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Illimoottil M, Bhattacharyya A, Ginat DT. Preoperative and Postoperative CT Imaging Assessment of Obstructive Sleep Apnea. J Comput Assist Tomogr 2025:00004728-990000000-00443. [PMID: 40165025 DOI: 10.1097/rct.0000000000001748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 02/07/2025] [Indexed: 04/02/2025]
Abstract
Obstructive sleep apnea (OSA) can result from various causes of partial or complete obstruction of the upper airway. CT is amenable to quantitative analysis of the upper airway and surrounding structures. CT is also useful for identifying abnormalities that could be attributed to the patient's symptoms and is relevant for surgical planning. There are various surgical procedures that can be performed for OSA that can also be encountered on CT. The relevant anatomic measurements, imaging features of various pathologies that can affect the upper airway, and postoperative imaging for OSA are reviewed in this article.
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Affiliation(s)
| | | | - Daniel Thomas Ginat
- Department of Neuroradiology, Pritzker School of Medicine, University of Chicago, Chicago, IL
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Mao WY, Fang YY, Wang ZZ, Liu MQ, Sun Y, Wu HX, Lei J, Fu KY. Automated diagnosis and classification of temporomandibular joint degenerative disease via artificial intelligence using CBCT imaging. J Dent 2025; 154:105592. [PMID: 39870190 DOI: 10.1016/j.jdent.2025.105592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 01/24/2025] [Accepted: 01/25/2025] [Indexed: 01/29/2025] Open
Abstract
OBJECTIVES In this study, artificial intelligence (AI) techniques were used to achieve automated diagnosis and classification of temporomandibular joint (TMJ) degenerative joint disease (DJD) on cone beam computed tomography (CBCT) images. METHODS An AI model utilizing the YOLOv10 algorithm was trained, validated and tested on 7357 annotated and corrected oblique sagittal TMJ images (3010 images of normal condyles and 4347 images of condyles with DJD) from 1018 patients who visited Peking University School and Hospital of Stomatology for temporomandibular disorders and underwent TMJ CBCT examinations. This model could identify DJD as well as the radiographic signs of DJD, namely, erosion, osteophytes, sclerosis and subchondral cysts. The diagnosis and classification performances of the model were evaluated on the test set. The accuracy of the model for evaluating images with one to four DJD signs was also evaluated. RESULTS The accuracy, precision, sensitivity, specificity, F1 score and mean average precision (mAP) at an intersection over union (IoU) threshold of 0.5 of the model for DJD detection all exceeded 0.95. The accuracies for identifying erosion, osteophytes, sclerosis and subchondral cysts were 0.91, 0.96, 0.91 and 0.96, respectively. The precisions, specificities and F1 scores for the DJD signs were all >0.90. The sensitivity ranged from 0.88 to 0.95, and the mAP (IoU=0.5) ranged from 0.87 to 0.97. The accuracies of the model for detecting one to four DJD signs in one image were 94 %, 84 %, 66 % and 63 %, respectively. CONCLUSIONS A deep learning model based on the YOLOv10 algorithm can not only detect the presence of TMJ DJD on CBCT images but also differentiate the typical radiographic signs of DJD, including erosion, osteophytes, sclerosis and subchondral cysts, with acceptable accuracy. CLINICAL SIGNIFICANCE TMJ DJD is a very common disease that causes joint pain and mandibular dysfunction and affects patients' quality of life; therefore, early diagnosis and intervention are particularly important. However, identifying radiographic signs of early-stage TMJ DJD is difficult. AI can quickly review CBCT images and assist in the accurate and rapid diagnosis and classification of TMJ DJD.
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Affiliation(s)
- Wei-Yu Mao
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing 100081, PR China; National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, PR China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, PR China; Beijing Key Laboratory of Digital Stomatology, Beijing 100081, PR China
| | - Yuan-Yuan Fang
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing 100081, PR China; National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, PR China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, PR China; Beijing Key Laboratory of Digital Stomatology, Beijing 100081, PR China
| | | | - Mu-Qing Liu
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing 100081, PR China; National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, PR China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, PR China; Beijing Key Laboratory of Digital Stomatology, Beijing 100081, PR China
| | - Yu Sun
- LargeV Instrument Corp. Ltd., Beijing 100084, PR China
| | - Hong-Xin Wu
- LargeV Instrument Corp. Ltd., Beijing 100084, PR China; Tsinghua University, Beijing 100084, PR China
| | - Jie Lei
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing 100081, PR China; National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, PR China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, PR China; Beijing Key Laboratory of Digital Stomatology, Beijing 100081, PR China.
| | - Kai-Yuan Fu
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing 100081, PR China; National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, PR China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, PR China; Beijing Key Laboratory of Digital Stomatology, Beijing 100081, PR China.
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Wei J, Wang Y, Tu S, Zhang S, Feng Y, Hou Y, Ai H, Chen Z. Circadian rhythm disruption upregulating Per1 in mandibular condylar chondrocytes mediating temporomandibular joint osteoarthritis via GSK3β/β-CATENIN pathway. J Transl Med 2024; 22:662. [PMID: 39010104 PMCID: PMC11251328 DOI: 10.1186/s12967-024-05475-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/03/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Temporomandibular joint osteoarthritis (TMJOA) has a high incidence rate, but its pathogenesis remains unclear. Circadian rhythm is an important oscillation in the human body and influences various biological activities. However, it is still unclear whether circadian rhythm affects the onset and development of TMJOA. METHODS We disrupted the normal rhythm of rats and examined the expression of core clock genes in the mandibular condylar cartilage of the jaw and histological changes in condyles. After isolating rat mandibular condylar chondrocytes, we upregulated or downregulated the clock gene Per1, examined the expression of cartilage matrix-degrading enzymes, tested the activation of the GSK3β/β-CATENIN pathway and verified it using agonists and inhibitors. Finally, after downregulating the expression of Per1 in the mandibular condylar cartilage of rats with jet lag, we examined the expression of cartilage matrix-degrading enzymes and histological changes in condyles. RESULTS Jet lag led to TMJOA-like lesions in the rat mandibular condyles, and the expression of the clock gene Per1 and cartilage matrix-degrading enzymes increased in the condylar cartilage of rats. When Per1 was downregulated or upregulated in mandibular condylar chondrocytes, the GSK3β/β-CATENIN pathway was inhibited or activated, and the expression of cartilage matrix-degrading enzymes decreased or increased, which can be rescued by activator and inhibitor of the GSK3β/β-CATENIN pathway. Moreover, after down-regulation of Per1 in mandibular condylar cartilage in vivo, significant alleviation of cartilage degradation, cartilage loss, subchondral bone loss induced by jet lag, and inhibition of the GSK3β/β-CATENIN signaling pathway were observed. Circadian rhythm disruption can lead to TMJOA. The clock gene Per1 can promote the occurrence of TMJOA by activating the GSK3β/β-CATENIN pathway and promoting the expression of cartilage matrix-degrading enzymes. The clock gene Per1 is a target for the prevention and treatment of TMJOA.
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Affiliation(s)
- Jiaming Wei
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 500630, China
| | - Yuxuan Wang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 500630, China
- Department of Stomatology, Shenzhen Sixth People's Hospital (Nanshan Hospital), Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Shaoqin Tu
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 500630, China
| | - Sai Zhang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 500630, China
| | - Yi Feng
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 500630, China
| | - Yuluan Hou
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 500630, China
| | - Hong Ai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 500630, China.
| | - Zheng Chen
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 500630, China.
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Su CL, Su AC, Chang CC, Lin AYH, Yeh CH. Temporomandibular joint degenerative changes following mandibular fracture: a computed tomography-based study on the role of condylar involvement. Oral Radiol 2024; 40:385-393. [PMID: 38421497 DOI: 10.1007/s11282-024-00742-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES This study assessed the incidence of postfracture radiological temporomandibular joint (TMJ) degeneration in patients with different types of mandibular fractures, focusing on the impact of condylar fractures. METHODS This retrospective review included patients diagnosed as having mandibular fractures from 2016 to 2020 who had undergone initial computed tomography (CT) and a follow-up CT scan at least 1-month postfracture. Patient demographics, fracture details, treatment methods, and radiological signs of TMJ degeneration on CT were analyzed to identify risk factors for postfracture TMJ degeneration, with a focus on condylar head fracture and non-head (condylar neck or base) fractures. RESULTS The study included 85 patients (mean age: 38.95 ± 17.64 years). The per-patient analysis indicated that the incidence of new radiologic TMJ degeneration on CT was significantly the highest (p < 0.001) in patients with condylar head fractures (90.91%), followed by those with non-head condylar fractures (57.14%), and those without condylar involvement (24.49%). The per-joint analysis indicated nearly inevitable degeneration (93.94%) in 33 TMJs with ipsilateral condylar head fractures. For the remaining 137 TMJs, multivariate logistic regression revealed that other patterns (ipsilateral non-head, contralateral, or both) of condylar fractures (odds ratio (OR) = 3.811, p = 0.007) and the need for open reduction and internal fixation (OR = 5.804, p = 0.005) significantly increased the risk of TMJ degeneration. CONCLUSIONS Ipsilateral non-head condylar fractures and contralateral condylar fractures are associated with a high risk of postfracture TMJ degeneration. Indirect trauma plays a vital role in postfracture TMJ degeneration.
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Affiliation(s)
- Chun-Lin Su
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - An-Chi Su
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Chen Chang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Arthur Yen-Hung Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Hua Yeh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Sahoo NK, Mowar A, Pandey S, Vashisht S, Vaswani H. Histopathological Interpretation of TMJ Osteophyte: Report and Review. J Maxillofac Oral Surg 2023; 22:1078-1082. [PMID: 38105841 PMCID: PMC10719170 DOI: 10.1007/s12663-023-01938-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/13/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Osteophytes are osseocartilaginous structures which are commonly found in common degenerative joint diseases. It can be free or attached to nature. There is a paucity of information in the literature regarding the histopathological interpretation of osteophytes in Temporomandibular Joint (TMJ). Purpose To report the incidental finding of osteophytes in cases of chronic protracted TMJ dislocation. Material and Method To present case of an elderly 72-year-old female and a 35-year-old male with chronic protracted TMJ dislocation who were treated surgically for their condition with an incidental finding of an osteophyte in TMJ intraoperatively. Result The histopathological examination revealed fibrocartilaginous core tissue surrounded by bone formation due to dystrophic calcification. Conclusion The microscopic examination is mandatory in order to study and understand the pathophysiology of an osteophyte. This study presents rare histopathological evidence of an osteophyte. It reflects the process of its formation and the possibilities of fate of an osteophyte in TMJ.
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Affiliation(s)
- N. K. Sahoo
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
| | - Apoorva Mowar
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
| | - Swati Pandey
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
| | - Sahil Vashisht
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
| | - Himani Vaswani
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
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Wei JM, Tu SQ, Wang YX, Zhang S, Feng Y, Ai H, Chen Z. Clock gene Per1 regulates rat temporomandibular osteoarthritis through NF-κB pathway: an in vitro and in vivo study. J Orthop Surg Res 2023; 18:817. [PMID: 37907921 PMCID: PMC10619284 DOI: 10.1186/s13018-023-04301-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/20/2023] [Indexed: 11/02/2023] Open
Abstract
PURPOSE Temporomandibular joint osteoarthritis (TMJOA) is a common disease that negatively affects the life quality of human beings. Circadian rhythm acts an important role in life activities. However, whether the clock genes are rhythmic expressed in mandibular condylar chondrocytes, or the clock genes have an effect on the progression of TMJOA remains unknown. In this study, we aim to explore expression of clock genes and regulatory mechanism of TMJOA in rat mandibular condylar chondrocytes. METHODS After synchronized by dexamethasone, the expression of core clock genes Per1, Per2, Clock, Cry1, Cry2 and Bmal1 and cartilage matrix degrading factor gene Mmp13 were analyzed in mandibular condylar chondrocytes every 4 h with RT-qPCR. The mandibular condylar chondrocytes were stimulated with IL-1β, and expression of Per1, Mmp13, P65 and p-P65 was assessed by RT-qPCR and Western blot. Sh-Per1 lentivirus was used to assess the effect of clock gene Per1 in IL-1β-induced chondrocytes, and expression of Mmp13, P65 and p-P65 was measured. After establishing a rat TMJOA model using unilateral anterior crossbite (UAC), micro-CT, H & E, Alcian Blue & Nuclear Fast Red and Safranin O & Fast Green, cartilage thickness was utilized to assess the damage of cartilage and subchondral bone. Immunohistochemistry of PER1, MMP13 and P65 was performed in condylar sections. RESULTS All core clock genes and Mmp13 were rhythmically expressed. And Mmp13 expression curve was closed in phase and amplitude with Per1. After stimulation with IL-1β, the expression of MMP13, PER1 and P65 and ratio of p-P65/P65 increased in condylar chondrocytes. After Per1 was down-regulated in condylar chondrocytes, the expression of MMP13 and P65 and ratio of p-P65/P65 decreased. Compared with the condyles of Sham group, the bony parameters of UAC group were significantly worse. The thickness of cartilage in UAC group significantly reduced. The modified Mankin scores and the expression of PER1, MMP13 and P65 in cartilage of UAC group significantly increased compared with Sham group. CONCLUSION Core clock genes and Mmp13 are rhythmic expressed in rat mandibular condylar chondrocytes. PER1 can regulate the expression of MMP13 through NF-κB pathway in IL-1β-induced mandibular condylar chondrocytes.
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Affiliation(s)
- Jia-Ming Wei
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Shao-Qin Tu
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Yu-Xuan Wang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Sai Zhang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Yi Feng
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Hong Ai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China
| | - Zheng Chen
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong, China.
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Lan KW, Chen JM, Jiang LL, Feng YF, Yan Y. Treatment of condylar osteophyte in temporomandibular joint osteoarthritis with muscle balance occlusal splint and long-term follow-up: A case report. World J Clin Cases 2022; 10:4264-4272. [PMID: 35665098 PMCID: PMC9131237 DOI: 10.12998/wjcc.v10.i13.4264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/16/2021] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Condylar osteophytes, a remodeling form of temporomandibular joint osteoarthritis (TMJ OA), mainly manifest as marginal angular outgrowths of the condyle. Previous researchers have advocated surgical removal of condylar osteophytes. Reports on the effect of occlusal splint on TMJ OA patients’ joints have mostly focused on treatment with this splint, which can reduce the absorption of the affected condyle and promote repair and regeneration. However, the effect of the splint on the dissolution of condylar osteophytes has not yet been reported.
CASE SUMMARY A 68-year-old female patient suffered from occlusal discomfort with left facial pain for 2 years. Cone beam computed tomography showed a rare osteophyte on top of her left condyle. She was finally diagnosed with TMJ OA. The patient refused surgical treatment and received conservative treatment with a muscle balance occlusal splint. The pain experienced by the patient on the left side of her face was relieved, and her chewing ability recovered after treatment. The osteophyte dissolved, and the condylar cortex remained stable during long-term follow-up observations.
CONCLUSION The muscle balance occlusal splint could be a noninvasive means of treating condylar osteophytes in TMJ OA patients.
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Affiliation(s)
- Kai-Wen Lan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Jia-Min Chen
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou 510182, Guangdong Province, China
| | - Liu-Lin Jiang
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Yi-Fan Feng
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Ying Yan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
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Long-term Changes of Temporomandibular Joint Osteoarthritis on Computed Tomography. Sci Rep 2020; 10:6731. [PMID: 32317672 PMCID: PMC7174364 DOI: 10.1038/s41598-020-63493-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 03/30/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to understand long-term changes of the osteoarthritic temporomandibular joint (TMJ) condyle using computed tomography (CT) and to verify its correlation with clinical characteristics of temporomandibular disorders. Eighty-nine patients (152 joints; 76 female, 13 male) who had taken follow-up CTs (mean follow-up period: 644.58 ± 325.71 days) at least once in addition to their initial evaluation were selected. Cross-sectional demographic and clinical data and longitudinal CT images were collected. Data were analyzed by analysis of variance and logistic regression. Overall destructive change index (number of TMJ condyle sections in which destructive change was observed) decreased from 1.56 to 0.66. Improvement was seen in 93 joints (61.2%) and 27 joints (17.8%) worsened. In the pain positive group, both initial and final destructive change index were significantly higher compared to the pain negative group (p = 0.04). Occlusal stabilization splint therapy and nonsteroidal anti-inflammatory drug administration showed a significant effect on improving the prognosis of TMJ osteoarthritis (p = 0.015 and 0.011). In conclusion, TMJ osteoarthritis showed long-term improvement in the majority of cases. TMJ osteoarthritis accompanied by pain showed unfavorable prognosis with additional bone destruction. Occlusal stabilization splint and nonsteroidal anti-inflammatory drug administration were beneficial on the prognosis of TMJ osteoarthritis.
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Reliability of diagnostic imaging for degenerative diseases with osseous changes in the temporomandibular joint with special emphasis on subchondral cyst. Oral Radiol 2019; 36:156-162. [DOI: 10.1007/s11282-019-00392-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
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Suenaga S, Nagayama K, Nagasawa T, Indo H, Majima HJ. The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders. JAPANESE DENTAL SCIENCE REVIEW 2016; 52:93-106. [PMID: 28408961 PMCID: PMC5390340 DOI: 10.1016/j.jdsr.2016.04.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 04/14/2016] [Accepted: 04/26/2016] [Indexed: 12/30/2022] Open
Abstract
The causes of pain symptoms in the temporomandibular joint (TMJ) and masticatory muscle (MM) regions may not be determined by clinical examination alone. In this review, we document that pain symptoms of the TMJ and MM regions in patients with temporomandibular disorders (TMDs) are associated with computed tomography and magnetic resonance (MR) findings of internal derangement, joint effusion, osteoarthritis, and bone marrow edema. However, it is emphasized that these imaging findings must not be regarded as the unique and dominant factors in defining TMJ pain. High signal intensity and prominent enhancement of the posterior disk attachment on fat saturation T2-weighted imaging and dynamic MR imaging with contrast material are closely correlated with the severity of TMJ pain. Magnetic transfer contrast, MR spectroscopy, diffusion tensor imaging, and ultrasonography findings have helped identify intramuscular edema and contracture as one of the causes of MM pain and fatigue. Recently, changes in brain as detected by functional MR neuroimaging have been associated with changes in the TMJ and MM regions. The thalamus, the primary somatosensory cortex, the insula, and the anterior and mid-cinglate cortices are most frequently associated with TMD pain.
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Affiliation(s)
- Shigeaki Suenaga
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Kunihiro Nagayama
- Department of Orthodontics and Dentofacial Orthopedics, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Taisuke Nagasawa
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hiroko Indo
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hideyuki J. Majima
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
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Donovan TE, Marzola R, Becker W, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP. Annual review of selected scientific literature: Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2015; 114:756-809. [PMID: 26611624 DOI: 10.1016/j.prosdent.2015.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 10/13/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Terence E Donovan
- Chair, Committee on Scientific Investigation, American Academy of Restorative Dentistry (AARD); and Professor and Chair for Biomaterials, Department of Operative Dentistry, University of North Carolina School of Dentistry at Chapel Hill, NC.
| | - Riccardo Marzola
- Adjunct Professor, Fixed Implant Prosthodontics, University of Bologna; and Private practice, Ferrara, Italy
| | - William Becker
- Clinical Professor, Advanced Education in Prosthodontics, Herman Ostrow School of Dentistry, Los Angeles, Calif
| | - David R Cagna
- Associate Dean, Professor and Director, Advanced Prosthodontics, University of Tennessee Health Sciences Center, Memphis, Tenn
| | - Frederick Eichmiller
- Vice President and Dental Director, Delta Dental of Wisconsin, Stevens Point, Wisc
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Suenaga S, Nagayama K, Nagasawa T, Kawabata Y, Indo H, Majima HJ. Evaluation of the relationships between contrast-enhanced magnetic resonance characteristics and joint pain in patients with temporomandibular disorders. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0213-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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