scholarly journals THE ROLE OF MAGNETIC RESONANCE RESEARCH IN THE TREATMENT OF DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT

2021 ◽  
pp. 59-63
Author(s):  
V.M. Novikov ◽  
M.A. Korostashova ◽  
V.I. Dodatko ◽  
O.S. Svyryda ◽  
Ya.O. Yushchenko

The main criterion for diagnosis of dysfunctional conditions of the temporomandibular joint is the visualization of the intra-articular cartilaginous disc. The method of diagnosis, that the most perfectly determines the disorders in the temporomandibular joint, particular the displacement of the menisci, is magnetic resonance imaging. So, the aim of the work was to determine the amplitude of anterior displacements of the menisci in patients suffering from dysfunction of the temporomandibular joint using magnetic resonance imaging. In 20 patients, who underwent magnetic resonance imaging, different amplitudes of the anterior displacements of the meniscus were determined. Patients were divided into groups. The first group included 6 patients who were diagnosed by MRI the anterior displacement of the disc to the center of the articular head. The second group included 4 patients who had anterior displacement of the disc to the center of the articular head by 2/3 of its own length. Ten patients of the third group had a displacement of the meniscus to the center of the articular head by 1/2 of its own length. For the future treatment of TMJ dysfunction, the distance of the pathological displacement of the meniscus determines the degree of occlusion. All patients were prescribed a Michigan-splint occlusal splint in combination with a sling-like head cap at night. The results of the selected treatment were interpreted after 3-6 months. A series of magnetic resonance imaging has described the articular fissures of the temporomandibular joint, articular discs (their shape in frontal projection and on parasagittal sections), posterior ligaments, and lateral pterygoid muscles. Each of the joints was carefully examined in the case when the mouth is closed and open. During the MRI description, the shape of the joint heads and their possible pathological changes were determined. In the position of the closed or open mouth, the positions of each of the discs and their poles relatively to the articular head in centimeters were compared, and the movement of the menisci was described. The sizes of disks of the closed and open mouth were defined. The study protocol also reported the shape and amplitude of the movements of the articular heads. Treatment was planned according to the selected protocol. For the first group of patients diagnosed with anterior meniscus dislocation, treatment was planned by separating the occlusion to the relatively physiological rest of the mandible (2 - 4 mm). The patients of the second group, in which anterior displacements of the disc relatively to the articular head by 2/3, were treated with detachment of the occlusion to contact with the cutting edge of the teeth of the upper and lower jaws. For the third patients’ group with diagnosed anterior displacement of the meniscus by 1/2, treatment was performed with a separation of the bite on 2 - 4 mm above the contact with the cutting edges of the front teeth. The main criterion for recovery is the complete disappearance of symptoms of dysfunction, even without the use of a splint. At the first stage of treatment the task was the following: reconstruction of a myotatic reflex by means of the medical and diagnostic occlusal splint "Michigan-splint" completed with the main slingshot cap. Patients were monitored monthly. The main problems were the following: after a week of using the structure the patients complained of increased salivation, muscle pain and burning, headache, which disappeared after approximately 3 weeks. The main cause of such phenomena is the physiological rearrangement of the muscular reflex, which involves a certain tension in the muscles and irritation of the nerve endings in the muscles due to changes in the usual occlusion. During planned examination, the patients demonstrated supercontacts followed by cap correction. In 3 or 6 months of using the Michigan-splint occlusal splint, patients noted a significant improvement and they didn’t have any complaints. The main criterion for recovery is the complete disappearance of symptoms of dysfunction, even without the use of a splint. Therefore, the next stage of treatment depended on the anatomical and functional changes of TMJ and consolidation of therapeutic effect was been necessary. Therefore, the use of magnetic resonance imaging of the temporomandibular joint to determine the amplitude of the displacements of the discs, ensures the effectiveness of the selected treatment. Prospects for further research include improvement of the MRI protocol and its correlation with definite symptoms, the distance of the vertical separation of occlusal surfaces, and the introduction of the protocol into practical health care.

2021 ◽  
Vol 107 (3) ◽  
pp. 76-81
Author(s):  
M. Drogomyretska ◽  
◽  
R. Mirza ◽  

Abstract. Magnetic resonance imaging is widely used in the presence of such patient complaints as clicking, locking and pain in the temporomandibular joint. The different problems in the treatment of temporomandibular joint pathology, which is accompanied by limited mouth opening, requires certain recommendations for magnetic resonance imaging, supported by current classifications. The purpose of the study: to substantiate the need for the use of an individual mandibular fixator, made before magnetic resonance imaging in the open mouth position to systematization of the treatment outcomes. Materials and methods. On the basis of clinical examination and objectification of the temporomandibular joint status by magnetic resonance imaging the results of treatment of diseases and internal disorders of the temporomandibular joint, which can be obtained by a dentist-gnathologist using non-invasive methods, was analyzed. To obtain images after treatment of the temporomandibular joint an individual mandibular fixator was used, which provided the possibility of evidencebased determination of the articular head position in the open mouth state. To systematize the analysis results of magnetic resonance imaging of the temporomandibular joint, the most convenient classification was chosen. Results. From a clinical sight, the gnathological treatment of temporomandibular joint dislocation without reposition is considered effective if the distance between the incisors, at maximum mouth opening, is 41–50 mm, the articular head is located at the apex of articular tubercle, and in the questioning and isometric tests the patient complaints are absent. Conclusions. The most effective non-invasive treatment of limited mouth opening is possibly with early ambulation, i.e. from three to seven months after onset. Key words: temporomandibular joint, gnathologist, magnetic resonance imaging.


Submit Manuscript | http://medc rav eonline.co m Introduction Colorectal adenocarcinoma is the third most common malignant neoplasia and the third leading cause of death from cancer in men and women in the United States. Current data show that the incidence of colorectal adenocarcinoma is decreasing in developed countries but increasing in developing countries. 1 The 2018 estimates of the Bra - zilian National Cancer Institute (Instituto Nacional do Câncer–INCA) were 17,380 new cases in men and 18,980 in women, making col - orectal adenocarcinoma the third most common neoplasia in men and the second most common in women in Brazil. 2 In the past 15 years, rectal cancer management has evolved in several aspects. Specifical - ly, a better understanding of the natural history of the disease, more precise radiological staging, multimodal therapeutic intervention, refined surgical techniques, and more detailed histopathological re - ports may have positively influenced patient survival. In this context, multidisciplinary management of colorectal cancer plays an important role and requires the coordinated teamwork of colorectal surgeons, oncologists, radiologists, and radiotherapists. 3 Total mesorectal exci - sion is still the basis of treatment in rectal cancer. However, neoadju - vant therapy and more conservative practices have been adopted in cases of clinical/pathological responses to radiochemotherapy. 4 Ra - diological evaluation of the response is of paramount importance for the selection of patients eligible for alternative treatment strategies, including ‘watch-and-wait’. Diffusion-weighted imaging is already being used routinely in the evaluation of the pathological response of rectal tumour patients submitted to neoadjuvant therapy. Some re - searchers have tried to estimate the tumour regression grade (TRG) using magnetic resonance imaging, as has been described for post-ra - diochemotherapy pathological evaluation, thus rendering it a valuable instrument. Considering the good results obtained with multimodal therapy in extraperitoneal rectal cancer, the evaluation of the pathological re - sponse post-neoadjuvant therapy must be considered as a factor for safe indication, both for the conservative option, in which the organ is preserved, and for radical surgical resection, influencing the choice between sphincter-preserving surgery and abdominoperineal excision. A precise evaluation, by comparing the results of post-neoadjuvant therapy magnetic resonance imaging with those obtained from his - Int J Radiol Radiat Ther. 2018;5(4):254 ‒ 258. 254 © 2018 Oliveira et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially. Magnetic resonance imaging is effective in assessing tumour regression after neoadjuvancy in rectal adenocarcinoma

Author(s):  
Fábio Henrique de Oliveira ◽  
Antônio Lacerda-Filho ◽  
Fábio Lopes de Queiroz ◽  
Tatiana Martins Gomide Leite ◽  
Paulo Guilherme Oliveira Sales ◽  
...  

2020 ◽  
Vol 61 (11) ◽  
pp. 1541-1544
Author(s):  
Giancarlo MC Domingues ◽  
Taise T da Silva ◽  
André Y Aihara ◽  
Fabiano N Cardoso ◽  
Virgílio O Barreto

Background Fibrocartilaginous coalition of the third tarsometatarsal joint has been indicated as an extremely rare form of tarsal coalition in the radiological literature, and most articles concerned with tarsal coalition do not mention involvement of this joint. Only two reports written in the English language that approach this subject were found, an orthopedic report and an anthropological report. Purpose To evaluate the prevalence of this finding and discuss and illustrate the radiological characteristics of this coalition. Material and Methods A retrospective analysis of 614 computed tomography or magnetic resonance imaging scans of the ankle and/or foot, acquired at a health service within a period of three months, was performed to assess the prevalence of this coalition. Results Of the examinations characterized as valid for analysis for the purposes of the study, 17 cases compatible with fibrocartilaginous coalition of the third tarsometatarsal joint were found, thus indicating an involvement of approximately 2.97% of the examined feet. Conclusion Our radiological findings are typical, and the prevalence found in this study was statistically significant, being similar to that described in the anthropological report (3.2%–6.8%).


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