-
Journal of Cranio-maxillo-facial... Apr 2024Imaging with bone scans plays an important role in the diagnostic path of patients with unilateral condylar hyperactivity or unilateral condylar hyperplasia (UCH). The... (Meta-Analysis)
Meta-Analysis Review
Imaging with bone scans plays an important role in the diagnostic path of patients with unilateral condylar hyperactivity or unilateral condylar hyperplasia (UCH). The aim of this study is to perform a systematic review of the diagnostic performance of the bone SPECT and SPECT/CT scan for the diagnosis of UCH. PubMed, SCOPUS and EMBASE were searched electronically to identify diagnostic accuracy studies that assessed the diagnostic value of bone SPECT and SPECT/CT for the diagnosis of UCH, Meta-analyses were performed with Metadisc 1.4 and 2.0. A total of 14 studies, with a total number of 887 patients, were included in the qualitative analysis and 11 studies qualified for meta-analyses. The pooled sensitivity and specificity for the SPECT scan were 0.814 (95 % CI: 0.639-0.915) and 0.774 (95 % CI: 0.655-0.861), for the SPECT/CT scan these were 0.818 (95 % CI: 0.749-0.874) and 0.901 (95 % CI: 0.840-0.945). The summary receiver operating characteristics of the SPECT scan showed an area under the curve of 0.847 (95 % CI: 0.722-0.972) and that of the SPECT/CT scan was 0.928 (95 % CI: 0.876-0.980). CONCLUSION: Both bone SPECT scan and SPECT/CT scan provide a high diagnostic accuracy for UCH. The added value of the SPECT/CT scan is questionable and given the potential disadvantages of the SPECT/CT scan, including the increased radiation dose and costs, the diagnostic modality of first choice in patients with UCH should be a SPECT scan.
Topics: Humans; Hyperplasia; Mandibular Condyle; Tomography, Emission-Computed, Single-Photon; Radionuclide Imaging; Single Photon Emission Computed Tomography Computed Tomography; Stomatognathic Diseases; Bone Diseases
PubMed: 38378369
DOI: 10.1016/j.jcms.2024.01.013 -
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 -
European Radiology May 2024This systematic review aimed to appraise the reliability and comprehensiveness of imaging methods in studies that used three-dimensional assessment of the... (Review)
Review
Recommendations for standard criteria for the positional and morphological evaluation of temporomandibular joint osseous structures using cone-beam CT: a systematic review.
OBJECTIVE
This systematic review aimed to appraise the reliability and comprehensiveness of imaging methods in studies that used three-dimensional assessment of the temporomandibular joint (TMJ) in order to propose a standardized imaging method.
METHODS
Six databases/search engines were searched up until September 2022. The outcomes of interest included measurements of the mandibular condyle, glenoid fossa, joint spaces, or the entire TMJ. Two checklists were utilized: one to assess the risk of bias, with a maximum score of 37, and the other, a pre-designed checklist consisting of 22 items to evaluate the comprehensiveness of the methods used, with a maximum score of 33.
RESULTS
Out of the 2567 records retrieved, only 14 studies, which used cone bean computed tomography (CBCT), were deemed eligible and thus included in the qualitative analysis. Three studies were deemed of low risk of bias, while the remaining studies were rated as moderate to high risk of bias, primarily due to improper reporting of inter-observer agreement, varying reliability values, and a limited number of cases included in the reliability analysis. Regarding the comprehensiveness of the methods used, only four studies achieved relatively high scores. The deficiencies observed were related to the reporting of variables such as slice thickness and voxel size, absence of or improper reporting of intra- and inter-examiner reliability analyses, and failure to assess all osseous components of the TMJ.
CONCLUSION
CBCT-based methods used to assess the positions and morphology of TMJ bony structures appear to be imperfect and lacking in comprehensiveness. Hence, criteria for a standardized assessment method of these TMJ structures are proposed.
CLINICAL RELEVANCE STATEMENT
Accurately, comprehensively, and reliably assessing the osseous structures of the temporomandibular joint will provide valid and valuable diagnostic features of the normal temporomandibular joint, and help establish potential associations between these osseous features and temporomandibular disorders.
REGISTRATION
The protocol for this systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO, No.: CRD42020199792).
KEY POINTS
•Although many methods have been introduced to assess the osseous structure of the temporomandibular joint, they yielded inconsistent findings. •None of the published studies comprehensively assessed the temporomandibular joint. •Recommendations for a comprehensive temporomandibular joint osseous assessment method were suggested for better validity and reliability of future research.
Topics: Humans; Cone-Beam Computed Tomography; Temporomandibular Joint; Reproducibility of Results; Imaging, Three-Dimensional; Temporomandibular Joint Disorders
PubMed: 37878020
DOI: 10.1007/s00330-023-10248-4 -
Journal of Oral & Maxillofacial Research 2023This systematic review searched three of the most used databases to assess if current evidence suggested a difference between surgical and non-surgical management of... (Review)
Review
OBJECTIVES
This systematic review searched three of the most used databases to assess if current evidence suggested a difference between surgical and non-surgical management of mandibular condyle fractures in paediatric patients.
MATERIAL AND METHODS
An electronic literature search was conducted of three well known databases - Ovid, PubMed and Web of Science. Studies included were conducted paediatric patients, in humans, written in English and published from January 1 1996 until April 1 2022. Data collection was carried out by two independent reviewers. Data collated from studies without high risk of bias was pooled for surgical vs non-surgical management and total tallies of all outcomes presented. Presence or absence of complications was recorded in 4 x 4 tables for each outcome and compared using a Chi-Square test.
RESULTS
After duplicate records were removed, 182 records were screened. After exclusion of unsuitable reports, 20 were included in the review. Further analysis showed the included studies had high risk of bias. Given this, comparison of this pooled data showed no significant difference between management methods.
CONCLUSIONS
Presently it appears conservative management is functionally adequate without risks associated with surgical management, even though incidence of these risks was shown to be low in the studies included in this review.
PubMed: 37521323
DOI: 10.5037/jomr.2023.14202 -
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 -
Journal of Clinical Medicine Nov 2022Background: Our study aimed to systematically summarize the dentoskeletal effects of Herbst appliance; Forsus fatigue resistance device; and Class II elastics in... (Review)
Review
Background: Our study aimed to systematically summarize the dentoskeletal effects of Herbst appliance; Forsus fatigue resistance device; and Class II elastics in adolescent Class II malocclusion. Methods: Five databases; unpublished literature; and reference lists were last searched in August 2022. Randomized clinical trials and observational studies of at least 10 Class II growing patients that assessed dentoskeletal effects through cephalometric/CBCT superimpositions were eligible. The included studies quality was assessed with the RoB 2 and ROBINS-I tools. A random-effects model meta-analysis was performed. Heterogeneity was explored with subgroup and sensitivity analyses. Results: Among nine studies (298 patients); two-to-three studies were included in each meta-analysis. Less post-treatment upper incisor retroclination (<2) and no overbite; overjet; SNA; SNB; and lower incisor inclination differences were found between Herbst/Forsus and Class II elastics. No differences in maxilla; condyle; glenoid fossa; and most mandibular changes were found between Herbst and Class II elastics; except for a greater 1.5 mm increase in mandibular length and right mandibular ramus height (1.6 mm) with Herbst. Conclusions: Herbst and Class II elastics corrected the molar relationship; but Herbst moved the lower molars more mesially. Apart from an additional mandibular length increase; no other dental and anteroposterior skeletal difference was found. Forsus was more effective in molar correction; overjet reduction; and upper incisor control than Class II elastics. Trial registration number OSF: 10.17605/OSF.IO/8TK3R.
PubMed: 36498570
DOI: 10.3390/jcm11236995 -
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 -
Animals : An Open Access Journal From... Aug 2022Skeletal Class II malocclusion is the most common skeletal anomaly in orthodontics. Growth in the body of the deficient mandible is induced by periosteal apposition and... (Review)
Review
Skeletal Class II malocclusion is the most common skeletal anomaly in orthodontics. Growth in the body of the deficient mandible is induced by periosteal apposition and endochondral ossification in the condyle. Functional appliances have been used in the correction of Class II malocclusions by inducing mandibular growth. Despite their utilization though, their effect still remains controversial. The aim of the present study is to review the existing literature regarding the effects of mandibular protrusion in mandibular growth of growing rats. A protocol was followed according to the guidelines of the . Databases were searched using a specific algorithm. From the ten studies finally analyzed, we conclude that the use of a functional appliance in growing rats induces cell proliferation and bone formation in their condyles, resulting in mandibular growth.
PubMed: 36009649
DOI: 10.3390/ani12162059 -
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 -
International Journal of Oral and... Jan 2023The aim of this study was to perform a systematic review of the literature on the temporomandibular joint (TMJ) prosthesis as a treatment option after mandibular condyle... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to perform a systematic review of the literature on the temporomandibular joint (TMJ) prosthesis as a treatment option after mandibular condyle fracture. Three databases were searched (PubMed, Embase, Cochrane Library) and 2670 unique papers were identified. A total of 337 studies were included (121 case reports, 89 case series, and 127 cohort/clinical studies). In total 14,396 patients and 21,560 prostheses were described. Of the 127 cohort or clinical studies, 100 (79%) reported inclusion criteria, 54 (43%) reported exclusion criteria, and 96 (76%) reported the inclusion period. The base population from which patients were recruited was reported in 57 studies (45%). The reason for TMJ prosthesis implantation was reported for 4177 patients (29.0%). A history of condylar fracture was present in 83 patients (2.0%); a history of mandibular trauma was present in 580 patients (13.9%). The meta-analysis showed a pooled prevalence of condylar fracture of 1.6% (95% confidence interval 0.9-2.4%) and a pooled prevalence of trauma or condylar fracture of 11.3% (95% confidence interval 7.1-16.0%). Heterogeneity was highly significant (P < 0.001). The TMJ prosthesis appears to be reserved for patients with persistent pain, bony or fibrous ankylosis, or osteomyelitis after primary closed or open treatment of fractures of the mandibular condyle.
Topics: Humans; Mandibular Condyle; Temporomandibular Joint Disorders; Tooth Ankylosis; Mandibular Fractures; Temporomandibular Joint; Ankylosis
PubMed: 35752530
DOI: 10.1016/j.ijom.2022.05.014