scholarly journals Optimal Use of a Panoramic Radiograph as a Screening Tool for Condylar Resorption in Patients Undergoing Active Orthodontic Treatment: A Case Series

2020 ◽  
Vol 10 ◽  
pp. 65
Author(s):  
Shaima Malik ◽  
Shilpa Singh ◽  
Robby T. George ◽  
Mayank Kakkar ◽  
Nikhilesh R. Vaid
Keyword(s):  
Orthodontic Treatment ◽  
Behavioral Therapy ◽  
Mandibular Condyle ◽  
Case Series ◽  
Panoramic Radiograph ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Initial Examination ◽  
Panoramic Radiographs ◽  
Specific Medication

Condylar resorption of temporomandibular joint findings in the panoramic radiographs is an indication of bone resorption suggesting possible degenerative joint disease that warrants early screen and subsequent referral to a dedicated specialist. This case series reports three patients that underwent the active orthodontic treatment for the duration of approximately 24–36 months. The patients were asymptomatic at the initial examination. The clinical examination was negative for clicking; the range of motion on opening, lateral excursion, and protrusion was normal. Neither of these patients had a history of rheumatic disease or bruxism. During the later stages of orthodontic treatment, two of the three patients reported mild pain and clicking during mastication, which was also confirmed chairside on clinical evaluation. Patients were referred to the orofacial pain specialist, were they were prescribed specific medication for the symptoms, along with cognitive behavioral therapy, and were further evaluated for splint therapy. Panoramic radiographs taken before the start of the treatment, during the treatment and at the completion of the orthodontic treatments indicate the progression in the resorption of mandibular condyle in all three patients suggesting possible degeneration that warrants further investigation and therapy.

scholarly journals Clinical Presentation, Management, and Prognosis of Pseudogout in Joint Arthroplasty: A Retrospective Cohort Study

2019 ◽  
Vol 4 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Merit P. George ◽  
Floranne C. Ernste ◽  
Aaron Tande ◽  
Douglas Osmon ◽  
Tad Mabry ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Medical Center ◽  
Case Reports ◽  
Joint Infection ◽  
Case Series ◽  
Calcium Pyrophosphate ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Antibiotic Overuse ◽  
Concomitant Infection

Abstract. Introduction: Calcium pyrophosphate deposition disease (CPPD), or pseudogout, is rare in prosthetic joints, but can mimic prosthetic joint infection (PJI) according to case reports. The purpose of this case series is to describe the demographics, presentation, management, and outcomes of a cohort of these patients seen at our academic medical center.Methods: Patients with post-implant pseudogout, who were evaluated at our medical center between January 1, 2000 and June 30, 2016, were identified from our EHR. Data pertaining to demographics, presentation, management, and outcomes were abstracted, and patients were categorized into two groups based on presence of concomitant infection along with positive CPDD findings in synovial fluid.Results: 22 patients were included. 90.9% of cases involved a TKA. The most common indication for arthroplasty was degenerative joint disease. Only four patients had a history of previous gout or pseudogout, three of which belonged to the group with no evidence of concomitant joint infection. Clinical features for patients without concomitant infection included pain (100%), swelling at the joint (88.9%), redness (33.3%), fever (22.2%), and decreased range of motion (100%). 45.5% of patients received antibiotics prior to joint aspiration (44.4% of patients with negative synovial fluid cultures, 46.2% of patients with concomitant infection).Conclusion: Our study suggests similar clinical presentation between post-implant pseudogout and PJI. Among patients with pseudogout as well as in those with PJI, the first dose of antibiotics should not be given before sampling for synovial culture. Unfortunately, many patients receive antibiotics prior to culture ascertainment, which raises concern for antibiotic overuse.

TMJ imaging: more pictures, less talk

2011 ◽  
Vol 2 (4) ◽  
pp. 172-182 ◽  
Author(s):  
Jimmy Makdissi de C Williams
Keyword(s):  
Rheumatoid Arthritis ◽  
Skull Base ◽  
Temporomandibular Joint ◽  
Temporal Bone ◽  
Mandibular Condyle ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Number Of Factors ◽  
Muscles Of Mastication ◽  
Anatomical Area

The temporomandibular joint (TMJ) is a complex anatomical area consisting of the mandibular condyle and the temporal bone of the skull base. It comes under the influence of a number of factors including the muscles of mastication, teeth, occlusion and the contralateral joint and thus there exists a spectrum of conditions. Internal derangement and degenerative joint disease remain the most common although there are a range of other less frequently occurring conditions such as rheumatoid arthritis, trauma and ankylosis.

scholarly journals Application of platelet-rich plasma for canine osteoarthritis treatment - a clinical series

2021 ◽  
Vol 24 (4) ◽  
pp. 601-607
Author(s):  
K. B Aminkov ◽  
N. H. Mehandzhiyski ◽  
B. Y. Aminkov ◽  
N. Z. Zlateva-Panayotova
Keyword(s):  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Case Series ◽  
Brief Pain Inventory ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Knee Joints ◽  
Radiographic Findings ◽  
Clinical Series ◽  
Osteoarthritis Treatment

Osteoarthritis, also known as degenerative joint disease (DJD), is defined as a progressive and permanent long-term deterioration of the cartilage surrounding the joints. There is no known cause for primary DJD. However, there are a wide variety of causes for secondary DJD, such as trauma, abnormal wear of joints and cartilage, or a congenital defect present at birth such as an improperly formed hip. One of the most popular methods used to biologically enhance healing in the fields of orthopaedic surgery and medicine includes the use of autologous blood products, namely, platelet rich plasma (PRP). Reports suggest that PRP, presumably containing high levels of platelet growth factors, may promote the recovery of the affected cartilage. This case series presents clinical and radiographic findings of three dogs with osteoarthritis of the elbow and knee joints. Pain score were assessed by CBPI (Canine Brief Pain Inventory). Treatment with three-fold intra-articular application of PRP, obtained by double centrifugation method, resulted in significant improvement in the function of the affected joint. Therefore, it could be concluded that PRP was clinically effective in the treatment of osteoarthritis in these three cases.

scholarly journals Giant cell tumor of tendon sheath: a case series

2018 ◽  
Vol 5 (6) ◽  
pp. 2372
Author(s):  
Ramesh Kumar Korumilli ◽  
Jakkula Srikanth ◽  
Sri Harsha Muvva ◽  
B. M. Yashwanth Reddy
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Case Series ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Degenerative Joint Disease ◽  
Cell Tumor ◽  
Joint Disease ◽  
High Recurrence Rate ◽  
Malignant Soft Tissue Tumor

Giant cell tumor of tendon sheath is a relatively rare non-malignant soft tissue tumor arising from the synovial cells and is associated with high recurrence rate. Many factors are considered for high recurrence including proximity to distal interphalangeal joints, presence of degenerative joint disease, pressure erosions in the radiograph and increased mitotic activity. But the most common cause for recurrence is incomplete surgical excision. However, it is the second most common tumor in hands after ganglion cysts. Here we present a case series comprising of 3 cases for whom marginal excision was done and they were kept on regular follow up without any recurrence.

scholarly journals Mechanobehavior and Ontogenesis of the Temporomandibular Joint

2018 ◽  
Vol 97 (11) ◽  
pp. 1185-1192 ◽  
Author(s):  
J.C. Nickel ◽  
L.R. Iwasaki ◽  
Y.M. Gonzalez ◽  
L.M. Gallo ◽  
H. Yao
Keyword(s):  
Temporomandibular Joint ◽  
Degenerative Change ◽  
Mandibular Condyle ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Recording Time ◽  
Mechanical Environment ◽  
Age Related ◽  
Tmj Disc

Craniofacial secondary cartilages of the mandibular condyle and temporomandibular joint (TMJ) eminence grow in response to the local mechanical environment. The intervening TMJ disc distributes normal loads over the cartilage surfaces and provides lubrication. A better understanding of the mechanical environment and its effects on growth, development, and degeneration of the TMJ may improve treatments aimed at modifying jaw growth and preventing or reversing degenerative joint disease (DJD). This review highlights data recorded in human subjects and from computer modeling that elucidate the role of mechanics in TMJ ontogeny. Presented data provide an approximation of the age-related changes in jaw-loading behaviors and TMJ contact mechanics. The cells of the mandibular condyle, eminence, and disc respond to the mechanical environment associated with behaviors and ultimately determine the TMJ components’ mature morphologies and susceptibility to precocious development of DJD compared to postcranial joints. The TMJ disc may be especially prone to degenerative change due to its avascularity and steep oxygen and glucose gradients consequent to high cell density and rate of nutrient consumption, as well as low solute diffusivities. The combined effects of strain-related hypoxia and limited glucose concentrations dramatically affect synthesis of the extracellular matrix (ECM), which limit repair capabilities. Magnitude and frequency of jaw loading influence this localized in situ environment, including stem and fibrocartilage cell chemistry, as well as the rate of ECM mechanical fatigue. Key in vivo measurements to characterize the mechanical environment include the concentration of work input to articulating tissues, known as energy density, and the percentage of time that muscles are used to load the jaws out of a total recording time, known as duty factor. Combining these measurements into a mechanobehavioral score and linking these to results of computer models of strain-regulated biochemical events may elucidate the mechanisms responsible for growth, maintenance, and deterioration of TMJ tissues.

Efficacy of Autologous Platelet-Rich Plasma Injections for Grade 3 Symptomatic Degenerative Meniscal Lesions: A 1-Year Follow-up Prospective Study

2021 ◽  
pp. 194173812110110
Author(s):  
Mattia Alessio-Mazzola ◽  
Lamberto Felli ◽  
Roberto Trentini ◽  
Matteo Formica ◽  
Andrea Giorgio Capello ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Symptomatic Relief ◽  
Case Series ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Level Of Evidence ◽  
Meniscal Lesions ◽  
Activity Scale ◽  
Tegner Activity Scale

Background: Platelet-rich plasma (PRP) injections have been proposed as a biologic option to provide symptomatic relief and delay surgery in patients with degenerative joint disease of osteoarthritis (OA). The efficacy of autologous PRP on symptomatic degenerative meniscal lesions (DMLs) has never been investigated. Hypothesis: We hypothesized that patients with symptomatic DMLs without OA undergoing autologous PRP injections experience a significant clinical improvement at 12 months. Study Design: Prospective case series. Level of Evidence: Level 4. Methods: A total of 69 patients with symptomatic DMLs without radiographic evidence of knee OA (Kellgren-Lawrence radiographic grading scale 0-1) received 4 autologous PRP injections once a week. Patients were prospectively evaluated before the injection and then at 1, 3, 6, and 12 months. Evaluation was based on Lysholm knee scoring scale (primary outcome), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Tegner activity scale, and visual analogue scale scores. Results: Patients treated with PRP injections demonstrated an improving knee function and symptoms over the duration of the study. A significant improvement from baseline to 12 months was observed in all the outcome measures, and no patients experienced failure or required surgery during the follow-up. Patients younger than 50 years reported lower subjective level of pain and higher Tegner activity scale at baseline and had significantly better Lysholm knee scoring scale ( P = 0.03) and WOMAC ( P = 0.03) scores at 6 months, as well as better range of motion at 3, 6, and 12 months ( P < 0.001). Thirty-three (47.8%) patients were very satisfied, 26 (37.7%) satisfied, 8 (11.6%) partially satisfied, and 2 (2.9 %) not satisfied, with 62 (89.8%) patients willing to repeat the same treatment. No patient was lost to follow-up and no patient experienced adverse reaction, infection, failure, recurrence or underwent further surgery. Conclusion: PRP injections provide short-term benefits in symptomatic DMLs. Although promising results were evident at 12 months, this is a preliminary study and no definitive recommendation can be made based, for example, on longer follow-up. Clinical Relevance: This research supports the use of autologous PRP injections for symptomatic DMLs.

scholarly journals Stabilization of Talocalcaneal Luxation with a Dorsal 1.0 mm Compression Plate in Four Cats

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e72-e78
Author(s):  
Matthew Smith ◽  
Nicholas Macdonald
Keyword(s):  
Musculoskeletal Pain ◽  
Low Cost ◽  
Case Series ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Compression Plate ◽  
Cost Treatment

AbstractThe objective of this case series was to report the surgical technique, complications, and long-term outcome of feline talocalcaneal luxation stabilized with a dorsally applied two-hole, 1.0 mm compression plate. It is a retrospective study of four cats that underwent surgical stabilization of talocalcaneal luxation with a dorsally applied two-hole, 1.0 mm compression plate between 2013 and 2019. Medical history and diagnostic imaging (radiographs ± computed tomography scans) were reviewed. The owners of three of the four cats were contacted with a follow-up questionnaire based on the Feline Musculoskeletal Pain Index to assess long-term outcome. No intraoperative or postoperative complications were encountered. All three owner questionnaires were returned and Feline Musculoskeletal Pain Index scores of 0, 1, and 4 were recorded out of a maximum score of 83 (normal cat range is −18 to 4; cats with degenerative joint disease range from 11 to 66). Quality of life was rated by the owners as excellent (⅔) or good (⅓). All cats returned to full activity. Stabilization of feline talocalcaneal luxation with a dorsally applied two-hole, 1.0 mm compression plate was technically straightforward, easily accessible, and a relatively low-cost treatment option which carries a low risk of complications and an excellent prognosis.

scholarly journals Regenerative Injection Therapy with Whole Bone Marrow Aspirate for Degenerative Joint Disease: A Case Series

2013 ◽  
Vol 6 ◽  
pp. CMAMD.S10951 ◽  
Author(s):  
Ross A. Hauser ◽  
Amos Orlofsky
Keyword(s):  
Bone Marrow ◽  
Platelet Rich Plasma ◽  
Direct Injection ◽  
Symptomatic Relief ◽  
Case Series ◽  
Cost Effective ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Vigorous Exercise ◽  
Patient Reported

Regenerative therapeutic strategies for joint diseases usually employ either enriched concentrates of bone marrow-derived stem cells, chondrogenic preparations such as platelet-rich plasma, or irritant solutions such as hyperosmotic dextrose. In this case series, we describe our experience with a simple, cost-effective regenerative treatment using direct injection of unfractionated whole bone marrow (WBM) into osteoarthritic joints in combination with hyperosmotic dextrose. Seven patients with hip, knee or ankle osteoarthritis (OA) received two to seven treatments over a period of two to twelve months. Patient-reported assessments were collected in interviews and by questionnaire. All patients reported improvements with respect to pain, as well as gains in functionality and quality of life. Three patients, including two whose progress under other therapy had plateaued or reversed, achieved complete or near-complete symptomatic relief, and two additional patients achieved resumption of vigorous exercise. These preliminary findings suggest that OA treatment with WBM injection merits further investigation.

scholarly journals Anterior Bite Opening in Adulthood

2017 ◽  
Vol 11 (1) ◽  
pp. 628-635 ◽  
Author(s):  
Karolina Broberg ◽  
Birgitta Lindskog-Stokland ◽  
Christina Mejersjö
Keyword(s):  
Orthodontic Treatment ◽  
Orofacial Pain ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Neuromuscular Diseases ◽  
Masticatory Muscles ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Tongue Pressure ◽  
Patient’S History

Objectives: To study anterior bite opening of unknown cause presenting in adulthood regarding prevalence, symptoms of Temporomandibular Dysfunction (TMD) and possible causes of the bite opening. Methods: Patients referred to two Orofacial Pain and TMD clinics with the complaint of recent anterior bite opening, presenting in adulthood and of unknown cause, were considered for the study. Patients with systemic rheumatic or neuromuscular diseases, degenerative joint disease, previous fractures of the jaws or orthodontic treatment, were excluded. The clinical examination was according to DC/TMD and extended for the occlusion. Reported symptoms, clinical signs, the occlusion and diagnoses found are presented. According to the information gained from the patient’s history, previous occlusion and appearance, and present signs of parafunction, a possible association with the bite opening was suggested. Results: Anterior bite opening was found in 1.6% of the referred patients. Symptoms of tiredness and/or orofacial pain were reported by 62%, headache by 41%, TMJ clicking by 24% and sensitive/tender teeth by 41%. Parafunction or bruxism was reported by 2/3 of the patients. A previous period in life of TMD symptoms, before the bite opening, was reported by 66%. Myalgia and headache associated with TMD were frequently diagnosed. The use of a partial dental splint, tongue pressure and pregnancy were possible causes found for the bite opening. Conclusion: Anterior bite opening can occur in adulthood without organic or systemic disease of the TMJ or masticatory muscles, and was frequently associated with muscle TMD symptoms.

scholarly journals Evaluation of Normal Morphology of Mandibular Condyle: A Radiographic Survey

2020 ◽  
Vol 10 ◽  
pp. 51
Author(s):  
Bhupender Singh ◽  
Nileena R. Kumar ◽  
Anita Balan ◽  
Mohammed Nishan ◽  
P. S. Haris ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Care Center ◽  
Mandibular Condyle ◽  
Panoramic Radiograph ◽  
Descriptive Study ◽  
Normal Variation ◽  
Cross Sectional ◽  
Normal Morphology ◽  
History Of ◽  
Condylar Morphology

Objectives: The temporomandibular joint (TMJ) is a complex, highly specialized joint. Along with the teeth, these joints are considered to be a “tri-joint complex.” Mandibular condyle morphology is characterized by a rounded bone projection with an upper biconvex and oval surface in axial plane. Anatomical knowledge of the TMJ is one of the basic foundations of clinical practice, allowing the understanding of TMJ pathologies and fabrication of condylar prostheses. The cross-sectional descriptive study was undertaken to evaluate normal variation in the condylar morphology on radiographs in persons without TMJ symptomatology and its relation to age, gender, dentition status, chewing habits, parafunctional habits, history of orthodontic treatment, and denture wearing was assessed. Material and Methods: A total of 350 subjects without TMJ symptomatology included in the study were further grouped by age, gender, dentition status, chewing habits, parafunctional habits, history of orthodontic treatment, and denture wearing history. Panoramic radiograph was taken for the assessment of condylar morphology. Results: A significant association between dentition status and bilaterally similar condylar morphology was noticed. Bilaterally similar condyles were seen in 81.4% of subjects. Round-shaped condyles were seen in 176 (62%) persons. Loss of bilateral occlusion tends to alter the condylar morphology. Association between normal chewing habits and bilaterally similar condyle shapes was significant. Conclusion: The study describes the normal morphology of mandibular condyles in a population attending the tertiary dental care center, Kozhikode. The dentition status and chewing habits of individuals had a significant role in determining condylar morphology.

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