scholarly journals Temporomandibular joint loads in subjects with and without disc displacement

2009 ◽  
Vol 1 (1) ◽  
pp. 29 ◽  
Author(s):  
Laura Rei Iwasaki ◽  
Michael Crosby ◽  
Yoly Gonzalez ◽  
Willard D. McCall ◽  
David B. Marx ◽  
...  
Keyword(s):  
Individual Differences ◽  
Temporomandibular Joint ◽  
Magnetic Resonance Images ◽  
Joint Disease ◽  
Computer Assisted ◽  
Disc Displacement ◽  
Joint Mechanics ◽  
Disc Position ◽  
Tmj Disc ◽  
Joint Loads

The likelihood of development of degenerative joint disease (DJD) of the temporomandibular joint (TMJ) is related to the integrity of the TMJ disc. Predilection for mechanical failure of the TMJ disc may reflect inter-individual differences in TMJ loads. Nine females and eight males in each of normal TMJ disc position and bilateral disc displacement diagnostic groups consented to participate in our study. Disc position was determined by bilateral magnetic resonance images of the joints. Three-dimensional (3D) anatomical geometry of each subject was used in a validated computer-assisted numerical model to calculate ipsilateral and contralateral TMJ loads for a range of biting positions (incisor, canine, molar) and angles (1-13). Each TMJ load was a resultant vector at the anterosuperior-most mediolateral midpoint on the condyle and characterized in terms of magnitude and 3D orientation. Analysis of variance (ANOVA) was used to test for effects of biting position and angle on TMJ loads. Mean TMJ loads in subjects with disc displacement were 9.5-69% higher than in subjects with normal disc position. During canine biting, TMJ loads in subjects with disc displacement were 43% (ipsilateral condyle, p=0.029) and 49% (contralateral condyle, p=0.015) higher on average than in subjects with normal disc position. Biting angle effects showed that laterally directed forces on the dentition produced ipsilateral joint loads, which on average were 69% higher (p=0.002) compared to individuals with normal TMJ disc position. The data reported here describe large differences in TMJ loads between individuals with disc displacement and normal disc position. The results support future investigations of inter-individual differences in joint mechanics as a variable in the development of DJD of the TMJ.

scholarly journals Evaluation of TMJ articular eminence morphology and disc patterns in patients with disc displacement in MRI

2007 ◽  
Vol 21 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Fabio Henrique Hirata ◽  
Antônio Sérgio Guimarães ◽  
Jefferson Xavier de Oliveira ◽  
Carla Ruffeil Moreira ◽  
Evangelo Tadeu Terra Ferreira ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Temporomandibular Joint ◽  
Contralateral Side ◽  
Magnetic Resonance Images ◽  
Disc Displacement ◽  
Articular Disc ◽  
Articular Eminence ◽  
Disc Position ◽  
Disc Configuration ◽  
Disc Displacement With Reduction

The aim of this study was to assess the shape of the temporomandibular joint (TMJ) articular eminence and the articular disc configuration and position in patients with disc displacement. TMJ magnetic resonance images (MRI) of 14 patients with bilateral disc displacement without unilateral reduction were analyzed. Articular eminence morphology was characterized as box, sigmoid, flattened, or deformed. Articular disc configuration was divided into biconcave, biplanar, biconvex, hemiconvex or folded, and its position, as "a" (superior), "b" (anterosuperior), "c" (anterior) or "d" (anteroinferior). The images were divided and the sides with disc displacement with reduction (DDWR) and without reduction (DDWOR) were compared. Regarding articular eminence shape, the sigmoid form presented the greatest incidence, followed by the box form, in the DDWR side, although this was not statistically significant. In the DDWOR side, the flattened shape was the most frequent (p = 0.041). As to disc configuration, the biconcave shape was found in 79% of the DDWR cases (p = 0.001) and the folded type predominated in 43% of the DDWOR cases (p = 0.008). As to disc position, in the DDWR side, "b" (anterosuperior position) was the most frequent (p = 0.001), whereas in the DDWOR side, "d" (anteroinferior position) was the most often observed (p = 0.001). The side of the patient with altered disc configuration and smaller shape of TMJ articular eminence seems to be more likely to develop non-reducing disc displacement as compared to the contralateral side.

scholarly journals High-resolution ultrasonography in assessing temporomandibular joint disc position

2018 ◽  
Vol 1 (1) ◽  
pp. 64 ◽  
Author(s):  
Daniel Talmaceanu ◽  
Lavinia Manuela Lenghel ◽  
Nicolae Bolog ◽  
Roxana Popa Stanila ◽  
Smaranda Buduru ◽  
...  
Keyword(s):  
High Resolution ◽  
Temporomandibular Joint ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Degenerative Changes ◽  
Disc Displacement ◽  
Disc Position ◽  
Tmj Disc ◽  
High Resolution Ultrasonography ◽  
Disc Displacement With Reduction

Aims: The purpose of this study was to determine the diagnostic value of high-resolution ultrasonography (US) in temporomandibular joint (TMJ) disc displacements.Materials and methods: A number of 74 patients (148 TMJs) with signs and symptoms of TMJ disorders, according to the Research Diagnostic Criteria for Temporomandibular Disorders, were included in this study. All patients received US and magnetic resonance imaging (MRI) of both TMJs 1 to 5 days after the clinical examination. MRI examinations were performed using 1.5 T MRI equipment (Siemens Avanto, Siemens, Erlangen). Ultrasonographic examination was performed on a Hitachi EUB 8500 (Hitachi Medical Corp., Tokyo, Japan) scanner with L 54 M6.5-13 MHz linear transducer.Results: MRI depicted 68 (45.95%) normal joints, 47 (31.76%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 34 (22.97%) with degenerative changes. US detected 78 (52.7%) normal joints, 37 (25%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 21 (14.19%) with degenerative changes. Compared to MRI, US showed a sensitivity of 93.1%, specificity of 87.88%, accuracy of 90.32%, a positive predictive value of 87.1% and a negative predictive value of 93.55% for overall diagnosis of disc displacement. The Youden index was 0.81.Conclusions: Based on our results, high-resolution ultrasonography showed high sensitivity, specificity and accuracy in the diagnosis of TMJ disc displacement. It could be a valuable imaging technique in assessing TMJ disc position. The diagnostic value of high-resolution ultrasonography depends strictly on the examiner’s skills and on the equipment used. 

scholarly journals The importance of multisection sagittal and coronal magnetic resonance imaging evaluation in the assessment of temporomandibular joint disc position

2020 ◽  
Vol 25 (1) ◽  
pp. 159-168
Author(s):  
Monika Litko-Rola ◽  
Jacek Szkutnik ◽  
Ingrid Różyło-Kalinowska
Keyword(s):  
Sagittal Plane ◽  
Temporomandibular Disorder ◽  
False Negative ◽  
Disc Displacement ◽  
Resonance Imaging ◽  
Imaging Evaluation ◽  
Magnetic Resonance Imaging Evaluation ◽  
Temporomandibular Joint Disc ◽  
Disc Position ◽  
Tmj Disc

Abstract Objectives The aim of this study was to evaluate diagnoses of temporomandibular (TMJ) disc displacement by comparing evaluations done on the basis of central sagittal scans only, the most often used in temporomandibular disorder (TMD) patients, with a multisection evaluation done with both sagittal and coronal scans. Materials and methods Multisection MRI analysis of 382 TMJs was conducted in 191 patients with disc displacement according to RDC/TMD criteria. Disc position in the intercuspal position (IP) was assessed two times using two different methods. The first method involved a TMJ disc position evaluation on the central slide in the oblique sagittal plane only. In the second method, the TMJ disc position was assessed on all oblique sagittal and coronal images. McNemar’s χ2 test was used to evaluate the differences between the sensitivities of two methods. Results The first method (central oblique sagittal scans assessment) identified 148 TMJs (38.7%) with normal disc position compared with 89 TMJs (23.3%) with normal disc position found by the second method (all oblique sagittal and coronal scans assessment). The sensitivity of analysis in both planes was significantly higher than in the sagittal plane only (p < 0.001). Conclusions The multisection analysis in the sagittal and coronal plane allows to distinguish the correct disc position from disc displacement and thus improve evaluation of TMJ internal derangement. Clinical relevance The multisection sagittal and coronal images should be recommended as a standard in MRI of the TMJ disc displacement in patients with TMD to avoid false-negative diagnoses.

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.

Is Temporomandibular Joint Disc Displacement without Reduction a Plausible Cause of Condylar Hypoplasia? A Case Report

2019 ◽  
Vol 1 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Yi-Shu Liu ◽  
Adrian U-Jin Yap ◽  
Jie Lei ◽  
Kai-Yuan Fu
Keyword(s):  
Temporomandibular Joint ◽  
Clinical Presentation ◽  
Mouth Opening ◽  
Disc Displacement ◽  
Normal Morphology ◽  
Temporomandibular Joint Disc ◽  
Tmj Disc ◽  
Heat Therapy ◽  
Initial Support ◽  
Tmj Pain

Background: The causes of mandibular condylar hypoplasia can be congenital or acquired in nature. Cited local causes of acquired hypoplasia include trauma, infection and irradiation. We report a case of hypoplastic condyle that was attributed to temporomandibular joint (TMJ) disc displacement without reduction (DDwoR). Clinical Presentation: A 16-year-old male presented with restricted mouth opening and right TMJ pain for 6 months. He was subsequently diagnosed with DDwoR. Conservative treatment comprising self-care and moist-heat therapy was administered and he was followed for 27 months without any further interventions. During this period, transitions from “normal” morphology to condylar flattening / erosion, and eventually a re-modeled smaller “normal” right TMJ were observed. Conclusion: The present case provided initial support that DDwoR could be a plausible cause of condylar hypoplasia in adolescents / young adults.

scholarly journals Temporomandibular joint (TMJ) disc position in patients with TMJ pain assessed by coronal MRI

2013 ◽  
Vol 42 (6) ◽  
pp. 20120199 ◽  
Author(s):  
L Eberhard ◽  
NN Giannakopoulos ◽  
S Rohde ◽  
M Schmitter
Keyword(s):  
Temporomandibular Joint ◽  
Disc Position ◽  
Tmj Disc ◽  
Tmj Pain

scholarly journals Magnetic Resonance Imaging Evaluation of Closed-Mouth TMJ Disc-Condyle Relationship in a Population of Patients Seeking for Temporomandibular Disorders Advice

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Matteo Tresoldi ◽  
Ricardo Dias ◽  
Alessandro Bracci ◽  
Marzia Segù ◽  
Luca Guarda-Nardini ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Temporomandibular Disorders ◽  
Clinical Symptoms ◽  
Management Strategies ◽  
Magnetic Resonance Images ◽  
Hospital Services ◽  
Resonance Imaging ◽  
Imaging Evaluation ◽  
Disc Position ◽  
Tmj Disc

Objective. To characterize the closed-mouth temporomandibular joint (TMJ) disc-condyle relationship in a population of individuals who sought hospital services for temporomandibular disorders (TMD). Methods. Two hundred and twenty-four TMJ magnetic resonance images (MRIs) of 112 patients were assessed in all spatial planes to classify disc position with respect to the condyle in a closed-mouth position. Results. Disc displacement (DD) was present in 62.1% and superior disc position in 29.9% of the patients. Position could not be determined in 8% of the cases. Among DD, pure anteriorized position was the most common condition (34.4%), with different combined translational and rotational displacements in all the other joints (27.7%). Conclusion. There is a wide biological variability in disc position in closed mouth among patients seeking for TMD advice. Getting deeper into the correlation with clinical symptoms is recommended to refine the potential relevance of any diagnostic and management strategies based on the imaging evaluation of TMJ disc position.

scholarly journals Effect of Occlusal Splints on the Stress Distribution on the Temporomandibular Joint Disc

2017 ◽  
Vol 28 (3) ◽  
pp. 324-329 ◽  
Author(s):  
Fabiane Maria Ferreira ◽  
Paulo Cézar Simamoto-Júnior ◽  
Carlos José Soares ◽  
António Manuel de Amaral Monteiro Ramos ◽  
Alfredo Júlio Fernandes-Neto
Keyword(s):  
Stress Distribution ◽  
Temporomandibular Joint ◽  
Disc Displacement ◽  
Fe Model ◽  
Distribution Analysis ◽  
Articular Disc ◽  
Occlusal Splint ◽  
Occlusal Splints ◽  
Anterior Disc Displacement ◽  
Disc Position

Abstract Conservative approach, including occlusal splint therapy, is the first option to treat temporomandibular disorders (TMD), because of its reversibility. The present study analyzed the effect of the articular disc position and occlusal splints use on the stress distribution on this disc. A two-dimensional (2D) finite element (FE) model of the temporomandibular joint with the articular disc at its physiologic position was constructed based on cone-beam computed tomography. Three other FE models were created changing the disc position, according to occlusal splint use and anterior disc displacement condition. Structural stress distribution analysis was performed using Marc-Mentat package. The equivalent von Mises stress was used to compare the study factor. Higher stress concentration was observed on the intermediate to anterior zone of the disc, with maximum values over 2MPa. No relevant difference was verified on the stress distribution and magnitude comparing disc positions and occlusal splint use. However, there was stress reduction arising from the use of the occlusal splints in cases of anterior disc displacement. In conclusion, based on the generated FE models and established boundary conditions, the stress increased at the intermediate zone of the TMJ disc during physiological mandible closure. The stress magnitude was similar in all tested situations

scholarly journals Temporomandibular joint anchorage surgery: a 5-year follow-up study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Xiuming Liu ◽  
Zhihang Zhou ◽  
Yi Mao ◽  
Xuzhuo Chen ◽  
Jisi Zheng ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Temporomandibular Joint ◽  
Clinical Evaluation ◽  
Mouth Opening ◽  
Vas Score ◽  
Disc Position ◽  
Tmj Disc ◽  
Condyle Position ◽  
Magnetic Resonance Imaging Mri

AbstractThe purpose of this study was to confirm the 5-year efficiency of temporomandibular joint (TMJ) anchorage, using clinical evaluation and magnetic resonance imaging (MRI). We also studied the influence of disc length and position on efficiency and postoperative condylar height. Sixty-one patients (76 joints) undergoing TMJ disc anchorage were followed up for >5 years. Visual analogue scale (VAS) score and maximum mouth-opening pre-and postsurgery were analysed and patient satisfaction recorded. Disc length, condyle height and disc position pre- and postsurgery were measured using MRI. Patients were ranked as A, B or C degree according to postoperative disc condyle position. Mean follow-up time was 71.34 months. Maximum mouth-opening improved by 14.34 ± 5.87 mm, and VAS score decreased by 33.44 ± 20.56 (P < 0.05). Clinical evaluation efficiency was 84.21%; patient satisfaction rate was 85.53%. On follow-up MRI, 68 joints were judged A or B degree (89.67%). Disc length was 7.96 ± 1.38 mm, 7.10 ± 1.41 mm and 5.75 ± 1.16 mm in A, B and C groups, respectively. In patients evaluated as C, condylar height decreased by 0.43 ± 1.36 mm, while increasing by 0.67 ± 1.88 mm and 0.51 ± 1.09 mm in A and B groups, respectively (all P < 0.05). We concluded that anchorage surgery improves mouth-opening and eliminates pain, longer disc length is related to better postoperative disc position, and significant condylar reconstruction occurs after disc repositioning. MRI confirmed that TMJ disc anchorage is reliable 5 years postsurgery.

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