THE EFFICACY OF HIGH CONDYLECTOMY IN INTERNAL DERANGMENT OF THE TEMPOROMANDIBULAR JOINT

Background: Temporomandibular joint (TMJ) is a giglymoarthroidal Joint; it is the only mobile joint in the entire maxillofacial region and is a part of craniomandibular articulation. Methods: All the patients with internal derangement of temporomandibular joint having anterior disc displacement without reduction with complaints of pain and limited opening of mouth, of all age group reporting to the Department of Oral & Maxillofacial Surgery, GDC Jaipur were included in the study. Results: At one month follow up out of 20 patients 13 patients were not satisfied and at 6 month follow up 2 patients were not satisfied at all. Conclusion: We conclude that surgical treatment for internal derangement of the TMJ is required; this technique is effective to improve pain and mouth opening without complications. Although this study has a short follow up period and small sample size. Keywords: Mandible, Maxilla, TMJ.

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Efficacy of Acrylic Splint in Management of Internal Derangement of Temperomandibular Joint

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v42i2.32040 ◽

2017 ◽

Vol 42 (2) ◽

pp. 72-77 ◽

Cited By ~ 2

Author(s):

Mohammed Ayaz Ahmed ◽

Quazi Billur Rahman ◽

Md. Wares Uddin ◽

Md. Asaduzzaman

Keyword(s):

Supportive Care ◽

Temporomandibular Joint ◽

Pain Score ◽

Mouth Opening ◽

Internal Derangement ◽

Controlled Clinical Trial ◽

Occlusal Splint ◽

Group A ◽

Group B

Occlusal splint plays a great role in the treatment of internal derangement of temporomandibular joint. Temporomandibular disorders affect 25 % of the population of the world. The purpose of the study was to elucidate the effectiveness of occlusal splint in reduction of pain, increase mouth opening, elimination of clicking sound. This randomized controlled clinical trial was done on 26 patients in two groups. Group A received occlusal splint and Group B received medications with supportive care. Monthly follow-up was done for a period of four months. In Group A and Group B, preoperative mean of mouth opening were 36.31 mm; and 39.77 mm. pain score 4.54 cm, clicking in 76.9% and 84.6% patients respectively. After 4 months of follow- up mouth opening 50.69 mm and 43.15 mm, pain score 0.154 cm and 0.69 cm, clicking 30.8% and 76.9% patients in both groups respectively. It may be conclude that the occlusal splint is highly efficient than medication and supportive care for managing of internal derangement of temporomandibular joint.

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Temporomandibular Joint Ankylosis Among Patients at Saint Paul’s Hospital Millennium Medical College, Ethiopia: a 9 Year Retrospective Study

10.21203/rs.3.rs-53966/v1 ◽

2020 ◽

Author(s):

Dereje Mekonnen ◽

Andamlak Gizaw ◽

Bruktawit Kebede

Keyword(s):

Temporomandibular Joint ◽

Medical Records ◽

Maxillofacial Surgery ◽

Mouth Opening ◽

Age Group ◽

Medical College ◽

Temporomandibular Joint Ankylosis ◽

Gap Arthroplasty ◽

Imaging Results ◽

Joint Ankylosis

Abstract Background: Temporomandibular joint ankylosis (TMJA) is a gradually developing pathological condition manifested by a limited mouth opening. It can result in an extremely disabling situation that may affect mastication, swallowing, speech, oral hygiene, and facial cosmetic appearance. The present study was aimed to determine the pattern of TMJA at St. Paul’s Hospital millennium medical college (SPHMMC), Addis Ababa, Ethiopia.Methods: A retrospective descriptive study design was conducted at SPHMMC. All medical records of patients with the diagnosis of TMJA that visited the Maxillofacial Surgery unit from September 2010 through August 2019 were reviewed. Clinical data including age, sex, place of residency, duration of the case, etiology, clinical presentations, imaging results, the type of operation and complications after surgery were collected, and analyzed by using SPSS version 20.0 windows software computer program. Results: A total of 130 patients’ medical records were reviewed. Out of this, 95 were included in the study. 42(44.2%) of the TMJA case were males, while the remaining 53(55.8%) were females with a female to male ratio of 1.26:1. The most affected age group was 20 to 39 years 36(37.9%), followed by the age group of 30 to 39 years 33(34.7%). Trauma was identified as the most common cause of TMJA. Notably, bilateral ankylosis was more common than unilateral, and mandibular deformity (micrognathia) was the most common deformity observed. The majority 52(54.7%) of TMJA patients were treated with Gap arthroplasty.Conclusions: Trauma was identified as the main cause of TMJA. The majority of TMJA cases were surgically treated with Gap arthroplasty with almost no postoperative complications. Thus early detection and intervention to release the ankylosed joint is needed to improve patient’s quality of life.

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Assessing Biomarkers of Breast Cancer Risk in Underserved Women in a Midwestern County

Journal of Primary Care & Community Health ◽

10.1177/21501327211017792 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110177

Author(s):

Marla A. DeWitt ◽

Ivana T. Croghan ◽

Celine M. Vachon ◽

Thomas D. Thacher ◽

Marcia R. Venegas Pont ◽

...

Keyword(s):

Vitamin D ◽

Mammographic Density ◽

Small Sample Size ◽

Vitamin D Insufficiency ◽

Screening Mammography ◽

Small Sample ◽

Vitamin D Status ◽

Small Pilot Study ◽

Unexpected Findings

Objective: The primary aim of this study was to evaluate the feasibility of collecting risk factor information and accessing digitized mammographic data in a medically marginalized population. A secondary aim was to examine the association between vitamin D status and mammographic density. Methods: Breast-screening examinations were provided for age-appropriate patients, and a referral for no-cost screening mammography was offered. Study participants were asked to undergo 25-hydroxyvitamin D testing at mammography and 1-year follow-up. Results: Of 62 women approached, 35 (56%) consented to participate. Of 32 participants who had baseline mammography, the median mammographic density measured by VolparaDensity (Volpara Solutions Limited) was 5.7%. After 1 year, 9 women obtained follow-up mammograms, with a median density of 5.7%. Vitamin D status was measured for 31 participants at baseline and 13 participants in the following year. Insufficient vitamin D status (<30 ng/mL) was noted in 77% at each time point. Mammographic density was not significantly correlated with vitamin D status ( P = .06). Conclusions: On the basis of this small pilot study, vitamin D insufficiency is common in this study population. Owing to the small sample size, an association between vitamin D insufficiency and breast density was not clear. Additional unexpected findings included substantial barriers in initial access to care and longitudinal follow-up in this population. Further study of these issues is needed.

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Role of Electro Acupuncture Therapy on Temporomandibular Joint Pain With Orofacial Myalgia Following Post Healed Unilateral Cervicofacial Burn

Acupuncture & Electro-Therapeutics Research ◽

10.3727/036012921x16164310686789 ◽

2021 ◽

Vol 46 (2) ◽

pp. 123-134

Author(s):

Gopal Nambi ◽

Walid Kamal Abdelbasset ◽

Shereen H. Elsayed ◽

Anju Verma ◽

Shimaa Abd El-Hamid Abase ◽

...

Keyword(s):

Acupuncture Therapy ◽

Temporomandibular Joint ◽

Joint Pain ◽

Pain Threshold ◽

Mouth Opening ◽

Temporomandibular Joint Pain ◽

Pain Frequency ◽

Disability Level

Background: Temporomandibular Joint (TJ) pain and orofacial myalgia (OM) are the most significant problems in physiotherapy context to treat in Cervicofacial burn (CB). However, there is a lack of clinical studies in investigating the effects of electro acupuncture therapy on TJ pain with OM following post healed CB patients.<br/> Objective: To investigate the effects of clinical and functional efficacy of electro acupuncture therapy on temporomandibular joint pain with orofacial myalgia following post healed cervicofacial burn patients.<br/> Methods: Through two block random sampling method, the eligible participants were randomized and allocated into active EAT (Active-EAT; n = 15) and placebo EAT (Placebo-EAT; n = 15) groups. The Active-EAT group received electro acupuncture therapy and the Placebo-EAT group received placebo effect with regular physiotherapy care for 4 times in a week for 4 weeks. Primary (pain intensity, pain threshold, pain frequency) and secondary (mouth opening, disability level and quality of life) measures were measured at baseline, after the 4th week, 8th week and 6 month follow up.<br/> Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p > 0.05). After 4 weeks of treatment, and at the end of 6 months follow up, the pain intensity, 3.0 (CI 95% 2.83 to 3.16), pain threshold 18.6 (CI 95% -35.0 to -2.1), pain frequency 2.9 (CI 95% 2.54 to 3.25), mouth opening, -13.4 (CI 95% -15.1 to -11.6), disability level 12.4 (CI 95% 12.16 to 12.63), and quality of life -25.8 (CI 95% -31.0 to -20.5) showed more improvement (p < 0.001) in Active-EAT group than Placebo-EAT group.<br/> Conclusion: The reports of this study proved that, 4 weeks active electro acupuncture therapy with regular physiotherapy care has an ideal treatment protocol for temporomandibular joint pain with orofacial myalgia following post healed cervicofacial burn. This study also provided a new knowledge for physiotherapists in the field of TJ rehabilitation.

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Role of multiparametric MRI in long-term surveillance following focal laser ablation of prostate cancer

British Journal of Radiology ◽

10.1259/bjr.20210414 ◽

2021 ◽

pp. 20210414

Author(s):

Mark Paxton ◽

Eitan Barbalat ◽

Nathan Perlis ◽

Ravi J Menezes ◽

Mark Gertner ◽

...

Keyword(s):

Laser Ablation ◽

Recurrent Disease ◽

Small Sample Size ◽

Focal Therapy ◽

Outcome Data ◽

Small Sample ◽

Restricted Diffusion ◽

Treatment Site ◽

Imaging Characteristics

Objective: Determine the multiparametric magnetic resonance imaging (mpMRI) appearance of the prostate following focal laser ablation (FLA) for PCa and to identify imaging characteristics associated with recurrent disease. Methods: Retrospective analysis of patients who underwent FLA for low-intermediate risk PCa between 2010 and 2014 was performed. Early (median 4 months) and late mpMRI (median 49 months) follow-up were qualitatively assessed for T2-weighted, dynamic contrast enhanced (DCE) and diffusion weighted imaging (DWI) appearances and also compared to corresponding PSA values and biopsy results. Results: 55 cancers were treated in 54 men (mean age 61.0 years). Early mpMRI was performed in 30 (54.5%) patients while late follow-up mpMRI in 42 (84%). Ill-defined scarring with and without atrophy at the treatment site were the most common appearances. In patients with paired MRI and biopsy, one of four patients with clinically significant PCa on biopsy (≥GG2 or≥6 mm GG1) showed hyperenhancement or restricted diffusion at early follow-up. At late follow-up, positive biopsies were seen in 5/8 (63%) cases with hyperenhancement and 5/6 (83%) cases with restricted diffusion at the treatment site. PSA change was not associated with biopsy results at either time point. Conclusion: mpMRI is able to document the morphological and temporal changes following focal therapy. It has limited ability to detect recurrent disease in early months following treatment. Late-term mpMRI is sensitive at identifying patients with recurrent disease. Small sample size is, however, a limitation of the study. Advances in knowledge: Implementing MRI in follow-up after FT may be useful in predicting residual or recurrent PCa and therefore provide reliable outcome data.

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Management of Internal Derangement of Temporomandibular Joint Disc Displacement with Reduction Using Two Different Lines of Treatment

Brazilian Dental Science ◽

10.14295/bds.2021.v24i2.2080 ◽

2021 ◽

Vol 24 (2) ◽

pp. 8

Author(s):

Mohamed Ahmed Helal ◽

Shoroog Hassan Agou ◽

Amr Bayoumi ◽

Ahmed Imam ◽

Ali Habiballah Hassan

Keyword(s):

Range Of Motion ◽

Temporomandibular Joint ◽

Lower Cost ◽

Internal Derangement ◽

Disc Displacement ◽

Temporomandibular Joint Disc ◽

Non Invasive ◽

Anterior Disc Displacement ◽

Disc Displacement With Reduction

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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Utility of chemotherapy given before and/or after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for appendiceal adenocarcinoma with peritoneal metastases.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e16276 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e16276-e16276

Author(s):

Tyler Friedrich ◽

Junxiao Hu ◽

Robert William Lentz ◽

Alexis Diane Leal ◽

Sunnie S. Kim ◽

...

Keyword(s):

Intraperitoneal Chemotherapy ◽

Cytoreductive Surgery ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Small Sample Size ◽

Peritoneal Metastases ◽

Small Sample ◽

Histologic Grade ◽

Low Grade ◽

Appendiceal Adenocarcinoma

e16276 Background: Appendiceal adenocarcinoma is relatively rare and often diagnosed incidentally during operations for acute appendicitis. It is commonly associated, either at time of initial presentation or upon recurrence, with peritoneal metastases. A typical treatment strategy for patients with peritoneal disease includes cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Extrapolating largely from literature in colorectal cancer, chemotherapy is frequently given before and/or after CRS/HIPEC though high-level evidence to support this is lacking. We sought to evaluate the effect of systemic chemotherapy on survival. Methods: Utilizing a database of CRS/HIPEC procedures at University of Colorado Hospital from 2008 to present we retrospectively reviewed cases of appendiceal adenocarcinoma. Data collected included staging, histologic grade, chemotherapy given, surgical outcomes, and time to disease recurrence. Patients without adequate information regarding treatment, or without at least 1 year of clinical follow-up, were excluded. Associations between administration of chemotherapy or histologic grade and 1-year DFS were analyzed using Fisher’s exact test, and logistic regression was used to assess whether 1-year DFS were different in chemotherapy-treated patients when adjusted for histologic grade. Results: In total, 117 cases reviewed indicated an appendiceal pathology. Of these, 54 cases in a total of 51 patients met the specified criteria for pathology and completeness and length of follow-up information. The average age was 58 years (range 26-81 years). Adenocarcinoma was graded as low in 15 (28%) cases, intermediate in 18 (33%) cases, and high in 21 (39%) cases. 23 (43%) patients received no chemotherapy while 31 (57%) received chemotherapy before and/or after surgery. In the overall population, there was no significant effect of chemotherapy on survival, with 1-year DFS demonstrated in 74.2% of patients receiving some chemotherapy and 70% in patients not receiving chemotherapy (p = 0.765). One-year DFS was achieved in 86% of low-grade cases, 61% of intermediate-grade cases, and 71% of high-grade cases, though this was also not statistically significant (p = 0.254). Furthermore, when 1-year DFS between chemotherapy and non-chemotherapy patients was adjusted for grade, there was again no significant interaction (odds ratio = 0.48, 95% C.I. (0.13-1.64), p = 0.763). Conclusions: In this small, single-institution experience of patients with peritoneal appendiceal adenocarcinoma, there was no significant effect of chemotherapy administration on 1-year DFS. These findings are likely affected by significant confounding with the small sample size and retrospective nature of the data. Further investigation on a larger scale is warranted.

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Arthrocentesis and Sodium Hyaluronate Infiltration in Temporomandibular Disorders Treatment. Clinical and MRI Evaluation

Journal of Functional Morphology and Kinesiology ◽

10.3390/jfmk5010018 ◽

2020 ◽

Vol 5 (1) ◽

pp. 18 ◽

Cited By ~ 1

Author(s):

Mario Santagata ◽

Roberto De Luca ◽

Giorgio Lo Giudice ◽

Antonio Troiano ◽

Giuseppe Lo Giudice ◽

...

Keyword(s):

Temporomandibular Joint ◽

Joint Damage ◽

Mouth Opening ◽

Sodium Hyaluronate ◽

Mean Value ◽

Temporomandibular Joint Disorders ◽

Mean Values ◽

Masticatory Efficiency ◽

The Mean

Arthrocentesis in temporomandibular joint disorders can be associated with the intra-articular infiltration of various drugs with the objective of increase treatment efficacy. The aim of this study was to evaluate the clinical indexes variation in patients affected by temporomandibular joint disorders treated with arthrocentesis and sodium hyaluronate (SH) injections. A total of 28 patients suffering from temporomandibular joint disorders underwent one cycle of five arthrocentesis and infiltrations of sodium hyaluronate. Spontaneous mouth opening improved from 36.3 ± 7.5 mm to 45.1 ± 1.9 mm at six months follow-up. A significant reduction in the pain at rest and during mastication mean values emerged at follow-up (p < 0.0001). The mean masticatory efficiency, evaluated through a visual analogic scale, showed improvement at the follow-up period, highlighted by the increase of mean value from a baseline of 3.1 ± 1.2 to a mean value of 8.5 ± 1.2 (p < 0.0001). The mean severity of the joint damage at baseline time was 2.4 ± 0.9 and decreased to 0.4 ± 0.3 at the end of the follow-up period. The decrease in values is confirmed by statistical test (p < 0.05). Our data show how arthrocentesis integrated with sodium hyaluronate infiltrations performed under local anesthesia is a valid method of treating temporomandibular joint disorders.

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Usefulness of mycophenolate mofetil in Indian patients with C3 glomerulopathy

Clinical Kidney Journal ◽

10.1093/ckj/sfy127 ◽

2018 ◽

Vol 12 (4) ◽

pp. 483-487 ◽

Cited By ~ 1

Author(s):

Joyita Bharati ◽

Karalanglin Tiewsoh ◽

Ashwani Kumar ◽

Ritambhra Nada ◽

Manish Rathi ◽

...

Keyword(s):

Mycophenolate Mofetil ◽

Small Sample Size ◽

Initial Response ◽

Immunosuppressive Agent ◽

Small Sample ◽

C3 Glomerulopathy ◽

Standardized Treatment ◽

Stage Renal Disease ◽

End Stage

Abstract Background C3 glomerulopathy (C3G) is a heterogeneous disease caused by alternative complement pathway abnormalities without any standardized treatment. An immunosuppressive agent, mycophenolate mofetil (MMF), has been recently shown to be useful in treating C3G, mainly in studies from the west. We report the clinical outcome of 17 Indian C3G patients treated with MMF with or without steroids. Methods The clinical and histology details of the C3G patients treated with MMF for at least 6 months with a follow-up of at least 12 months were retrieved from the medical records of our center. Results The median serum creatinine and proteinuria at presentation were 0.8 mg/dL and 3.7 g/day, respectively, with the majority (88.2%) presenting as nephrotic syndrome. The mean dose of MMF was 1.65 (±0.56) g/day, and the median duration of MMF therapy was 18 months. Two-thirds (64%) of the patients responded to the treatment, with complete remission in 4 (23%) and partial remission in 7 (41%) (median time: 9 months). Three patients progressed to end-stage renal disease (ESRD) on follow-up. Of the three patients, one (33%) had an initial response in proteinuria to MMF but did not respond after a relapse and subsequently progressed to ESRD and two (67%) other patients were nonresponsive to MMF from the start of the therapy. Conclusion Despite a small sample size and lack of a control arm, this study describes the effectiveness of MMF in treating C3G patients from Asia and forms a basis for future randomized trials.

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Improved Postoperative Survival for Intraductal- Growth Subtype of Intrahepatic Cholangiocarcinoma

The American Surgeon ◽

10.1177/000313481608201132 ◽

2016 ◽

Vol 82 (11) ◽

pp. 1133-1139 ◽

Cited By ~ 3

Author(s):

Laura L. Dover ◽

Rojymon Jacob ◽

Thomas N. Wang ◽

Joseph H. Richardson ◽

David T. Redden ◽

...

Keyword(s):

Intrahepatic Cholangiocarcinoma ◽

Small Sample Size ◽

Tumor Stage ◽

Small Sample ◽

Postoperative Survival ◽

Rank Test ◽

Intraductal Growth ◽

Kaplan Meier ◽

Disease Free

Intrahepatic cholangiocarcinoma (ICC) is classified according to the following subtypes: mass-forming (MF), periductal infiltrating (PI), and intraductal growth (IG). The aim of this study is to measure the association between ICC subtypes and patient survival after surgical resection. Data were abstracted on all patients treated with definitive resections of ICC at a single institution between 2000 and 2011 with at least three years follow-up. Survival estimates were quantified using Kaplan-Meier curves and compared using the log-rank test. There were 37 patients with ICC treated with definitive partial hepatectomies with a median survival of 33.5 months. Tumor stage (P < 0.0001), satellitosis (P < 0.001), lymphovascular space invasion (P = 0.003), and macroscopic subtype (P = 0.003) were predictive of postoperative survival. Disease-free survivals for MF, PI, and IG subtypes, respectively, were 30 per cent, 0 per cent, and 57 per cent (P = 0.017). Overall survivals among ICC macroscopic subtypes were as follows: MF 37 per cent, PI 0 per cent, and IG 71 per cent (P = 0.003). Although limited by the small sample size of this rare cancer, this study demonstrates significant differences among macroscopic subtypes of ICC in both disease-free survivals and overall survivals after definitive partial hepatectomy.

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