Ultrasound Imaging for Temporomandibular Joint Disc Anterior Displacement.
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ABSTRACT:
SUBMITTER: Tu KH
PROVIDER: S-EPMC6029202 | biostudies-literature | 2018 Apr-Jun
REPOSITORIES: biostudies-literature
Publications
Ultrasound Imaging for Temporomandibular Joint Disc Anterior Displacement.
Tu Keng-Hua KH Chuang Hung-Jui HJ Lai Li-An LA Hsiao Ming-Yen MY
Journal of medical ultrasound 20180401 2
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Project description:BackgroundUltrasonography has been applied as an alternative method in the assessment of temporomandibular joint (TMJ) pathology including anterior disc displacement (ADD). However, a concrete screening or diagnostic method which is feasible in clinical practice has not yet been established. The study aimed to establish a quantitative ultrasonographic method and determine its diagnostic efficacy for ADD of the TMJ.MethodsA total of 75 joints were allocated to either the normal disc position (NDP) group or the ADD group using magnetic resonance imaging (MRI) as the reference standard. Longitudinal scans of the lateral articular compartment were obtained by a 14-MHz L-shaped linear array transducer. The width of the lateral joint space (LJS), the upper lateral joint space (ULJS), and the lower lateral joint space (LLJS), as well as the position of the lateral articular disc edge (ADE), were investigated by stepwise logistic regression analysis to identify significant indicators of ADD and to build a diagnostic model. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were computed at the optimal cut-off value.ResultsMRI detected 25 joints in the NDP group and 50 joints in the ADD group. Correlation analysis indicated that all 4 variables were associated with ADD. With the best performance of the area under the receiver operating characteristic (ROC) curve (AUC) of 0.939, LJS and ULJS were identified as predictors of ADD and subsequently adopted to build a diagnostic model by stepwise logistic regression. The optimal cut-off value of the 2-variable regression model for diagnosing ADD was 0.800, with a sensitivity of 82%, specificity of 96%, PPV of 97.6%, NPV of 72.7%, and an accuracy of 86.7%.ConclusionsThe quantitative ultrasonographic diagnostic method showed promising diagnostic efficacy. It has the potential to be used for ADD screening in future clinical practice.
| S-EPMC10585577 | biostudies-literature
Project description:Numerous reports describe the association between the single-nucleotide polymorphism (SNP) rs12722 and rs13946 in the COL5A1 gene and injuries, such as Achilles tendon pathology, anterior cruciate ligament (ACL) injuries, and tennis elbow. Hence, there were no studies investigating COL5A1 and temporomandibular joint (TMJ) pathology. The aim of this study is to evaluate the relationship between COL5A1 rs12722 and rs13946 SNPs and TMJ articular disc displacement without reduction (ADDwoR). In this case-control study, the study group consisted of 124 Caucasian patients of both sexes. Each patient had a history of ADDwoR no more than 3 months prior. The control group comprised 126 patients with no signs of TMD according to DC/TMD. Genotyping of the selected SNPs was performed by real-time PCR using TaqMan probes. The significance of the differences in the distribution of genotypes was analyzed using Pearson's chi-square test. Logistic regression modeling was performed to analyze the influence of the 164 investigated SNPs on ADDwoR. The COL5A1 marker rs12722 turned out to be statistically significant (p-value = 0.0119), implying that there is a difference in the frequencies of TMJ ADDwoR. The distribution of rs12722 SNPs in the study group TT(66), CC(27), CT(31) vs. control group TT(45), CC(26), CT(51) indicates that patients with CT had an almost 2.4 times higher likelihood of ADDwoR (OR = 2.41) than those with reference TT (OR = 1), while rs13946 genotypes were shown to be insignificant, with a p-value of 0.1713. The COL5A1 rs12722 polymorphism is a risk factor for ADDwoR in the Polish Caucasian population.
| S-EPMC8470511 | biostudies-literature
Project description:This study has characterized a rat model with temporomandibular osteoarthritis (TMJ-OA) following a surgical anterior displacement of their articular disc (ADD). The well-established model of OA, induced by an intra-articular injection of complete Freund's adjuvant (CFA) into the TMJ, was used for comparison purposes. Male Wistar rats were assigned into two surgical groups, namely, ADD (anterior disc displacement) and sham-operated (surgical access, without ADD). Additional groups received an intra-articular infiltration of CFA (50 μl/site; 1:1 oil/saline emulsion), or the vehicle (0.9% NaCl). The separate experimental subgroups were euthanized at 15, 30 or 60 days and their left TMJs were collected for histological, immunohistochemistry and micro-CT analyses. The serum levels of IL-1β, IL-6 and TNF were analyzed. The fibrocartilage thicknesses were increased in the ADD groups at all of the analyzed time-points. In the CFA group, fibrocartilage thickenings were seen only in the posterior thirds at 15 days. The ADD group displayed an increase of the proteoglycan contents and ADAMTS5 immunopositivity in the fibrocartilage at 30 and 60 days, without any variations of the collagen contents or the osteoclast activation. Upon the micro-CT evaluation, the ADD group presented increments of their trabecular separations and bone surfaces, with reduced trabecular thicknesses and bone volumes, plus osteophyte formations and condyle flattenings, from 30 to 60 days. The IL-1β, TNF or IL-6 serum levels were undetectable. The surgical ADD in the rats led to long-term OA-like alterations, with typical structural and morphological derangements of the TMJ, representing a reliable experimental model to investigate the TMJ-OA-related mechanisms.
| S-EPMC6291709 | biostudies-literature
Project description:Background and Objective:Intra-articular temporomandibular disorders are often related to pain in the area of the temporomandibular joint, ear, and temple. The aim of the study was to investigate the efficiency of anterior repositioning splints in decreasing pain related to temporomandibular joint disc displacement with reduction. Methods:The research material consisted of 112 patients, aged 24 to 45 years, of both genders, who reported for treatment at the Consulting Room of Temporomandibular Joint Dysfunctions at the Jagiellonian University in Cracow between 2014 and 2016 due to pain in the area of the temporomandibular joint(s) and noise(s) of temporomandibular joint(s) present during jaw movements with comorbid contracture of masticatory muscles. Subjects were examined according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol and, after diagnosis of painful disc displacement with reduction and masticatory muscle contracture, they were assigned randomly to either the study or control groups (56 patients in each). In the study group, we used an anterior repositioning splint on the full lower arch for about 20 hours usage over a 4-month period. In the control group, a noninvasive therapy was applied using a biostimulation laser over 12 sessions performed every second day on the area of both temporomandibular joints with mouth open and while performing muscle self-exercises with a dominant protrusive position of the mandible. Pain intensity was evaluated using the Verbal Numerical Rating Scale (VNRS) immediately before the treatment and then after 4 and 16 weeks. The obtained data were analyzed using the Mann-Whitney U test (p ? 0.005). Results:The VNRS values reported during the final examination for the study group were significantly lower than for the control group (p=0.0004). Conclusions:The anterior repositioning splint is an efficient tool in decreasing pain related to disc displacement with reduction. This trial is registered with Clinicaltrials.gov NCT03057262.
| S-EPMC5841089 | biostudies-literature
Project description:ObjectivesThe aim of this study was to investigate the role of ESR1 rs1643821 and TNF-α rs1800629 as potential genetic factors regulating anterior disc displacement without reduction-mediated inflammatory pathway.BackgroundThe temporomandibular joint is a complex synovial joint that allows mandibular movement in three directions. Although temporomandibular disorders are widespread, limited data is available on the biochemical characteristics of the displaced disc and quality of the surrounding soft tissue. Changes in degenerative tissue provoke disc displacement which involves secretion of inflammatory markers and sequential conversion of fibroblast-like cells into chondrocyte-like cells. Due to the high occurrence in female adolescents, the potential role of sex hormones in temporomandibular joint disorders has been speculated. Furthermore, anterior disc displacement without reduction severely affects the quality of life.Methods124 Caucasian patients with a history of at least one anterior disc displacement without reduction within 3 months were enrolled. Anterior disc displacement without reduction was diagnosed based on clinical examination, diagnostic criteria (DC)/TMD, and cone-beam computed tomography/magnetic resonance imaging (CBCT/MRI). The control group consisted of 126 patients with no temporomandibular joint disorders. Genotyping of two single nucleotide polymorphisms, estrogen receptor 1 (ESR1) rs1643821, and tumor necrosis factor α (TNF-α) rs1800629 was performed.ResultsESR1 rs1643821 showed significant P values (using chi-square analysis) revealing the difference in anterior disc displacement without reduction frequencies while TNF-α rs1800629 polymorphism was found to be statistically insignificant when compared to the control group. Furthermore, patients with a genotype of ESR1 rs1643821 showed a decreased probability (OR = 0.412) against anterior disc displacement without reduction when compared to the GG genotype (OR = 1).ConclusionESR1 rs1643821 with A allele frequency was lower in patients with anterior disc displacement without reduction compared to the control group. Thus, the rs1643821 variant is significantly associated with susceptibility to the anterior disc displacement without a reduction in European Caucasians. Conversely, TNF-α rs1800629 was a statistically insignificant factor against anterior disc displacement without reduction when compared to the control group.
| S-EPMC7576356 | biostudies-literature
Project description:BACKGROUND:Temporomandibular dysfunction involving anterior disc derangement with or without reduction, secondary to posterior ligament insufficiency is typically managed conservatively with success in a majority of patients. When conservative management fails, the next step in the continuum of care is unclear. Platelet-rich plasma injection combined with a 3-week immobilization period may be effective in treating posterior ligament insufficiency following a period of physical therapy. The result of this case was exceptionally successful, with the patient reporting 100% improvement 6 months post-injection. Prior to this case, we predicted a 20% success rate based on her inability to maintain the effects of conservative management over the long term. CASE PRESENTATION:A 33-year-old white woman presented with temporomandibular dysfunction, which responded to an initial course of physical therapy aimed at restoring the mechanics of her temporomandibular joint, exercise management, and education on self-management strategies. She returned 20 months later and responded well to another course of physical therapy. Despite improvement in pain, range of motion, and mechanics, she continued to present with a reduction click at the end range of opening. The crisp and loud nature of the reduction click indicated a viable posterior ligament and reduction of the anteriorly displaced disc. She opted for platelet-rich plasma injection, provided by a chronic pain specialist with the assistance of a physical therapist. She was immobilized for 3 weeks, followed by a weaning period with reduced posterior support for an additional 5 weeks. Follow-up appointments with a physical therapist occurred at 3 weeks, 8 weeks, and 6 months post-injection. CONCLUSIONS:At 6 months, she reported 100% improvement. Objectively, there was no indication that the disc condyle relationship was disrupted. At 6 months post-platelet-rich plasma injection, preceded by a period of conservative physical therapy management, and followed with appropriate physical therapy follow-up, this individual had complete resolution of her anterior disc derangement with reduction.
| S-EPMC5971088 | biostudies-literature
Project description:The temporomandibular joint (TMJ) disc displacement is the most common temporomandibular disorders (TMD) condition. It causes clicking, pain, limited mandibular movements, and even masticatory difficulties in many people. The aim of this study is showcasing hotspots and frontiers in the field and providing a reference for the future research by a bibliometric analysis. Studies published from 1992 to 2022 were retrieved from Web of Science Core Collection on 23 April 2023. A total of 1882 studies (1739 articles and 143 reviews) were included in the bibliometric analysis. From 1992 to 2022, the annual number of publications and citations greatly increased. The United States of America (USA) contributed the most publications about TMJ disc displacement. Shanghai Jiao Tong University was the most productive institution; meanwhile, Yang, C. from this institution was the most prolific author. The University of Washington was the most influential institution, and Brooks, S. was the most influential author. Diagnostic criteria and management of TMJ disc displacement, as well as TMJ disc displacement-associated conditions, might be a hotspot for current global research. We provided an objective and valuable reference for future research on TMJ disc displacement.
| S-EPMC10379638 | biostudies-literature
Project description:Temporomandibular disorders (TMDs) may affect up to 25% of the population, with almost 70% of these TMD cases developing malpositioning of the disc over time in what is known as internal derangement (ID). Despite significant efforts, the molecular mechanism underlying disease progression is not yet very well known. In this study, the role of COL12A1 rs970547 and rs240736 polymorphisms as potential genetic factors regulating ID was investigated. The study included 124 Caucasian patients of both sexes after disc displacement without reduction (DDwoR) in either one or two temporomandibular joints (TMJs), either of which meet the criteria for this condition. All patients underwent clinical examination and 3D digital imaging. The COL12A1 rs970547 and rs240736 polymorphisms were evaluated. There were no statistically significant differences in the chi-square test between the study group and healthy controls. The examined COL12A1 rs240736 and rs970547 polymorphisms do not contribute to DDwoR in Polish Caucasians.
| S-EPMC8148001 | biostudies-literature
Project description:Treatments for temporomandibular joint (TMJ) disc thinning and perforation, conditions prevalent in TMJ pathologies, are palliative but not reparative. To address this, scaffold-free tissue-engineered implants were created using allogeneic, passaged costal chondrocytes. A combination of compressive and bioactive stimulation regimens produced implants with mechanical properties akin to those of the native disc. Efficacy in repairing disc thinning was examined in minipigs. Compared to empty controls, treatment with tissue-engineered implants restored disc integrity by inducing 4.4 times more complete defect closure, formed 3.4-fold stiffer repair tissue, and promoted 3.2-fold stiffer intralaminar fusion. The osteoarthritis score (indicative of degenerative changes) of the untreated group was 3.0-fold of the implant-treated group. This tissue engineering strategy paves the way for developing tissue-engineered implants as clinical treatments for TMJ disc thinning.
| S-EPMC6553461 | biostudies-literature
Project description:The aim of this study is to evaluate the diagnostic concordance of MRI and electrovibratography (EVG) of the temporomandibular joint (TMJ) in the diagnosis of articular disc displacement with reduction (ADDwR) and articular disc displacement without reduction (ADDw/oR).50 patients (12 males, 38 females; mean age 37.46 ± 15.64 years) with a hypothesis of disc displacement were selected. For each patient an MRI of the TMJ was performed. MRIs were evaluated sorting the 100 TMJs by kind of pathology (no pathology, ADDwR, ADDw/oR, and joint hypermobility). Afterwards, the patients had an EVG exam. The EVG exams were performed with vibration transducers over each TMJ, enabling simultaneous, bilateral recording of vibrations emanating from joint sounds during the opening and closing movements. The presence of a sound peak was compared with the MRI diagnosis of ADDwR, while a multipeak aspect was compared with ADDw/oR diagnosis using Cohen's kappa test.The presence of a peak-shaped track has high specificity for ADDwR (90.27%). The Cohen's kappa calculated for the ADDwR was 0.5615 (good-moderate). The presence of a multipeak-shaped track has low specificity (65.22%) and sensitivity (70.42%). The Cohen's kappa calculated for the ADDw/oR was 0.2992 (poor).The present study recommends the use of EVG to support the clinical diagnosis of a disc displacement with reduction when MRI is not available or when subjects cannot be investigated by MRI.
| S-EPMC3667518 | biostudies-other