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      Osteoartritis de la Articulación Temporomandibular: Parte III Manifestaciones Histopatológicas, clínicas, serológicas y radiográficas, tratamiento y pronóstico Translated title: Osteoarthritis affecting the Temporomandibular: Joint (III)


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          En la osteoartritis de la articulación temporomandibular el aspecto macroscópico del cartílago sufre algunas modificaciones, histológicamente hay una pérdida de proteoglicanos, una desintegración de la red de fibras colágeno y una degeneración grasa. La zona de hueso subyacente sufre modificaciones, ocurren microfracturas y un aumento en la densidad ósea. Se pueden formar osteofitos. La formación de nuevo hueso puede ser liso, esclerótico o eburnado. Se discuten otros cambios estructurales. Los hallazgos clínicos pueden incluir dolor a la palpación, crepitación, limitación de los movimientos con desviación hacia el lado afectado y evidencia radiográfica de cambios estructurales. El mejor manejo de la mayoría de los pacientes con osteoartritis de la articulación temporomandibular es a través de un tratamiento conservador y no invasivo.

          Translated abstract

          In the osteoarthritis affecting the temporomandibular joint, the macroscopic aspects of the cartilage presents some modifications, histologically, there is a proteoglycan depletion, collagen fiber network desintegration, and a fatty degeneration. The underlyng cartilagenous zone is modified. There are microfractures, and subarticular deposition of bone. It might be osteophytic lipping. The new bone might be smooth, sclerotic, or eburnated. Other structural changes are discussed. Clinical findings may include point tenderness on palpation, crepitus, limited range of motion with deviation on opening to the affected side, and radiographic evidence of structural bony changes. The management of patients suffering from osteoarthritis of the temporomandibular joint is best accomplished by conservative and non-invasive measures.

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          Most cited references28

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          Effect of occlusal splints on TMJ symptomatology.

          The clinical response of TMJ symptomatology to full-coverage occlusal splints, when used as the only means of treatment, was evaluated. The symptomatology recorded during the last postoperative visit was compared to the initial visit. The response of the different symptoms to the use of the occlusal splint was analyzed statistically using a chi-square test. A statistically significant difference (p = .03) was only found when comparing those groups having only pain or dysfunction symptomatology. The response favored the remission of pain. However, every symptom was improved with the use of an occlusal splint. It was concluded that: 1. Both pain and dysfunction symptomatology will benefit from the occlusal splint therapy. 2. The pain response will be significantly better than the dysfunction response when the patient is treated with an occlusal splint. 3. Eighty percent of the patients suffering from a TMJ syndrome will improve or be cured when the only form of treatment is the use of a full-coverage occlusal splint.
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            Temporomandibular Disorders: Guidelines for Classifi cation, ssessment, and Managment

            C. McNeill (1993)
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              Interleukin-1beta in synovial fluid from the arthritic temporomandibular joint and its relation to pain, mobility, and anterior open bite.

              The purpose of this study was to investigate whether interleukin-1beta in synovial fluid or blood plasma is involved in the development of pain or hyperalgesia of the temporomandibular joint (TMJ), as well as reduced mandibular mobility and anterior open bite. Twenty-nine patients with TMJ arthritis and seven healthy subjects were studied. VAS measurement of TMJ tenderness on palpation of the TMJ (TDP), TMJ pressure pain threshold and tolerance level (PPTL), mandibular mobility, pain during joint movements, and degree of anterior open bite (AOB) were assessed. IL-1beta levels were analyzed in TMJ synovial fluid (SF-IL-1beta) and blood samples and correlated with the preceding factors. SF-IL-1beta showed significant positive correlations with VAS measurement of pain, TDP, and AOB and a negative correlation with PPTL. This study indicates that IL-1beta in the synovial fluid is associated with pain and hyperalgesia in the TMJ region as well as an anterior open bite. Concerning the latter condition, IL-1beta seems to be a warning signal of tissue destruction.

                Author and article information

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                Acta Odontológica Venezolana
                Acta odontol. venez
                Facultad de Odontología -UCV (Caracas )
                December 1999
                : 37
                : 3
                : 91-97
                [1 ] UCV



                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0001-6365&lng=en

                Osteoarthritis,diagnosis,histopathology,signs and symptoms,treatment,prognosis,Osteoartritis,diagnóstico,histopatología,signos y síntomas,tratamiento,pronóstico


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