Dataset Information

Changes in the temporomandibular joint clicking and pain disorders after orthognathic surgery: Comparison of orthodontics-first approach and surgery-first approach.

ABSTRACT: The purposes of this study were to investigate the influence of the orthodontics-first approach (OFA) and surgery-first approach (SFA) on changes in the signs and symptoms of temporomandibular joint disorders (TMDs) and to compare pre- and postoperative orthodontic treatment duration and total treatment duration between the two approaches. This retrospective study recruited 182 adult patients with malocclusions treated with OFA and SFA and recorded variables such as age, gender, skeletal classification, and signs and symptoms of TMD (clicking and pain disorders) before the start of the surgical-orthodontic treatment and after surgery. Changes in the signs and symptoms of TMD and treatment duration were evaluated within each approach and compared between two approaches. A binary logistic regression was performed to assess the influence of the variables on the postoperative signs and symptoms of TMD. There were no significant postoperative changes in temporomandibular joint (TMJ) pain for OFA and SFA, whereas a significant reduction was found in TMJ clicking after surgery for both approaches. According to binary logistic regression, the type of surgical-orthodontic treatment (OFA or SFA) was not a significant risk factor for postoperative TMJ clicking and pain, and the risk of postoperative TMJ clicking and pain was significant only when TMJ clicking (OR = 10.774, p < 0.001) and pain (OR = 26.876, p = 0.008) existed before the start of the entire treatment, respectively. With regard to the treatment duration, SFA (21.1 ± 10.3 months) exhibited significantly shorter total treatment duration than OFA (34.4 ± 11.9 months) (p < 0.001). The results of this study suggest that surgical-orthodontic treatment using SFA can be a feasible option of treatment for dentofacial deformities based on the equivalent effect on TMD and shorter overall treatment period compared to conventional surgical-orthodontic treatment using OFA.

SUBMITTER: Zhai Y

PROVIDER: S-EPMC7473545 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Changes in the temporomandibular joint clicking and pain disorders after orthognathic surgery: Comparison of orthodontics-first approach and surgery-first approach.

Zhai Ying Y Han Jeong Joon JJ Jung Seunggon S Kook Min-Suk MS Park Hong-Ju HJ Oh Hee-Kyun HK

PloS one 20200904 9

The purposes of this study were to investigate the influence of the orthodontics-first approach (OFA) and surgery-first approach (SFA) on changes in the signs and symptoms of temporomandibular joint disorders (TMDs) and to compare pre- and postoperative orthodontic treatment duration and total treatment duration between the two approaches. This retrospective study recruited 182 adult patients with malocclusions treated with OFA and SFA and recorded variables such as age, gender, skeletal classif ...[more]

PMID: 32886686

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Project description:BACKGROUND:Upon orthognathic mandibular advancement surgery the adjacent soft tissues can displace the distal bone segment and increase the load on the temporomandibular joint causing loss of its integrity. Remodeling of the condyle and temporal fossa with destruction of condylar cartilage and subchondral bone leads to postsurgical condylar resorption, with arthralgia and functional limitations. Patients with severe lesions are refractory to conservative treatments, leading to more invasive therapies that range from simple arthrocentesis to open surgery and prosthesis. Although aggressive and with a high risk for the patient, surgical invasive treatments are not always efficient in managing the degenerative lesions. METHODS:We propose a regenerative medicine approach using in-vitro expanded autologous cells from nasal septum applied to the first proof-of-concept patient. After the required quality controls, the cells were injected into each joint by arthrocentesis. Results were monitored by functional assays and image analysis using computed tomography. RESULTS:The cell injection fully reverted the condylar resorption, leading to functional and structural regeneration after 6 months. Computed tomography images showed new cortical bone formation filling the former cavity space, and a partial recovery of condylar and temporal bones. The superposition of the condyle models showed the regeneration of the bone defect, reconstructing the condyle original form. CONCLUSIONS:We propose a new treatment of condylar resorption subsequent to orthognathic surgery, presently treated only by alloplastic total joint replacement. We propose an intra-articular injection of autologous in-vitro expanded cells from the nasal septum. The proof-of-concept treatment of a selected patient that had no alternative therapeutic proposal has given promising results, reaching full regeneration of both the condylar cartilage and bone at 6 months after the therapy, which was fully maintained after 1 year. This first case is being followed by inclusion of new patients with a similar pathological profile to complete an ongoing stage I/II study. TRIAL REGISTRATION:This clinical trial is approved by the National Commission of Ethics in Medical Research (CONEP), Brazil, CAAE 12484813.0.0000.5245, and retrospectively registered in the Brazilian National Clinical Trials Registry and in the USA Clinical Trials Registry under the Universal Trial Number (UTN) U1111-1194-6997 .

Project description:BackgroundThe application of artificial intelligence (AI) in orthodontics and orthognathic surgery has gained significant attention in recent years. However, there is a lack of bibliometric reports that analyze the academic literature in this field to identify publishing and citation trends. By conducting an analysis of the top 100 most-cited articles on AI in orthodontics and orthognathic surgery, we aim to unveil popular research topics, key authors, institutions, countries, and journals in this area.MethodsA comprehensive search was conducted in the Web of Science (WOS) electronic database to identify the top 100 most-cited articles on AI in orthodontics and orthognathic surgery. Publication and citation data were obtained and further analyzed and visualized using R Biblioshiny. The key domains of the 100 articles were also identified.ResultsThe top 100 most-cited articles were published between 2005 and 2022, contributed by 458 authors, with an average citation count of 22.09. South Korea emerged as the leading contributor with the highest number of publications (28) and citations (595), followed by China (16, 373), and the United States (7, 248). Notably, six South Korean authors ranked among the top 10 contributors, and three South Korean institutions were listed as the most productive. International collaborations were predominantly observed between the United States, China, and South Korea. The main domains of the articles focused on automated imaging assessment (42%), aiding diagnosis and treatment planning (34%), and the assessment of growth and development (10%). Besides, a positive correlation was observed between the testing sample size and citation counts (P = 0.010), as well as between the time of publication and citation counts (P < 0.001).ConclusionsThe utilization of AI in orthodontics and orthognathic surgery has shown remarkable progress, particularly in the domains of imaging analysis, diagnosis and treatment planning, and growth and development assessment. This bibliometric analysis provides valuable insights into the top-cited articles and the trends of AI research in this field.

Dataset Information

Changes in the temporomandibular joint clicking and pain disorders after orthognathic surgery: Comparison of orthodontics-first approach and surgery-first approach.

Publications

Changes in the temporomandibular joint clicking and pain disorders after orthognathic surgery: Comparison of orthodontics-first approach and surgery-first approach.

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