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1.
Ummugulsum Coskun Celal Candirli Gokcen Kerimoglu Fatih Taskesen 《Journal of cranio-maxillo-facial surgery》2019,47(2):357-364
Purpose
The aim of the study is to evaluate the effect of platelet-rich plasma (PRP) injection on temporomandibular joint (TMJ) cartilage and subchondral bone healing.Materials and methods
Sixteen New Zealand rabbits were divided into two groups, including single PRP and multiple PRP injection groups. Sodium mono-iodoacetate (MIA) was injected bilaterally into the TMJ of all rabbits to create osteoarthritis (OA). PRP was injected once into the right TMJ in the single PRP group and was injected three times (once a week) into the right TMJ in the multiple injection group 4 weeks after injection of MIA. At the time of each PRP injection, isotonic NaCl solution was injected into the left TMJ in the control groups. All animals were sacrificed 30 days after the first PRP injection.Results
As a result of the histological evaluation, there was no statistically significant difference in cartilage and subchondral bone regeneration between the groups (p > 0.05).Conclusions
Although there was no statistically significant difference between PRP and control groups, it was seen that improvement were better in PRP groups. According to the Results of our study, it seems that different methods should be tried to investigate the efficacy of PRP on the TMJ healing. 相似文献2.
《International journal of oral and maxillofacial surgery》2021,50(9):1233-1243
A systematic review based on the PRISMA guidelines was conducted to investigate and compare treatment with hyaluronic acid (HA), corticosteroids, and blood products in patients with temporomandibular joint osteoarthritis (TMJOA). The MEDLINE/PubMed, Embase, and Cochrane Library databases were searched for articles published until September 25, 2019. Articles met the inclusion criteria if they reported patients with TMJOA, a comparison group, and a follow-up period of at least 6 months. The mean and standard deviation for TMJ pain and maximum mouth opening (MMO) were reported. Nine studies involving 443 patients were included. Injectables and Ringer’s lactate solution or normal saline were reported to significantly improve TMJ pain and MMO. Regarding TMJ pain, two studies showed a significant superiority of plasma rich in growth factors (PRGF)/platelet-rich plasma (PRP) injections with or without arthrocentesis over HA, but HA showed a significant improvement compared to corticosteroids. For MMO, no injectable was found to be superior to Ringer’s lactate or a normal saline control, but arthrocentesis + PRP resulted in MMO improvement compared to arthrocentesis + HA. Overall, all injectables in conjunction with arthrocentesis were efficient in alleviating pain and improving MMO in TMJOA patients; however, a meta-analysis was not possible due to heterogeneity across studies. 相似文献
3.
Fernanda Stefani Folle Rodrigo Lorenzi Poluha Enio Tadashi Setogutti Eduardo Grossmann 《Journal of cranio-maxillo-facial surgery》2018,46(12):2003-2007
Purpose
To compare the clinical efficacy of the conventional double puncture versus single puncture type 2 arthrocentesis for management of temporomandibular joint disc displacement without reduction (DDWOR).Materials and methods
Twenty-six patients with DDWOR were randomly and blindly allocated into two treatment groups (N = 13): Group 1, conventional double puncture arthrocentesis; Group 2, single puncture type 2 arthrocentesis. Data on gender, side of painful joint complaint, age (years), duration of joint pain (months), maximum interincisal distance (MID – mm), and pain intensity self-reported with a visual analog scale (VAS; 0–10) were collected. VAS scores and MID were measured before (baseline) and 6 months after arthrocentesis (final).Results
Both techniques resulted in significantly reduced VAS scores and increased MID (p = 0.001) after 180 days. However, there were no statistically significant differences between techniques (p > 0.05).Conclusions
The two arthrocentesis methods tested were effective in reducing VAS scores and increasing MID in patients with DDWOR. 相似文献4.
Natália Ferreira Danielle Masterson Rodrigo Lopes de Lima Brenda de Souza Moura Aleli T. Oliveira Tatiana Kelly da Silva Fidalgo Antônio C.P. Carvalho Marcos F. DosSantos Eduardo Grossmann 《Journal of cranio-maxillo-facial surgery》2018,46(11):1943-1952
Objective
To perform a systematic review of the viscosupplementation effectiveness with hyaluronic acid (HA) in the articular Temporomandibular Dysfunctions (TMDs) clinical management.Method
Electronic searches were performed in the following databases: MEDLINE (via PubMed), Scopus, Web of Science, Cochrane Library, EMBASE, LILACS, BBO, SIGLE (System for Information on Grey Literature in Europe), ClinicalTrials.gov, and the Brazilian Clinical Trials Registry (ReBec). Only randomized clinical trials that evaluated the intra-articular administration of HA or its derivatives in osteoarthritis and/or anterior displacement of the temporomandibular joint (TMJ) disc were included. The primary outcomes evaluated were patients' self-report of pain and/or discomfort in the TMJ. Each study was assessed for the risk of bias, using the Cochrane collaboration's risk of bias tool.Results
A total of 640 studies were obtained in the electronic search. After the application of the eligibility criteria, manual search, and duplicate removal, 21 articles were included. Five articles classified their volunteers with internal derangements of the TMJ, in 4 articles the treatment was directed to participants with disc displacement with reduction and the other articles evaluated HA therapy in osteoarthritis. The protocols presented heterogeneity, varying in the form of application, associated or not with arthrocentesis, number of applications, molecular weight, dose and concentration. Nine studies presented high risk of bias.Conclusion
Due to the heterogeneity and methodological inconsistencies of the studies evaluated, it was not possible to establish the efficacy of HA in articular TMDs. 相似文献5.
Rafael Martin Granizo Diana Carolina Correa Muñoz Elisa Varela Reyes 《Journal of cranio-maxillo-facial surgery》2018,46(9):1555-1560
Purpose
Arthroscopic surgery is an effective treatment for patients with temporomandibular disorders, releasing symptoms and restoring the mandibular function. In patients with poor arthroscopic outcomes, several options of treatment can be considered such as conservative nonsurgical therapy, open surgery, or a second arthroscopy. The purpose of this study was to evaluate our results after 619 arthroscopies.Materials and methods
The clinical data of 619 arthroscopies performed between 1996 and 2015 were reviewed retrospectively. Outcome assessments were based on reductions in pain, measured using a visual analog scale (VAS), and improvement in maximal interincisal opening (MIO). The minimum follow-up period was 24 months.Results
The incidence of TMJ reoperation in the 371 patients who underwent arthroscopic surgery was 5.9%, with a mean time between surgeries of 66.73 months. Significant improvement between presurgical and postsurgical pain and presurgical and postsurgical MIO at months 6 and 12 were evident. The mean of preoperative MIO was 30.84 mm, which increased to 35.92 mm 1-year postsurgery, these results being statistically significant (p < 0.05).Conclusions
In most of the cases the result of a new arthroscopy is satisfactory. Rearthroscopy of the TMJ is a valid and effective method for patients with a first unsuccessful arthroscopy. 相似文献6.
Audrey E. Paglio Aaron P. Bradley R. Shane Tubbs Marios Loukas Piotr B. Kozlowski Anthony C. Dilandro Yujiro Sakamoto Joe Iwanaga Cameron Schmidt Anthony V. D&#x;Antoni 《Journal of cranio-maxillo-facial surgery》2018,46(1):63-66
Purpose
To study the morphology of temporomandibular joint (TMJ) elements and examine the feasibility of a novel biofidelic articular disc casting technique.Methods
18 formalin-fixed cadavers (77.8% female, 22.2% male) with mean (SD) death age of 71.9 (13.7) years were used for this study. In each specimen the masseter muscle, mandibular ramus, and articular disc were dissected bilaterally and measured for length, width, and thickness. All anatomic measurements were made using a digital slide caliper (Hawk Inc., Cleveland, OH). Further, a novel method for the creation of biofidelic articular disc models was established through trial and error. Models were measured for accuracy against their biological counterparts.Results
Left articular disc length and thickness were inversely correlated (r = ?0.58, p < 0.049). Direct correlations existed between right disc and ramus thickness (r = 0.56, p < 0.039), masseter length and thickness (r = 0.59, p < 0.009), and masseter width and thickness (r = 0.66, p < 0.003). Comparison of the model measurements with their biological counterparts found no significant differences.Discussion
These observed correlations between elements of the TMJ hold relevance for oral-maxillofacial surgeons and researchers examining disorders of the TMJ. Additionally, our casting technique proved accurate in modeling human articular discs. 相似文献7.
Girish B. Giraddi A. Siddaraju Bimleshwar Kumar Chandravir Singh 《Journal of maxillofacial and oral surgery》2012,11(3):258-263
Aims and Objectives
Internal derangements are the commonest disorders of temporomandibular joint (TMJ). Different treatment modalities including conservative and surgical methods have been proposed to treat the same. Arthrocentesis is gaining popularity in the treatment of internal derangement of TMJ. Being minimally invasive it does not have the demerits of surgical approaches and at the same time is producing better results than conservative approaches. This study evaluates and compares corticosteroid and sodium hyaluronate after arthrocentesis in the treatment of internal derangement of TMJ.Materials and Methods
Sixteen patients with internal derangement were randomly selected and divided into 2 groups (8 in each group). Arthrocentesis of the upper joint space was then performed using Ringer lactate under local anaesthesia followed by injection of either betamethasone or sodium hyaluronate into the joint. Clinical data was collected in the form of pain (visual analog scale), maximum mouth opening, joint sound and deviation before and after treatment up to 6 months.Results
Both groups of patients were benefited from the treatment at the 6 month follow up and there was slightly less intensity of pain in sodium hyaluronate group compared with corticosteroid group. Maximum mouth opening was also increased in both groups. A decrease in clicking and deviation were seen in both groups. There was no statistically significant difference between betamethasone and sodium hyaluronate.Conclusion
Intra articular injection of corticosteroid or sodium hyaluronate after arthrocentesis had considerable effect on the TMJ. Both betamethasone and sodium hyaluronate can be used after arthrocentesis with similar results. 相似文献8.
Purpose
Sagittal split ramus osteotomy (SSRO) is a standard procedure in which miniplates and screws are used to achieve stabilization. Although the titanium plate and screw fixation system is stable, resorbable fixation systems are also used. There is currently no consensus on the ideal fixation technique for SSRO procedures and its effect on the condyle. We aimed to evaluate the stress distribution on temporomandibular joints (TMJ).Methods
A 3D finite element model of a hemimandible was designed and 5 mm advancement was simulated on a computer model. Four different fixation techniques were applied: inverted-L shaped bicortical screws, L-shaped bicortical screws, miniplate with monocortical screws, and miniplate with monocortical screws and bicortical screw. Computer models were prepared twice for resorbable and titanium material. Load of 600N and muscle forces were applied. In the finite element analysis, computer models simulated and analyzed stress distribution of bone, fixation materials and condyle.Results
Bicortical screws increase the total stress on TMJ, and the stress is located more on the posterior part than the anterior. Miniplates decrease the stress, and the forces are located more on the anterior aspect of the TMJ.Conclusion
According to our analysis, the use of bicortical screws increases the stress amount on the condyle. For the patients with a tendency toward temporomandibular disorders, using miniplate fixation techniques may decrease the forces around the condyle. These findings should be useful for oral surgeons when deciding on the most appropriate fixation technique in patients with a tendency toward temporomandibular joint disorders. 相似文献9.
Poornima Patel Faisal Idrees Vilas Newaskar Deepak Agrawal 《Oral and maxillofacial surgery》2016,20(4):405-410
Background
Internal derangement of the temporomandibular joint (TMJ) is one of the most common forms of temporomandibular disorders. The minimally invasive treatments such as arthrocentesis as well as arthroscopic lysis and lavage are often used as a first-line surgical treatment or in conjunction with nonsurgical modalities with low morbidity and high efficacy. Sodium hyaluronate (SH) has been proposed as an alternative therapeutic agent with similar therapeutic effects.Objective
A prospective study was carried out for evaluation of efficacy of TMJ arthrocentesis with and without injection of SH in management of internal derangements.Material and methods
A total of 30 patients suffering from internal derangement of TMJ were selected for this study. Patients were randomly divided into the following two groups: group 1—arthrocentesis-only group and group 2—arthrocentesis + SH group. Each group constituted 15 patients.Results
Six-month postoperative mean mouth opening (MMO) increase was 13.61?±?1.64 and 15.53?±?3.01 mm in group 1 and group 2, respectively. At 6 months, there was marked improvement in masticatory efficiency with mean increase of 5.07?±?0.13 in group 1 and 6.40?±?0.04 in group 2. Mean pain reduction was 5.27?±?0.67 and 6.48?±?0.44 in group 1 and group 2, respectively.Conclusion
Although our series comprised a limited number of cases and a short follow-up period, initial results suggested that arthrocentesis with SH injection seemed to be superior to art.10.
George Dimitroulis Stephen Austin Peter Vee Sin Lee David Ackland 《Journal of cranio-maxillo-facial surgery》2018,46(8):1192-1198
Purpose
The aim of this study is to present the preliminary clinical data on the OMX Temporomandibular Joint (TMJ) Prosthetic total joint replacement system.Materials and Methods
A prospective, cohort, clinical study was undertaken of consecutive adult patients with Category 5 end-stage joint disease who were implanted with the OMX TMJ prosthesis between May 2015 and April 2017. A total of 50 devices were implanted in 38 patients, with 12 patients receiving bilateral prosthetic joints. There were 31 females and 7 males in this cohort, who ranged in age from 20 to 66 years, with a mean of 43.8 years (±14.0 years). Ten of the 50 prosthetic joints (20%) were fully customized, while the remaining were patient matched using virtual planning software.Results
Based on a mean follow-up period of 15.3 months (range 12–24 months) following the TMJ total joint replacement, preliminary results suggest the OMX TMJ prosthesis has made a positive impact on clinical outcomes, with a mean 74.4% reduction in joint pain levels and significant improvements (p < 0.05) in jaw function as measured by the visual analogue scales for mouth opening (30.8%), diet (77.1%), and function (59.2%). No device failures were reported during the study period.Conclusion
This study suggests that the print-on-demand OMX TMJ prosthesis, designed for rapid delivery of both patient-matched and fully customize devices, represents a safe, reliable and versatile implantable joint replacement system for the treatment of category 5 end-stage TMJ disease. 相似文献11.
Stefanos Kanatsios Omar Breik George Dimitroulis 《Journal of cranio-maxillo-facial surgery》2018,46(10):1697-1702
Purpose
The aim of this study was to determine the long-term outcomes following TMJ replacement using the stock Zimmer-Biomet TMJ device. In particular, investigated whether the titanium condylar implant and number of screws used to fixate it to the mandibular ramus had any impact on outcomes.Methods
Subjects who underwent surgical implantation of a stock Zimmer-Biomet TMJ prosthesis were identified for this retrospective study. All patients received a titanium condylar component secured with four or five screws and ultra-high molecular weight polyethylene (UHMWPE) fossa with no metal reinforcement. Pre- and postoperative pain scores (VAS) and maximum interincisal opening (MIO) data were collected. Additional data included patient demographics, as well as operative, postoperative and follow-up details. Data were analysed with IBM SPSS 2.0 through the use of paired t-tests, and ANOVA and ANCOVA analysis.Results
190 subjects were identified. Following exclusions, the remaining study population (n = 60) consisted of 58 females and two males with a mean age of 53.5 years at time of surgery. Preoperative VAS and MIO values were 6.08 (SD = 2.24) and 31.88 mm (SD = 7.38 mm), respectively. 90% of the cohort required four screws to fix the prosthetic condylar component in place. After a median follow up of 5.2 years (95% CI: 4.73–5.62 years), with a range of 2–9 years, the VAS was 0.91 (SD = 1.89; p < 0.001) and the MIO was 34.8 mm (SD = X; p = 0.015). Only one device failed over the 9-year study period.Conclusion
The results of this study demonstrate good VAS and MIO outcomes following the implantation of a stock Zimmer-Biomet TMJ device. Additionally, good long-term outcomes were obtained with a titanium condylar component, fixed to the mandibular ramus with only four or five screws, and a UHMWPE fossa with no metal reinforcement. 相似文献12.
Koichiro Ueki Akinori Moroi Takamitsu Tsutsui Ryota Hiraide Akihiro Takayama Yuki Saito Momoko Sato Nana Baba Tatsuya Tsunoda Asami Hotta Kunio Yoshizawa 《Journal of cranio-maxillo-facial surgery》2018,46(4):679-687
Purpose
The purpose of this study was to compare time-course changes in temporomandibular joint (TMJ) space between mandibular advancement surgery and setback surgery after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy.Subjects and Methods
The subjects were 46 patients (92 joints) who underwent bi-maxillary surgery. The TMJ disc position was assessed by magnetic resonance imaging (MRI) and the anterior, superior, posterior, medial and lateral joint spaces were assessed by computed tomography (CT), preoperatively and at 1 week and 1 year postoperative. The 92 joints were divided into 2 groups, namely class II (n = 46 joints), and class III (n = 46 joints) (an advanced group vs a setback group). Next, the 92 joints were divided into 2 groups comprising 36 joints with anterior disc displacement joint (ADD group) and 56 joints without (non-ADD group). Time-course changes in the measurements were compared statistically between the advanced and setback groups, and between the ADD and non-ADD groups.Results
There were no significant differences between the advance group and setback group regarding time-course change in all the joint spaces. However, there were significant differences between the ADD group and non-ADD group regarding time-course change in the medial, anterior, superior and posterior joint spaces (P < 0.05).Conclusion
This study suggested that ADD could affect the time-course change in TMJ space and condylar position after bi-maxillary osteotomy. 相似文献13.
Hatem Hussein Al-Ahmady Ahmad Farouk Abd Elazeem Nermeen El-moataz Bellah Ahmed Wael Mahmoud Shawkat Mohamed Elmasry Mostafa Ahmed Abdelrahman Mohsena Ahmed Abderazik 《Journal of cranio-maxillo-facial surgery》2018,46(9):1593-1600
Introduction
The aim of this study was to examine and assess the use of autologous bone marrow mononuclear cells (BMMNCs) combined with platelet-rich fibrin (PRF) and nanohydroxyapatite for bone regeneration as an effective technique for alveolar cleft repair.Patients and methods
This study included 20 patients with unilateral alveolar cleft defects and with an age range of 8–15 years. They were divided equally into two groups: Group A, received treatment via the regenerative approach which includes; autologous BMMNCs seeded on a collagen sponge in combination with nanohydroxyapatite and autologous PRF. Group B, received the standard alveolar bone grafting with iliac crest bone. The effectiveness of the new technique was evaluated and compared to the standard grafting technique through a 12-month follow-up via clinical and radiographic assessments.Results
During the 12-month follow-up, Group A exhibited less donor site complications, faster and better soft tissue healing, and less postoperative pain, when compared to group B. 90% of the cases in group A, exhibited complete alveolar bone union verses 70% only in group B.Conclusion
Combination of BMMNCs, nanohydroxyapatite, and PRF greatly promote bone regeneration in alveolar cleft defects providing an alternative novel therapeutic strategy to the standard alveolar bone grafting. 相似文献14.
Rafael Martin-Granizo Diana Carolina Correa-Muñoz 《Journal of cranio-maxillo-facial surgery》2018,46(1):82-89
Objective
The objective of this study was to describe the arthroscopic findings of chondromalacia and its relation with the internal derangement of the temporomandibular joint (TMJ).Patients and methods
A total of 161 patients (299 TMJs) who underwent arthroscopy were included in the study. The TMJs were evaluated objectively under arthroscopic vision, and 4 groups of patients were established according to the degree of involvement, degree I, II, III and IV. Statistical analyses were conducted using logistic regression models (P < 0.05).Results
It was observed that 95 patients (59%) had no sign of chondromalacia and 66 (41%) in 88 joints exhibited some degree of chondromalacia (44 patients unilaterally and 22 bilaterally). Of the 88 joints with chondromalacia, 14 (15.9%) had chondromalacia degree I, 12 (13.6%) chondromalacia degree II, 20 (22.7%) chondromalacia degree III and 42 (47.7%) chondromalacia degree IV. The chondromalacia was more significantly found in patients with ADDwR and discal perforation (P < 0.05), even as a common finding in patients without any internal deragement. Chondromalacia degree IV was a significant finding in cases of ADDwoR (P = 0.000619).Conclusions
Chondromalacia of the TMJ is a common finding in patients with internal derangement even at the early stages. 相似文献15.
David S.P. Heidsieck Jan Harm Koolstra Maurits H.T. de Ruiter Aarnoud Hoekema Jan de Lange 《Journal of cranio-maxillo-facial surgery》2018,46(2):288-292
Purpose
Mandibular advancement devices are commonly used in the treatment of patients with mild to moderate obstructive sleep apnea (OSA). Designed to maintain the mandible in forced protrusion while being worn, mandibular advancement devices (MADs) are intended to increase the upper airway during sleep, thereby reducing OSA symptoms. Depending on the extent of mandibular protrusion, side effects including temporomandibular joint dysfunction are frequently reported. These are likely to reduce overall treatment success by affecting therapeutic adherence.Material and methods
To investigate the biomechanical effects of an MAD on the temporomandibular joints, we used a biomechanical model of the human masticatory system. Alterations to the model were applied to mimic the effects of a titratable duoblock MAD. The extent of mandibular protrusion was simulated up to 10 mm in steps of 1 mm. Compression and shear stresses on the temporomandibular structures were predicted during an open–close maneuver and in neutral position.Results
As the extent of mandibular advancement increased, the mandibular condyle migrated anteriorly until passing the articular tubercle. Stress on the temporomandibular joint structures did not considerably increase in rest whatever the extent of mandibular advancement. However, closure of the jaw required extra muscle force as mandibular advancement increased.Conclusion
Results from this study suggest that temporomandibular dysfunction following MAD wearing might be related to altered muscle dynamics rather than changes due to increased stress in the temporomandibular joint itself. 相似文献16.
Itır Şebnem Bilici Yusuf Emes Buket Aybar Serhat Yalçın 《Journal of cranio-maxillo-facial surgery》2018,46(6):916-922
Purpose
In temporomandibular disorders (TMDs), unless splints are effective, combined therapies are performed. The aim of this study is to show the effectiveness of the local anaesthethic injections (trigger point injections) to the masticatory muscles.Materials and methods
The study was composed of TMD patients and the predictor variables were therapy combinations including stabilization splint (SS) therapy, SS+trigger point injection therapy (TPI) and arthrocentesis. The primary outcome variables were pain and jaw movements. The follow-ups were done at 1st and 3rd months. 56 patients who were treated for TMD with only SS or combined therapies were included in the study. The effects of additional TPIs were compared to SS therapy alone. Also the effect of arthrocentesis was evaluated too.Results
All groups revealed significant decreases in pain scores. Decreases in mouth openings were observed in some of the patients in the injection groups.Conclusion
The combined treatment method in which the injections were applied at shorter time intervals, was a more effective method for decreasing VAS scores in TMD patients in this study but further studies are required. 相似文献17.
Luca Guarda-Nardini Cristina Cadorin Antonio Frizziero Stefano Masiero 《Cranio : the journal of craniomandibular practice》2017,35(5):276-282
Objective: The aim of this study was to evaluate cervical spine pain and function after five sessions of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) osteoarthritis.
Methods: Forty-nine patients, (79% females, aged between 43–81 years), affected by TMJ osteoarthritis and concurrent cervical spine pain and limited function were recruited. All patients underwent a cycle of five weekly arthrocenteses and viscosupplementation with 1 ml of medium molecular weight HA according to the single-needle arthrocentesis technique. Outcome variables were TMJ pain (VAS), cervical active ranges of motion, cervical disability (NPDS), and presence of painful palpation sites. Assessments were carried out at baseline and at one, three and six months after the end of treatment protocol.
Results: A significant reduction over time was shown both in TMJ pain levels and in NPDS values with respect to baseline (p < 0.001). Most parameters of active cervical range of motion showed an improvement with time. Benefits remained stable throughout six months after the viscosupplementation protocol.
Conclusions: A protocol of TMJ intra articular arthrocentesis and viscosupplementation improved cervical function and reduced disability in patients with concurrent cervical spine pain. These findings add to the complex amount of literature on the relationship between temporomandibular disorders and cervical spine disorders. 相似文献
18.
Leila Galiay François Simon Raphaël Lévy Vincent Couloigner Jean Donadieu Julie Toubiana Thomas Blauwblomme Roman Hossein Khonsari 《Journal of cranio-maxillo-facial surgery》2018,46(8):1179-1184
Purpose
Gorham-Stout disease (GS) is a rare and little understood bone disease that leads to the progressive replacement of the affected bone by fibrous tissues. The mandible is the most commonly affected craniofacial bone, but there is no report to date of temporomandibular joint (TMJ) lesions in this condition. We aimed to characterize the involvement of the TMJ in this uncommon bone disorder.Material and methods
We retrospectively included all patients managed for craniofacial forms of GS in our pediatric institution over a period of 12 years. We collected clinical data on TMJ function and radiological data from computed tomography and magnetic resonance imaging.Results
Four pediatric patients were managed for craniofacial forms of GS between 2005 and 2017. All patients presented with various radiological lesions of the TMJs, including osteolytic lacunae of the condylar head, condylar head flattening and thinning of the glenoid cavity. Only one patient presented with functional TMJ impairment.Conclusion
The TMJ appears to be radiology affected in pediatric craniofacial forms of GS. Nevertheless, TMJ lesions, even when radiologically severe, rarely impair TMJ function. TMJ structure and function should be systematically assessed in craniofacial forms of GS, and, in the case of joint lesions, a regular follow-up of TMJ function should be considered. 相似文献19.
Branca Heloisa Oliveira Joana Cunha-Cruz Anjana Rajendra Richard Niederman 《Journal of the American Dental Association (1939)》2018,149(8):671-679.e1
Background
In this systematic review, the authors aim to assess the effect of silver diamine fluoride (SDF) in preventing and arresting caries in exposed root surfaces of adults.Types of Studies Reviewed
Two reviewers independently searched for controlled clinical trials with at least 12 months of follow-up, without language or date of publication restraints, in 8 electronic databases, 5 registries of ongoing trials, and reference lists of narrative reviews.Results
The authors found 2,356 unique records and included 3 trials in which the investigators randomly assigned 895 older adults. Investigators in all studies compared SDF with placebo; investigators in 1 also compared 38% SDF with chlorhexidine and sodium fluoride varnishes. The primary effect measures were the weighted mean differences (WMDs) in decayed or filled root surfaces (DFRS) and the mean differences in arrested carious lesions between SDF and control groups. The studies had low risk of bias in most domains. SDF applications had a significantly better preventive effect in comparison with placebo (WMD DFRS: 24 months, ?0.56; 95% confidence interval, ?0.77 to ?0.36; 30 months or more, ?0.80; 95% confidence interval, ?1.19 to ?0.42), and they were as effective as either chlorhexidine or sodium fluoride varnish in preventing new root carious lesions. SDF also provided a significantly higher caries arrest effect than did placebo (pooled results not calculated). Complaints about black staining of the carious lesions by SDF were rare among older adults.Conclusions and Practical Implications
Yearly 38% SDF applications to exposed root surfaces of older adults are a simple, inexpensive, and effective way of preventing caries initiation and progression. 相似文献20.