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Diagnostics (Basel, Switzerland) Oct 2023The aim of this study was to describe the prevalence of anatomical variants in the bifid mandibular condyle (BMC) and report its association with temporomandibular joint... (Review)
Review
OBJECTIVE
The aim of this study was to describe the prevalence of anatomical variants in the bifid mandibular condyle (BMC) and report its association with temporomandibular joint (TMJ) pathology.
METHODS
We searched the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to September 2023. Two authors independently performed the search, study selection, and data extraction, and they also assessed the methodological quality with an assurance tool for anatomical studies (AQUA). Finally, the pooled prevalence was estimated using a random effects model.
RESULTS
A total of 50 studies met the eligibility criteria. Twenty studies, with a total of 88,625 subjects, were included in the meta-analysis. The overall prevalence of the bifid mandibular condyle (BMC) variant was 1% (95% CI = 1% to 2%).
CONCLUSIONS
The correlation between the BMC and TMJ pathologies has a relatively low prevalence in studies that present a considerable number of subjects. From a clinical point of view, a direct association cannot be made between the presence of the BMC and TMJ pathologies or symptoms.
PubMed: 37892103
DOI: 10.3390/diagnostics13203282 -
Journal of Clinical Medicine May 2021The retroauricular approach (RA) has been developed in order to expose the temporomandibular joint in a way that minimizes the risk of injury to the facial nerve and... (Review)
Review
INTRODUCTION
The retroauricular approach (RA) has been developed in order to expose the temporomandibular joint in a way that minimizes the risk of injury to the facial nerve and masks the postoperative scar. One of its characteristics is an excellent posterolateral view of the mandibular head, which allows for the preservation of the lateral temporomandibular joint ligaments in the course of open intracapsular surgery.
AIM
The aim of this study is to systematically review the currently used variants and modifications of RA.
MATERIALS AND METHODS
The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was performed based on the PubMed and BASE search engines; furthermore the authors performed a more detailed search in the Google Scholar article database as well as a loop search within the references of papers included in the systematic review.
RESULTS
Searching medical articles databases, Google Scholar, and references yielded a total of 85 records. First the titles and abstracts were blindly screened which was followed by a full-text eligibility check resulting in eventually including and qualifying 7 articles for detailed analysis.
DISCUSSION
All known variants and modifications of RA are characterized by high safety for the facial nerve and an aesthetically hidden scar. There were no reports of auricle necrosis in the collected material.
CONCLUSIONS
In this systematic review, 2 variants and 2 modifications of RA that allow for open temporomandibular joint surgery have been identified; all of them together cover a large spectrum of indications for joint surgery, including reposition and osteosynthesis of mandibular head fractures, eminoplasty, or eminectomy and treatment of some forms of ankylosis.
PubMed: 34064639
DOI: 10.3390/jcm10102049 -
Medicina Oral, Patologia Oral Y Cirugia... Sep 2016Although many orthodontists have no doubts about the effectiveness of functional appliances for mandibular advancement, the impact on the temporomandibular joint (TMJ)... (Review)
Review
BACKGROUND
Although many orthodontists have no doubts about the effectiveness of functional appliances for mandibular advancement, the impact on the temporomandibular joint (TMJ) is still in dispute. The objective of this systematic review is to examine the main effects on the TMJ of using functional appliances, both in healthy patients and in patients with a pre-existing disorder.
MATERIAL AND METHODS
A systematic review of the literature was conducted in accordance with the PRISMA guidelines. Only systematic reviews, meta-analyses, randomized clinical trials (RCTs), case-control studies and cohort studies were included. A detailed language-independent electronic search was conducted in the Pubmed, Scopus, Cochrane Library and Embase databases. All studies published between 2000 and 2015 were included.
RESULTS
A total of 401 articles were identified. Of these, 159 were duplicates and were excluded. On reading the title and abstract, 213 articles were excluded because they did not answer the research question, leaving a total of 29 articles. These articles were read and assessed. Following critical reading of the full text, eight articles were excluded: seven because they were considered of low quality and one because it published redundant data. As a result, 21 articles were included.
CONCLUSIONS
After treatment with functional appliances, the condyle was found to be in a more advanced position, with remodelling of the condyle and adaptation of the morphology of the glenoid fossa. No significant adverse effects on the TMJ were observed in healthy patients and the appliances could improve joints that initially presented forward dislocation of the disk.
Topics: Humans; Mandibular Advancement; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 27475694
DOI: 10.4317/medoral.21180 -
Journal of Clinical Medicine Aug 2021Fixing fractures of the base and neck of mandibular condyles is demanding due to the difficulties in surgical access and the various shapes of bone fragments. Classic... (Review)
Review
INTRODUCTION
Fixing fractures of the base and neck of mandibular condyles is demanding due to the difficulties in surgical access and the various shapes of bone fragments. Classic fixation techniques assume the use of straight mini-plates, utilized for other craniofacial bone fractures. Three dimensional mini-plates may provide a reasonable alternative due to their ease of use and steadily improved mechanical properties. The multitude of different shapes of 3D mini-plates proves the need for their evaluation.
AIM
This paper aims to summarize the clinical trials regarding the use of various types of 3D condylar mini-plates in terms of need for reoperation and the incidence of loosening and damage to the osteosynthetic material.
MATERIALS AND METHODS
A systematic review was conducted in accordance with PICOS criteria and PRISMA protocol. The risk of bias was assessed using ROBINS-I and RoB 2 Cochrane protocols. The obtained data series was analyzed for correlations (Pearson's ) respecting statistical significance (Student's -test > 0.05) and visualized using OriginLab.
RESULTS
13 clinical trials with low overall risk of bias regarding 6 shapes of 3D mini-plates were included in the synthesis. The number of reoperations correlates with the number of fixations ( = 0.53; = 0.015) and the total number of screw holes in the mini-plate ( = -0.45; = 0.006). There is a strong correlation between the number of loosened osteosynthetic screws and the total number of fractures treated with 3D mini-plates ( = 0.79; = 0.001 for each study and = 0.99; = 0.015 for each mini-plate shape). A correlation between the percentage of lost screws and the number of distal screw holes is weak regarding individual studies ( = -0.27; = 0.000) and strong regarding individual mini-plate shape ( = -0.82; = 0.001). Three cases of 3D mini-plate fractures are noted, which account for 0.7% of all analyzed fixation cases.
DISCUSSION
The reasons for reoperations indicated by the authors of the analyzed articles were: mispositioning of the bone fragments, lack of bone fragment union, secondary dislocation, and hematoma. The known screw loosening factors were poor bone quality, bilateral condylar fractures, difficulties in the correct positioning of the osteosynthetic material due to the limitations of the surgical approach, fracture line pattern, including the presence of intermediate fragments, and mechanical overload. Fractures of the straight mini-plates fixing the mandibular condyles amounts for up to 16% of cases in the reference articles.
CONCLUSIONS
There is no convincing data that the number of reoperations depends on the type of 3D mini-plate used. The frequency of osteosynthetic screw loosening does not seem to depend on the 3D mini-plate's shape. Clinical fractures of 3D mini-plates are extremely rare.
PubMed: 34441900
DOI: 10.3390/jcm10163604 -
National Journal of Maxillofacial... Aug 2022To review the literature on the effect of different surgical approaches on facial nerve injuries. The present systematic review addresses the following focus question:... (Review)
Review
To review the literature on the effect of different surgical approaches on facial nerve injuries. The present systematic review addresses the following focus question: Is the facial nerve at risk following surgical correction of mandibular condylar fracture? Electronic and manual literature searches were conducted on databases:PubMed, ScienceDirect and Google scholar,Cochrane and clinicaltrials.gov for studies published until July 2020 to collect information about the effect of different surgical approaches on facial nerve injuries. Systematic literature review was performed following the prisma guidelines to identify studies. Quantitative retrospective and prospective studies,controlled trials,controlled clinical trials were included;case reports and review articles were excluded from this systematic review. 1500 articles published till July 2020 was identified. 116 articles met inclusion criteria. After applying exclusion criteria seven articles were shortlisted. The level of heterogeneity was observed to be less than 50%, between all parameters for all studies making publication bias to be minimum. On comparing various studies statistically using Z-test for all parameters,it was observed that level of significance was significant for various findings like Displacement/Dislocation of fracture and transient facial nerve weakness was found to be statistically significant between all studies (p-value <0.05). Odd ratio, relative ratio and 95% CI was derived for all parameters recorded for various studies. Due to less number of subjective studies, and variability in study designs and lack of reporting on confounding factors,definitive conclusions on effect of various surgical approaches on facial nerve injury cannot be drawn Future well-designed long-term randomized controlled trials are necessary to reveal the necessary correlation between both the parameters.
PubMed: 36393942
DOI: 10.4103/njms.njms_481_21 -
Journal of Oral Rehabilitation Sep 2023Fractures of the mandibular condyle are the most common jaw fractures. There are several treatment approaches. There is the non-surgical and surgical approach. The... (Review)
Review
Conservative treatment of temporomandibular joint condylar fractures: A systematic review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.
OBJECTIVE
Fractures of the mandibular condyle are the most common jaw fractures. There are several treatment approaches. There is the non-surgical and surgical approach. The purpose of this systematic literature review is to evaluate the indications and contraindications of either method to help the clinician make the best treatment choice.
METHODS
Pubmed, Web of Science and Lilacs were systematically searched until 20 May 2023. Clinical trials were selected to compare the two treatments for condyle fracture and evaluate indications and contraindications.
RESULTS
Out of 2515 papers, four studies were included. The surgical approach allows faster functional recovery and decreases patient discomfort. The study analyses under what circumstances a surgical procedure is more practical than a non-surgical one.
CONCLUSION
There is no evidence regarding the reliability of either method. Both have superimposable results. However, age, type of occlusion and other factors direct the clinician towards a surgical choice.
Topics: Humans; Treatment Outcome; Fracture Fixation, Internal; Conservative Treatment; Reproducibility of Results; Mandibular Fractures; Mandibular Condyle; Temporomandibular Joint Disorders; Temporomandibular Joint
PubMed: 37191365
DOI: 10.1111/joor.13497 -
Archives of Oral Biology Oct 2018The aim of this systematic review was to provide a comprehensive synthesis of available evidence evaluating the effect of dietary loading on temporomandibular... (Meta-Analysis)
Meta-Analysis Review
The impact of dietary consistency on structural craniofacial components: Temporomandibular joint/condyle, condylar cartilage, alveolar bone and periodontal ligament. A systematic review and meta-analysis in experimental in vivo research.
OBJECTIVE
The aim of this systematic review was to provide a comprehensive synthesis of available evidence evaluating the effect of dietary loading on temporomandibular joint/condyle, condylar cartilage, alveolar bone of the mandible and the periodontal ligament in healthy mice and rats.
DESIGN
Medline via PubMed, EMBASE and Open Grey databases were searched for published and unpublished literature. Search terms included "mandiblular condyle", "alveolar bone", "temporomandibular joint", "condylar cartilage", "periodontal ligament", "rat", "mice". After data extraction, risk of bias (SYRCLE) and reporting quality (ARRIVE) were assessed. Random effects meta-analyses were performed for the outcomes of interest where applicable.
RESULTS
A total of 33 relevant articles were considered in the systematic review, while only 6 studies were included in the quantitative synthesis. Risk of Bias in all studies was judged to be unclear to high overall, while reporting quality was suboptimal. Comparing soft to hard diet animals, significantly reduced anteroposterior condylar length (4 studies, weighted mean difference: -0.40 mm; 95% CI: -0.47, -0.32; p < 0.001) and width (4 studies, weighted mean difference: -0.043 mm; 95% CI: -0.51, -0.36; p < 0.001) were found in rats. Decreased anteroposterior condylar dimensions were detected for mice as well (2 studies, weighted mean difference: -0.049; 95% CI: -0.56, -0.43; p < 0.001).
CONCLUSIONS
Overall, there was strong evidence to suggest a significant effect of soft diet on reduced condylar dimensions in rodents; however, there is need for further high quality experimental studies to inform current knowledge on condylar cartilage, alveolar bone and periodontal ligament related outcomes.
Topics: Animal Feed; Animals; Cartilage, Articular; Databases, Factual; Diet; Mandible; Mandibular Condyle; Mice; Periodontal Ligament; Rats; Temporomandibular Joint
PubMed: 29957455
DOI: 10.1016/j.archoralbio.2018.06.016 -
Dento Maxillo Facial Radiology Jul 2020To critically synthesize the literature surrounding segmentation of the mandibular condyle using three-dimensional imaging modalities. Specifically, analyzing the...
OBJECTIVE
To critically synthesize the literature surrounding segmentation of the mandibular condyle using three-dimensional imaging modalities. Specifically, analyzing the reliability and accuracy of methods used for three-dimensional condyle segmentation.
METHODS
Three electronic databases were searched for studies reporting the reliability and accuracy of various methods used to segment mandibular condyles from three-dimensional imaging modalities. Two authors independently reviewed articles for eligibility and data extraction.
RESULTS
Nine studies fulfilled the inclusion criteria. Eight studies assessed the condylar segmentation from CBCT images and limited studies were available on non-CBCT three-dimensional imaging modalities. Threshold-based volume segmentation, manual segmentation, and semi-automatic segmentation techniques were presented. Threshold-based volume segmentation reported higher accuracy when completed by an experienced technician compared to clinicians. Adequate reliability and accuracy were observed in manual segmentation. Although adequate reliability was reported in semi-automatic segmentation, data on its accuracy were lacking.
CONCLUSION
A definitive conclusion with regards to which current technique is most reliable and accurate to efficiently segment the mandibular condyle cannot be made with the currently available evidence. This is especially true in terms of non-CBCT imaging modalities with very limited literature available.
Topics: Cone-Beam Computed Tomography; Imaging, Three-Dimensional; Mandibular Condyle; Reproducibility of Results
PubMed: 31778321
DOI: 10.1259/dmfr.20190150 -
Oral Surgery, Oral Medicine, Oral... Sep 2022This systematic review aimed to summarize the morphologic changes in the temporomandibular joint (TMJ) in patients who underwent orthodontic treatment and were assessed... (Review)
Review
OBJECTIVE
This systematic review aimed to summarize the morphologic changes in the temporomandibular joint (TMJ) in patients who underwent orthodontic treatment and were assessed by 3-dimensional (3D) imaging techniques (e.g., magnetic resonance imaging, cone beam computed tomography, and multidetector computed tomography).
STUDY DESIGN
The authors searched PubMed, Web of Science, and Embase databases to identify original articles from 2014 to 2021 containing keywords for morphologic changes in the TMJ, orthodontic treatment, and three-dimensional imaging methods. Prospective and retrospective studies, including observational, cross-sectional, randomized, and nonrandomized clinical trials, cohort studies, and case-control studies, were reviewed. The review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The risk of bias was assessed in studies selected for the full-text review.
RESULTS
The search strategy yielded 294 publications. After an initial screening and the application of exclusion criteria, 13 studies were selected for the final review.
CONCLUSION
Differences were found in condylar positioning, typically in an anterior position; condylar morphology, primarily with increased diameter or head height; and articular disk position within the anterior-posterior plane post-treatment. Changes in the glenoid fossa were not consistent between the studies. The overall risk of bias among studies was moderate. The influence of orthodontic treatment on morphologic changes in the TMJ remains unclear.
Topics: Cross-Sectional Studies; Humans; Mandibular Condyle; Prospective Studies; Retrospective Studies; Temporomandibular Joint
PubMed: 35871168
DOI: 10.1016/j.oooo.2022.05.003 -
Journal of Clinical and Experimental... Jul 2015The joint space measurements of the temporomandibular joint have been used to determine the condyle position variation. Therefore, the aim of this study is to perform a... (Review)
Review
INTRODUCTION
The joint space measurements of the temporomandibular joint have been used to determine the condyle position variation. Therefore, the aim of this study is to perform a systematic review and meta-analysis on the coronal joint spaces measurements of the temporomandibular joint.
MATERIAL AND METHODS
An electronic database search was performed with the terms "condylar position"; "joint space"AND"TMJ". Inclusionary criteria included: tomographic 3D imaging of the TMJ, presentation of at least two joint space measurements on the coronal plane. Exclusionary criteria were: mandibular fractures, animal studies, surgery, presence of genetic or chronic diseases, case reports, opinion or debate articles or unpublished material. The risk of bias of each study was judged as high, moderate or low according to the "Cochrane risk of bias tool". The values used in the meta-analysis were the medial, superior and lateral joint space measurements and their differences between the right and left joint.
RESULTS
From the initial search 2706 articles were retrieved. After excluding the duplicates and all the studies that did not match the eligibility criteria 4 articles classified for final review. All the retrieved articles were judged as low level of evidence. All of the reviewed studies were included in the meta-analysis concluding that the mean coronal joint space values were: medial joint space 2.94 mm, superior 2.55 mm and lateral 2.16 mm.
CONCLUSIONS
the analysis also showed high levels of heterogeneity. Right and left comparison did not show statistically significant differences. Key words:Temporomandibular joint, systematic review, meta-analysis.
PubMed: 26330944
DOI: 10.4317/jced.52439