Abstract. The objective of this study was an analysis of the patient complaints of a structure and the nature of the formation of clinical groups for the study of patients with temporomandibular disorders (TMD). We examined 28 men and 148 women with TMD. We analyzed 604 tomographic images. Statistical processing included cross tables and chi-square analysis. Twenty-eight percent of the study population was followed up in a general clinical network, presenting with facial pain. Dental clinics established primary clinical diagnoses: arthrosis and arthritis (71%), dislocation or subluxation of the temporomandibular joint head (16.5%), and/or temporomandibular joint dysfunction (12.5%). X-rays showed the combination of functional disorders (75%) and degenerative dystrophic changes (67%) of the temporomandibular joint; the x-ray norm was observed in 9% of cases. By TMJ visualization, we established the clinical features of females with TMD, depending on the reproductive stage. For patients in puberty, joint mobility was limited (44.4%, p = 0.045) compared with head dislocation, and arthritis (p = 0.024) was predominant. For patients in the early reproductive stage, head subluxation (48.5%, p < 0.010) was found in all detected pathologies except deforming arthrosis. For patients in the late reproductive stage and perimenopause, half of the examined patients had deforming arthrosis (52.8% in the late reproductive stage, p < 0.01, for all detected pathologies, except for limited joint mobility; 50% in perimenopause, p < 0.05, with radiologic norms, dislocation of the head, and arthritis). In postmenopausal women, arthritis and sclerotic arthrosis were noted (30.8% and 27.8%, respectively). Structure of the patient complaints and the nature of the formation of clinical groups of patients with TMD were determined by the place of primary treatment, specialization of the institution, and the level of techniques of primary diagnosis of TMD. This affected the patients' quality of treatment and is a cause of chronic (58%) TMD.
Objective: to propose a procedure for analyzing the X-ray image of the temporomandibular joint (TMJ) through the automated calculation of linear and angular measurements from craniometry points in comparison with the reference values.Material and methods. Fifty TMJ cone beam computed tomography images were analyzed in 25 volunteers aged 18-25 years with orthognathic bite and physiological occlusion. All the tomography images were analyzed from craniometric points, by using a section corresponding to the midsagittal plane of the TMJ. Angular and linear measurements characterizing the functional capacities of the TMJ were determined. A statistical analysis involved descriptive methods and was carried out by the IBM SPSS 21 statistics.Results. The introduction of automated estimation of TMJ functional capacities from angular and linear measurements made it possible to obtain the following data: the α-angle was 11.99±2.44° for the right TMJ and 12.12±2.78° for the left one; the β-angle was 11.58±2.31° for the right TMJ and 12.42±2.81° for the left one; the γ-angle was 156.41±4.57° for the right TMJ and 155.46±5.50° for the left one. A descriptive statistics checking revealed no gross errors.Conclusion. It is expedient to take into account the findings as reference values to characterize the anatomical and functional state of the TMJ on the x-ray image.
Control and analysis of small, inaccessible to human vision changes in medical images make it possible to focus on diagnostically important radiological signs important for the correct diagnosis.The aim of the study was to develop information technology facilitating the early diagnosis of diseases using medical images. Materials and Methods. To control changes in the image, we used its transformation based on solving a particular case of the knapsack problem. The proposed transformation is highly sensitive to any changes in the image and provides the possibility to record deviations visually with high accuracy. Medical images were obtained using cone beam computed tomography.Results. Practical evaluation of the information technology on tomograms showed the following: the transformed images of healthy bone tissue fragments from different parts of the jaw have similar shapes and nearly the same range of brightness. The transformed image of bone tissue after treatment has a shape close to that of the transformed image of healthy bone tissue. The transformed image of the affected bone tissue has a shape and brightness range differing from the shape and color of the transformed images of healthy bone tissue and bone tissue after treatment. However, transformation of medical images obtained with the Planmeca ProMax 3D Classic device (Finland) allows recording changes that account for less than 0.0001% of the entire image.Conclusion. The proposed method allows human vision to capture changes as small as nearly one pixel in the transformed image, which is impossible with the original medical image. Increasing the color contrast of the transformed medical image makes it possible to reveal the structure of the analyzed medical image fragment. The proposed image transformation method can be used for early diagnosis of diseases and in other fields of medicine.
The purpose of this study was to establish a methodology for determining the midsagittal plane of the temporomandibular joint (TMJ) via the cephalometric landmarks in the structure of diagnostic criteria for temporomandibular disorders.Study Design: Cephalometry of 20 human skulls was obtained. Targeted linear tomography of the TMJ was obtained in a lateral projection. Statistical processing included descriptive methods. Frequencies of the level of the midsagittal plane of the temporomandibular joint are presented.Results: Using cephalometry, we found the midsagittal plane of the frontal process of zygomatic bone (lateral orbital wall) to correspond to the midsagittal plane of the TMJ, parallel to the midsagittal plane of the skull. The lateral orbital wall of the skull was projected onto the lateral rim of the angle of the eye. The distance between lateral orbital rims was the distance between midsagittal planes of the TMJ heads. To check cephalometric results, we used the method of targeted linear TMJ tomography. According to anatomical landmarks, the depth of the tomographic slice at the midsagittal plane of the TMJ level was defined. In total, 176 patients were examined, and 604 tomograms were studied. Images of excellent and good quality were obtained in 94.2% of cases. The depth of tomographic slices in 86.7% of studies ranged from 2.0 to 3.0cm (in 42.2% of observations, 2.5cm; in 21.6% of observations, 2.0cm; in 22.9% of observations, 3.0cm). Conclusion:The lateral orbital wall can be used as a cephalometric landmark defining the midsagittal plane of the TMJ. The resulting landmark makes it possible to determine the individual depths of tomographic slices, to calculate the distance between heads of the mandibular jaw, and to plan treatment in reconstructive maxillofacial surgery, orthodontics, and orthopedics.
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