1/152. Reconstruction of the mandibular condyle using transport distraction osteogenesis.Transport distraction osteogenesis was used to reconstruct the articulation of the temporomandibular joint in two patients. Patient 1 underwent a gap arthroplasty for release of a bony ankylosis. Patient 2 had degenerative joint disease after tumor resection. Both patients had painful, limited mouth opening and facial asymmetry as a result of condylar shortening. A reverse-L osteotomy was performed from the sigmoid notch to the posterior border of the mandible. An external transport distraction device was applied, and the segment was advanced superiorly, 1.0 mm per day, until contact was made with the glenoid fossa. After distraction, the bone was found to have remodeled, inducing a new cortical layer on the articular surface. Additionally, a pseudodisk was generated as a result of the transport distraction. The two patients tolerated the procedure well, returning to pain-free normal mouth opening and being able to masticate regular diets.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/152. Long-term stability of mandibular orthopedic repositioning.Mandibular anterior repositioning appliances attempt to diminish temporomandibular joint pain, soft tissue noise, and myofascial discomfort by altering condyle-disc relationships. Secondary stabilization of the occlusion to this arbitrary anterior position through orthodontic tooth movement may significantly alter functional and muscular relationships. A case report is illustrated to show that as the functional environment attempted to reestablish equilibrium through adaptation, relapse occurred as the condyles "seated" posteriorly and superiorly toward their original relationship within the fossa. For all practical purposes, complete relapse of the orthodontic treatment result took place over time.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
3/152. Case report: treatment for a patient with a history of TMJ disorder.Establishing a knowledge-based protocol for the treatment of orthodontic patients who report a history of temporomandibular dysfunction can alert the practitioner to potential treatment pitfalls before they happen. While the joints can be extremely adaptive, some individuals are subject to painful and/or limited function. Others have acquired condylar positions that, if not recognized, could lead to serious alterations in the original treatment plan. Combining a thorough diagnostic protocol with a therapeutic regimen that seeks to establish a stable condylar and occlusal position-prior to initiating treatment- is essential.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
4/152. Phase II therapy for a chronic pain patient: a clinical report.One of the roadblocks to success in treating temporomandibular joint dysfunction (TMD) patients is an accurate diagnosis. The terms "TMJ" or "TMD" are not specific enough to provide definitive treatment. Initially the disorder must be classified as a muscular or an internal derangement problem. Once accomplished, the further diagnostic breakdown of the problem will prepare the patient and the doctor for the scope of treatment necessary and the prognosis. This lack of a specific diagnosis can lead to inappropriate treatment and inadequate communication among clinical dentists, academia and patients. Our patients and the profession will continue to suffer until a single diagnostic system is universally agreed upon and utilized.- - - - - - - - - - ranking = 2keywords = pain (Clic here for more details about this article) |
5/152. Rheumatoid arthritis-affected temporomandibular joint pain analgesia by linear polarized near infrared irradiation.PURPOSE: To describe a new short-term treatment for pain in rheumatoid arthritis (RA)-affected temporomandibular joint (TMJ). CLINICAL FEATURES: We investigated four female patients (age 42.8 /-26.0 yr) with chronic rheumatoid arthritis affecting a single TMJ. patients had received antirheumatic drugs such as sodium aurothiomalate, and as a result showed no symptoms in other body joints. Linear polarized near infrared radiation using Super Lizer was applied weekly with and/or without jaw movement to the unilateral skin areas overlying the mandibular fossa, anterior articular tubercle, masseter muscle and posterior margin of the ramus of the mandible. The duration of irradiation to each point was two seconds on and ten seconds off per cycle and the intensity at each point was approximately 138 J x cm(-2) at a wavelength of 830 nm. Interincisal distance was measured with maximal mouth opening in the absence and presence of pain before and after each treatment. Additionally, subjective TMJ pain scores assessed using a visual analog scale were performed for painful maximal mouth opening before and after each irradiation. TMJ pain disappeared after only four treatments. Moreover, painless maximal mouth opening without pain after irradiation in three patients was on average improved to 5.3 /-2.1 mm. However, one case was observed where the opening length prior to irradiation did not improve, despite the fact that the RA-affected TMJ pain had disappeared. CONCLUSION: Application of linear polarized near infrared irradiation to patients with RA-affected TMJ pain is an effective and non-invasive short-term treatment.- - - - - - - - - - ranking = 6.5keywords = pain (Clic here for more details about this article) |
6/152. An 8-year-old girl with unilateral facial and ear pain and isolated frontal headaches.An 8 1/2-year-old with chronic but fluctuating unilateral facial pain, earache, frontal headache and facial swelling is presented. Her journey through the health care system provides an instructional lesson for all who deal with patients with unusual or difficult to recognize conditions.- - - - - - - - - - ranking = 2.781904836404keywords = pain, headache (Clic here for more details about this article) |
7/152. Idiopathic condylar resorption: diagnosis, treatment protocol, and outcomes.Idiopathic condylar resorption is a poorly understood progressive disease that affects the TMJ and that can result in malocclusion, facial disfigurement, TMJ dysfunction, and pain. This article presents the diagnostic criteria for idiopathic condylar resorption and a new treatment protocol for management of this pathologic condition. Idiopathic condylar resorption most often occurs in teenage girls but can occur at any age, although rarely over the age of 40 years. These patients have a common facial morphology including: (1) high occlusal and mandibular plane angles, (2) progressively retruding mandible, and (3) Class II occlusion with or without open bite. Imaging usually demonstrates small resorbing condyles and TMJ articular disk dislocations. A specific treatment protocol has been developed to treat this condition that includes: (1) removal of hyperplastic synovial and bilaminar tissue; (2) disk repositioning and ligament repair; and (3) indicated orthognathic surgery to correct the functional and esthetic facial deformity. patients with this condition respond well to the treatment protocol presented herein with elimination of the disease process. Two cases are presented to demonstrate this treatment protocol and outcomes that can be achieved. Idiopathic condylar resorption is a progressive disease that can be eliminated with the appropriate treatment protocol.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
8/152. Metastatic cancer presenting as TMD. A case report.The dentist's responsibility in managing patients should include the awareness that not every pain in the face is due to a toothache or a temporomandibular disorder (TMD). This paper reviews the case of a 66-year-old patient who presented to the dental office with a chief complaint of unilateral jaw pain. The symptoms seemed consistent with TMD. Two years prior, the patient had undergone successful removal of a cancerous prostate and had remained under urologist care with a favorable prognosis. Subsequent imaging studies confirmed that the facial pain was due to multiple metastatic lesions to areas including the zygoma, infratemporal fossa, maxilla and brain. However, these metastatic lesions were not of prostate origin, but rather were from a squamous cell carcinoma originating in a primary site other than the prostate.- - - - - - - - - - ranking = 1.5keywords = pain (Clic here for more details about this article) |
9/152. Worsening of pre-existing TMJ dysfunction following sagittal split osteotomy: a study of three cases.When patients seeking treatment for malocclusion also suffer from temporomandibular joint (TMJ) disorders, it is hard to predict the result of simultaneous treatment of both conditions, or to plan for its different goals, because of unpredictable changes in the relationship between the disk, the fossa and the condylar head. Prediction is harder in cases of presurgical TMJ hypomobility, especially those with adhesion in the upper TMJ compartment. Authors differ widely on the likely effect of orthognathic surgery on TMJ disorders. This paper reports three cases in which TMJ disorders worsened after treatment of malocclusion by sagittal split osteotomy. It examines how presurgical diagnosis of TMJ disorders could assist treatment planning in such cases. The results suggest that microbleeding in the upper TMJ compartment during orthognathic surgery, as well as long-term postoperative intermaxillary fixation, carries a risk of creating worse adhesion that adversely affects the outcome for patients. Therefore, preoperative diagnosis of disk position and pathological conditions in the upper TMJ compartment, as well as careful choice of method and term of postoperative fixation, are essential in planning the treatment of malocclusion with sagittal split osteotomy.- - - - - - - - - - ranking = 0.0061718208968144keywords = upper (Clic here for more details about this article) |
10/152. A destructive calcium pyrophosphate dihydrate deposition disease of the temporomandibular joint.A case of calcium pyrophosphate dihydrate (CPPD) crystal deposition arthropathy of the temporomandibular joint is reported. The patient presented a 10-year history of swelling and pain of the left preauricular region. Magnetic resonance imaging showed a calcified mass filling the joint space and destroying the roof of the joint. Radiographs showed chondrocalcinosis of other joints. The authors discuss the diagnosis of this arthropathy and the reason why the temporomandibular joint is more affected than the other joints in the patient reported.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
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