Random errors in localization of landmarks in postero-anterior cephalograms.
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The aim of the present study was to evaluate the random error in localization of the most common landmarks in postero-anterior cephalograms (PAC). The study took place at the Department of Orthodontics of Aarhus University during the period 1993-1995. The material consisted of 30 standardized PAC taken in natural head position. Five examiners had to identify 34 landmarks on each cephalogram. Subsequently, all examiners had to identify again the same 34 landmarks on one randomly selected cephalogram five times with a time interval of at least 24 hours. All landmarks were digitized, related to an X-Y co-ordinate system, and an arithmetical mean was calculated. The accuracy of digitizing was evaluated by digitizing one randomly selected cephalogram 10 times. The main findings of this study are: (1) The digitizing error is negligible compared to the errors introduced by landmark identification. (2) Each landmark has its own characteristic pattern of variance, which is very similar on both sides. (3) Significant differences in accuracy exist between the various postero-anterior landmarks. The six most accurate landmarks are mastoid left (l) and right (r), latero-orbitale (l) and (r), and antegonion (l) and (r). The six least accurate landmarks are coronoid (l) and (r), condylar (l) and (r), and mandibular foramen (l) and (r). (4) A significant difference in the accuracy of landmark identification between the five examiners was only seen for seven of the 34 landmarks. (5) No evidence was found that one examiner was consistently better/worse than the others. (6) No improvement in the accuracy was found after repeated identification, thus there seems to be no short-term 'learning process'. Refereed Paper (+info)
EMG activities of two heads of the human lateral pterygoid muscle in relation to mandibular condyle movement and biting force.
(10/314)
Electromyographic (EMG) activities of the superior (SUP) and inferior heads (INF) of the lateral pterygoid muscle (LPT) were recorded in humans during voluntary stepwise changes in biting force and jaw position that were adopted to exclude the effects of acceleration and velocity of jaw movements on the muscle activity. The SUP behaved like a jaw-closing muscle and showed characteristic activity in relation to the biting force. It showed a considerable amount of background activity (5-32% of the maximum) even in the intercuspal position without teeth clenching and reached a nearly maximum activity at relatively lower biting-force levels than the jaw-closing muscles during increment of the biting force. Stretch reflexes were found in the SUP, the function of which could be to stabilize the condyle against the biting force that pulls the condyle posteriorly. This notion was verified by examining the biomechanics on the temporomandibular joint. The complex movements of the mandibular condyle in a sagittal plane were decomposed into displacement in the anteroposterior direction (Ac) and angle of rotation (RAc) around a kinesiological specific point on the condyle. In relation to Ac, each head of the LPT showed quite a similar behavior to each other in all types of jaw movements across all subjects. Working ranges of the muscle activities were almost constant (Ac <3 mm for the SUP and Ac >3 mm for the INF). The amount of EMG activity of the SUP changed in inverse proportion to Ac showing a hyperbola-like relation, whereas that of the INF changed rather linearly. The EMG amplitude of the SUP showed a quasilinear inverse relation with RAc in the hinge movement during which the condyle rotated with no movement in the anteroposterior direction. This finding suggests that the SUP controls the angular relationship between the articular disk and the condyle. On the other hand, the position of the disk in relation to the maxilla, not to the condyle, is controlled indirectly by the INF because the disk is attached to the condyle by tendinous ligaments. (+info)
Location of the glenoid fossa after a period of unilateral masticatory function in young rabbits.
(11/314)
Changes in glenoid fossa position and skull morphology after a period of unilateral masticatory function were studied. The right-side maxillary and mandibular molars in twenty-seven 10-day-old rabbits were ground down under general anaesthesia. The procedure was repeated twice a week, until the rabbits were 50 days old. Fourteen rabbits were then killed and 13 left to grow to age 100 days. Nine 50-day-old and sixteen 100-day-old rabbits with unmodified occlusions served as controls. Three-dimensional measurements were made using a machine-vision technique and a video-imaging camera. The glenoid fossa position become more anterior in both groups of animals subjected to molar grinding as compared with controls (P < 0.01 in the 50-day-old group and P < 0.05 in 100-day-old group). In the 100-day-old group the right-side fossa was also in a more inferior position (P < 0.01). The glenoid fossa was more anteriorly located on the right than on the left side of individual animals in the group in which the right-side molars had been ground down (P < 0.001). (+info)
Effect of metabolic acidosis on the growth hormone/IGF-I endocrine axis in skeletal growth centers.
(12/314)
BACKGROUND: Chronic metabolic acidosis (CMA) adversely affects bone metabolism and skeletal growth. Given the cardinal role played by the local growth hormone (GH)/insulin-like growth factor-I (IGF-I) in promoting cell proliferation and differentiation in growth plates, we tested the effect of CMA on the GH/IGF-I axis in a skeletal growth center. METHODS: We employed an in vitro organ culture system using the murine mandibular condyle as a model for endochondral active growth center. Condyles from six-day-old ICR mice were cultured in BGJb medium of either neutral pH (pH approximately 7.4) or acidic pH (pH approximately 7.15). After 24, 48, 72, and 96 hours of culture, the condyles were washed, fixed in formaldehyde, and processed for paraffin embedding. We assessed histologic markers of the growth center. In addition, the protein level and mRNA expression for the different components of the GH/IGF-I axis were evaluated by immunohistochemistry and in situ hybridization, respectively. Finally, we evaluated the effect of acidosis on the biological functions mediated by GH and IGF-I (namely, proliferation and differentiation of cartilage cells in the active growth center). RESULTS: Following three to four days in acidic conditions, there was a marked reduction in the size of young chondrocytic population, suggesting a defect in the process of endochondral differentiation. Immunohistochemistry and in situ hybridization analyses revealed a marked reduction in the expression of the IGF-I receptor, as well as in the GH receptor. These changes were already evident after 48 hours of incubation in acidic conditions. At 48 hours of acidosis, there was also a marked reduction in the expression of IGF-I both under basal conditions (nonstimulated) and following stimulation with GH. The expression of IGF binding protein 2 (IGFBP-2) and IGFBP-4, which serve as negative modulators of IGF-I, was enhanced in CMA. IGF-I markedly stimulated chondrocytic proliferation (assessed by BrdU incorporation into DNA) and differentiation (assessed as cartilage specific proteoglycan expression). These responses were markedly attenuated in acidic conditions. CONCLUSION: CMA exerts an anti-anabolic effect in bone growth centers, which is partly related to a state of resistance to GH and IGF-I, created by CMA. This phenomenon may underlie the disturbance in longitudinal bone growth in CMA (that is, renal tubular acidosis) and may contribute to renal osteodystrophy in patients suffering from chronic renal failure. (+info)
The changes in temporomandibular joint disc position and configuration in early orthognathic treatment: a magnetic resonance imaging evaluation.
(13/314)
This study aimed to examine the effects of chin cup therapy on the temporomandibular joint (TMJ) disc position and configuration with magnetic resonance imaging (MRI). Twenty-five individuals ranging in age from 5 to 11 years were evaluated. The treatment group consisted of 15 subjects (10 females and five males) with prognathic facial structures, while the control group comprised 10 subjects (six females and four males) with an orthognathic facial structure. The magnitude of the chin cup force applied to the mandible was 600 g. Unilateral MRIs of the TMJ were taken in all subjects at the beginning and end of the study. No statistically significant changes in the TMJ disc position and configuration during the treatment and control periods could be seen. The values of the alpha angle measurements were found to be different in the treatment and control groups at the beginning (166.23 +/- 2.15 and 172 +/- 1.97, respectively), and end of the treatment and control periods (160.00 +/- 2.16 and 172.00 +/- 2.68). These findings show that if the chin cup appliance is used at an early age and with appropriate forces, there will be no adverse effect on the TMJ disc position and configuration. (+info)
Functional magnetic resonance imaging of temporomandibular joint disorders.
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Fifty-eight temporomandibular joints (TMJs) from 40 patients with TMJ-related symptoms were examined by means of magnetic resonance scans with modified gradient echo sequences and a special double coil. This technique yielded a good spatial resolution of the intra-articular soft tissues, especially the articular disc and the bone structure of the TMJ. In combination with an incremental jaw opener, the disc-condyle complex was analysed in various closed and open mouth positions, depending on the clinical examination. Open mouth movement with differentiation of disc-condyle rotational and translation movement was demonstrated. Disturbances of TMJ motion showed interrupted condylar translation combined with mandibular deviation during open mouth movement (n = 8/58). Early phases of internal derangement of the TMJ with partial anterior disc displacement with (n = 12/58) or without (n = 2/58) reduction, total anterior disc displacement without reduction (n = 10/58), disc deformation (n = 10/58), disc adhesion (n = 2/58), condylar hypermobility (n = 6/58), condylar displacement (n = 8/58), and late phases of internal derangement of the TMJ with osteoarthrosis (n = 14/58) were clearly identified. Bilateral TMJ disorder was found in 72.5 per cent of the patients. By using motion-adapted, semi-dynamic magnetic resonance imaging (MRI), it is possible to improve the understanding of the complexity of TMJ movements. (+info)
Distribution and characterization of proliferative cells in the rat mandibular condyle during growth.
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Distribution of proliferative cells and localization of types I and II collagen were examined in the rat mandibular condylar cartilage of 36 long-Evans/Turku strain rats during normal postnatal growth using an immunohistochemical method combined with histomorphometry. There were considerable differences in the thickness of the proliferative cell layer in the condylar head, with most mitoses occurring in the postero-superior area. It was found that the extracellular matrix of the proliferative cells does not stain for type II collagen in 20-day-old and older rats, and that besides the subchondral bone, the strongest intensity for type I collagen stain was always localized in the articular surface of the condylar head. Statistically significant overlapping of the proliferative cell layer and the one secreting type II collagen occurred during the earlier stages of development, particularly in the postero-superior area of the condylar head. As type II collagen is considered to be a marker for identification of typical cartilage cells, the findings indicate that, in addition to undifferentiated cells, a portion of the proliferative cells can be characterized as chondroblasts during the early postnatal period in rats, but not in the later stages of development. The developmental phase of the condylar cartilage should therefore be taken into consideration when the effect of various biomechanical and humoral/hormonal factors on growth of the condylar cartilage is examined. (+info)
Computer tomographic and radiographic changes in the temporomandibular joints of two young adults with occlusal asymmetry, treated with the Herbst appliance.
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Two young patients, one female and one male, with asymmetric occlusal deviation and extreme Angle Class II division 1 malocclusions were treated with the Herbst appliance after cessation of endochondral growth (union of the radius epiphysis). During treatment, computer tomographic (CT) scanning and orthopantomograms of the temporomandibular joints (TMJs) revealed, as a result of bone modelling, asymmetrical new bone formation as a double contour on the distocranial part of the condyles. The treatment results were followed for more than 2 years and the new bone was found to be stable. (+info)