scholarly journals Hand-Carried Ultrasonography Instrumentation in the Diagnosis of Temporomandibular Joint Dysfunction

2021 ◽  
Vol 4 (4) ◽  
pp. 81
Author(s):  
Marco Severino ◽  
Silvia Caruso ◽  
Sofia Rastelli ◽  
Roberto Gatto ◽  
Tommaso Cutilli ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Correct Diagnosis ◽  
Mechanical Problem ◽  
Diagnostic Efficacy ◽  
Temporomandibular Joint Dysfunction ◽  
Non Invasive ◽  
Disc Position ◽  
High Level ◽  
Opening And Closing ◽  
Bone Structures

Internal derangement (ID) in the temporomandibular joint (TMJ) is defined as a mechanical problem of the joint that interferes with its function. It is attributed to an abnormal interaction among the articular disc, condyle, and joint eminence. The aim of this study is to evaluate diagnostic efficacy of non-invasive hand-carried ultrasonography instrumentation (US) to provide high-level images for a correct diagnosis of ID. Twenty-eight ID patients, 15 female and 13 males, were examined both clinically and by MRI images in order to achieve a diagnosis of ID (using Helkimo index). Then, they were submitted to US examination with a 12 MHz transducer by using hand-carried instrumentation by a clinician that was blind to their diagnosis and clinical data. TMJ US examination was performed with the mouth closed and mouth open, with proper technique. Each position was then evaluated with two different orientations of the transducer. US showed acceptable results in identifying bone structures. Lower values of diagnostic efficacy were obtained for disc position during joint movements with respect to MRI images. MRI still represents the gold standard for the identification of joint structures. If not corroborated by clinical and anamnestic data, the diagnostic efficacy of US in identifying the position of the disc during opening and closing jaw movements appears limited than compared to MRI.

Signs of temporomandibular joint dysfunction in individuals with different dentition defects and unequal preservation of antagonist pairs of teeth

2021 ◽  
pp. 52-58
Author(s):  
I.S. Redinov ◽  
Ye.A. Pylaeva ◽  
O.O. Strakh ◽  
B.A. Lysenko
Keyword(s):  
Hearing Loss ◽  
Early Diagnosis ◽  
Temporomandibular Joint ◽  
Pathological Process ◽  
Orthopedic Treatment ◽  
Temporomandibular Joint Dysfunction ◽  
Significant Frequency ◽  
System A ◽  
Lower Jaw ◽  
Opening And Closing

As a result of examination and questionnaire of 143 patients who applied for orthopedic treatment of defects of teeth and dental rows, it was found that signs of dysfunction of temporomandibular joint with preserved dental rows are diagnosed in 36—55% cases, and with defects of dental rows — in 45—90% cases. The absence of eighth teeth in the dental row does not significantly change the functional state of the dental-jaw system. A statistically significant frequency of signs of EHS dysfunction has been identified among individuals having terminal dentition defects.In patients with terminal dentition defects, each 3rd patient is diagnosed with cochleovestibular syndrome, and in each 2nd, sounds are determined in the area of VNHS when the lower jaw moves. It has been found that if 15—13 and 12—11 pairs of antagonist teeth are preserved, the signs of dysfunction are determined in 55—45% cases, if the number of teeth having antagonists is reduced to 10—5 (in 90.0% these are patients with preserved 7—8 pairs of antagonist teeth), then the frequency of dysfunction signs increases to 75.0% (t1-3=1.33; t2-3=2.00), in such patients significantly more often — in 75.0% of cases, mandibular deviation is diagnosed when opening and closing the mouth than in persons with a large number of preserved antagonist teeth, respectively 55.0% (t=2.66) and 45.0% (t=3.93) in 1 and 2 groups. Thus, the identification of such signs as crunching, clicking in the joints, hearing loss or tinnitus, suggests the presence of intra-articular disorders in such patients. The deviation of the jaw from its main trajectory when opening the mouth indicates the possible involvement of the masticators muscles in the pathological process. All this requires the dentist to carry out early diagnosis and timely orthopedic treatment.

The Incidence Rate of Temporomandibular Joint Dysfunction in Patients with Earache

2020 ◽  
Author(s):  
Shamsoulmolouk Najafi ◽  
Nafiseh Sheykhbahaei ◽  
Maryam-Sadat Sadrzadeh-Afshar ◽  
Shahin Asadi-Ghalhari ◽  
Narges Gholizadeh
Keyword(s):  
Temporomandibular Joint ◽  
Incidence Rate ◽  
Correct Diagnosis ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Temporomandibular Joint Dysfunction ◽  
Chi Square Test ◽  
Axis I ◽  
And Gender

Background and Objectives: Temporomandibular joint dysfunction (TMD) is known as a chronic pain in the earsmanifested in the form of tinnitus, earache, hearingloss, vertigo, and other impairments. Although patients affected with this disorderundergo long-term treatmentsusing various medicines without significant pain relief,medical care is still possible with a correct diagnosis. This study investigated the incidencerate of TMD in patients suffering from earache. Materials and Methods:This cross-sectional study investigate theincidencerate of TMDin patients with earache referring todental clinics affiliated toTehran University of Medical Sciences (TUMS), Iran, including patients with over six months of earache or those having pain despite using medicines. The Diagnostic Criteria for TMD (DC/TMD) Axis I and II Protocol was used for examining TMD and stress, and also independent t-test and Chi-square test were employedto compare TMD patientsin terms of age and gender. Results:A total number of 100 individuals aged between 18 and 65 years, including 40 males and 60 females were examined in this study. The incidence rate of TMD in patients with earache was also reported by 76.5%. Conclusion:The results indicated a highincidence rate ofTMDin patients having earache. Accordingly, patients complaining about TMD required specialized earache evaluationsby dentists and medics.

scholarly journals Efficiency of treatment of patients with muscular and joint dysfunction of the temporomandibular joints

2020 ◽  
Vol 86 (1) ◽  
pp. 94-102
Author(s):  
T. Kostiuk ◽  
A. Kaniura
Keyword(s):  
Temporomandibular Joint ◽  
Sagittal Plane ◽  
Muscle Relaxation ◽  
Pain Syndrome ◽  
Temporomandibular Joint Dysfunction ◽  
Occlusal Splints ◽  
Temporomandibular Joints ◽  
Number Of Patients ◽  
Before And After ◽  
Opening And Closing

The prevalence of dysfunction of the temporomandibular joint, especially in people aged 18-60 years, reached 95-98 % among all dental applications. The course of the pathology is usually hidden, with periodic recurrences and has a long nature, which is accompanied by a decrease in overall quality of life. Treatment of this pathology of the temporomandibular joint is a set of complex therapeutic, orthopedic and psychological measures. The literature describes many ways to treat temporomandibular joint dysfunction, one of the modem ones is the use of occlusal splints, which allow to change the position of the mandible, diagnose and eliminate musculoskeletal dysfunction of the temporomandibular joint. The aim of the study was to determine the effectiveness of treatment of musculoskeletal dysfunction of the temporomandibular joint with occlusal splints according to axiography. 274 patients aged 18 to 65 years were diagnosed with temporomandibular joint pain syndrome before and after treatment. All patients with signs of temporomandibular joint dysfunction before treatment had a violation of the trajectory of the mandible (deviation is 68.7 %, dyslexia is 31.3 %). When opening and closing the mouth, asymmetrical shifts of the lower jaw to the sides of more than 2 mm (deviation from the midline is more than 2 mm) were observed. After treatment with occlusal splints there was an improvement in the trajectory of opening and closing the mouth: the number of patients with a violation of the trajectory decreased by 89.1 %, and the displacement of the mandible during opening and closing the mouth in 92.4 % of patients decreased on average to 0.9 mm. When analyzing the movements of the mandible in the sagittal plane in 79 % of cases, deviations of the trajectory of the mandible were detected. After treatment with occlusive muscle relaxation splints, elimination of violations of the trajectory of the mandible in the transverse plane was noted in 93.4 % of cases, reduction of displacement to 0.9 mm in 78.1 % of patients. The trajectory of the mandible in the sagittal plane improved in 80.1 % of patients, normalization of the position of the mandible relative to the neuromuscular trajectory was achieved in 93.4 % of clinical cases. According to the analysis of parameters, such treatment should be considered effective. Keywords: musculoskeletal dysfunction, temporomandibular joint, clinical dysfunction index, axiography, sagittal articular pathway angle, sagittal incisor pathway angle, Bennett’s angle (movement), duration.

scholarly journals Analysis of height and width of mandibular condyle and shape of the articular eminence with and without clicking using TMJ radiography

2019 ◽  
Vol 4 (3) ◽  
pp. 99-103
Author(s):  
Cek Dara Manja ◽  
◽  
Daashinta Rajaduray ◽  
Keyword(s):  
Temporomandibular Joint ◽  
Mandibular Condyle ◽  
Average Height ◽  
Glenoid Fossa ◽  
Articular Eminence ◽  
Temporomandibular Joint Dysfunction ◽  
Average Width ◽  
Significant Difference ◽  
Average Form ◽  
Opening And Closing

The temporomandibular joint (TMJ) is the joint of the mandibular condyle with the glenoid fossa of the temporal bone and is the only joint in the head that is responsible for opening and closing movements of the jaw. Cliking is the most frequent symptom indicating temporomandibular joint dysfunction. Several radiographic techniques are used to establish the diagnosis in the examination of the temporomandibular joint. This research was carried out using closed mouth TMJ radiography. The purpose of this study was to determine the height and width of the mandibular condyle and the form of eminence with and without clicking using TMJ radiographs. This research is a descriptive analytic study. The results showed that the average height of the mandibular condyle with clicking was 18,796 mm and without clicking was 22,812 mm. The average width of the mandibular condyle with cliking is 11673mm and without cliking is 11,181mm. The average form of articular eminence with clicking is 36.754 ° and without cliking is 41.081 °. The conclusion of the study was that using the Independent t test there were significant differences in the height of the mandibular condyle and the shape of the articular eminence but there was no significant difference in the width of the mandibular condyle with and without clicking using TMJ radiographs.

scholarly journals Magnetic resonance imaging of the temporomandibular joint acquired using different parameters

2014 ◽  
Vol 31 (02) ◽  
pp. 103-109 ◽  
Author(s):  
M. Alonso ◽  
T. Gamba ◽  
S. Lopes ◽  
A. Cruz ◽  
D. Freitas ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cortical Bone ◽  
Temporomandibular Joint ◽  
Proton Density ◽  
Response Patterns ◽  
Resonance Imaging ◽  
Medullary Bone ◽  
Disc Position ◽  
Bone Structures

Abstract Introduction: Magnetic resonance imaging (MRI) is considered the examination of choice for the diagnosis of abnormalities in the TMJ. Considering the difficulty in defining and standardizing the diagnostic criteria, and the need for more accurate and reliable diagnosis of conditions in the TMJ, the aim of the present study was to compare three different MRI parameters: Tl-weighted, T2-weighted and proton density-weighted in the diagnosis of changes in the temporomandibular joint. Materials and Methods: Fifty magnetic resonance imaging examinations of the temporomandibular joint (100 temporomandibular joints) were conducted according to a protocol that evaluates disc position, disc function and bone abnormalities. The images were obtained bilaterally in parasagittal sections in closed and open mouth positions in the three studied parameters Three trained oral radiologists assessed all the images. Reliability of the intra- and inter-examiner response was analyzed using the concordance test (Fleiss' kappa; α = 0.05). Results: The reliability of the response patterns between observers for different protocols varied from very good to good. Observers were less constant in their response patterns when assessing proton density-weighted images. There was very good agreement for disc morphology, cortical bone and bone structures/functions; however, there was wide variation for medullary bone marrow signs. Conclusion: T2-weighted imaging was found to be the best examination to assess the medullary bone. For evaluating of disc morphology, cortical bone and bone structures/functions, any protocol is indicated once the protocol does not interfere with the analysis.

scholarly journals Non-invasive approach in the treatment of temporomandibular joint osteoarthritis

2020 ◽  
pp. 79-79
Author(s):  
Andjela Milojevic-Samanovic ◽  
Dejan Zdravkovic ◽  
Stefan Velickovic ◽  
Milica Jovanovic ◽  
Marko Milosavljevic
Keyword(s):  
Temporomandibular Joint ◽  
Muscle Tension ◽  
Masticatory Muscles ◽  
Invasive Approach ◽  
Non Invasive ◽  
Temporomandibular Joint Osteoarthritis ◽  
Patient Reported ◽  
Orofacial Region ◽  
The Right ◽  
Bone Structures

Introduction. Temporomandibular dysfunction (TMD) is a set of disorders that involve the masticatory muscles, the temporomandibular joint (TMJ) and its associated structures. Osteoarthritis (OA), as one of the forms of TMD, leads to permanent changes in the bone structures of TMJ. These changes can be the cause of serious functional disorders of the TMJ. Case outline. This article describes a case of a 24-year-old female patient who sought help due to pain and swelling in the area of the right and left TMJ, accompanied by muscular tension, severe headaches, which did not respond to medication. ?fter establishing the diagnosis, we have applied a therapy in the treatment of the bilateral OA of TMJ, where we used non-invasive methods. Six months later, the patient reported the absence of pain, swelling, headache, and muscle tension in the orofacial region. Conclusion. There is no ?gold standard? for the management of ?? of ???. In our study, non-invasive therapy had a positive effect, where we achieved success in eliminating pain, increasing range of motion of the lower jaw, stopping the progression of the disease and advancing quality of life.

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

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