ABSTRACT
OBJECTIVES: The goal of this work was to investigate the volume development of the mandible in growing rabbits with bilaterally induced temporomandibular joint (TMJ) arthritis that was either left untreated or treated with the tumor necrosis factor-alpha (TNF-α) antagonist etanercept. METHODS: A total of 18 New Zealand White rabbits aged 8 weeks were randomized to three groups of 6 animals each. Two of these groups were used as arthritis groups by sensitizing the 12 animals to ovalbumin (OA) at 10 weeks, followed by intraarticular OA injections to induce bilateral TMJ arthritis and repeating these injections every 3 weeks to maintain the inflammation. One of the two arthritis groups was treated by weekly subcutaneous etanercept injections, whereas the other group was left untreated. The remaining 6 animals served as controls. Maxillofacial CT scans were obtained at 3-week intervals (from week 10 of the rabbits' lives to the end of the experiment at 22 weeks) to volumetrically track the development of the mandibles after segmentation. RESULTS: The mandibles did not grow at a continuous rate, but the rate of development was found to decrease in all groups over the course of the study (weeks 10-22). The most extensive volume increases were noted during weeks 10-13. Severe growth deficiencies, especially of the condylar processes, were observed in the arthritis group not receiving treatment. The arthritis group treated with etanercept showed better rates of growth without, however, reaching the normal range of the control group. CONCLUSION: Antigen-induced TMJ arthritis was found to involve severe problems of growth similar to those in juvenile idiopathic arthritis. Etanercept can improve the volume development but does not reestablish an entirely normal rate of growth.
Subject(s)
Arthritis/drug therapy , Arthritis/pathology , Etanercept/therapeutic use , Mandible/pathology , Temporomandibular Joint Disorders/drug therapy , Temporomandibular Joint Disorders/pathology , Aging/pathology , Animals , Antirheumatic Agents/therapeutic use , Female , Mandible/drug effects , Organ Size/drug effects , Rabbits , Reference Values , Treatment OutcomeABSTRACT
INTRODUCTION AND AIM: The logopedic examination according to Kittel (1998) is a method frequently used to diagnose tongue dysfunction. There has been a lack of reliable parameters to confirm this analysis. MR images visualize resting position and tongue movement as well as surrounding structures relevant to oral function. The aim of this study was to compare logopedic and MRI findings in evaluating tongue function and to assess whether MRI findings can replace logopedic examination for diagnostic purposes. MATERIAL AND METHODS: 56 subjects were examined by the following methods: - Logopedic examination according to Kittel (1998) - MR images of the tongue resting position (T1-weighted) and deglutition process (2D-FIESTA technique) - MRI analysis according to Fujiki et al. (2000) RESULTS: We observed marked differences between the logopedic and MRI findings, yet there were no significant correlations between the logopedic outcome and distances measured via MRI in tongue resting position and swallowing patterns. CONCLUSION: We noted little concordance between logopedic findings according to Kittel and MRI analysis according to Fujiki et al. Which of these findings correctly reflects the actual clinical situation remains unclear.
Subject(s)
Magnetic Resonance Imaging/methods , Physical Examination/methods , Tongue Diseases/diagnosis , Tongue/pathology , Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Young AdultABSTRACT
OBJECTIVE: This study investigated the validity and reliability of logopedic assessments of tongue function. MATERIALS AND METHODS: At two practices for myofunctional therapy, diagnosis of tongue dysfunction according to Kittel (1984, 1996, 2008) was carried out in 52 subjects (aged 5 to 63 years) by three speech pathologists at each practice. RESULTS: The agreement of the logopedic assessments was mostly satisfactory at one of the two practices but was unsatisfactory in most cases at the other practice. CONCLUSION: The inconsistent agreement between the logopedic assessments does not permit a definitive statement about the actual clinical situation.
Subject(s)
Physical Examination/methods , Tongue Diseases/diagnosis , Tongue/pathology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Young AdultABSTRACT
A case report is presented to examine the question of whether a panoramic x-ray in standard projection can be readily replaced by a radiation-reduced projection with shielding of the condylar processes.A female patient with juvenile idiopathic arthritis was examined by a panoramic x-ray and MRI prior to TMJ splinting. The panoramic x-ray in standard projection showed short, atypically-shaped condylar processes with cystic lesions and cortical erosion. The MRI confirmed the TMJ destruction. The condylar processes were shielded on the x-rays taken for a previous orthodontic treatment. Thus TMJ assessment was not done, though it is an integral part of orthodontic radiodiagnostics according to Hirschfelder and other authors. This example of juvenile idiopathic arthritis with TMJ involvement shows that visualization of the condylar processes is indispensable.
