Examination for the Factors Involving to Joint Effusion in Patients with Temporomandibular Disorders Using Magnetic Resonance Imaging.

BACKGROUND: This study investigated the factors involving joint effusion in patients with temporomandibular disorders. METHODS: The magnetic resonance images of 131 temporomandibular joints (TMJs) of patients with temporomandibular disorders were evaluated. Gender, age, disease classification, duration of manifestation, muscle pain, TMJ pain, jaw opening disturbance, disc displacement with and without reduction, deformation of the articular disc, deformation of bone, and joint effusion were investigated. Differences in the appearance of symptoms and observations were evaluated using cross-tabulation. The differences in the amounts of synovial fluid in joint effusion vs. duration of manifestation were analyzed using the Kruskal-Wallis test. Multiple logistic regression analysis was performed to analyze the factors contributing to joint effusion. RESULTS: Manifestation duration was significantly longer when joint effusion was not recognized (p < 0.05). Arthralgia and deformation of the articular disc were related to a high risk of joint effusion (p < 0.05). CONCLUSIONS: The results of this study suggest that joint effusion recognized in magnetic resonance imaging was easily observed when the manifestation duration was short, and arthralgia and deformation of the articular disc were related to a higher risk of joint effusion.

Odontogenic Infection Pathway to the Parapharyngeal Space: CT Imaging Assessment.

Introduction: Parapharyngeal space infection may lead to severe and potentially life-threatening complications. The aim of this study was to assess the odontogenic infection pathway to the parapharyngeal space using CT imaging. Materials and Methods: Nineteen patients in mandibular odontogenic infections with abscess who underwent contrast-enhanced CT were evaluated in this study. We reviewed the location of abscess and spread of odontogenic infections to the different components of the buccal space, submandibular space, sublingual space, masticator space and parapharyngeal space using CT imaging. The location of abscess and spread of odontogenic infections were analyzed with the Pearson Chi-square test. Results: Regarding the odontogenic infection pathway to parapharyngeal space, the masticator space (100%) was the most frequent, followed by the buccal space (85.7%), submandibular space (85.7%) and sublingual space (57.1%), while those without parapharyngeal space, the submandibular space (83.3%) was the most frequent, followed by the buccal space (75.0%), masticator space (58.3%) and sublingual space (33.3%). The masticator space was significant space in patients with/without parapharyngeal space infection (P = 0.047). Conclusion: CT imaging could be an effective method in assessment of odontogenic infection pathway to the parapharyngeal space. The odontogenic infection in masticator space tends to display spread of parapharyngeal space.

Diagnosis of root fractures using cone-beam computed tomography: difference of vertical and horizontal root fracture.

OBJECTIVES: The aim of this study was to investigate the occurrence of vertical and horizontal root fractures using cone-beam computed tomography (CBCT). METHODS: We reviewed the CBCT images of 51 patients who were examined by CBCT for the diagnosis of root fracture. The occurrences of vertical and horizontal root fractures were investigated concerning the pulpal vitality and the kind of tooth, and analyzed by cross-tabulation. The fracture direction of vertical root fracture and the fracture angle were also investigated, and analyzed by cross-tabulation and Kruskal-Wallis test, respectively. RESULTS: The occurrence of vertical and horizontal root fractures was statistically significantly different between vital tooth and non-vital tooth (p = 0.044). The occurrence of vertical and horizontal root fractures was also different among anterior, premolar, and molar teeth (p = 0.004). The kind of tooth on traumatized tooth was only anterior teeth and the number was larger on horizontal root fracture. The occurrence of vertical and horizontal root fractures on non-traumatized tooth was different among the kind of tooth (p = 0.007), and the number of vertical root fracture was larger than that of horizontal root fracture on premolar teeth. Fracture direction was not different, but the fracture angle was different among the kind of tooth on vertical root fracture (p = 0.027). CONCLUSIONS: The results suggested that the number of vertical root fracture was larger on non-vital tooth and that of horizontal root fracture was larger on vital tooth. The number of vertical root fracture was larger on premolar teeth.

Gallium-67 SPECT-CT for the evaluation of head and neck: preliminary study on maximum standardised uptake value in lesions, and in the parotid and submandibular glands.

PURPOSE: The aim of this study was to investigate the gallium-67 (67Ga) single-photon emission-computed tomography (SPECT-CT) for the evaluation of head and neck, especially maximum standardised uptake value (SUVmax) in lesions, and in the parotid and submandibular glands. MATERIAL AND METHODS: Fourteen patients with head and neck lesions who underwent SPECT-CT at 72 hours after injection of 67Ga were included in this study. The 67Ga SPECT-CT parameters SUVmax were compared between the parotid glands and submandibular glands. Statistical analyses for the SUVmax were performed by Mann-Whitney U test. A p value lower than 0.05 was considered as statistically significant. RESULTS: Of all 14 patients, 67Ga SPECT-CT was positive for two cases (one malignant lymphoma and one osteomyelitis). The SUVmax for malignant lymphoma and osteomyelitis were 11.21 and 10.95, respectively. Furthermore, SUVmax for parotid glands and submandibular glands of all patients were 4.86 ± 1.89 and 4.64 ± 1.64, respectively (p = 0.694). CONCLUSIONS: This study investigated the 67Ga SPECT-CT for the evaluation of head and neck, especially SUVmax of lesions, and the parotid and submandibular glands. 67Ga SPECT-CT may be an effective technique for the evaluation of maxillofacial lesions.

Forming temperature of ethylene vinyl acetate sheets for fabrication of vacuum-formed mouthguards.

BACKGROUND/AIMS: The appropriate heating temperature for the fabrication of mouthguards using ethylene vinyl acetate sheets is reported to be 80-120°C. However, the measurement side of the heating temperature has not been determined. The aim of this study was to investigate the influence of the measurement side of the heating temperature when fabricating mouthguards. MATERIALS AND METHODS: Mouthguard sheets of 3.8 mm ethylene vinyl acetate were vacuum-formed on working models until the sheet was heated to 120°C. The sheet temperature was measured at the upper side and the lower side. The thickness of the mouthguard was measured at the labial surface of the central incisor, and the buccal and occlusal surfaces of the first molar. The fit of the mouthguard was examined at the central incisor and the first molar by measuring the distance between the mouthguard and the cervical margin of the working model. Differences in the thickness and fit of the mouthguards were analyzed by two-way analysis of variance. RESULTS: Mouthguard thickness varied among the measured regions of the central incisors and first molars (P < .01). The thicknesses at the labial surface of the central incisor and buccal surface of the first molar were larger when the sheet temperature measured at the lower side was 120°C compared to when the sheet temperature measured at the upper side was 120°C (P < .01). The fit of the mouthguard was better when the sheet temperature measured at the lower side was 120°C (P < .05). CONCLUSIONS: The sheet temperature should be measured at the lower side of the sheet and it should be 120°C for fabricating mouthguards.

Usefulness of measuring plasma cytokines in oral and maxillofacial surgery.

We determined the intra- and postoperative plasma concentrations of cytokines (tumor necrosis factor [TNF]-Alpha, interleukin [IL]-1Beta, IL-6, and IL-8) in oral surgery patients with procedures ranging in duration from 20 to 375 min and investigated their relationship to the intensity of the surgical stress over time. No significant differences from baseline levels were observed in the levels of TNF-Alpha, IL-1Beta, and IL-8. By contrast, increased IL-6 levels were noted only on the first postoperative day, when they reached 1500% of the baseline level, after which they decreased to preoperative levels by the third postoperative day and tended to reflect the intensity of surgical stress.