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      Changes in temporomandibular joint spaces after arthroscopic disc repositioning: a self-control study

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          Abstract

          Disc repositioning is a common procedure for patients with anterior disc displacement (ADD). The purpose of this retrospective record-based study was to evaluate changes in the widths of joint spaces and condylar position changes in patients with unilateral ADD following arthroscopic disc repositioning, with the healthy sides as self-control, using magnetic resonance images (MRI).Widths of anterior, superior, and posterior joint spaces (AS, SS, and PS) were measured. The condylar position was described as anterior, centric or posterior, expressed as . Paired-t test and Chi-square test were used to analyze the data. Fifty-four records conformed to the inclusion criteria (mean age of 21.02 years). Widths of SS and PS increased significantly after surgery ( P < 0.001) on the operative sides, while joint spaces of healthy sides and AS of operative sides had no significant changes. Dominant location of condyles of operative sides changed from a posterior position to an anterior position, while healthy sides were mostly centric condylar position no matter preoperatively or postoperatively. Therefore, the results of this study indicate that unilateral arthroscopic disc repositioning significantly increases the posterior and superior spaces of the affected joints, without affecting spaces of the healthy sides.

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          Most cited references29

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          Application of cone beam computed tomography for assessment of the temporomandibular joints.

          Radiographic examination is essential for the diagnosis and management of temporomandibular joint (TMJ) disorders. The goals of TMJ radiography are to evaluate cortical and trabecular architecture of the bony structures and confirm their integrity, to assess the extent and monitor progression of osseous changes, and to evaluate the response to treatment. Accurate evaluation of the TMJ by conventional radiography is limited by structure superimposition. Cone beam computed tomography (CBCT) provides high-resolution multiplanar images and delivers substantially lower radiation dose, compared with multislice CT. CBCT allows examination of TMJ anatomy without superimposition and distortion to facilitate analysis of bone morphology, joint space and dynamic function in all three dimensions. This article will describe the role of CBCT imaging for the assessment of the TMJ osseous structures and present typical appearances of common pathological conditions of the TMJ. © 2012 Australian Dental Association.
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            Assessment of optimal condylar position with limited cone-beam computed tomography.

            There are no quantitative standards for the optimal position of the mandibular condyle in the glenoid fossa. Recently developed limited cone-beam computed tomography (LCBCT) allows measurement of this position with high accuracy. LCBCT was used to assess 24 joints in 22 symptom-free subjects (10 male, 12 female; mean age, 18 years) who had no disc displacement as verified by magnetic resonance imaging. Their joints had optimum function with the starting and end points of all functional jaw movements coincident with maximum intercuspation. Linear measurements of anterior space (AS), superior space (SS), and posterior space (PS) were made to determine the position of the condyle for each joint. The mean AS, SS, and PS values were 1.3 mm (SD +/- 0.2 mm), 2.5 mm (SD +/- 0.5 mm), and 2.1 mm (SD +/- 0.3 mm), respectively. The ratio of AS to SS to PS was 1.0 to 1.9 to 1.6. No significant sex difference was noted in joint space distances. The results showed less variability of condylar position in the fossa than previously reported in normal subjects. These data from optimal joints might serve as norms for the clinical assessment of condylar position obtained by LCBCT.
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              Computed tomography evaluation of the temporomandibular joint in Class I malocclusion patients: condylar symmetry and condyle-fossa relationship.

              The purpose of this study was to investigate the condyle-fossa relationship, the concentric position of the condyles, and the dimensional and positional symmetries between the right and left condyles in subjects with Class I malocclusion. Thirty subjects from 13 to 30 years of age with Class I malocclusion had computed tomography imaging of the temporomandibular joints. The images obtained from axial slices were evaluated for possible asymmetries in size and position between the condylar processes associated with this malocclusion. The images obtained from sagittal slices were used to assess the depth of the mandibular fossa, the condyle-fossa relationship, and the concentric position of the condyles of this malocclusion. Paired Student t tests were applied, and Pearson product moment correlations were determined after measurements on both sides were obtained. We found no statistically significant asymmetries between the condylar processes in this sample. No statistically significant asymmetries were found in the mandibular fossa depth, the anterior joint space, and the superior joint space. The posterior joint space showed statistically significant asymmetry (P <0.05) between the right and left sides. Statistically significant (P <0.05) anterior positioning of the condyles was observed (nonconcentric positioning). Only the posterior articular space had a statistically significant difference between the right and left sides. There was a higher mean for posterior articular space on the right temporomandibular joint. Evaluation of the concentric position of the condyles in their mandibular fossae showed nonconcentric positioning for the 2 sides.
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                Author and article information

                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group
                2045-2322
                31 March 2017
                2017
                : 7
                : 45513
                Affiliations
                [1 ]Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology , Shanghai, People’s Republic of China
                [2 ]Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University , Alexandria, Egypt
                Author notes
                [*]

                These authors contributed equally to this work.

                Article
                srep45513
                10.1038/srep45513
                5374534
                28361905
                234378db-4c23-4be7-9d2a-2c89f307c8f4
                Copyright © 2017, The Author(s)

                This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                History
                : 28 October 2016
                : 27 February 2017
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