Clinical natural course of temporomandibular joint intermittent closed lock / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the clinical natural course of temporomandibular joint (TMJ) intermittent closed lock (ICL) through 24 months follow-up.</p><p><b>METHODS</b>Sixty-eight patients with ICL were included, and 54 patients finished 24 months follow-up. The disease duration, frequency of joint lock and joint pain were recorded at the patient's first visit. Telephone interviews were taken for every month, and the frequency of joint lock and joint pain were recorded. According to the development of ICL, the patients were divided into 3 groups: symptom-worsened group, symptom-disappeared group, symptom-persisted group.</p><p><b>RESULTS</b>There were 16 patients (30%) whose symptoms worsened into closed lock (disk displacement without reduction), 32 patients (59%) whose symptoms persisted during the 24 months follow-up, and 6 patients' (11%) symptoms disappeared. In symptom-persisted group, the frequency of joint lock decreased in 11/32 (34%), increased in 4/32 (13%), did not change in 17/32 (53%). There was no significant difference in gender, age, frequency of joint lock and joint pain recorded at the first visit among these 3 groups (P > 0.05). The disease duration in the symptom-disappeared group was much shorter than the other 2 groups (P < 0.05).</p><p><b>CONCLUSIONS</b>ICL of TMJ was more likely to get worse into closed lock. There seemed no significant relation between the sequelaes of ICL and patients' gender, age, disease duration, frequency of joint lock and joint pain, and larger sample studies were necessary.</p>

Strengthen research on the relationship between oral diseases and systemic diseases / 中国医学科学院学报

Literatures have demonstrated the association between oral diseases and systemic diseases. For example, periodontitis is associated with coronary heart disease, diabetes, preterm low birth weight, and gastritis. Therefore, more relevant research on the relationship between oral diseases and systemic diseases should be carried out.

Positional changes of temporomandibular joint disk and condyle with insertion of anterior repositioning splint / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To measure the positional changes of temporomandibular joint (TMJ) disk and condyle with insertion of anterior repositioning splint (ARS) using magnetic resonance imaging (MRI) for further understanding of the splint therapy mechanisms.</p><p><b>METHODS</b>Twenty-two patients with temporomandibular joint clicks were included. 31 TMJs were diagnosed as anterior disk displacement with reduction (disk-displaced group), and the other 13 TMJs were normal (normal group). All joints were scanned oblique-sagittally by MRI before splint treatment in three positions including closed-mouth position of centric occlusion (the position before insertion of ARS), incisors' edge to edge position, and mandibular least forward protrusion position (the position after insertion of ARS).</p><p><b>RESULTS</b>1) Disk-condyle angle: In closed-mouth position, the average angle was 54.23 degrees in the disk-displaced group, while it was 9.80 degrees in the normal group; in incisors' edge to edge position and mandibular least forward protrusion position, the angle was reduced to normal in most of the disk-displaced cases. 2) Disk position: From closed-mouth position to incisors' edge to edge position or mandibular least forward protrusion position, the forward displaced disk moved backward significantly, while the disk with normal position did not change significantly in the three positions. 3) Condyle position: From closed-mouth position to incisors' edge to edge position or mandibular least forward protrusion position, the condyle moved forward and downward significantly both in the disk-displaced group and in the normal group.</p><p><b>CONCLUSION</b>With insertion of the splint, the condyle moved anteriorly and inferiorly and the disk moved posteriorly, most of the anterior displaced disks could be reduced to normal positions in the joint fossa. The result indicated that the splint protruded condyle forward and prevented the backward reduced disk from displacing forward again during mouth closing.</p>

The relationship between symptoms and signs of temporomandibular disorders and the patients' quality of life / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the relationship between symptoms and signs of temporomandibular disorders (TMD) and the patients' quality of life (QOL).</p><p><b>METHODS</b>A total of 492 TMD patients were included in this study. The clinical examination results were recorded using Fricton index of temporomandibular joint function. "Visual analog scale (VAS) evaluation of QOL disturbance" was designed to quantitate patients' QOL, to evaluate the degree that the patients QOL was affected.</p><p><b>RESULTS</b>Chewing, daily life and emotion among all 8 items of QOL were frequently affected by TMD, and joint clicking had the least influence on QOL. Intermittent closed lock had more severe interference with QOL than joint clicking only. Severe and moderate pain or limited mouth opening affected the QOL more severely than mild pain or mild limited mouth opening. The simple linear relationship between Fricton index and patients' QOL was poor (r < 0.4).</p><p><b>CONCLUSIONS</b>Pain is the most frequently seen symptom in TMD. TMD could affect patients' QOL, including both physical and social-psychological functions. The results suggest that the patients' QOL as well as TMD symptoms and signs should be considered in the management of TMD.</p>

Diagnosis and management of 49 cases of hemangiomas in infants and children / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To observe the management results of hemangioma in infants and children.</p><p><b>METHODS</b>Forty-nine cases of hemangioma in infants and children managed from 1986 to 2004 were reviewed. During the management period, the incidence and first visit age and sex were recorded. The location and volume of the lesions were photographed and followed up at an interval of 3 to 12 months until the complete involution of the tumor. The treatment modalities used included local injection of prednisone in 16 cases, surgery in 6 cases, and the remaining 33 cases were observed without treatment.</p><p><b>RESULTS</b>Thirty-three cases receiving no treatment involuted naturally. The complete involution age was found from 9 months to 10 years with average age of 5.4 years. The cosmetic results after involution were good.</p><p><b>CONCLUSIONS</b>Most hemangiomas do not need treatment and can involute naturally. However, in cases with severe complications such as expansion, destruction and obstructive or congestive heart failure, treatment is indicated.</p>

A primary research on the concomitant symptoms of temporomandibular joint pain / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the states of chronic symptoms of other parts of the body concomitant with temporomandibular joint (TMJ) pain.</p><p><b>METHODS</b>Fifty-one patients with TMJ pain and thirty-one control subjects without TMJ symptoms were chosen randomly. The TMJ symptoms and chronic symptoms of other regions were investigated at the base line. The TMJ pain patients were investigated again half year after treatment. Between-symptom correlations were analyzed using linear regression and Chi-squared analysis method (alpha = 0.05).</p><p><b>RESULTS</b>The chronic symptoms related to the TMJ pain at the base line were headache, back pain, numbness of hand, neck and shoulder pain, insomnia, dizziness, reduced hearing ability, eye pain and fatigue (P < 0.05). The incidences of the symptoms of patients were higher than those of the control subjects (P < 0.01). Half year later, the headache, neck and shoulder pain and fatigue were the symptoms improved with the TMJ pain treatment (P < 0.05).</p><p><b>CONCLUSION</b>The symptoms of adjacent regions of orofacial area such as neck and shoulder pain and headache are the main concomitant symptoms of the TMJ pain, and these symptoms may be improved by the treatment of TMJ.</p>

Hemimasticatory muscle spasm: an electromyogram analysis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the usefulness of electromyogram (EMG) in the diagnosis of the patients with hemimasticatory spasm (HMS).</p><p><b>METHODS</b>Four cases with HMS were reported. All the 4 patients were undertaken needle and surface electrode EMG examination.</p><p><b>RESULTS</b>Needle electrode EMG of the 4 patients with HMS showed grouped potentials synchronously with the onset of the spasm, which indicated abnormal excitatory electrical activities of the trigeminal nerve resulting in involuntary masticatory muscle movements.</p><p><b>CONCLUSION</b>It is very important to use EMG for the diagnosis of HMS.</p>

A study on the classification and treatment of zygomatic complex fractures / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate a new classification and treatment of zygomatic complex fractures (ZCF) by clinical and radiographic studies.</p><p><b>METHODS</b>Standard radiographs with Waters, submental vertex views had been obtained before and after operation in 206 patients (212 sides) with ZCF. Patients with complicated fractures underwent two and three dimensional CT. Computer-assisted measuring system was used to measure the degree of displacement.</p><p><b>RESULTS</b>ZCF were classified into 3 types and 6 subtypes according to the degree of displacement of segments and facial deformities. Treatment principles were proposed. The results were satisfied through clinical application and measurement of post-operative images.</p><p><b>CONCLUSIONS</b>The treatment for ZCF should be selected according to the fracture types. The key of operation is to recover the malar prominence. Remodeling the length and radian of zygomatic arch guarantee the recovery of malar prominence. Zygomatic-sphenoid and zygomatic-maxillary fissures are very important reference marks for reduction and fixation.</p>

Comparative study on the clinical appearances between acute and chronic anterior disc displacement without reduction / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare the clinical appearances of TMD patients between acute and chronic anterior disc displacement without reduction.</p><p><b>METHODS</b>Successive one hundred TMD patients with fully recorded documents diagnosed as anterior disc displacement without reduction (ADDw/oR) were included, 45 acute and 55 chronic ADDw/oR patients. Clinical appearances including signs and symptoms, maximal mouth opening, Fricton's craniomandibular index, condylar bone changes on radiograms, findings on arthrograms and MRI were compared.</p><p><b>RESULTS</b>The main reason for asking treatment was joint pain in chronic, instead of limited mouth opening in acute patients. Clinical symptoms such as pain and limited mandibular movement showed improvement in chronic patients. Fricton's joint dysfunction index was higher in acute than in chronic patients, but muscle palpation index was higher in chronic than in acute patients, but Fricton's craniomandibular index was not significantly different between chronic and acute patients. The destructive bone changes of condyle on radiograms, the damage of stretched disc attachment on arthrograms and the morphological deformed disc on MRI were more frequently found in chronic than in acute patients.</p><p><b>CONCLUSIONS</b>In acute patients there is a great likelihood that tissues are healthy and not morphologically changed, we suggest that early and efficacious intervention should be made to reposition the anterior displaced disc that may block the progress of pathological impairment to both the disc and the condyle of TMJ.</p>

Bone regeneration on hard palate after palatal surgery on cleft palate and the relative factors / 中华整形外科杂志

<p><b>OBJECTIVE</b>Attending to observe the bony healing on hard palate after palatal repair, and to discuss the factors affecting on it.</p><p><b>METHODS</b>52 patients with repaired cleft palate over 5 years postoperatively were examined, the CT scan of head was taken. The incidence of the bone regeneration among the patients examined was calculated, the position and quality of bone tissue were measured according to the CT images. After all, analysis was applied to evaluate the factors affecting on the bone tissue formation.</p><p><b>RESULTS</b>Formation of bone bridge was found in the 37 cleft gaps out of 52 patients (71%), the ratio of the sex among the patients who had bone bridge was 1:1, there was no obvious difference between unilateral and bilateral cleft palate. Considering the operation age with the bone formation, the highest percentage of bone bridge formation fell into the group of 4-7 years old, and the most occurring region were in premolar and anterior part of molar area.</p><p><b>CONCLUSION</b>There could be bony healing(regeneration bone tissue RBT) after palatal repair on cleft palate patients. The operation age could be an important affecting factor to RBT, but the sex and the clinical type of cleft palate make no difference on the bone tissue formation.</p>

Application of the nasal lining flap to correct the wide unilateral complete cleft lip / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To study use of nasal lining flap in correction of the wide complete unilateral cleft lip.</p><p><b>METHODS</b>78 patients with wide complete cleft lip were. operated, firstly to be sure. That the lip length on both sides was equal. Then the nasal lining flap was used to enhance the height of the lip on cleft side for keeping symmetry with the non-cleft side. The rest of procedures was the same as "Millard" method.</p><p><b>RESULTS</b>84.6 percent of patients had good appearance at one and half years after surgery.</p><p><b>CONCLUSIONS</b>It is an effective way to take advantage of the nasal lining flap to correct the wide complete unilateral cleft lip.</p>

The influence of the osteogenesis in cleft palate after palatal surgery to the transverse growth of dental occlusion / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare the transverse growth of the dental cast following palatal surgery with or without osteogenesis in palatal gap.</p><p><b>METHODS</b>31 patients at 13 - 28 years old with repaired palate were selected to take the dental cast, the width of the dental arch, alveolar base and the matching degree between arches were measured and the average was calculated. After the length of the bone bridge in palate was measured through CT scan, the relationship between the osteogenesis in palatal gap and the transfers growth of dental cast was studied.</p><p><b>RESULTS</b>The critical length of the bone regeneration in palatal gap to affect the dental growth is 4 mm, mean while the sufficient length is 8 mm. The group of sufficient bone bridge has a better development in both the width of dental alveolar base and that of dental arch and the matching degree than the group of unsurficience. And this intendance was more obvious in premolar region than in molar region.</p><p><b>CONCLUSIONS</b>The osteogenesis in palatal gap following palatal surgery can strongly support the transfers growth in the width of dental arch, the width of alveolar base and the matching degree between upper and lower dental arch.</p>

Disc-like changes and type II collagen mRNA expression in the bilaminar zone of rabbit temporomandibular joint following disc displacement / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To study the adaptive alteration in bilaminar zone of rabbits' temporomandibular joint following disc displacement.</p><p><b>METHODS</b>Twenty-six Japanese white rabbits were used in this study. Among these rabbits,6 were used as controls. The right discs of other 20 rabbits were displaced anteriorly by operation. Four of these rabbits were killedatn 1, 2, 4, 6 and 8 weeks respectively after surgery. The TMJS were studied by HE staining, Alcin bluen staining and in situ detection of type II collagen mRNA expression.</p><p><b>RESULTS</b>There appeared cartilage metaplasia after one week following disc displacement. Typical chondrocytes could be found in the bilaminar zone. The new chondrocytes expressed type II collagen.</p><p><b>CONCLUSIONS</b>The bilaminar zone of TMJ will be remodeled following disc displacement and become a disc-like tissue to function as a disc.</p>