Konik Işınlı Bilgisayarlı Tomografi Kullanılarak Temporomandibular Eklem Bozukluğu Olan Hastalarda Kondiller Şekil ve Pozisyonunun Değerlendirilmesi
Abstract
Amaç: TME
rahatsızlıkları sıklıkla görülmektedir ve erişkin popülasyonunda sınırlıdır.
Epidemiyolojik araştırmalarda yetişkinlerin 75%'inde muayene sırasında en az
bir adet eklem disfonksiyonu belirtisi görülürken, üçte birinin en az bir
semptomu vardır. Ancak, TME belirtileri olan yetişkinlerin sadece yüzde 5'i
tedaviye ihtiyaç duymakta ve daha az sayıda kronik veya zayıflatıcı semptom
geliştirmektedir. TMD'nin iki gruba ayrıldığı hastalarda temporomandibular
hastalıkların erken tanısı ve tedavisinin kemik yıkımının başarıyla kontrol
edilmesi için son derecede önem taşıdığı düşünülmektedir. Bu çalışma, iki gruba
ayrılan TMD'li hastalarda (disk yer değiştirmeli bir grup ve osteoartritli bir
grup) kondilin yerini ve şeklini CBCT görüntülerine dayalı olarak araştırmak
için yürütülmüştür.
Gereç
ve Yöntem: Bu çalışma, Mashhad Tıp Bilimleri Üniversitesi,
Mashhad, İran Araştırma Etik Komitesi tarafından onaylanan kesitsel bir
çalışmadır Bu çalışma, klinik muayene ile TMD tip II (disk yer değiştirmesi) ve
tip III (osteoartrit) olduğu saptanan 13 ila 82 yaşları arasındaki (Ort. 37.5)
45 hastada (5 erkek ve 37 kadın) gerçekleştirildi. Kondil şekli ve pozisyonu
ile birlikte artiküler eminensin sagital, koronal ve eksenel düzlemlerde
eğimini araştırmak için, hastaların maksimal dental oklüzyonunda
temporomandibular eklemden her iki taraftan CBCT görüntüleri alındı.
Bulgular:
Kolmogorov-Smirnov testi, ağız kapalı (post + ante / post-ante) yatay kondil
pozisyonunun kantitatif analizinde verilerin normal dağılımının olmamasını gösterdi.
Ardından, RDC ve TMD gruplarındaki bu göstergeyi karşılaştırmak için
Mann-Whitney testi kullanıldı ve ikisinin arasında anlamlı bir fark vardı (P =
0.002). Grup II'de, kondil posterior pozisyona doğru daha büyük bir eğilim
gösterdi. Mediolateral kondüler pozisyon (merkez, medial ve lateral
pozisyonlar) ile RDC veya TMD grup tipi arasında anlamlı bir ilişki bulundu (P
= 0.02) ve kondil her iki grupta lateral pozisyona daha büyük bir eğilim
gösterdi. Ki-kare testi, kondilin sagital şekli ile RDC veya TMD grubu tipi
arasında anlamlı bir ilişki olduğunu gösterdi (P = 0.02) ve kondil şekli, her
iki grupta da ön düzleşmeye karşı daha büyük eğilim gösterdi. Koronal düzlemde
ve grup tipinde farklı kondiler şekilleri arasında anlamlı bir ilişki bulundu.
Sonuç:
Elde edilen sonuçlar ergen disk yer değişikliği ve
osteoartritin kondilin fossa içindeki yerini ve şeklini değiştirmesine neden
olabileceğini göstermektedir.
References
- Referans1. Koh H, Robinson PG. Occlusal adjustment for treating and preventing temporomandibular joint disorder. J Oral Rehabil 2004;31:287-92.
- Referans2. Rutkiewicz T, Kononen M, Suominen-Taipale L, Nord blad A, Alanen P. Occurrence of clinical signs of temporomandibular disorders in adult Finns. J Orofac Pain2006;20:208-17. Referans3. Hentschel K, Capobianco DJ, Dodick DW. Facial pain Neurologist 2005;11:244-9.
- Referans4. Standring S .Gray’s anatomy the anatomical basis of clinical practice, (39thedn). Elsevier Ltd 2005; 519- 530.
- Referans5. Alomar X, Medrano J, Cabratosa J, Clavero JA, Lorente M, et al. Anatomy of temporomanidular joint. Seminars in Ultrasound CT and MRI 2007; 28: 170-183.
- Referans6. Hegde Sh, Praveen BN and Ram Shetty SH. Morphological and Radiological Variations of Mandibular Condyles in Health and Diseases: A Systematic Review. Dentistry 2013;3(1): e1000154.
- Referans7. White.s and Pharoah .J, Oral Radiology Principles and Interpretation, Mosby Elsevier, 6th edition, 2009.
- Referans8. O’Ryan. Fand B. N. Epker, “Temporomandibular joint function and morphology: observations on the spectra of normalcy,” Oral Surgery Oral Medicine and Oral Pathology 1984; 58(3):272–279.
- Referans9. Kurita.H, Ohtsuka.A, H. Kobayashi, and K. Kurashina, “Flattening of the articular eminence correlates with progressive internal derangement of the temporomandibular joint,” Dentomaxillofacial Radiology 2000;29 (5):277–279.
- Referans10. Katsavrias E.G and Dibbets J. M., “The growth of articular eminence height during craniofacial growth period,” Cranio 2001; 19(1): 13–20.
- Referans11. S¨ul¨un .T, Cemgil.T, Duc.J, Rammelsberg. P, J¨ager. J, and Gernet. W, “Morphology of the mandibular fossa and inclination of the articular eminence in patients with internal derangement and in symptom-free volunteers,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontic 2001; 92(1): 98–107.
- Referans12. Kircos LT, Ortendahl DA, Mark AS, et al: Magnetic resonance imaging of the TMJ disc in asymptomatic volunteers. J Oral Maxillofac Surg 1987;45:852-854.
- Referans13. Larheim TA, Westesson PL, Sano T: Temporomandibular joint disk displacement: comparison in asymptomatic volunteers and patients. Radiology 2001;218:428-432.
- Referans14. Sanchez-Woodworth RE, Katzberg RW, Tallents RH, et al: Radiographic assessment of temporomandibular joint pain and dysfunction in the pediatric age-group. ASDC J Dent Child 1988;55:278-281.
- Referans15. Hatcher DC, Blom RJ, Baker CG: Temporomandibular joint spatial relationships: osseous and soft tissues. J Prosthet Dent 1986;56:344-353.
- Referans16. Gateno J, Anderson PB, Xia JJ, et al: A comparative assessmentof mandibular condylar position in patients with anterior disc displacement of the temporomandibular joint. J Oral Maxillofac Surg 2004;62:39-43.
- Referans17. Honda K, Arai Y, Kashima M, et al: Evaluation of the usefulness of the limited cone-beam CT (3DX) in the assessment of the thickness of the roof of the glenoid fossa of the temporomandibular joint. Dentomaxillofac Radiol 2004;33:391-395.
- Referans18. Ikeda K, Kawamura A, et al: Assessment of optical condylar position in the coronal and Axial planes with limited Cone–Beam Computed tomography. Journal of prosthodontics 2011;20:432-438.
- Referans19. Mercuri LG. Osteoarthritis, osteoarthrosis, and idiopathic condylar resorption. Oral Maxillofac Surg Clin North Am 2008;20:169-183.
- Referans20. Kinzinger G, Kober C, Diedrich P. Topography and Morphology of the Mandibular Condyle during Fixed Functional Orthopedic Treatment–a Magnetic Resonance Imaging Study. Journal of Orofacial Orthopedics/ Fortschritte der Kieferorthopädie. 2007;68(2): 124-47.
- Referans21. Tsiklakis K, Syriopoulos K, Stamatakis H. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofacial Radiology. 2004;33(3):196.
- Referans22. Zabarovi D, Jerolimov V, Carek V, Vojvodi D, Zabarovi K, Bukovi Jr D. The effect of tooth loss on the TM-joint articular eminence inclination. Collegium antropologicum. 2000; 24:37.
- Referans23. Ikeda. k, Kawamura A. Disc displacement and changes in condylar position. Dentomaxillofacial radiology J 2013;42:84-92.
- Referans24. Hongchen L, Jilin Z, Ning L. Edentulous position of the temporomandibular joint. The Journal of Prosthetic Dentistry. 1992;67(3):401-4.
- Referans25. Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofacial Radiology. 2009;38(3):141.
- Referans26. Katsavrias EG, Halazonetis DJ Condyle and fossa shape in Class II and Class III skeletal patterns: A morphometric tomographic study. Am J Orthod Dentofacial Orthop 2005; 128: 337-346.
- Referans27. Dilhan E, Mehmet I, ErdoLan F. Articular Eminence Inclination, Height, and Condyle Morphology on Cone Beam Computed Tomography. The ScientificWorld J 2014; Article ID 761714, 6 pages.
EVALUATION OF THE CONDYLAR SHAPE AND POSITION IN PATIENTS WITH TEMPOROMANDIBULAR JOINT DISORDERS USING CONE BEAM COMPUTED TOMOGRAPHY
Abstract
Background:
TMJ disorders are common and often self-limited in the adult population. In
epidemiologic studies, up to 75 percent of adults show at least one sign of
joint dysfunction on examination and as many as one third have at least one
symptom. The present study was conducted to investigate the position and shape
of the condyle in patients with TMD divided into two groups (a group with disc
displacement and a group with osteoarthritis) and based on their CBCT images.
Materials: The present study was conducted on 45 patients (5 men
and 37 women) aged 13 to 82 (with a mean age of 37.5) known by their clinical
examinations to have TMD type II (disc displacement) and type III
(osteoarthritis). To investigate the shape and position of the condyle and the
slope of the articular eminence in the sagittal, coronal and axial planes, CBCT
images were taken from the patients' TMJ on both sides at maximum dental
occlusion.
Results: The result of this study showed the lack of a normal
distribution of the data in the quantitative analysis of the horizontal
condylar position with the mouth closed (post+ante/post-ante). The compare this
indicator in the RDC and the TMD groups, revealing a significant difference
between the two (P=0.002). In group II, the condyle showed a greater tendency
toward the posterior position. A significant relationship was found between the
mediolateral condylar position (central, medial and lateral positions) and the
RDC or TMD group type (P=0.02), and the condyle showed a greater tendency toward
the lateral position in both groups. However, a significant relationship
between the sagittal shape of the condyle and the RDC or TMD group type
(P=0.02.
Conclusion: The results obtained indicate that adolescent disc
displacement and osteoarthritis can cause the condyle to change its position
and shape in the fossa.
References
- Referans1. Koh H, Robinson PG. Occlusal adjustment for treating and preventing temporomandibular joint disorder. J Oral Rehabil 2004;31:287-92.
- Referans2. Rutkiewicz T, Kononen M, Suominen-Taipale L, Nord blad A, Alanen P. Occurrence of clinical signs of temporomandibular disorders in adult Finns. J Orofac Pain2006;20:208-17. Referans3. Hentschel K, Capobianco DJ, Dodick DW. Facial pain Neurologist 2005;11:244-9.
- Referans4. Standring S .Gray’s anatomy the anatomical basis of clinical practice, (39thedn). Elsevier Ltd 2005; 519- 530.
- Referans5. Alomar X, Medrano J, Cabratosa J, Clavero JA, Lorente M, et al. Anatomy of temporomanidular joint. Seminars in Ultrasound CT and MRI 2007; 28: 170-183.
- Referans6. Hegde Sh, Praveen BN and Ram Shetty SH. Morphological and Radiological Variations of Mandibular Condyles in Health and Diseases: A Systematic Review. Dentistry 2013;3(1): e1000154.
- Referans7. White.s and Pharoah .J, Oral Radiology Principles and Interpretation, Mosby Elsevier, 6th edition, 2009.
- Referans8. O’Ryan. Fand B. N. Epker, “Temporomandibular joint function and morphology: observations on the spectra of normalcy,” Oral Surgery Oral Medicine and Oral Pathology 1984; 58(3):272–279.
- Referans9. Kurita.H, Ohtsuka.A, H. Kobayashi, and K. Kurashina, “Flattening of the articular eminence correlates with progressive internal derangement of the temporomandibular joint,” Dentomaxillofacial Radiology 2000;29 (5):277–279.
- Referans10. Katsavrias E.G and Dibbets J. M., “The growth of articular eminence height during craniofacial growth period,” Cranio 2001; 19(1): 13–20.
- Referans11. S¨ul¨un .T, Cemgil.T, Duc.J, Rammelsberg. P, J¨ager. J, and Gernet. W, “Morphology of the mandibular fossa and inclination of the articular eminence in patients with internal derangement and in symptom-free volunteers,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontic 2001; 92(1): 98–107.
- Referans12. Kircos LT, Ortendahl DA, Mark AS, et al: Magnetic resonance imaging of the TMJ disc in asymptomatic volunteers. J Oral Maxillofac Surg 1987;45:852-854.
- Referans13. Larheim TA, Westesson PL, Sano T: Temporomandibular joint disk displacement: comparison in asymptomatic volunteers and patients. Radiology 2001;218:428-432.
- Referans14. Sanchez-Woodworth RE, Katzberg RW, Tallents RH, et al: Radiographic assessment of temporomandibular joint pain and dysfunction in the pediatric age-group. ASDC J Dent Child 1988;55:278-281.
- Referans15. Hatcher DC, Blom RJ, Baker CG: Temporomandibular joint spatial relationships: osseous and soft tissues. J Prosthet Dent 1986;56:344-353.
- Referans16. Gateno J, Anderson PB, Xia JJ, et al: A comparative assessmentof mandibular condylar position in patients with anterior disc displacement of the temporomandibular joint. J Oral Maxillofac Surg 2004;62:39-43.
- Referans17. Honda K, Arai Y, Kashima M, et al: Evaluation of the usefulness of the limited cone-beam CT (3DX) in the assessment of the thickness of the roof of the glenoid fossa of the temporomandibular joint. Dentomaxillofac Radiol 2004;33:391-395.
- Referans18. Ikeda K, Kawamura A, et al: Assessment of optical condylar position in the coronal and Axial planes with limited Cone–Beam Computed tomography. Journal of prosthodontics 2011;20:432-438.
- Referans19. Mercuri LG. Osteoarthritis, osteoarthrosis, and idiopathic condylar resorption. Oral Maxillofac Surg Clin North Am 2008;20:169-183.
- Referans20. Kinzinger G, Kober C, Diedrich P. Topography and Morphology of the Mandibular Condyle during Fixed Functional Orthopedic Treatment–a Magnetic Resonance Imaging Study. Journal of Orofacial Orthopedics/ Fortschritte der Kieferorthopädie. 2007;68(2): 124-47.
- Referans21. Tsiklakis K, Syriopoulos K, Stamatakis H. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofacial Radiology. 2004;33(3):196.
- Referans22. Zabarovi D, Jerolimov V, Carek V, Vojvodi D, Zabarovi K, Bukovi Jr D. The effect of tooth loss on the TM-joint articular eminence inclination. Collegium antropologicum. 2000; 24:37.
- Referans23. Ikeda. k, Kawamura A. Disc displacement and changes in condylar position. Dentomaxillofacial radiology J 2013;42:84-92.
- Referans24. Hongchen L, Jilin Z, Ning L. Edentulous position of the temporomandibular joint. The Journal of Prosthetic Dentistry. 1992;67(3):401-4.
- Referans25. Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofacial Radiology. 2009;38(3):141.
- Referans26. Katsavrias EG, Halazonetis DJ Condyle and fossa shape in Class II and Class III skeletal patterns: A morphometric tomographic study. Am J Orthod Dentofacial Orthop 2005; 128: 337-346.
- Referans27. Dilhan E, Mehmet I, ErdoLan F. Articular Eminence Inclination, Height, and Condyle Morphology on Cone Beam Computed Tomography. The ScientificWorld J 2014; Article ID 761714, 6 pages.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Original Research Articles |
| Authors | |
| Publication Date | May 12, 2017 |
| Submission Date | April 20, 2017 |
| Published in Issue | Year 2017 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
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