ABSTRACT
La simetría mandibular es esencial para determinar los patrones no solo de belleza facial sino de función masticatoria; las alteraciones de crecimiento y desarrollo, patologías genéticas, traumáticas o neoplásicas o por características propias de cada población, que afectan a la mandíbula, generan consecuencias que llevan a tratamientos inclusive quirúrgicos para su corrección. El análisis de Thilander en radiografías panorámicas, permite la valoración de la magnitud de las asimetrías mandibulares, como parte de los exámenes complementarios en el proceso diagnóstico. Determinar la frecuencia de asimetrías condilares, de cuerpo y rama mandibular en radiografías panorámicas digitales. Estudio descriptivo de corte transversal en 500 radiografías panorámicas digitales, de adecuado contraste y densidad, obtenidas de pacientes mayores de 18 años de edad, con dentición completa; se registró sexo, edad y mediante el programa CliniView 9.1 se tomaron las medidas mandibulares propuestas por Thilander calculando las diferencias con la fórmula de Bezzur. La prevalencia de asimetrías condilares patológicas en la población mayor de 18 años es del 6 %. Se encontró una diferencia significativa en las medidas verticales entre los dos lados sin que en ellas tenga influencia el género o la edad. Las diferencias en la altura de la rama mandibular se encuentran en la mayoría de los casos a expensas del cóndilo y las discrepancias entre los lados derecho e izquierdo, deben considerarse como elemento diagnóstico en posibles patologías articulares.
The mandibular symmetry is essential to determine the patterns, not only of facial beauty, but also in the masticatory function. The growth and development alterations, genetic pathologies, traumatic, neoplasic or the characteristics of each population, that affect the jaw, generate consequences that may lead to even surgical treatments for correction. Thilander analysis on panoramic x-rays, allows the assessment of the magnitude of mandibular asymmetries, as part of the complementary exams in the diagnostic process. The objective of the study was to determine the frequency of condylar asymmetries in mandibular body and ramus in digital panoramics x-rays. A cross-sectional study was carried out in 500 digital panoramic x-rays with adequate contrast and density, obtained from patients over 18 years of age, with full dentition. Sex and age were registered by 9.1 CliniView program. Proposed mandibular measurements were recorded by Thilander, calculating the differences with the Bazzur's formula. The prevalence of pathological condylar asymmetries in the population over 18 years is 6 %. A significant difference was found in the vertical measurements between the two sides, though there was no influence by either sex or age. The differences in the height of the mandibular ramus are, in most cases, at the expense of the condyle. The discrepancies between the left and right sides must be considered as diagnostic element in possible articular pathologies.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Facial Asymmetry/epidemiology , Mandible/diagnostic imaging , Mandible/pathology , Radiography, Panoramic , Colombia/epidemiology , Epidemiology, Descriptive , PrevalenceABSTRACT
Background Temporomandibular joint (TMJ) total replacement with alloplastic prostheses has been performed since 1960s. Research in these last two decades has achieved important improvement in the development of biomaterials, design, adaptation, and fixation of the prosthesis components. Objective To evaluate total TMJ replacement with alloplastic prostheses. Methods We studied 27 patients, between 19 and 73 years old, who had total TMJ uni- or bilateral replacement surgery with custom-made alloplastic prostheses manufactured by TMJ Concepts, Inc. (Ventura, CA) between 1996 and 2011. The general data and preoperative measurements were taken from medical records. Subjective data related to pain, diet consistency, and current quality of life were collected with a questionnaire answered by the patients; measures of maximum interincisal opening and lateral mandibular movements were obtained from direct examination. Results We found significant difference (p < 0.05) comparing pre- to postoperative results about improvement in mouth opening, pain relief, and satisfaction with the surgery and diet consistency. Conclusion The results of this study show that total alloplastic TMJ prostheses are an efficient, safe, and stable long-term solution for patients who need TMJ total replacement.
