Muscular and condylar response to rapid maxillary expansion. Part 3: Magnetic resonance assessment of condyle-disc relationship

Arat, F. Emel; Arat, Z. Mirzen; Tompson, Bryan; Tanju, Sumru

doi:10.1016/j.ajodo.2007.03.026

Cited by 20 publications

(28 citation statements)

References 31 publications

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“…This is in line with the findings in symptom-free patients before and after receiving orthodontic treatment, 16 30% of whom showed a "medial" or "anteromedial" disc position according to the abovementioned nomenclature. 12 Alterations in the position of the disc may be accompanied by joint sounds, joint pain and/or restricted mouth opening.…”

Section: Discussionsupporting

confidence: 74%

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

Eberhard¹,

Giannakopoulos²,

Rohde³

et al. 2013

Dentomaxillofacial Radiology

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Objectives: To assess the position of the temporomandibular joint (TMJ) disc in patients with TMJ pain and compare it with equivalent published data of asymptomatic volunteers. Methods: The oblique coronal closed-and open-jaw MR images from 66 patients with TMJ pain were evaluated. Clinical examination followed the research diagnostic criteria for temporomandibular disorders. In all coronal images, the transverse condylar axis and the medial and lateral edges of the disc were determined using special software. Inter-rater agreement was calculated [two raters; inter-rater correlation coefficient (ICC)]. The presence of osteoarthrosis (OA) was determined by two independent raters. The influence of OA was estimated in patients (generalized estimation equation model). The results were compared with those of healthy volunteers (t-test). Differences between closed and open jaw in patients were analysed with the Wilcoxon matched-pair test. Results: The ICC was good for the transverse condylar axis (0.987) and the medial edge of the disc (0.799) and fair for the lateral edge (0.355). On average, the disc projected 5.5% to the medial side; laterally, the condyle was partially uncovered by the disc (216.6%). In the openjaw position, both the medial and the lateral edges shifted medially (to 17.6% vs 223.6%, Wilcoxon matched-pair test, p , 0.001). OA had no significant influence (generalized estimation equation model, p 5 0.952). The disc position differed significantly from asymptomatic individuals (t-test, p , 0.001) who showed a medial disc position and full coverage of the condyle. Conclusions: In patients with TMJ pain, the disc seems to be smaller and located less medially than in healthy volunteers. The extent of the medial shift on opening was similar.

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Section: Discussionsupporting

confidence: 74%

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

Eberhard¹,

Giannakopoulos²,

Rohde³

et al. 2013

Dentomaxillofacial Radiology

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“…In contrast, bilateral crossbites seem to have less orthopaedic consequences and were not associated with TMD symptoms in children and teenagers . However, the predictive value of unilateral functional crossbite for disc displacements may be quite low due to successful skeletal adaptation in most cases rather than adaptation at the expense of the articular disc. Notably, a prospective MRI study revealed that only 1/15 children with unilateral crossbite occlusions had a disc derangement (locking) .…”

Section: Functional Crossbites Are Nature's Continuing Experimental Omentioning

confidence: 90%

Establishing better biological models to understand occlusion. I: TM joint anatomic relationships

Pullinger¹

2013

J of Oral Rehabilitation

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Belief in and rejection of a relationship of occlusion and temporomandibular joint (TMJ) condyle-fossa position with normal and abnormal function are still contentious issues. Clinical opinions can be strong, but support in most published data (mostly univariate) is problematic. Distribution overlap, low sensitivity and specificity are a common basis to reject any useful prediction value. Notwithstanding, a relationship of form with function is a basic tenet of biology. These are multifactor problems, but the questions mostly have not been analysed as such. This review moves the question forward by focusing on TM joint anatomic organisation as the multifactor system it is expected to be in a closed system like a synovial joint. Multifactor analysis allows the data to speak for itself and reduces bias. Classification tree analysis revealed useful prediction values and usable clinical models which are illustrated, backed up by stepwise logistic regression. Explained variance, R(2), predicting normals from pooled TMJ patients was 32·6%, sensitivity 67·9%, specificity 85·7%; 37% versus disc displacement with reduction; and 28·8% versus disc displacement without reduction. Significant osseous organisational differences between TM joints with clicking and locking suggest that this is not necessarily a single disease continuum. However, a subset of joints with clicking contained characteristics of joints with locking that might contribute to symptom progression versus resistance. Moderately strong models confirm there is a relationship between TMJ osseous organisation and function, but it should not be overstated. More than one model of normals and of TM derangement organisation is revealed. The implications to clinical decision-making are discussed.

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“…Consistently, Arat et al. (64) investigated condyle‐disc positions on sagittal and coronal closed‐mouth magnetic resonance imaging (MRI) in unilateral and bilateral posterior crossbite patients before and 18 weeks after rapid maxillary expansion (RME). The authors concluded that RME is neither a risk factor nor a prevention for TMD.…”

Section: Does Malocclusion Cause Tmd?mentioning

confidence: 97%

The role of orthodontics in temporomandibular disorders

Michelotti

Iodice

2010

Journal of Oral Rehabilitation

201

167

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Temporomandibular Disorder (TMD) is the main cause of pain of non-dental origin in the oro-facial region including head, face and related structures. The aetiology and the pathophysiology of TMD is poorly understood. It is generally accepted that the aetiology is multifactorial, involving a large number of direct and indirect causal factors. Among such factors, occlusion is frequently cited as one of the major aetiological factors causing TMD. It is well known from epidemiologic studies that TMD-related signs and symptoms, particularly temporomandibular joint (TMJ) sounds, are frequently found in children and adolescents and show increased prevalence among subjects between 15 and 45 years old. Aesthetic awareness, the development of new aesthetic orthodontic techniques and the possibility of improving prosthetic rehabilitation has increased the number of adults seeking orthodontic treatment. The shift in patient age also has increased the likelihood of patients presenting with signs and symptoms of TMD. Because orthodontic treatment lasts around 2 years, orthodontic patients may complain about TMD during or after treatment and orthodontists may be blamed for causing TMD by unsatisfied patients. This hypothesis of causality has led to legal problems for dentists and orthodontists. For these reasons, the interest in the relationship between occlusal factors, orthodontic treatment and TMD has grown and many studies have been conducted. Indeed, claims that orthodontic treatment may cause or cure TMD should be supported by good evidence. Hence, the aim of this article is to critically review evidence for a possible association between malocclusion, orthodontic treatment and TMD.

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Muscular and condylar response to rapid maxillary expansion. Part 3: Magnetic resonance assessment of condyle-disc relationship

Cited by 20 publications

References 31 publications

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

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

Establishing better biological models to understand occlusion. I: TM joint anatomic relationships

The role of orthodontics in temporomandibular disorders

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