Revisión Exploratoria: Comunicación de la Articulación Temporomandibular y del Oído Medio en Fetos y Niños / Exploratory Review: Temporomandibular Joint and Middle Ear Communication in Fetuses and Infants

La Articulación temporomandibular (ATM) cumple funciones importantes para la vida; su adecuado funcionamiento se puede alterar por trastornos temporomandibulares (TTM). La sintomatología de los TTM es variada, entre ellos se encuentra dolor en los músculos masticatorios, ruidos articulares y con menos frecuencia algunos pacientes refieren síntomas auditivos, lo que sugiere la existencia de una relación entre la ATM y el oído medio; sin embargo, esta relación no es clara. En consecuencia, el presente estudio tiene como propósito realizar una revisión de literatura para identificar los aspectos conocidos, desconocidos y controvertidos sobre la relación entre la ATM y el oído medio en niños y fetos. Se efectuó una búsqueda de la literatura en bases de datos utilizando los operadores booleanos (AND/OR) y los términos clave en inglés y en español. Se identificaron inicialmente 1080 artículos, se eliminaron los artículos duplicados y se aplicaron los criterios de inclusión y exclusión. Finalmente, se seleccionaron un total de 14 artículos que se revisaron a texto completo. Los estudios encontrados se enfocan en el desarrollo histoembriológico de la ATM y cómo ese desarrollo se da en conjunto con los componentes del oído medio. Adicionalmente, se identificaron investigaciones sobre el origen, la morfología y función del ligamento discomaleolar, el ligamento esfenomandibular y la fisura petrotimpánica como estructuras que conectan la ATM y el oído medio, pero los resultados han sido controvertidos. Se concluye que son necesarios más estudios para determinar cualquier relación anatómica y fisiológica que pueda existir entre la ATM y el sistema auditivo en fetos y niños.

SUMMARY: The temporomandibular joint (TMJ) has important functions for life; its proper functioning can be altered by temporomandibular disorders (TMD). The symptomatology of TMD is varied, including pain in the masticatory muscles, joint noises and less frequently some patients report auditory symptoms, suggesting the existence of a relationship between the TMJ and the middle ear; however, this relationship is not clear. Consequently, the present study aims to conduct a literature review to identify the known, unknown and controversial aspects of the relationship between TMJ and the middle ear in children and fetuses. A literature search was performed in databases using Boolean operators (AND/ OR) and key terms in English and Spanish. A total of 1080 articles were initially identified; duplicate articles were eliminated and inclusion and exclusion criteria were applied. Finally, a total of 14 articles were selected and reviewed in full text. The studies found focus on the histoembryological development of the TMJ and how that development occurs in conjunction with the middle ear components. Additionally, research on the origin, morphology, and function of the discomalleolar ligament, sphenomandibular ligament, and petrotympanic fissure as structures connecting the TMJ and middle ear was identified, but the results have been controversial. It is concluded that further studies are necessary to determine any anatomical and physiological relationship that may exist between the TMJ and the auditory system in fetuses and children.

Histological effect of platelet-rich plasma on temporomandibular joint osteoarthritis: systematic review in animal models

SUMMARY: The aim of this systematic review was to assess the histological effects of platelet-rich plasma (PRP) on temporomandibular joint osteoarthritis (TMJ-OA) in animal models. A systematic search was performed using PubMed, WoS, EMBASE, Science Direct and SCOPUS databases. The inclusion criteria were experimental studies in animal models that evaluated the use of PRP as a treatment for TMJ-OA with or without arthrocentesis/arthroscopy. Comparison was made to a healthy control group or to other treatment. The variables evaluated were the histological effects of the treatments, characteristics of the primary articles, characteristics of the sample studied and the risk of bias. The systematic search identified 120 studies. Eventually 5 studies were included in the analysis. Four of the studies showed a statistically significant repair in joint tissues and improvement of cartilage thickness in animals treated with PRP. The global risk of bias was unclear. The results of this systematic review suggest that PRP treatment in TMJ-OA has benefits at the histological level in cartilage, articular disc and articular bone tissue in animal models. However, due to the low number of studies and the risk of bias, further research is needed to recommend its use.

El objetivo de esta revisión sistemática fue evaluar los efectos histológicos del plasma rico en plaquetas (PRP) en la osteoartritis de la articulación temporomandibular (ATM-OA) en modelos animales. Se realizó una búsqueda sistemática en las bases de datos PubMed, WoS, EMBASE, Science Direct y SCOPUS. Los criterios de inclusión fueron estudios experimentales en modelos animales que evaluaran el uso de PRP como tratamiento para la ATM-OA con o sin artrocentesis/ artroscopia. La comparación se realizó con un grupo de control sano o con otro tratamiento. Las variables evaluadas fueron los efectos histológicos de los tratamientos, las características de los artículos primarios, las características de la muestra estudiada y el riesgo de sesgo. La búsqueda sistemática identificó 120 estudios. Finalmente se incluyeron 5 estudios en el análisis. Cuatro de los estudios mostraron una reparación estadísticamente significativa en los tejidos articulares y una mejora del grosor del cartílago en los animales tratados con PRP. El riesgo global de sesgo fue incierto. Los resultados de esta revisión sistemática sugieren que el tratamiento con PRP en la ATM-OA tiene beneficios a nivel histológico en el cartílago, el disco articular y el tejido óseo articular en modelos animales. Sin embargo, debido al escaso número de estudios y al riesgo de sesgo, se necesitan investigaciones adicionales para recomendar su uso.

Relationship between the condyle morphology and clinical findings in terms of gender, age, and remaining teeth on cone beam computed tomography images

Aim: This study aimed to evaluate the relationship between clinical findings and some factors such as age, gender, and remaining teeth on the anatomy of the temporomandibular joint in order to diagnose normal variations from abnormal cases. Methods: In this cross-sectional study, cone-beam computed tomography (CBCT) images of 144 patients referring to Tabriz Dental School for various reasons were selected and evaluated. The different aspects of the clinical parameters and the morphology of the condyle were evaluated on coronal, axial, and sagittal views. The CBCT prepared using the axial cross-sections had been 0.5 mm in thickness. The sagittal cross-sections had been evaluated perpendicular to the lengthy axis of the condyle at a thickness of 1 mm and the coronal cross-sections had been evaluated parallel to the lengthy axis of the condyle at a thickness of 1 mm. Data were analyzed with descriptive statistical methods and t-test, chi-squared test, using SPSS 20. The significance level of the study was p < 0.05. Results: There was a significant relationship between the condyle morphology, number of the teeth, and mastication side (p = 0.040). There were significant relationships between the condyle morphology, age between 20-40, and occlusion class I on the all the three views (coronal, axial, sagittal) (p = 0.04), (p = 0.006), (p = 0.006). Also, significant relationships were found in the condyle morphology and location of pain according to age, the number of remaining teeth, and gender. (p = 0.046) (p = 0.027) (p = 0.035). Conclusion:There are significant relationships between the clinical symptoms and condyle morphology based on age, gender, and the number of remaining teeth. The clinical finding that has the most significant relationship between the condyle morphology, remaining teeth (9-16 teeth), all of the age range (20-80 year), and gender was mastication side

Use of "bicondylar" as a descriptive term for the temporomandibular joint: a scoping review / Uso de "bicondíleo" como término descriptivo de la articulación temporomandibular: una revisión de alcance

SUMMARY: The temporomandibular joint (TMJ) is the joint between the mandibular condyles, the mandibular fossa and the articular tubercle of the temporal bone. TMJ has been described as a "bicondylar" joint, a term that in current literature is used in multiple and dissimilar contexts. We present a scoping review of the term "bicondylar" as a descriptive term for TMJ in the scientific literature of the last 5 years. After selection according to the inclusion/exclusion criteria, 24 articles were selected for further analysis. The countries with the most publications were Brazil, India and Turkey with 3 articles each. Seven articles (29.17 %) were published by Spanish- speaking authors, six of these written in Spanish. Regarding the use of the term "bicondylar", 50 % of the articles referred to this term but did not explain it; 25 % cited this term to refer to the location in the left and right mandibular condyles; and 25 % the articles use the term and explain it according to the morphology of the articular surfaces. Discrepancies were also detected regarding as to how to consider TMJ: 54.17 % considered that TMJ is a single joint between a single bone (the jaw) and two bones of the cranium, while 45.83 % considered that TMJ are actually two different TMJs that work at the same time. We suggest discussing the appropriate use of the term "bicondylar" to avoid confusion and to be able to adapt and satisfy the needs of both anatomists and clinicians.

RESUMEN: La articulación temporomandibular (ATM) es la articulación entre los cóndilos mandibulares con la fosa mandibular y el tubérculo articular del hueso temporal. La ATM ha sido descrita como una articulación "bicondílea", término que en la literatura actual se utiliza en múltiples y disímiles contextos. Presentamos una revisión con búsqueda sistemática del término "bicondíleo" como término descriptivo de la ATM en la literatura científica de los últimos 5 años. Siguiendo criterios de inclusión/exclusión, se seleccionaron 24 artículos para su posterior análisis. Los países con más publicaciones fueron Brasil, India y Turquía con 3 artículos cada uno. Siete artículos (29,17 %) fueron publicados por autores de habla hispana, seis de ellos escritos en español. En cuanto al uso del término "bicondilar", el 50 % de los artículos se refieren a él, pero no lo explican; un 25 % citó este término para referirse a la ubicación en los cóndilos mandibulares izquierdo y derecho; y el 25 % de los artículos utilizan el término y lo explican según la morfología de las superficies articulares. También se detectaron discrepancias en cuanto a cómo considerar la ATM: el 54,17 % consideró que la ATM es una única articulación entre un solo hueso (la mandíbula) y dos huesos del cráneo, mientras que el 45,83 % consideró que la ATM son en realidad dos ATM diferentes que funcionan al mismo tiempo. Se sugiere discutir el uso adecuado del término "bicondilar" para evitar confusiones y poder adaptar y satisfacer las necesidades tanto de anatomistas como de clínicos.

Anatomical and histological components of the bilaminar zone of the temporomandibular joint: a narrative review / Componentes anatómicos e histológicos de la zona bilaminar de la articulación temporomandibular: una revisión narrativa

SUMMARY: One of the structures which contributes to the correct functioning of the Temporomandibular Joint (TMJ) is the Articular Disc (AD). Viewed in sagittal section, the AD is divided into four zones, the last is the Bilaminar Zone (BZ). The BZ is essential for keeping the AD in its superior position and for retracting the AD to posterior in the maximum aperture position. Its composition and the disposition of its components is unclear. The object of this narrative review is to update concepts on the anatomy of the BZ, with its variations, histological components, vascularization and innervation. The following databases were reviewed: PUBMED, SCOPUS, EMBASE, WEB OF SCIENCE, SciELO and LILACS. Only studies in human beings without alterations to the TMJ, using dissection in cadavers or radiography in live subjects, were included. Systematic reviews, letters to the editor, technical articles and experimental or quasi-experimental studies in animals were excluded. This review included a total of 24 articles which corresponded to the proposed research object. Our results describe the morphology of the BZ, its anatomical relations and possible variations, its histological components, types of fibre and distribution percentages; the latter are discussed in the literature, but no consensus exists. This is not the case for the vascularization and innervation of the BZ; all authors analyzed agree on these points, with just one author adding two possible arteries that may play a part in irrigation. Furthermore, a large number of authors recognize the discomalleolar ligament and its close relation with the BZ.

RESUMEN: Una de las estructuras que contribuye al correcto funcionamiento de la Articulación Temporomandibular (ATM) es el Disco Articular (DA). Visto en sección sagital, el DA se divide en cuatro zonas, la última de las cuales es la Zona Bilaminar (BZ). El BZ es esencial para mantener el AD en su posición superior y para retraer el AD hacia atrás en la posición de máxima apertura. Su composición y disposición de sus componentes no está clara. El objetivo de esta revisión es actualizar conceptos sobre la anatomía del BZ, además de sus variaciones, componentes histológicos, vascularización e inervación. Se revisaron las siguientes bases de datos: PUBMED, SCOPUS, EMBASE, WEB OF SCIENCE, SciELO y LILACS. Se incluyeron estudios en seres humanos sin alteraciones de la ATM, utilizando disección en cadáveres o radiografía en sujetos vivos. Se excluyeron las revisiones sistemáticas, cartas al editor, artículos técnicos y estudios experimentales o cuasi-experimentales en animales. Esta revisión incluyó un total de 24 artículos que correspondían al objeto de investigación propuesto. Nuestros resultados describen la morfología del BZ, sus relaciones anatómicas y posibles variaciones, sus componentes histológicos, tipos de fibras y porcentajes de distribución; estos últimos se discuten en la literatura, pero no existe consenso. Este no es el caso de la vascularización e inervación del BZ; todos los autores analizados coinciden en estos aspectos, y solo un autor agrega dos posibles arterias que pueden tener un papel en la irrigación. Además, un gran número de autores reconocen el ligamento disco maleolar y su estrecha relación con el BZ.

Análisis morfológico y funcional del músculo pterigoideo lateral: una revisión de la literatura / Morphological and functional analysis of the lateral pterygoid muscle: a review of the literature

RESUMEN: El músculo pterigoideo lateral (MPL) es una estructura compleja y variable, poder determinar su anatomía exacta, relaciones vecinas, origen e inserciones, ayuda a los clínicos a comprender de mejor forma su función en el sistema estomatognático. En esta revisión se busca analizar la literatura que ayude a esclarecer la función antagónica de las cabezas del músculo pterigoideo lateral, desde un punto de vista nervioso, la descripción de su origen e inserciones y sus posibles variaciones anatómicas, además del análisis de sus funciones evaluado a través de la literatura tradicional y compararlo con lo descrito en artículos originales. Se analizaron diferentes bases de datos electrónicos y libros, con criterios de inclusión e exclusión claramente definidos, la lectura fue llevada a cabo por dos investigadores de manera independiente consultando de ser necesario con un tercer investigador. Esta revisión incluyo un total de 11 artículos y 4 libros atingentes a nuestro tema de estudio. Se expusieron los resultados a través de tablas de extracción de datos, que incluyó las funciones, inervación, el origen e inserción y las variaciones anatómicas del MPL. Nuestros resultados muestran que se identificaron claramente los elementos comunes de origen del MPL, pero su inserción mostró variaciones entre los distintos estudios, tanto en el porcentaje de fibras unidas como a los elementos anatómicos insertados. Considerando las funciones antagónicas de sus dos cabezas, autores lo han descrito como dos músculos diferentes, sin embargo desde un punto de vista nervioso, esta teoría no es apoyada. Finalmente comprender las funciones del MPL durante su acción es complejo, ya que la gran mayoría de los estudios disponibles utilizan cadáveres o electromiografía por lo que creemos que el desarrollo de metodologías menos invasivas y dolorosas, ayudarían a comprender el comportamiento de este músculo durante su función y como las variaciones anatómicas influyen en estas.

SUMMARY: The Lateral Pterygoid Muscle (LPM) is a complex and variable structure. Being able to determine its exact anatomy, neighboring relationships, origin and insertions, helps clinicians to better understand its function in the stomatognathic system. This review seeks to analyze the literature, in order to clarify the antagonistic function of the lateral pterygoid muscle heads, from a nervous point of view. Furthermore, the description of its origin, aspects of insertions and possible anatomical variations, its functions as reported in traditional literature, are analyzed and compared with original articles. Different electronic databases and books were analyzed, with designated inclusion and exclusion criteria. Two researchers independently reviewed the articles, whennecessary a third researcher resolved any differences. This review includes a total of 11 articles and 4 books related to our study topic. Results were reported using data extraction tables, which included functions, innervation, origin and insertion, and anatomical variations of the LPM. Our results show that the common elements of origin of LPM were clearly identified, but their insertion showed variations between the different studies, both in the percentage of fibers joined and the anatomical elements inserted. Considering the antagonistic functions of the two heads, authors have described it as two different muscles. However from a nervous point of view, this theory is not supported. Finally, understanding the functions of the LPM during its action is complex, since most studies available use cadavers or electromyography. Therefore, we believe that the development of less invasive and painful methodologies, would help to understand the influence of anatomical variations on the function of this muscle.

Características anatómicas-funcionales que orientan la posición del cóndilo en la fosa mandibular en una relación céntrica: una descripción narrativa / Anatomical functional characteristics that guide the condylar position in mandibular fossa a centric relation: narrative description

RESUMEN: La Relación Céntrica (RC) es un concepto que busca definir la posición ideal del cóndilo de la mandíbula en la fosa mandibular, siendo esta posición muy discutida en la literatura y ha ido cambiado con los avances en conocimiento y tecnología. Tomándose en la actualidad en consideración elementos anatómicos esenciales que son utilizados como guía para el clínico. La importancia de poder reconocer esta posición radica en la correcta ejecución tanto de procedimientos diagnósticos como de tratamiento en diversas áreas de la odontología. Existen elementos anatómicos de la articulación temporomandibular (ATM) que nos ayudarían a comprender mejor el concepto de RC, entre estos destacan que la condensación ósea de las superficies articulares funcionales y su recubrimiento por fibrocartílago; la porción media del disco articular, desprovista de vasos y nervios; el techo de la fosa mandibular que puede llegar a ser extremadamente delgado por lo cual no se consideraría un área para soportar carga; la prolongación posterior del disco articular (DA) que es altamente vascularizada e inervada. El DA se encuentra íntimamente relacionado con estructuras como el ligamento temporomandibular o lateral y la cabeza superior del músculo pterigoideo lateral que permitirían junto a los elementos anteriormente mencionados el adecuado funcionamiento de la ATM. El correcto aprendizaje y utilización de estos conceptos contribuirá a lograr un mejor ejercicio del desarrollo profesional de estudiantes y profesionales del área de la odontología.

SUMMARY: The Central Relation (CR) is a concept that defines the ideal position of the mandibular condyle in the mandibular fossa. The position has been the subject of much discussion in the literature, noting changes as advancements in knowledge and technology are achieved. Thus, certain essential anatomical elements that are used as a guide for the clinician, are taken into account. The importance of being able to identify this position lies in the correct execution of both diagnostic and treatment procedures in various areas of dentistry. There are anatomical elements of the temporomandibular joint (TMJ) that improve understanding of the CR concept. These include: Bone condensation of the functional articular surfaces and their fibrocartilage coating; the middle portion of the joint disc, devoid of vessels and nerves. The roof of the mandibular fossa can become extremely thin, so it would not be considered an area to support load; the posterior prolongation of the articular disc (AD) Which is highly vascularized and innervated. The AD is also closely related to structures such as the temporomandibular or lateral ligament and the superior head of the lateral pterygoid muscle. Along with the previously described elements, this would allow proper functioning of the TMJ. The correct learning and use of these concepts contributes to a better exercise in the professional development of students and professionals in the area of dentistry.

Clinical study on the posterior occlusal plane and morphology of temporomandibular joint / Estudio clínico sobre el plano oclusal posterior y la morfología de la articulación temporomandibular

The objective of the study was to investigate the morphological features of the temporomandibular joint in adult patients with posterior occlusal plane and different inclinations. Fifty five skeletal I occlusion patients with average were included, shooting CBCT in the intercuspal position, divided into 3 groups according to OPP-FH angle, and measurement of the temporomandibular joint morphology was calculated with cone beam computed tomography (CBCT) special software Invivo 5.0, Statistical analysis of three groups of data using SPSS23.0. The condyle usually locates in the middle of the fossa, the maximum axial area of the condyle (A) was statistically significant between the group 1 and the group 3. The internal and external diameter (MD) of the condyle was statistically significant between group 1 and group 3, and group 2 and group 3. The bilateral TMJ morphological features of the three groups were basically symmetrical. The position of the condyle in the fossa is mostly centered, and some of the posterior, the maximum axial area and the internal and external diameter of the condyle are different in three groups.

El objetivo de este estudio fue investigar las características morfológicas de la articulación temporomandibular (ATM) en pacientes adultos con plano oclusal posterior y diferentes inclinaciones. Se incluyeron 55 pacientes con oclusión esquelética tipo I, visualizados por tomografía computarizada de haz cónico (CBCT) en posición intercuspiana, y se dividieron en 3 grupos según el ángulo OPP-FH. La medición morfológica de la articulación temporomandibular se calculó con CBCT y mediante el software especial Invivo 5.0. El análisis estadístico de datos se realizó con el software SPSS 23.0. El cóndilo de la mandíbula generalmente se ubica en el centro de la fosa; el área axial máxima del cóndilo de la mandíbula (A) fue estadísticamente significativa entre los grupos 1 y 3. Los datos de los diámetros medial y lateral (DM) del cóndilo de la mandíbula fueron estadísticamente significativos entre los grupos 1 y 3 y los grupos 2 y 3. Las características morfológicas de la ATM de los tres grupos fueron básicamente simétricas. La posición del cóndilo de la mandíbula en la fosa fue principalmente centrada, y parte del área axial máxima, posterior y los diámetros medial y lateral del cóndilo de la mandíbula fueron diferentes en los tres grupos.

Risk Factors for Temporomandibular Disorders among Amphetamine Users in Indonesia

Abstract Objective: To determine the possible risk factors for temporomandibular disorders (TMD) among amphetamine users in Indonesia. Material and Methods: This cross-sectional study involved 152 male amphetamine users, aged 18-45 years, who were undergoing rehabilitation. Data were obtained from medical records, questionnaires, and clinical examinations. Data obtained from medical records included age, gender, duration of amphetamine use, duration of rehabilitation, and psychiatric status. Collected data were analyzed using the Chi-square and logistic regression tests to identify correlations between TMD and bruxism, oral habits, tooth wear, duration of amphetamine abused, and duration of rehabilitation Results: TMD was found in 84.2% of amphetamine users, with clicking being the most frequently reported sign (72.4%). Tooth wear (72.4%), oral habits (60.5%), and bruxism (56.6%) were also frequently found. Statistically, a significant association was found between TMD and bruxism (p<0.001), tooth wear (p<0.001), and oral habits (p<0.001). However, there was no association observed between TMD and duration of amphetamine abused (p=0.526), and duration of rehabilitation (p=0.679). Odds ratios produced by logistic regression for tooth wear, oral habits, and bruxism were 6.657, 6.2, and 1.659, respectively Conclusion: Tooth wear, oral habits, and bruxism were identified as risk factors for TMD among amphetamine users in Indonesia.

Presencia y relaciones anatomofuncionales del ligamento discomaleolar: una revisión de la literatura / Presence and anatomofunctional relations of the discomaleolar ligament: a literature review

El Ligamento Discomaleolar es una estructura que no se describe en los textos clásicos de anatomía a pesar de ser descrito por primera vez por Rees, Pinto y luego por diversos autores como una estructura ligamentosa de tejido fibroelástico que conecta el cuello y el proceso anterior del martillo a través de la fisura petrotimpánica hasta la parte medioposterosuperior de la cápsula de la articulación temporomandibular (ATM), el disco articular y el ligamento esfenomandibular. Diversos estudios han reportado las implicaciones clínicas del ligamento discomaleolar y la relación entre los trastornos temporomandibulares con los síntomas asociados al oído medio. El objetivo de este estudio fue realizar una revisión sobre estudios que describen el ligamento discomaleolar y determinar si se considera una estructura independiente anatómica y funcionalmente y su relación con el oído medio. Se realizó una búsqueda de literatura científica identificó artículos donde se identifican las estructuras anatómicas asociadas a la articulación témporomandibular y el oído medio, fueron seleccionados 24 artículos según los criterios de selección. Los resultados obtenidos en los estudios seleccionados en esta revisión sugieren la existencia de una lámina o fascículo fibroso que conecta el disco de la ATM con el maléolo del oído medio, lo que validaría la presencia y relación entre el ligamento discomaleolar y los trastornos del oído medio.

The Discomaleolar Ligament is a structure that is not described in the classic texts of anatomy despite being described for the first time by Rees, Pinto and later by various authors as a ligamentous structure of fibroelastic tissue that connects the neck and the anterior process of the malleus through the petrotympanic cleft to the mid-superior part of the capsule of the temporomandibular joint (TMJ), the articular disc and the sphenomandibular ligament. Several studies have reported the clinical implications of the discomaleolar ligament and the relationship between temporomandibular disorders and symptoms associated with the middle ear. The aim of this study was to conduct a review of studies that describe the discomaleolar ligament and determine if an anatomically and functionally independent structure and its relation to the middle ear is considered. A search was performed of scientific literature identified articles where the anatomical structures associated with the temporomandibular joint and the middle ear were identified, 24 articles were selected according to the selection criteria. The results obtained in the studies selected in this review suggest the existence of a lamina or fibrous fascicle that connects the TMJ disc with the malleolus of the middle ear, which would validate the presence and relationship between the discomaleolar ligament and middle ear disorders.

Review of the Tanaka ligament in the temporomandibular joint: analyzing its scientific validity / Revisión del ligamento de tanaka en la articulación temporomandibular: analizando su validez científica

SUMMARY: The temporomandibular joint (TMJ) is composed of bony structures, cartilage, capsule, articular disc, synovial membrane and ligaments. Some authors consider the "Tanaka ligament" described in the 1980s by Terry Tanaka as an intra-capsular ligament of the TMJ that unites medially the articular disc and mandibular fossa. The aim of the present study was to analyze the use of the term "Tanaka ligament" in the literature evaluating the scientific support of its existence. A literature review was carried out under the terms "Tanaka Ligament [AND] TMJ" and "Ligamento Tanaka [AND] ATM" (Spanish and Portuguese) in the search engines: MEDLINEPubmed, Science Direct, Google Scholar, LILACS-Bireme and SciELO. Scientific articles and theses were considered in English, Spanish and Portuguese. A total of 1,355 studies were found, summing up the results of all the search engines, of which 8 studies (5 articles and 3 theses) were selected after applying inclusion and exclusion criteria, selection by title, abstract and content. Most of these studies were discarded because they had contents related to the TMJ and/or ligaments wherein an author used the surname "Tanaka", that were not related to the Tanaka ligament. Among the 8 selected studies, 6 of them cite text books, 1 cites a video published by Terry Tanaka and 1 cites a thesis. Most of these textbooks cited also refer to videos by Terry Tanaka and his books. Moreover, most of the anatomical literature does not consider this ligament as an individualized structure. Although there are descriptions of Tanaka's ligament in textbooks, the scientific support of its existence is based only on videos and texts by Terry Tanaka. The dissemination of knowledge associated with this ligament must be cautious, as there is a need for further morphological and functional studies to confirm its existence.

RESUMEN: La articulación temporomandibular (TMJ) se compone de estructuras óseas, cartílago, cápsula, disco articular, membrana sinovial y ligamentos. Algunos autores consideran el "ligamento de Tanaka" descrito en los años 80 por Terry Tanaka como un ligamento intra-capsular de la ATM que une medialmente el disco articular y la fosa mandibular. El objetivo del presente estudio fue analizar el uso del término "ligamento de Tanaka" en la literatura evaluando el soporte científico de su existencia. Se realizó una revisión de la literatura bajo los términos "Tanaka Ligament [AND] TMJ" y "Ligamento Tanaka [AND] ATM" (Español y Portugués) en los buscadores: MEDLINE-Pubmed, Science Direct, Google Académico, LILACS-Bireme y SciELO. Se consideraron artículos científicos y tesis en inglés, español y portugués. Se obtuvieron un total de 1.355 estudios, sumando los resultados de todos los motores de búsqueda, de los cuales se seleccionaron 8 estudios (5 artículos y 3 tesis) después de aplicar los criterios de inclusión y exclusión y la selección por título, resumen y contenido. La mayoría de estos estudios fueron descartados porque tenían contenidos relacionados con la ATM y/o ligamentos cuyo autor tenía el apellido "Tanaka", que no estaba relacionado con el ligamento de Tanaka. Entre los 8 estudios seleccionados, 6 de ellos citan libros de texto, uno cita un video publicado por Terry Tanaka y otro cita una tesis. La mayoría de estos libros citados también se refieren a los videos de Terry Tanaka y sus libros. Además, la mayor parte de la literatura anatómica no considera este ligamento como una estructura individualizada. Aunque hay descripciones del ligamento de Tanaka en los libros de texto, el apoyo científico de su existencia se basa sólo en videos y textos de Terry Tanaka. La difusión del conocimiento asociado a este ligamento debe ser cautelosa, revelando la necesidad de más estudios morfológicos y funcionales para confirmar su existencia.

Propuesta sobre la inclusión y eliminación de términos anatómicos en terminologia anatomica correspondientes a la articulación temporomandibular / Proposal on inclusion and elimination of anatomical terms in terminologia anatomica corresponding to the temporomandibular joint

En esta comunicación breve se plantea como objetivo la necesidad de analizar los términos anatómicos relacionados a la articulación temporomandibular presentes en Terminologia Anatomica Internacional (TAI) y, en referencia a estos, incluir nuevos términos no presentes en la TAI, eliminar términos no correctos de la TAI y analizar otros términos que son identificados en la literatura científica pero que no están incluidos en Terminologia Anatomica.

The objective presented in this short communication is the need to analyze anatomical terms related to the temporomandibular joint as noted in the International Anatomical Terminology (IAT) and referring to these, include new terms not present in the IAT, removing the incorrect terms of the IAT and analyzing other terms that are identified in the scientific literature but are not included in Terminologia Anatomica.

Tuberculose e suas manifestações na ATM: uma revisão de literatura / Tuberculosis and its manifestations in TMJ: a literature review

A disfunção temporomandibular tem caráter multifatorial e merece uma abordagem diferenciada tanto para seu diagnóstico quanto seu tratamento, sendo frequentemente recomendada a atuação de uma equipe multidisciplinar. Várias são as manifestações que podem acometer as articulações temporomandibulares decorrentes de patologias sistêmicas. Dentre estas, a tuberculose raramente as acomete, mas a ocorrência de manifestações extrapulmonares vem crescendo nos últimos anos. Estima-se que a tuberculose acometa 8.8 milhões de pessoas ao ano, levando 1.45 milhões destas ao óbito. O objetivo desta revisão foi levantar dados e informações para profissionais da área da saúde, em especial os Cirurgiões Dentistas,para um correto e precoce diagnóstico, uma vez que a detecção correta da patologia possibilita tratamento adequado e previne o surgimento de alterações graves na forma e função das articulaçõesenvolvidas.

Temporomandibular disorders are a multifactorial disease, that deserves a special approachfor its diagnosis and treatment, and a multidisciplinary team is suggested. Various systemic pathologies have a TMJ manifestation. Among these diseases, tuberculosis rarely has a temporomandibularjoint occurrence, but extra pulmonary manifestation is increasing in the last years.About 8,8 million people are affected by tuberculosis each year, and 1,45 million die because ofit. The objective of this review is collect data and information for health professional, in special Dentists, in order to clarify the relationship between TMD and tuberculosis, early diagnosis and correct treatment, once that the correct identification of this patology can provide adequate treatment and prevents for more severe complications.

Análisis de los términos utilizados en la literatura científica para referirse a la cápsula articular y ligamentos articulares de la articulación temporomandibular / Analysis of terms used in the literature to refer to temporomandibular joint capsule and joint ligaments

La identificación de las estructuras anatómicas con un término único, informativo y con ausencia de homónimos, entre otros principios, es la tarea primordial que lleva adelante la Federación Internacional de Programas de Terminologia Anatomica (FIPAT) perteneciente a la International Federation of Anatomical Associations (IFAA). Sin embargo, en la literatura científica, sobre todo con orientación clínica y quirúrgica, existen aún dificultades para adoptar la Terminologia Anatomica Internacional (TAI), generándose múltiples denominaciones para una misma estructura anatómica, complicando la comunicación científica. El objetivo de este trabajo fue analizar los términos utilizados en la literatura científica en relación a la cápsula articular y los ligamentos articulares de la articulación temporomandibular. Se revisaron artículos científicos y también libros de texto de anatomía general y específicos de la articulación temporomandibular. Se compararon los términos adoptados en la literatura especializada con la establecida en la TAI, identificándose los términos de la TAI más utilizados, como así también aquellos mencionados en artículos científicos y libros de texto pero no presentes en la TAI. El análisis realizado en esta investigación permitió identificar el uso de términos presentes y ausentes en la TAI, analizando su denominación, origen, inserción y función específica.

The identification of anatomical structures with a single, informative term and absence of homonyms, among other principles, the primary task is being conducted by the International Federation of programs Anatomical Terminology (FIPAT) belonging to the International Federation of Anatomical Associations (IFAA). However, in the literature, particularly with clinical and surgical direction, there is still difficulty in adopting the Terminologia Anatomica Internacional (TAI), generating multiple names for the same anatomical structure, complicating scientific communication. The aim of this study was to analyze the terms used in the literature in relation to the joint capsule and joint ligaments of the temporomandibular joint. Scientific papers and textbooks on general and specific anatomy, of the temporomandibular joint is reviewed. We compared the terms adopted with TAI literature specialized terms, identifying the TAI terms most used, as well as those mentioned in scientific and textbook literature, but not present in the TAI. The analysis in this study identified the use of terms present and absent in TAI, analyzing their name, origin, insertion and specific function.

Caracterización de los componentes óseos de la articulación temporomandibular: una revisión de la literatura / Characterization of bone components of the temporomandibular joint: a literature review

La articulación temporomandibular (ATM) es una articulación sinovial bilateral de tipo ginglimo-artroidal que anatómicamente está conformada por el cóndilo mandibular, fosa mandibular y tubérculo articular. Es necesario tener un acabado conocimiento de la anatomía de la ATM para una correcta comprensión de su funcionamiento. La descripción anatómica de las estructuras óseas presente en la literatura científica, y que componen la ATM, no es del todo exacta, con diversas diferencias sobre la delimitación del cóndilo mandibular, las fisuras presentes en la fosa mandibular y las superficies articulares de la fosa mandibular y tubérculo articular, así como una amplia variabilidad de términos para referirse a cada estructura anatómica. Se realizó una revisión sistemática de textos y artículos científicos sobre la descripción anatómica de los componentes óseos de la ATM y los términos para referirse a ellos, comparándolos con los términos establecidos por la Terminología Anatómica Internacional.

The temporomandibular joint (TMJ) is a ginglymus-arthrodial bilateral synovial joint, anatomically composed by the mandibular condyle, mandibular fossa and articular tubercle. It is necessary to have a perfect knowledge of the anatomy of the TMJ for a proper understanding of its function. The anatomical description of bony structures of the TMJ present in the scientific literature is not entirely accurate, with several differences on the delimitation of the mandibular condyle, the limits of the articular surfaces, the fissures present in the mandibular fossa. In addition, there is a wide variability of terms for each anatomical structure. A review of textbooks and scientific articles was performed, about the anatomical description of the bony components of the TMJ and terms to refer to them, compared with the terms established by the Anatomical Terminology.

Avaliação em 3D da cabeça da mandíbula em crianças portadoras de mordida cruzada posterior unilateral por meio de tomografia computadorizada de feixe cônico / 3D evaluation of the condyle in children with unilateral posterior cross bite using Cone Beam Computed Tomography

Durante o desenvolvimento da oclusão, a instalação de maloclusões podem resultar em desarmonias dento faciais de natureza e severidade diversas, podendo provocar alterações no desenvolvimento crânio facial, dentre as estruturas envolvidas as Articulações Temporo Mandibulares (ATM), podem sofrer alguma influência, dessa forma a avaliação desta região, no aspecto morfológico e funcional, constituí tema de interesse, sempre que levados em conta os aspectos funcionais da oclusão. A relação entre a forma e a função, tanto das cabeças da mandíbula, bem como o contorno da fossa mandibular com as maloclusões ainda é controversa e não está compreendida por completo, porém a literatura sobre o assunto, demonstra correlação entre a instalação de maloclusões e modificações neste sistema, mesmo que algumas alterações não sejam de ordem estatística e em amostras de indivíduos em tenra idade, as mesmas podem comprometer o desenvolvimento adequado em indivíduos adultos ou mesmo adultos jovens.

Tendo como propósito nesse estudo a avaliação das cabeças da mandíbula quanto ao volume e superficíe dos lados direito e esquerdo, cruzado e não cruzado, a amostra selecionada foi de 20 indivíduos com mordida cruzada posterior unilateral, com idades entre 06 e 09 anos de idade, utilizando imagens de tomografia computadorizada por feixe cônico, imagens obtidas por um equipamento modelo i- Cat, sendo utilizado na reformatação e manipulação das imagens o programa computacional - NemoCeph 3D® versão 11.5. Nas medições propostas para esse estudo, utilizou-se o teste t pareado de Student para amostras com distribuição normal. Na observação das tabelas e seus respectivos gráficos, podemos verificar que na comparação entre os lados direito e esquerdo, e cruzado e não cruzado das cabeças da mandíbula, com relação ao volume e superfície, existem diferenças numéricas entre elas, porém não pode ser observado diferenças estatísticas significantes, nessa amostra especifica com a metodologia empregada para esse estudo. Assim foi possível concluir que nas Mordidas Cruzadas Posteriores Unilaterais as cabeças da mandíbula tanto em seu volume como em sua superfície não apresentaram diferenças estatisticamente significantes na amostra estudada.

During the development of occlusion, malocclusions installation may result in disharmony dento facial nature and various severity, can cause changes in craniofacial development, among the structures involved in the temporomandibular joints mandibular (ATM), may suffer some influence, thus the evaluation of this region, the morphological and functional aspect, constitutes topic of interest, when taken into account the functional aspects of occlusion. The relationship between form and function, both the heads of the jaw, as well as the outline of the mandibular fossa with malocclusion remains controversial and is not fully understood, but the literature on the subject shows correlation between the installation of malocclusions and modifications to this system, even if some changes are not of statistical order and samples from individuals at an early age, they can compromise the proper development in adults and even young adults. With the intent of this study was to evaluate the heads of the jaw as the volume and surface of the right and left sides, crossed and uncrossed, the selected sample of 20 subjects with unilateral posterior cross bite, aged from 06 to 09 years old, using computed tomography cone beam, images obtained by a device model i-Cat, being used in reformatting and manipulation of images the computer program - NemoCeph 3D® version 11.5.

The proposals measurements for this study, we used the paired t-test of Student for samples with normal distribution. The observation of the tables and their graphs, we can see that the comparison between the right and left sides, and crossed and uncrossed the heads of the mandible in relation to the volume and surface, there are numerical differences between them, but can not be observed differences statistically significant, this sample specifies the methodology used for this study. Thus it was concluded that the Unilateral Posterior Crossbites the heads of the jaw in both its volume and its surface showed no statistically significant differences

Avaliação em 3D da cabeça da mandíbula em crianças portadoras de mordida cruzada posterior unilateral por meio de tomografia computadorizada de feixe cônico / 3D evaluation of the condyle in children with unilateral posterior cross bite using Cone Beam Computed Tomography

Durante o desenvolvimento da oclusão, a instalação de maloclusões podem resultar em desarmonias dento faciais de natureza e severidade diversas, podendo provocar alterações no desenvolvimento crânio facial, dentre as estruturas envolvidas as Articulações Temporo Mandibulares (ATM), podem sofrer alguma influência, dessa forma a avaliação desta região, no aspecto morfológico e funcional, constituí tema de interesse, sempre que levados em conta os aspectos funcionais da oclusão. A relação entre a forma e a função, tanto das cabeças da mandíbula, bem como o contorno da fossa mandibular com as maloclusões ainda é controversa e não está compreendida por completo, porém a literatura sobre o assunto, demonstra correlação entre a instalação de maloclusões e modificações neste sistema, mesmo que algumas alterações não sejam de ordem estatística e em amostras de indivíduos em tenra idade, as mesmas podem comprometer o desenvolvimento adequado em indivíduos adultos ou mesmo adultos jovens...

During the development of occlusion, malocclusions installation may result in disharmony dento facial nature and various severity, can cause changes in craniofacial development, among the structures involved in the temporomandibular joints mandibular (ATM), may suffer some influence, thus the evaluation of this region, the morphological and functional aspect, constitutes topic of interest, when taken into account the functional aspects of occlusion. The relationship between form and function, both the heads of the jaw, as well as the outline of the mandibular fossa with malocclusion remains controversial and is not fully understood, but the literature on the subject shows correlation between the installation of malocclusions and modifications to this system, even if some changes are not of statistical order and samples from individuals at an early age, they can compromise the proper development in adults and even young adults. With the intent of this study was to evaluate the heads of the jaw as the volume and surface of the right and left sides, crossed and uncrossed, the selected sample of 20 subjects with unilateral posterior cross bite, aged from 06 to 09 years old, using computed tomography cone beam, images obtained by a device model i-Cat, being used in reformatting and manipulation of images the computer program - NemoCeph 3D® version 11.5...

Análisis de los términos utilizados en la literatura científica para referirse a los ligamentos extracapsulares de la articulación témporomandibular: parte ii: ligamentum stylomandibulare y raphe pterymandibulare / Analysis of terms used in scientific literature referred to extracapsular ligaments of the temporomandibular joint: part ii: ligamentum stylomandibulare and raphe pterymandibulare

La Terminología Anatómica Internacional (TAI) es la consecuencia de siglos de trabajo científico tendientes a unificar los términos para denominar a las estructuras anatómicas del cuerpo humano y facilitar la comunicación entre la comunidad científica. Sin embargo, su uso en la literatura no se ha aplicado por completo. El objetivo de esta investigación fue analizar la bibliografía en relación a la correcta implementación de los términos referentes al ligamento estilomandibular y al rafe pterigomandibular. Se realizó una revisión en libros de anatomía y artículos científicos relacionados. Se encontraron diferencias en cuanto a los términos usados para referirse tanto al ligamento estilomandibular y al rafe pterigomandibular, como a las estructuras que sirven de origen e inserción a estos, al compararlos con los términos establecidos por la TAI en latín, inglés y español.

The Anatomical Terminology (TAI) is the result of centuries of scientific work to unify the terms referring to the anatomical structures of the human body and facilitate communication between the scientific community. However, its use in the literature has not been fully implemented. The objective of this research was to analyze the literature regarding the correct implementation of the terms relating to stylomandibular ligament and pterigomandibular raphe. A review was performed in anatomy text books and scientific articles. Differences in the terms used were found to describe both pterigomandibular ligament and stylomandibular raphe, and also to describe structures that serve as origin and insertion of these, when compared with the terms established by the TAI in Latin, English and Spanish.

Análisis de los términos utilizados en la literatura científica para referirse a los ligamentos extracapsulares de la articulación témporomandibular: Parte I: Ligamentum sphenomandibulare / A study of terms used in scientific literature to refer to the extracapsular ligaments of the temporomandibular joint: Part I: Ligamentum sphenomandibulare

La Terminología Anatómica es la base de correcta comunicación anatómica y establece la unificación internacionalmente aceptada para diversas estructuras anatómicas. Sin embargo, su uso en la literatura pedagógica y científica no se ha aplicado por completo. El objetivo de esta investigación fue analizar la literatura en relación al uso correcto de los términos referentes al Ligamento esfenomandibular de la Articulación témporomandibular (ATM). Se realizó una revisión en libros de anatomía y artículos científicos relacionados y se comparó el uso de términos referentes al ligamento esfenomandibular con la Terminología Anatómica Internacional (TAI). Se encontraron diferencias en cuanto a los términos usados (sinonimia) para referirse tanto al ligamento esfenomandibular, así como a las estructuras que sirven de origen e inserción a este con los términos establecidos por la TAI en latín, inglés y algunos términos traducidos al español. La sinonimia y uso de epónimos encontrados dificultan la comunicación entre los científicos del área, así como el aprendizaje de los alumnos de pregrado y postgrado, cuya principal fuente de estudio continúan siendo los libros de anatomía.

Terminología Anatómica is currently the international standard for anatomical terminology, and establishes an internationally accepted and unified nomenclature for several anatomical structures. However, International Anatomical Terminology (IAT) is not always used correctly in scientific literature. The purpose of this review is to examine scientific literature in order to determine whether the terms that refer to the sphenomandibular ligament of the temporomandibular joint (TMJ) are being used correctly. Scientific books and articles were reviewed, and the terms used were compared with those established by the IAT. Our study found differences between the terms actually used (Synonyms) to refer to the sphenomandibular ligament and to the anatomical structures where the ligament originates and where it is inserted and those established by the IAT in Latin, English and some terms translated into Spanish. The use of eponyms and synonyms found, creates difficulties in communication between scientists and in the learning process of undergraduate students, who frequently use textbooks.

Mínima invasión en la terapia de disfunciones oclusales / Minimal invasion in the therapy of occlusl disorders

La función en odontología ha sido la fuente de permanente discusión. Existe controversia y confusión en la comunidad académica y clínica, con consecuencias en los planes de tratamiento. En diversos pacientes, al no poseer armonía oclusal, ocurre destrucción dentaria significativa por la carga inadecuada y sus consecuencias en la Articulación Témporo Mandibular (ATM). A pesar de la falta de evidencia científica para tratamientos específicos, es importante la adquisición de habilidades generales, procedimientos precisos, reproducibles, fáciles y rápidos, y alcanzar profundo conocimiento/ destrezas para reducir fracasos innecesarios. La discusión en esta revisión se centra en un protocolo de diagnóstico basado en la toma de decisiones para lograr resultados predecibles de tratamiento. Una presunción significativa es evitar cambios de oclusión en procedimientos en personas sanas, y reconocer que los métodos irreversibles se indican solo ocasionalmente en pacientes con estas disfunciones. Respetando estos principios, la oclusión tomará su lugar biológicamente alineada y centrada en el paciente, en la ciencia odontológica moderna e innovadora.

Function in dentistry has been the source of permanent discussion. There is controversy and confusion in the academic and clinical community, with consequences in treatment plans. In different patients, not having occlusal harmony, occur significant tooth destruction due to improper loading and its consequences in the temporo mandibular articulation. Despite the lack of scientific evidence for specific treatments, it is important to the acquisition of general skills, accurate, reproducible, easy and quick procedures, and reaches deep knowledge / skills to reduce unnecessary failures. The discussion in this review focuses on a diagnostic protocol based on decision-making to achieve predictable results of treatment. A significant assumption is to avoid changes of occlusion procedures in healthy people, and recognize that irreversible methods are only occasionally indicated in patients with these disorders. Respecting these principles, the occlusion will take his place biologically aligned and centered on the patient, in the modern and innovative dental science.