1/24. Dynamic magnetic resonance imaging technique for the study of the temporomandibular joint.AIMS: Echo planar imaging (EPI) is an ultrafast magnetic resonance imaging (MRI) technique that can scan a single frame in less than a second. The aim of this study was to use the EPI technique to develop a new dynamic MRI protocol for the temporomandibular joint (TMJ). methods: Basic fast-field echo and EPI pulse sequences were used for dynamic studies of the TMJ. The subjects were instructed to perform spontaneous, continuous, slow opening/closing movements without visual or audio feedback. Different scanning parameter settings were explored to optimize the results. RESULTS: With an opening/closing movement of approximately 6 to 7 seconds per cycle, the proposed protocol yielded a good insight into the relative motion between condyle and disc. It was also possible to see the deformation of the disc during movement. CONCLUSION: The EPI technique is a non-invasive technique that can be used for dynamic imaging study of a slow but continuous, uninterrupted jaw movement.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/24. Autologous blood injection for treatment of recurrent temporomandibular joint dislocation.OBJECTIVE: The purpose of this study was to reintroduce a rather simple, safe, minimally invasive, and rapid alternative procedure for the treatment of recurrent dislocation of the condyles. STUDY DESIGN: Subjects were 3 patients (5 joints) who suffered from recurrent condyle dislocation. The technique consisted of visually identifying a line from tragus to the eye angle. Then the articular fossa point was identified in this line, 10 mm anteriorly to tragus and 2 mm below the line. A 19-gauge needle was inserted at the articular fossa point. After injection of saline in the superior compartment, 5 cc of autologous blood drawn from the cubital fossa was injected (4 cc in the superior compartment and 1 cc in the pericapsular tissue). After this an elastic bandage was applied and left for the first 24 hours. patients were advised to constrain their mandibular motion and to eat only soft foods for a week. They received cephalosporin antibiotics and nonsteroidal anti-inflammatory drugs for 7 days. A week after the procedure, supervised physiotherapy was started and the patients were encouraged to increase their mandibular opening to 40 mm. RESULTS: Postoperative recoveries were uneventful. Dislocation of condyles did not reoccur; however, patient no. 3 experienced an episode of unilateral subluxation. At follow-up all patients presented with normal mouth opening. CONCLUSION: Bleeding resulted from the introduction of a needle for injection in the pericapsular tissue. blood coming from this wound, associated with autologous blood injected in the superior compartment, generates a bed for fibrous tissue formation in the region, creating a limitation of mandibular movement, thus ceasing dislocation of the condyles. temporomandibular joint autologous blood injection is a simple procedure performed on an outpatient basis that we advise as an alternative treatment for patients with recurrent dislocation of the condyles.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/24. Chronic dental infections mimicking temporomandibular disorders.BACKGROUND: trismus and jaw pain are not only caused by temporomandibular disorders (TMD), but also by various pathologies, namely infection, trauma, or neoplasms. TMD-like symptoms, as a result of the pathologies, may be confusing to a clinician. This paper reports two cases of chronic dental infection mimicking TMD. methods: Two patients were initially diagnosed with, and treated for, TMD. However the patients did not respond to the treatment. Limited range of motion and jaw pain were then clinically evaluated for differential diagnoses. Laboratory examinations and computerized tomography (CT) scans were carried out to disclose any underlying lesion. RESULTS: Laboratory examination, such as, c-reactive protein helped to detect latent infection. CT scans revealed insidious chronic dental infection imitating TMD. Surgical drainage and chemotherapy resolved the symptoms. CONCLUSION: The importance of a rational diagnostic process, including clinical and laboratory examinations and radiologic imaging, cannot be over-emphasized in elucidating true cause of the symptoms.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/24. Navigation-guided resection of temporomandibular joint ankylosis promotes safety in skull base surgery.PURPOSE: Computer-assisted surgery (CAS) has not been a routine part of craniomaxillofacial surgery to date. This report investigates the use of CAS to promote the safe removal of ankylosed temporomandibular joint bone in the skull base. patients AND methods: Out of a total pool of experience with 102 navigation-guided CAS procedures between January 1998 and December 2000, we report on 2 cases of navigation-aided resection of severe ankylosis of the mandibular condyle with a predetermined safety margin of the resection toward the middle cranial fossa, and identification of the foramen ovale. RESULT: The use of CAS with navigation resulted in the promotion of safe surgical excision of the ankylosed skull base tissue. CONCLUSIONS: We regard navigation-aided resection of an ankylosis fo the mandibular condyle as a valuable additional technique in this potentially complicated procedure.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/24. ankylosis of the temporomandibular joint developing shortly after multiple facial fractures.A 41-year-old male patient was referred for treatment of extensive facial fractures and lateral condylar dislocations. The patient underwent open reduction and fixation under general anaesthesia. Intermaxillary fixation was released in 2 weeks and mouth opening was 21 mm. Despite postoperative physical exercises, the range of motion decreased to 10 mm at 5 weeks after the surgery. MR arthrography revealed a fibrous ankylosis in the bilateral TMJs. Coronal CT scans depicted a bony outgrowth of the left TMJ tuber. The patient underwent surgery for the ankylosis including discectomy and coronoidectomy, and removal of the bony outgrowth. An interincisal distance of 30 mm on maximal mouth opening has been maintained for 14 postoperative months. The importance of imaging assessment was emphasized for diagnosing the precise pathologic state of the ankylosis and selecting an appropriate surgical treatment of choice.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/24. Temporomandibular disorder or Eagle's syndrome? A clinical report.This clinical report describes the diagnosis and treatment of a patient under emotional stress with orofacial pain, headaches, and the feeling of a foreign body in the throat. An elongated styloid process at the beginning of the oral pharynx was diagnosed. Although these symptoms could be aspects of Eagle's syndrome, deflective occlusal interferences, tender muscles of mastication, and a clicking temporomandibular joint led to an evaluation for temporomandibular disorder related to malocclusion. An occlusal splint was used to confirm the diagnosis and to alleviate symptoms. Occlusal adjustments were subsequently performed. In a 10-year follow-up, the patient had no complaints.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/24. Single air contrast arthrography for temporomandibular joint disorder using limited cone beam computed tomography for dental use.MRI has the problem of artefacts caused by metal or body motion and is also incompatible for patients with claustrophobia. arthrography is invasive and involves the risk of perforation or allergy to a contrast medium. This report discusses a patient with temporomandibular joint (TMJ) disorder who required soft tissue imaging of the TMJ. As she had claustrophobia and a reaction to iodine, air contrast arthrography and pumping manipulation therapy using limited cone beam computed tomography for dental use (3DX) was performed. We conclude that the 3DX examination method used in the study is practical as a diagnostic procedure and thus recommend this method to be used for patients with TMJ disorder in the presence of iodine contraindication.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/24. Surgical treatment of temporal bone chondroblastoma.BACKGROUND: temporal bone chondroblastoma is a rare primary bone tumor that affects the floor of the middle cranial fossa. This tumor is known to have high recurrence rate after curettage, and wide resection is therefore recommended. However, the literature provides little information regarding long-term results after wide resection of temporal bone chondroblastoma. methods: Four cases of surgically treated temporal bone chondroblastoma underwent long-term follow-up. RESULTS: Four patients, 3 males and 1 female, with mean age of 34, were surgically treated at the neurosurgery department of Keio University Hospital. Two patients were treated for recurrent tumor and the other two for new disease. In all cases the tumor mainly involved the mandibular fossa with variable degree of infiltration into tympanic and petrous parts. The tumor was totally removed via zygomatic approach in all patients. In 3 patients, the mandibular condyle was removed to expose the tumor. These patients had temporary malocclusion and restricted motion postoperatively, which resolved within 3 to 12 months with conservative treatment. All patients have no recurrence to date with a mean follow-up period of 9 years. CONCLUSION: temporal bone chondroblastoma was removed totally with skull base surgical technique and no recurrence has occurred for 6 to 13 years postoperatively. We found that removal of the mandibular head does not cause permanent problems of mastication in patients with normal dentures.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/24. Clinical management of a patient following temporomandibular joint arthroscopy.This case report describes a patient in whom arthroscopic surgery of the temporomandibular joint (TMJ) was used to break up adhesions between the TMJ disc and the articular eminence and therefore improve mobility of the joint. Postsurgical physical therapy procedures used were high voltage electrical stimulation, transcutaneous electrical nerve stimulation, moist heat, ultrasound, ice, mobilization, and therapeutic exercises. Postsurgical goals included normalization of range of motion, elimination of pain, elimination of inflammation, and mandibular function without restriction. Special emphasis is given to an unusually effective mobilization technique used to decrease tenderness in the TMJ. The conservative therapy described may be used for persons with similar symptoms and evaluation findings who do not require surgery. [Waide FL, Bade DM, Lovasko J, montana J. Clinical management of a patient following temporomandibular joint arthroscopy.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/24. Computed tomography of the TMJ in diagnosis of ankylosis: two case reports.ankylosis of the temporomandibular joint is characterized by restriction or limitation of mandibular movement. It presents as a classic symptom a limited range of motion on opening. Radiographically, ankylosis presents features that facilitate the diagnosis. However, its visualization is not clear in most of the cases involving conventional radiographic techniques. With the evolution of radiographic techniques, computed tomography (CT) became an important examination in the diagnosis of the ankylosis of temporomandibular joint. Due to the increasing use of the CT and its importance in the diagnosis of this disease, the aim of this paper is to present and describe tomographic images of ankylosis of this joint by presenting two clinical cases, using several slices as axial, coronal, and three-dimensional reformatted images.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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