scholarly journals Prevalence of internal derangements of temporomandibular joint in patients with cleft-lip/palate

2018 ◽  
Vol 17 ◽  
pp. e181201
Author(s):  
Eduardo Grossmann ◽  
Thales Botomé Cousen ◽  
Rodrigo Lorenzi Poluha ◽  
Marcus Vinícius Martins Collares ◽  
Enio Setogutti

Aim: The aim of this study was to estimate the prevalence of internal derangements (ID) of temporomandibular joint (TMJ) in patients with cleft-lip/palate. Also, to evaluate the correlation of diagnosis between Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) clinical examination and Magnetic resonance imaging (MRI). Methods: Twenty patients with cleft-lip/palate, were clinically evaluated by RDC/TMD and by MRI. The ID of TMJ evaluate were disc displacement with reduction (DDWR) and disc displacement without reduction (DDWOR). Results: The present study showed that 9 (45%) of the patients were diagnosed with ID of TMJ (8 [40%] patients with DDWR and 1 [5%] with DDWOR) and 11 (55%) present no disorders, by RDC/TMD. MRI examination revealed that 15 (75%) of the patients had ID of TMJ (13 [65%] patients with DDWR and 2 [10%] with DDWOR) and 5 (25%) present no disorders.  The Kappa index between the clinical and imaging diagnosis was 0.01. Conclusion: In the present study, DDWR was diagnosed in 40-65% by the RDC/TMD and MRI, respectively; DDWOR was diagnosed in 5-10% by the RDC/TMD and MRI, respectively. The diagnostic correlation between the clinical examination based on RDC and on MRI was weak.

2017 ◽  
Vol 21 (3) ◽  
Author(s):  
Mathias Pante Fontana ◽  
Nádia Assein Arús ◽  
Mariana Boessio Vizzotto ◽  
Priscila Fernanda Da Silveira ◽  
Heloísa Emília Dias da Silveira ◽  
...  

Introduction: magnetic resonance imaging is described as the reference standard for the evaluation of temporomandibular joint soft tissues; however, the literature shows conflicting results regarding the reproducibility of this method. Objective: this study aimed to assess the reproducibility of temporomandibular joint diagnoses using magnetic resonance imaging at 0.5 and 1.5 Tesla. Methods: a trained observer analyzed 212 temporomandibular joint images (134 at 0.5T and 78 at 1.5T) and diagnosed the presence or absence of nine conditions. Results: overall agreement was over 80% in both magnetic resonance units, with no significant differences (P > 0.05). Images at 0.5T and 1.5T provided excellent reproducibility for anterior disc displacement without reduction (κ = 0.82 and 0.80, respectively), hypermobility (κ = 0.84 and 0.90), and hypomobility (κ = 0.80 and 0.95), while fair to moderate values were obtained for anterior disc displacement with reduction (κ = 0.48 and 0.42) and disc shape changes (κ = 0.45 and 0.37). Conclusion: magnetic resonance imaging diagnoses at 0.5T and 1.5T presented good agreement. However, the lowest reproducibility for anterior disc displacement with reduction and disc shape change reveals the difficulty to diagnose these disorders.


Author(s):  
Shunmugavelu KARTHIK ◽  
◽  
Dimple M VASWANI ◽  
Shanmugam ARASU ◽  
Raghavelu Narendran MUGUNDAN ◽  
...  

Background: Internal derangement of the temporomandibular joint (TMJ) results in anterior disc displacement with reduction (ADDR), the disc is ante- riorly displaced in the closed position whereas in the opened position the disc returns to its normal location. In anterior disc displacement without reduction (AD- DWR), the disc is anteriorly displaced in the closed po- sition but does not return to its original location in the opened position. Here we studied and compared the effects of the ADDR and the ADDWR on the components of the TMJ by using the magnetic resonance imaging technique (MRI). Methods and materials: From the archival MRI records, 214 joints from 107 patients were included. The selec- tion criteria for the patients complaints as TMJ pain, clicking, limited mouth opening, headache, jaw tenderness and difficulty in eating. MRI records with sequences Proton Density (PD), PD FAT SAT and T2* gradient in the closed position and T2* gradient echo in the opened position. Data analysis and frequency distribution of explanatory variables by disc position in the open state was performed using chi-square test Results: Statistically significant differences were observed between the variables such as the joint space (closed position), disc morphology (closed position) and range of movement (opened position) among the ADDR and the ADDWR. In ADDWR, 20.3% demonstrated narrowed joint space and 1.6% with widened joint space, while in ADDR, 2.5% of joints had narrowed joint space and 0% widened joint space. Same was observed with abnormal disc morphology and rang of movement. Conclusion: The disc deformity is more in ADDWR compared to ADDR which can be seen as an alteration in the signal intensity. The malaligned disc could lead to the narrowing of the joint space and decreased range of movement in the ADDWR affected individuals.


2004 ◽  
Vol 12 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Elisa Emi Tanaka ◽  
Emiko Saito Arita ◽  
Bunji Shibayama

Occlusal stabilization appliances or splints are the most widely employed method for treatment of temporomandibular disorders (TMD). Magnetic Resonance Imaging (MRI) is the most indicated imaging modality to evaluate the components of the temporomandibular joint (TMJ). Forty patients with signs and symptoms of temporomandibular disorders were treated with splints for a mean period of 12 months, comprising regular semimonthly follow-ups. After stabilization of the clinical status, occlusal adjustments and MRI evaluation were performed. It was concluded that the success of this kind of treatment are related to the total (70%) or partial improvement (22.5%) of painful symptomatology and to the functional reestablishment of the craniomandibular complex. The MRI allowed evaluation and also the conclusion that the splints provide conditions for the organism to develop means to resist to the temporomandibular disorders by means of elimination of several etiologic factors. Moreover, after treatment the patients are able to cope with disc displacements with larger or smaller tolerance.


2021 ◽  
Vol 24 (2) ◽  
pp. 8
Author(s):  
Mohamed Ahmed Helal ◽  
Shoroog Hassan Agou ◽  
Amr Bayoumi ◽  
Ahmed Imam ◽  
Ali Habiballah Hassan

Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases.   Keywords Arthrocentesis; Anterior repositioning splint; TMD; Internal derangement; Anterior disc displacement; Mandibular range of motion.


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