Tumoral calcinosis of the temporomandibular joint: CT and MR findings. (73/78)

In this article, the CT, three-dimensional CT, and MR findings are reviewed in a 59-year-old woman with tumoral calcinosis involving the temporomandibular joint.  (+info)

Immunohistochemical and histological studies on internal derangement and organic disturbance of temporomandibular joint. (74/78)

The study examined the articular cartilages of 14 patients who suffered from temporomandibular joint disturbance syndrome (TMJDS) and 3 healthy fresh cadavers by light microscopy and immunofluorescence, and assayed 14 patients' synovial fluids and sera with indirect hemoagglutination. The results showed that there were antibodies to type II collagen in synovial fluids in 5 of 14 patients and there were some immune complexes in cartilage. So, the authors think that there are autoimmune reactions in the articular tissues in TMJDS because of the exposure of some sequestered antigens.  (+info)

Use and misuse of intra-articular corticosteroids in treatment of temporomandibular joint pain. (75/78)

In certain cases of intractable pain in the temporomandibular joint after conservative treatments have been unsuccessful, a single intra-articular injection of up to 40 mg of prednisolone trimethylacetate has been shown to be useful for permanent relief. This treatment has most success in patients over the age of 30 years; the older the patient the greater likelihood of clinical improvement. It is not to be recommended in the younger age groups. There is no evidence that a single intra-articular injection of any such corticosteroid causes damage that can be detected radiographically to an apparently sound articular surface. But it is still possible that multiple injections can cause damage, and they should not be used for any age group. In some cases where there is radiographic evidence of articular erosion before treatment, an advance of the lesion with reduction of the size of the mandibular condyle can be expected but is consistent with a reduction of the symptoms. The final result may be said to resemble a pharmacologically-achieved arthroplasty. Judgment of the success of the treatment by symptomatic assessment has proved to be entirely satisfactory, since the majority of patients have been grateful for the initial and continued relief of their pain and dysfunction. They have, in fact, avoided surgery to their joints and have no untoward side-effects.  (+info)

The aetiology of temporomandibular disorders: a philosophical overview. (76/78)

Over the last 50 years many theories have been put forward to explain the syndrome currently called 'temporomandibular disorders'. However, it is doubtful whether any single theory fits all the complex features of this condition. The 'multifactorial' explanation also appears flawed. On the assumption that a valid theory should fit the whole evidence, this paper starts by separating the 'predisposing' from the 'initiating' factors, and notes that most existing theories appear to identify the former rather than the latter. The research material is examined in an effort to formulate a theory that is both logical and fits all the known clinical findings.  (+info)

Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. (77/78)

Epidemiology is the study of the distribution, determinants, and natural history of disease in populations. Epidemiology has several uses in addition to its traditional role of documenting the public health significance of a condition. Notably, epidemiologic methods and data can be used to identify and verify causes of disease. This article reviews the epidemiologic data on pain in the temporomandibular region, and on signs and symptoms associated with specific subtypes of temporomandibular disorders, with the aim of identifying possible etiologic factors for these conditions that deserve further study. Despite methodologic and population differences, several consistencies are apparent in the epidemiologic literature. Pain in the temporomandibular region appears to be relatively common, occurring in approximately 10% of the population over age 18; it is primarily a condition of young and middle-aged adults, rather than of children or the elderly, and is approximately twice as common in women as in men. This prevalence pattern suggests that etiologic investigations should be directed at biologic and psychosocial factors that are more common in women than in men, and diminish in older age groups. Most signs and symptoms associated with particular temporomandibular disorders (e.g., joint sounds, pain in the joint) also appear to be more prevalent in women than in men, although age patterns for these signs and symptoms are not as clear as for temporomandibular pain. The available data highlight the need for further research on etiologic factors associated with temporomandibular pain and with specific diagnostic subtypes of temporomandibular disorders.  (+info)

Oral splints: the crutches for temporomandibular disorders and bruxism? (78/78)

Despite the extensive use of oral splints in the treatment of temporomandibular disorders (TMD) and bruxism, their mechanisms of action remain controversial Various hypotheses have been proposed to explain their apparent efficacy (i.e., true therapeutic value), including the repositioning of condyle and/or the articular disc, reduction in the electromyographic activity of the masticatory muscles, modification of the patient's "harmful" oral behavior, and changes in the patient's occlusion. Following a comprehensive review of the literature, it is concluded that any of these theories is either poor or inconsistent, while the issue of true efficacy for oral splints remains unsettled. However, the results of a controlled clinical trial lend support to the effectiveness (i.e., the patient's appreciation of the positive changes which are perceived to have occurred during the trial) of the stabilizing splint in the control of myofascial pain. In light of the data supporting their effectiveness but not their efficacy, oral splints should be used as an adjunct for pain management rather than a definitive treatment. For sleep bruxism, it is prudent to limit their use as a habit management aid and to prevent/limit dental damage potentially induced by the disorder. Future research should study the natural history and etiologies of TMD and bruxism, so that specific treatments for these disorders can be developed.  (+info)