COMPARATIVE EVALUATION OF THE TEMPOROMANDIBULAR JOINT STRUCTURES AFFECTED BY TMJ DYSFUNCTION.

OBJECTIVE: The aim: To investigate the individual anatomical features of the temporomandibular joint structures affected by TMJ disorders and compare them with those of asymptomatic patients. PATIENTS AND METHODS: Materials and methods: The sample consisted of 41 patients. The study group included 29 patients. The retroposition of the right mandibular head was observed in 16 patients, the anterior position of the right mandibular head - in 13 patients, the retroposition of the left mandibular head - in 19 patients, and the anterior position of the left mandibular head - in 10 patients. The control group consisted of 12 patients with an anterior or central position of the right and left mandibular heads. RESULTS: Results: In the study group, a comparative analysis of the ABC angle on the right and left sides found no statistically significant difference in Student's criterion (p=0.176). In the control group, a comparative analysis of the ABC angle on the right and left sides found no statistically significant difference in Student's criterion (p=0.131). To identify a possible difference in the inclination of the articular tubercle in the study and control groups (anterior position of the mandibular head), calculations were carried out and when comparing two related samples using Wilkinson's T-criteria, the difference is not statistically significant p=0.119. The mean values obtained using Student's criterion did not reveal any statistically significant difference between both groups, р*=0,811. CONCLUSION: Conclusions: A comparative analysis of the ABC angle in patients with TMJ dysfunction and the control group did not reveal any statistically significant difference. At the same time, there was no statistically significant difference between patients with the anterior and posterior position of the mandibular head.

Pneumatization of the articular eminence in cone-beam computed tomography: prevalence and characteristics - literature review.

BACKGROUND: The articular tubercle is a site prone to pneumatization within the cranial bones. Knowledge of the anatomical variations of pneumatization adjacent to the temporomandibular joint (TMJ) is an important issue. Air cells exhibit decreased resistance to trauma, facilitate the spread of various pathologies in the TMJ, such as inflammation, tumours or fractures. Articular tubercle pneumatization may cause complications during TMJ surgery. Information of possible location allows to detect and conduct differential diagnosis of pneumatization of the articular tubercle (PAT) during cone-beam computed tomography (CBCT) examinations. The aim of this study is to determine the prevalence and characteristics of PAT, with respect to age, gender, location and type through assessment in CBCT images. MATERIALS AND METHODS: Articles were selected through database search (PubMed, Scopus, Google Scholar), in which the main objective was to assess the prevalence of articular tubercle pneumatization using CBCT. Search strategies included the following keywords: "pneumatized articular eminence" and "CBCT", "pneumatized articular tubercle" and "CBCT" and "zygomatic air cell defect" and "CBCT". A meta-analysis of prevalence using a random effects model was performed. RESULTS: Fifteen studies met the selection criteria. The results showed that an overall prevalence of articular tubercle pneumatization was 25.22% (n = 6393; 95% confidence interval [CI] 15.84-35.94). The occurrence of PAT in females was 25.14% (n = 3064; 95% CI 14.96-36.94). The frequency of PAT in males was 25.81% (n = 2671; 95% CI 15.30-37.99). CONCLUSIONS: There was no correlation between the frequency, location or type of PAT with age and gender.

Prevalence of Pneumatized Articular Tubercle Using Panoramic Radiography and Cone Beam-Computed Tomography: A Retrospective Study.

CONTEXT: In 1985, Tyndall and Matteson first described the air cells that occur in the root of zygomatic arch and in the articular eminence of the temporal bone but do not extend beyond the zygomaticotemporal suture. AIMS: The aim is to study the prevalence and patterns of pneumatized articular tubercle (PAT) retrospectively using two different imaging modalities, i.e., digital panoramic radiography and cone-beam computed tomography (CBCT). SUBJECTS AND METHODS: Total 3000 panoramic radiographs belonging to 1291 females and 1709 males and CBCT scans of 200 patients belonging to 62 females and 138 males were studied retrospectively and investigated for radiographic features of pneumatized articular tubercle. RESULTS: Prevalence found by using panoramic radiography is 1.96% and by using CBCT is 12.5%. CONCLUSIONS: This research scrutinizes the prevalence of pneumatized articular tubercle and establishes the prevalence of the same among the studied population, using panoramic radiography and CBCT.

Are morphologic and topographic alterations of the mandibular fossa after fixed functional treatment detectable on tomograms? Visual classification and morphometric analysis.

AIM: The goal was to evaluate if changes in morphology and topography of the mandibular fossa after Functional Mandibular Advancer (FMA) treatment are detectable on tomograms. Furthermore, the suitability of digital tomograms (DT) over magnetic resonance imaging (MRI) for this particular question was investigated. MATERIALS AND METHODS: In all, 25 patients (14 female, 11 male) with a skeletal class II malocclusion received treatment with a FMA. DTs were available prior to (T1) and after (T2) FMA treatment. A total of 50 temporomandibular joints were investigated. The mandibular fossae were evaluated metrically and visually regarding treatment-induced alterations. A p < 0.05 was set as the level for statistical significance for all tests. Results were compared to the results of a recent MRI study. RESULTS: Visual inspection of all 50 joints in the DT at T1 and T2 revealed no alterations of the fossa shape in the sagittal plane; 24 patients showed identical morphology of right and left joints. The metrical analysis revealed no significant changes regarding width, depth and ratio thereof between T1 and T2. There also were no bilateral differences. Another 18 different distance measurements between porion, mandibular fossa, articular eminence and pterygoid fossa showed no significant changes. There was no detectable proof of a fossa shift. CONCLUSIONS: No changes in the sagittal plane, mandibular fossa, the articular tubercle, or a possible fossa shift were found in the DT of class II patients after FMA treatment. DT and MRI measurements and the visual inspection revealed identical findings; thus, DT appears to be a valuable research tool for sagittal analysis of mandibular fossa changes.

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.

Zygomatic air cell defect: A panoramic radiographic study of a south Indian population.

AIMS: To determine the prevalence, patterns of occurrence and variations of zygomatic air cell defects (ZACDs) using panoramic radiographs. METHODS AND MATERIALS: Dental panoramic radiographs of 600 outpatients were examined to evaluate the variations and characteristics of ZACDs. RESULTS: ZACDs were identified in 15 subjects out of 600, giving an overall prevalence of 2.5%. Seven ZACDs were seen in males and eight in females. Among the 15 ZACDs, nine were unilateral and six were bilateral. CONCLUSION: The overall prevalence of ZACD is relatively low in south Indian population and careful radiographic evaluation is needed to detect these entities.