.05) comparing pre- to postoperative results about improvement in mouth opening, pain relief, and satisfaction with the surgery and diet consistency. Conclusion The results of this study show that total alloplastic TMJ prostheses are an efficient, safe, and stable long-term solution for patients who need TMJ total replacement.

scholarly journals Application of the rapid prototyping technique to design a customized temporomandibular joint used to treat temporomandibular ankylosis

2009 ◽  
Vol 42 (01) ◽  
pp. 085-093
Author(s):  
Suresh M. Chaware ◽  
Vaibhav Bagaria ◽  
Abhay Kuthe
Keyword(s):  
Rapid Prototyping ◽  
Temporomandibular Joint ◽  
Three Dimensional ◽  
Mouth Opening ◽  
Clinical Results ◽  
Postoperative Recovery ◽  
Normal Diet ◽  
Success Rates ◽  
Tmj Ankylosis ◽  
Custom Made

ABSTRACTAnthropometric variations in humans make it difficult to replace a temporomandibular joint (TMJ), successfully using a standard “one-size-fits-all” prosthesis. The case report presents a unique concept of total TMJ replacement with customized and modified TMJ prosthesis, which is cost-effective and provides the best fit for the patient. The process involved in designing and modifications over the existing prosthesis are also described. A 12-year- old female who presented for treatment of left unilateral TMJ ankylosis underwent the surgery for total TMJ replacement. A three-dimensional computed tomography (CT) scan suggested features of bony ankylosis of left TMJ. CT images were converted to a sterolithographic model using CAD software and a rapid prototyping machine. A process of rapid manufacturing was then used to manufacture the customized prosthesis. Postoperative recovery was uneventful, with an improvement in mouth opening of 3.5 cm and painless jaw movements. Three years postsurgery, the patient is pain-free, has a mouth opening of about 4.0 cm and enjoys a normal diet. The postoperative radiographs concur with the excellent clinical results. The use of CAD/CAM technique to design the custom-made prosthesis, using orthopaedically proven structural materials, significantly improves the predictability and success rates of TMJ replacement surgery.

scholarly journals Loose intra-articular body in the temporomandibular joint: case report of a successful conservative management

2021 ◽  
Author(s):  
Yumi C Del Rey ◽  
Hian Parize ◽  
Christiano Oliveira-Santos ◽  
Marina G Almeida
Keyword(s):  
Temporomandibular Joint ◽  
Conservative Management ◽  
Temporomandibular Disorder ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Loose Body ◽  
Low Level Laser Therapy ◽  
Surgical Removal ◽  
Invasive Approach ◽  
The Right

Loose intra-articular bodies are a rare finding in the temporomandibular joint. Surgical removal of the loose bodies isoften described as the only treatment option; however, it presents possible postoperative complications. The aim of thispaper is to report the successful conservative management of a temporomandibular disorder associated with a singleloose intra-articular body. A 62-year-old woman presented with pain in the right temporomandibular joint andpre-auricular region, limited mouth opening and open-lock episodes. Panoramic radiography and cone-beam computedtomography exams revealed the presence of a single loose body located anterior to the right condyle. Magnetic resonanceimages showed bilateral anterior disc displacement without reduction. A non-invasive approach consisting of an occlusalsplint and low-level laser therapy associated with home-based physical therapy was performed for management ofclinical signs and symptoms. The patient was followed up for 2 years and presented significant pain reduction andimprovement in the range of mandibular movements. The combination of conservative therapies may be an alternativefor surgical intervention to control pain and improve mandibular function in patients with temporomandibulardysfunction associated with a loose body in the temporomandibular joint.

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