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Advanced Healthcare Materials Jan 2019Tissue engineering potentially offers new treatments for disorders of the temporomandibular joint which frequently afflict patients. Damage or disease in this area... (Review)
Review
Tissue engineering potentially offers new treatments for disorders of the temporomandibular joint which frequently afflict patients. Damage or disease in this area adversely affects masticatory function and speaking, reducing patients' quality of life. Effective treatment options for patients suffering from severe temporomandibular joint disorders are in high demand because surgical options are restricted to removal of damaged tissue or complete replacement of the joint with prosthetics. Tissue engineering approaches for the temporomandibular joint are a promising alternative to the limited clinical treatment options. However, tissue engineering is still a developing field and only in its formative years for the temporomandibular joint. This review outlines the anatomical and physiological characteristics of the temporomandibular joint, clinical management of temporomandibular joint disorder, and current perspectives in the tissue engineering approach for the temporomandibular joint disorder. The tissue engineering perspectives have been categorized according to the primary structures of the temporomandibular joint: the disc, the mandibular condyle, and the glenoid fossa. In each section, contemporary approaches in cellularization, growth factor selection, and scaffold fabrication strategies are reviewed in detail along with their achievements and challenges.
Topics: Animals; Glenoid Cavity; Humans; Intercellular Signaling Peptides and Proteins; Mandibular Condyle; Stem Cells; Temporomandibular Joint; Temporomandibular Joint Disc; Temporomandibular Joint Disorders; Tissue Engineering; Tissue Scaffolds
PubMed: 30556348
DOI: 10.1002/adhm.201801236 -
BMJ Case Reports Feb 2019Unilateral condylar hyperplasia is characterised by slow progressive growth of the different parts of mandible, the aetiology of which is still unclear. It is a... (Review)
Review
Unilateral condylar hyperplasia is characterised by slow progressive growth of the different parts of mandible, the aetiology of which is still unclear. It is a self-limiting condition mostly seen between the age of 11-30 years causing facial asymmetry and its progression ceases after a certain time. In literature until now very few cases have been reported and every case that is being reported adds to its features or the aetiology. Previously, it has been classified into two types that is, hemimandibular hyperplasia and hemimandibular elongation. Here, we report a similar case with a few features distinct from those reported earlier.
Topics: Adult; Facial Asymmetry; Humans; Hyperplasia; Male; Malocclusion; Mandible; Mandibular Condyle; Oral Surgical Procedures; Osteotomy; Treatment Outcome
PubMed: 30737324
DOI: 10.1136/bcr-2018-227569 -
Scientific Reports Oct 2022We compared mandibular condyle positions as determined by magnetic resonance imaging (MRI) and a mechanical device, the condylar position indicator (CPI). Both methods...
We compared mandibular condyle positions as determined by magnetic resonance imaging (MRI) and a mechanical device, the condylar position indicator (CPI). Both methods assessed 3 mandibular positions in 10 asymptomatic males and 10 asymptomatic females, aged 23 to 37 years, free from temporomandibular disorders: maximum intercuspation, bimanually manipulated centric relation, and the unguided neuromuscular position. Bite registrations were obtained for bimanual operator guidance and neuromuscular position. 3 T MRI scans of both temporomandibular joints produced 3D data of the most superior condylar points in all 3 mandibular positions. Using mounted plaster casts and the same bite registrations, an electronic CPI displayed 3D data of its condylar spheres in these positions. The results showed interclass correlation coefficients ranging from 0.03 to 0.66 (95% confidence intervals from 0 to 0.8) and significantly different condyle positions between both methods (p = 0.0012, p < 0.001). The implications of the study emphasize that condyle position is unpredictable and variable. Its exact knowledge requires radiological imaging and should not rely on CPI assessments.
Topics: Female; Humans; Male; Centric Relation; Magnetic Resonance Imaging; Mandibular Condyle; Temporomandibular Joint
PubMed: 36284175
DOI: 10.1038/s41598-022-22745-5 -
Chinese Journal of Traumatology =... Apr 2020Mandibular condylar fractures are among the most common facial fractures and some of the most difficult to manage. Opinions about the management of mandibular condylar... (Review)
Review
Mandibular condylar fractures are among the most common facial fractures and some of the most difficult to manage. Opinions about the management of mandibular condylar fractures differ among surgeons. With the implementation of new technology, an increased understanding of fracture management, and better functional and morphological outcomes reported in the literature, open reduction and internal fixation is becoming many surgeons' preferred choice for the treatment of condylar fractures. Because surgical treatment of such fractures is complex, certain factors must be considered to achieve satisfactory outcomes. In this article, we summarise six key points in the management of mandibular condylar fractures: virtual evaluation of condylar fracture, a suitable surgical approach, good reduction, stable internal fixation, repair of the articular disc, and restoration of the mandibular arch width. We believe that these points will help to improve the prognosis of mandibular condyle fractures.
Topics: Fracture Fixation, Internal; Humans; Mandibular Condyle; Mandibular Fractures; Open Fracture Reduction; Prognosis; Temporomandibular Joint Disc
PubMed: 31744656
DOI: 10.1016/j.cjtee.2019.08.006 -
Orthodontics & Craniofacial Research Feb 2023Certain malocclusions or unilateral tooth loss can lead to asymmetric functional load of the two mandibular sides during mastication and induce skeletal asymmetries to...
OBJECTIVE
Certain malocclusions or unilateral tooth loss can lead to asymmetric functional load of the two mandibular sides during mastication and induce skeletal asymmetries to the condylar process of growing individuals. However, in adults, asymmetric function may have a different impact. The aim of the present study was to investigate three-dimensionally the effects of unilateral masticatory function on the condylar process morphology in growing and adult rats and the adaptive processes to differential condylar loading.
MATERIALS AND METHODS
Fifty-six growing and adult Wistar rats aged 4 and 26 weeks respectively were obtained. The maxillary right molars of the experimental animals were extracted and all animals were followed for 12 weeks. Three-dimensional images were obtained by an in-vivo microcomputed tomography (micro-CT) examination. The following measurements were studied: condylar process height, condylar base width, and condylar cross-sectional surface.
RESULTS
While no differences were found with regards to condylar process height and base width, the cross-section of the condyle on the extraction side did not increase during growth in the young rats. No such differences were found in adults. Young rats had statistically significantly shorter condylar height, base width and cross-sectional surface than the adult rats and showed significant growth of these structures during the experimental period.
CONCLUSION
Condylar height and base width growth are not hindered by reduced occlusal function, contrary to the average cross-sectional surface, which implies that the condyle form of growing individuals becomes thinner while maintaining its length, in the absence of occlusal stimuli. The condyle of adult rats with extractions is less affected by occlusion changes.
Topics: Rats; Animals; Mandibular Condyle; X-Ray Microtomography; Cross-Sectional Studies; Rats, Wistar; Mandible
PubMed: 35347850
DOI: 10.1111/ocr.12575 -
Journal of Oral Science 2020Magnetic resonance imaging (MRI) was used to observe growth of the mandibular condyle, mandibular fossa, and articular disc as a single unit. Changes in each component's...
Magnetic resonance imaging (MRI) was used to observe growth of the mandibular condyle, mandibular fossa, and articular disc as a single unit. Changes in each component's relative position and size were observed using 7-tesla MRI. Mandibular condyle chondrocytes' growth was evaluated with immunohistochemistry, using the expression of zinc transporter ZIP13. Three-dimensional T-weighted (T) MRI was used to obtain images of the TMJ of Sprague Dawley rats at 4-78 days old (P4-78) with a voxel resolution of 65 μm. Two-dimensional T MR images were acquired after a subcutaneous injection of the contrast reagent gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). The T MR images showed that the mandibular condyle was located posterior to the mandibular fossa until P20; however, it then moved to a location underneath the mandibular fossa. In the Gd-DTPA enhanced images, the articular disc was identified as a region with lower signal intensity from P20. The number of ZIP13-positive chondrocytes at P6 was larger than the number at P24. In conclusion, the mandibular condyle with cartilage and disc grows on the posterior side of the mandibular fossa until P20, which was the weaning age. Then, the condyle fit into the mandibular fossa and completed the functional unit.
Topics: Animals; Magnetic Resonance Imaging; Mandibular Condyle; Rats; Rats, Sprague-Dawley; Temporomandibular Joint; Weaning
PubMed: 32224572
DOI: 10.2334/josnusd.19-0202 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jan 2022Mandibular condyle fractures can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation. Although many studies have...
BACKGROUND
Mandibular condyle fractures can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation. Although many studies have discussed for the optimal treatment method, the issue remains controversial. In this study, we aimed to compare conservative techniques in the mandibular condyle fractures.
METHODS
Twenty four unilateral condyle fracture patients aged between 18 and 48 years were treated according to one of three different modalities. Bracketing, arch bar or mini screw was applied to all non-surgery patients to obtain IMF. Eight patients were treated with only IMF meanwhile eleven patients were treated with one or double-sided amplifier occlusal splint according to the status of fractured segments, in addition to IMF. Remaining five patients have undergone open reduction and fractured segments immobilized with mini plates. Pre- and post-operative images were recorded with a computerized tomography device. Clinical and radiological examinations were performed by orthodontists and surgeons at baseline and at 6 months of treatment.
RESULTS
The condyle lengths of the patients with unilateral fracture after recovery were compared with the unaffected side. The length between the most protruding point of the condyle and the mandible was measured and the length difference was only 5.94 mm in patients who were treated by IMF. The length difference of patients who used brackets and splints was 3.36 mm (p<0.05). The length difference of patients who were repaired by plate screws was 1.80 mm (p>0.05). However, there was no statistically significant difference (p>0.05) between the groups in the IMF, occlusal splint and IMF and mini plate groups, between the trauma side and the opposite side. None of the patients developed ankylosis, open mouth, limitation of mouth opening, facial asymmetry, laterognathia, and retrognathia. The occlusion of the patients who were not known to have pre-trauma occlusions were directed, repositioned and provided an appropriate occlusion.
CONCLUSION
The use of IMF with an occlusal splint is a more conservative and acceptable treatment modality than open reduction in selected cases.
Topics: Adolescent; Adult; Bone Screws; Follow-Up Studies; Fracture Fixation, Internal; Humans; Jaw Fixation Techniques; Mandibular Condyle; Mandibular Fractures; Middle Aged; Treatment Outcome; Young Adult
PubMed: 34967439
DOI: 10.14744/tjtes.2020.94992 -
Australian Dental Journal Dec 1997Although the mandibular condyle is one of the most common sites of injury of the facial skeleton, it is also the most overlooked and least diagnosed site of trauma in... (Review)
Review
Although the mandibular condyle is one of the most common sites of injury of the facial skeleton, it is also the most overlooked and least diagnosed site of trauma in the head and neck region. The condyle forms the very cornerstone of mandibular form and function and therefore injuries to the mandibular condyle in growing children may adversely affect growth and development of the jaws and the occlusion. The aim of this article is to present an overview of condylar injuries in growing patients for the purpose of increasing the awareness of all dental practitioners involved in the treatment of children with acute oro-facial injuries.
Topics: Child; Child, Preschool; Dental Care for Children; Humans; Infant; Malocclusion; Mandibular Condyle; Mandibular Fractures; Temporomandibular Joint Disorders
PubMed: 9470277
DOI: 10.1111/j.1834-7819.1997.tb06079.x -
Journal of Dentistry May 2023Quantitative analysis of the volume and shape of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT) requires accurate segmentation of the...
OBJECTIVE
Quantitative analysis of the volume and shape of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT) requires accurate segmentation of the mandibular condyles and the glenoid fossae. This study aimed to develop and validate an automated segmentation tool based on a deep learning algorithm for accurate 3D reconstruction of the TMJ.
MATERIALS AND METHODS
A three-step deep-learning approach based on a 3D U-net was developed to segment the condyles and glenoid fossae on CBCT datasets. Three 3D U-Nets were utilized for region of interest (ROI) determination, bone segmentation, and TMJ classification. The AI-based algorithm was trained and validated on 154 manually segmented CBCT images. Two independent observers and the AI algorithm segmented the TMJs of a test set of 8 CBCTs. The time required for the segmentation and accuracy metrics (intersection of union, DICE, etc.) was calculated to quantify the degree of similarity between the manual segmentations (ground truth) and the performances of the AI models.
RESULTS
The AI segmentation achieved an intersection over union (IoU) of 0.955 and 0.935 for the condyles and glenoid fossa, respectively. The IoU of the two independent observers for manual condyle segmentation were 0.895 and 0.928, respectively (p<0.05). The mean time required for the AI segmentation was 3.6 s (SD 0.9), whereas the two observers needed 378.9 s (SD 204.9) and 571.6 s (SD 257.4), respectively (p<0.001).
CONCLUSION
The AI-based automated segmentation tool segmented the mandibular condyles and glenoid fossae with high accuracy, speed, and consistency. Potential limited robustness and generalizability are risks that cannot be ruled out, as the algorithms were trained on scans from orthognathic surgery patients derived from just one type of CBCT scanner.
CLINICAL SIGNIFICANCE
The incorporation of the AI-based segmentation tool into diagnostic software could facilitate 3D qualitative and quantitative analysis of TMJs in a clinical setting, particularly for the diagnosis of TMJ disorders and longitudinal follow-up.
Topics: Humans; Deep Learning; Temporomandibular Joint; Mandibular Condyle; Temporomandibular Joint Disorders; Cone-Beam Computed Tomography; Image Processing, Computer-Assisted
PubMed: 36870441
DOI: 10.1016/j.jdent.2023.104475 -
Folia Morphologica 2022Panoramic radiographs are the most common radiographic tool used by the dental clinicians to evaluate teeth, mandible and other related structures of the jaws....
BACKGROUND
Panoramic radiographs are the most common radiographic tool used by the dental clinicians to evaluate teeth, mandible and other related structures of the jaws. Mandibular condyle is an important anatomical landmark for facial growth, expressed in an upward and backward direction. The presentation of mandibular condyle differs widely among different group of ages and individuals.
MATERIALS AND METHODS
The retrospective cross-sectional study was conducted from November 2018 to March 2019 at Dow International Dental College Karachi that includes radiographic evaluation of 500 mandibular condyles. All retrievable orthopantomograms were obtained and data were extracted regarding age, gender and condylar morphology.
RESULTS
The morphological appearances of mandibular condyle have great variation among different age groups and subjects. Normally, we recognise five basic shapes i.e. oval, bird beak, crooked finger, diamond and mixed. Out of 250 pair of condylar heads that were evaluated, 50% were oval, 40% bird beak, 4.8% crooked finger and diamond 4.8%.
CONCLUSIONS
All four morphological types of mandibular condyles were observed and the oval shape condyles were most prevalent among both genders and all age groups. In future studies, the inclusion of other parameters and large sample size may provide unique information.
Topics: Cross-Sectional Studies; Female; Humans; Male; Mandible; Mandibular Condyle; Radiography, Panoramic; Retrospective Studies
PubMed: 34018177
DOI: 10.5603/FM.a2021.0049