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Temporomandibular eklem disfonksiyonu açısından Helkimo disfonksiyon indeksine göre semptomatik ve asemptomatik hastalardaki, konik-ışınlı bilgisayarlı tomografide belirlenen kemik değişikliklerinin karşılaştırılması ve bu klinik indeksin radyografideki kemik değişiklikleriyle ilişkisi

Year 2021, Volume: 14 Issue: 1, 155 - 165, 04.01.2021
https://doi.org/10.31362/patd.755539

Abstract

Amaç: Temporomandibular eklem disfonksiyonu (TMED); TME ve ilişkili olduğu kas, yumuşak doku ve kemik bileşenlerini etkileyen, bir şemsiye terimdir. Bu çalışmada, TMED açısından semptomatik ve asemptomatik hastaların, TME bölgesindeki kemik değişikliklerini karşılaştırmak, ayrıca Helkimo Di’nin (disfonksiyon indeksi) kemik değişiklikleri ve yaşla ilişkisinin araştırılması amaçlandı.
Gereç ve yöntem: Çalışmaya, TMED açısından 34'ü semptomatik ve 34'ü asemptomatik toplam 68 hasta dahil edildi. TMED şiddetini belirlemek amacıyla yapılan klinik muayene kapsamında Helkimo Di kullanıldı. Radyolojik muayenede, konik-ışınlı bilgisayarlı tomografi (KIBT) ile TME bölgesindeki kemik değişiklikleri belirlendi.
Bulgular: Çalışma grubunun yaş ortalaması 30,35'di ve %76,5’ı kadındı. Kontrol grubu için bu değerler 38,5 ve %44,1 idi (p<0,05). Glenoid fossada dejenerasyon dışında tüm kemik değişiklikleri çalışma grubunda daha fazla gözlendi. Ancak sadece, kondilde düzleşme, skleroz, osteofit ve artiküler eminenste düzleşme açısından istatistiksel olarak anlamlı fark vardı (p<0,05). Helkimo Di’nin şiddeti arttıkça, ortalama yaş ve TME bölgesindeki kemik değişikliği de artmaktaydı, ancak istatiksel olarak anlamlı fark yoktu (p>0,05).
Sonuç: TMED hastalarında, TME bölgesindeki kemik değişiklerinin daha fazla gözlendiğini ancak bunun hastalığın şiddeti ile ilişkili olmadığını, bundan dolayı teşhis ve tedavi planlaması yaparken radyolojik bulguların yanında klinik muayenenin de önemli olduğu söylenebilir.

Supporting Institution

Yok

Project Number

Yok

Thanks

Bu çalışma Umut Pamukçu'nun Gazi Üniversitesi, Ankara, Temmuz 2019'da sunulan “Temporomandibular eklem disfonksiyonu olan hastalardaki klinik ve radyolojik bulguların değerlendirilmesi” başlıklı uzmanlık tezinin bir parçasını oluşturmaktadır.

References

  • 1. Mujakperuo HR, Watson M, Morrison R, Macfarlane TV. Pharmacological interventions for pain in patients with temporomandibular disorders. Cochrane Database Syst Rev 2010CD004715. https://doi.org/ 10.1002/14651858.CD004715.pub2.
  • 2. dos Anjos Pontual M, Freire J, Barbosa J, Frazão M, dos Anjos Pontual A, Fonseca da Silveira M. Evaluation of bone changes in the temporomandibular joint using cone beam CT. Dentomaxillofac Radiol 2012;41:24-29.
  • 3. Pihut M, Ferendiuk E, Szewczyk M, Kasprzyk K, Wieckiewicz M. The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache. J Headache Pain 2016;17:29. https://doi.org/ 10.1186/s10194-016-0621-1.
  • 4. Peck C, Murray G, Gerzina T. How does pain affect jaw muscle activity? The Integrated Pain Adaptation Model. Aust Dent J 2008;53:201-207.
  • 5. Mapelli A, Zanandrea Machado BC, Giglio LD, Sforza C, De Felicio CM. Reorganization of muscle activity in patients with chronic temporomandibular disorders. Arch Oral Biol 2016;72:164-171. https://doi.org/ 10.1016/j.archoralbio.2016.08.022.
  • 6. Hiraba K, Hibino K, Hiranuma K, Negoro T. EMG activities of two heads of the human lateral pterygoid muscle in relation to mandibular condyle movement and biting force. J Neurophysiol 2000;83:2120-2137. https://doi.org/ 10.1152/jn.2000.83.4.2120.
  • 7. De Leeuw R, Klasser G. Orofacial pain: guidelines for assessment, diagnosis, and management. Am J Orthod Dentofacial Orthop 2008;134:171.
  • 8. Rao VM, Bacelar MT. MR imaging of the temporomandibular joint. Magn Reson Imaging Clin N Am 2002;10:615-630. https://doi.org/ 10.1016/s1064-9689(02)00011-9.
  • 9. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;6:301-355.
  • 10. Dijkgraaf LC, Liem RS, de Bont LG. Ultrastructural characteristics of the synovial membrane in osteoarthritic temporomandibular joints. J Oral Maxillofac Surg 1997;55:1269-1279; discussion 1279-1280. https://doi.org/ 10.1016/s0278-2391(97)90183-x.
  • 11. Kalladka M, Quek S, Heir G, Eliav E, Mupparapu M, Viswanath A. Temporomandibular joint osteoarthritis: diagnosis and long-term conservative management: a topic review. J Indian Prosthodont Soc 2014;14:6-15. https://doi.org/ 10.1007/s13191-013-0321-3.
  • 12. Hatcher DC, Aboudara CL. Diagnosis goes digital. Am J Orthod Dentofacial Orthop 2004;125:512-515. https://doi.org/ 10.1016/j.ajodo.2003.12.009.
  • 13. Honda K, Larheim TA, Maruhashi K, Matsumoto K, Iwai K. Osseous abnormalities of the mandibular condyle: diagnostic reliability of cone beam computed tomography compared with helical computed tomography based on an autopsy material. Dentomaxillofac Radiol 2006;35:152-157. https://doi.org/ 10.1259/dmfr/15831361.
  • 14. Tsiklakis K, Syriopoulos K, Stamatakis H. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofac Radiol 2004;33:196-201.
  • 15. Helkimo M. Studies on function and dysfunction of the masticatory system. IV. Age and sex distribution of symptoms of dysfunction of the masticatory system in Lapps in the north of Finland. Acta Odontol Scand 1974;32:255-267. https://doi.org/ 10.3109/00016357409026342.
  • 16. Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:844-860.
  • 17. Arnett G, Milam S, Gottesman L. Progressive mandibular retrusion—idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop 1996;110:8-15.
  • 18. Widmalm SE, Westesson PL, Kim IK, Pereira FJ, Jr., Lundh H, Tasaki MM. Temporomandibular joint pathosis related to sex, age, and dentition in autopsy material. Oral Surg Oral Med Oral Pathol 1994;78:416-425. https://doi.org/ 10.1016/0030-4220(94)90031-0.
  • 19. Yasuoka T, Nakashima M, Okuda T, Tatematsu N. Effect of estrogen replacement on temporomandibular joint remodeling in ovariectomized rats. J Oral Maxillofac Surg 2000;58:189-196; discussion 196-187. https://doi.org/ 10.1016/s0278-2391(00)90337-9.
  • 20. Kiliç SC, Kiliç N, Sümbüllü M. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. Int J Oral Maxillofac Surg 2015;44:1268-1274.
  • 21. Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol 2009;38:141-147.
  • 22. Bae S, Park M-S, Han J-W, Kim Y-J. Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints. Maxillofacial plastic and reconstructive surgery 2017;39:19.
  • 23. Ishibashi H, Takenoshita Y, Ishibashi K, Oka M. Age-related changes in the human mandibular condyle: a morphologic, radiologic, and histologic study. J Oral Maxillofac Surg 1995;53:1016-1023; discussion 1023-1014. https://doi.org/ 10.1016/0278-2391(95)90117-5.
  • 24. Gabriela Cortese S, Elizabeth Fridman D, Liliana Farah C, Bielsa F, Grinberg J, María Biondi A. Frequency of oral habits, dysfunctions, and personality traits in bruxing and nonbruxing children: a comparative study. CRANIO® 2013;31:283-290.
  • 25. Lelis ER, Guimaraes Henriques JC, Tavares M, de Mendonca MR, Fernandes Neto AJ, Almeida Gde A. Cone-beam tomography assessment of the condylar position in asymptomatic and symptomatic young individuals. J Prosthet Dent 2015;114:420-425. https://doi.org/ 10.1016/j.prosdent.2015.04.006.
  • 26. Von Korff MR, Howard JA, Truelove EL, Sommers E, Wagner EH, Dworkin S. Temporomandibular disorders. Variation in clinical practice. Med Care 1988;26:307-314.
  • 27. De Kanter RJ, Truin GJ, Burgersdijk RC, Van 't Hof MA, Battistuzzi PG, Kalsbeek H, et al. Prevalence in the Dutch adult population and a meta-analysis of signs and symptoms of temporomandibular disorder. J Dent Res 1993;72:1509-1518. https://doi.org/ 10.1177/00220345930720110901.
  • 28. Crusoé-Rebello IMR, Campos PSF, Rubira IRF, Panella J, Mendes CMC. Evaluation of the relation between the horizontal condylar angle and the internal derangement of the TMJ-a magnetic resonance imaging study. Braz Oral Res 2003;17:176-182.
  • 29. Khojastepour L, Vojdani M, Forghani M. The association between condylar bone changes revealed in cone beam computed tomography and clinical dysfunction index in patients with or without temporomandibular joint disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2017;123:600-605.
  • 30. Nanthaviroj S, Omnell KA, Randow K, Oberg T. Clicking and temporary "locking" in the temporomandibular joint. A clinical, radiographical and electromyographical study. Dentomaxillofac Radiol 1976;5:33-38. https://doi.org/ 10.1259/dmfr.1976.0005.
  • 31. Koyama J, Nishiyama H, Hayashi T. Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofac Radiol 2007;36:472-477.
  • 32. Yamada K, Hiruma Y, Hanada K, Hayashi T, Koyama J-i, Ito J. Condylar bony change and craniofacial morphology in orthodontic patients with temporomandibular disorders (TMD) symptoms: a pilot study using helical computed tomography and magnetic resonance imaging. Clin Orthod Res 1999;2:133-142.
  • 33. Wiberg B, Wanman A. Signs of osteoarthrosis of the temporomandibular joints in young patients: a clinical and radiographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:158-164. https://doi.org/ 10.1016/s1079-2104(98)90118-4.
  • 34. Talaat W, Al Bayatti S, Al Kawas S. CBCT analysis of bony changes associated with temporomandibular disorders. Cranio 2016;34:88-94. https://doi.org/ 10.1179/2151090315Y.0000000002.
  • 35. Al-Juhani HO, Alhaidari RI, Alfaleh WM. Comparative study of the prevalence of temporomandibular joint osteoarthritic changes in cone beam computed tomograms of patients with or without temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2015;120:78-85.
  • 36. Alkhader M, Al-Shawaf R. Cone-beam computed tomography findings of temporomandibular joints with osseous abnormalities. Oral Radiol 2012;28:82-86.
  • 37. Larsson E, Ronnerman A. Mandibular dysfunction symptoms in orthodontically treated patients ten years after the completion of treatment. Eur J Orthod 1981;3:89-94. https://doi.org/ 10.1093/ejo/3.2.89.
  • 38. Su N, Liu Y, Yang X, Luo Z, Shi Z. Correlation between bony changes measured with cone beam computed tomography and clinical dysfunction index in patients with temporomandibular joint osteoarthritis. J Craniomaxillofac Surg 2014;42:1402-1407.

In terms of temporomandibular joint dysfunction, according to Helkimo dysfunction index, comparison of bone changes determined in cone-beam computed tomography in symptomatic and asymptomatic patients and the relationship of this clinical index with bone changes on radiography

Year 2021, Volume: 14 Issue: 1, 155 - 165, 04.01.2021
https://doi.org/10.31362/patd.755539

Abstract

Project Number

Yok

References

  • 1. Mujakperuo HR, Watson M, Morrison R, Macfarlane TV. Pharmacological interventions for pain in patients with temporomandibular disorders. Cochrane Database Syst Rev 2010CD004715. https://doi.org/ 10.1002/14651858.CD004715.pub2.
  • 2. dos Anjos Pontual M, Freire J, Barbosa J, Frazão M, dos Anjos Pontual A, Fonseca da Silveira M. Evaluation of bone changes in the temporomandibular joint using cone beam CT. Dentomaxillofac Radiol 2012;41:24-29.
  • 3. Pihut M, Ferendiuk E, Szewczyk M, Kasprzyk K, Wieckiewicz M. The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache. J Headache Pain 2016;17:29. https://doi.org/ 10.1186/s10194-016-0621-1.
  • 4. Peck C, Murray G, Gerzina T. How does pain affect jaw muscle activity? The Integrated Pain Adaptation Model. Aust Dent J 2008;53:201-207.
  • 5. Mapelli A, Zanandrea Machado BC, Giglio LD, Sforza C, De Felicio CM. Reorganization of muscle activity in patients with chronic temporomandibular disorders. Arch Oral Biol 2016;72:164-171. https://doi.org/ 10.1016/j.archoralbio.2016.08.022.
  • 6. Hiraba K, Hibino K, Hiranuma K, Negoro T. EMG activities of two heads of the human lateral pterygoid muscle in relation to mandibular condyle movement and biting force. J Neurophysiol 2000;83:2120-2137. https://doi.org/ 10.1152/jn.2000.83.4.2120.
  • 7. De Leeuw R, Klasser G. Orofacial pain: guidelines for assessment, diagnosis, and management. Am J Orthod Dentofacial Orthop 2008;134:171.
  • 8. Rao VM, Bacelar MT. MR imaging of the temporomandibular joint. Magn Reson Imaging Clin N Am 2002;10:615-630. https://doi.org/ 10.1016/s1064-9689(02)00011-9.
  • 9. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;6:301-355.
  • 10. Dijkgraaf LC, Liem RS, de Bont LG. Ultrastructural characteristics of the synovial membrane in osteoarthritic temporomandibular joints. J Oral Maxillofac Surg 1997;55:1269-1279; discussion 1279-1280. https://doi.org/ 10.1016/s0278-2391(97)90183-x.
  • 11. Kalladka M, Quek S, Heir G, Eliav E, Mupparapu M, Viswanath A. Temporomandibular joint osteoarthritis: diagnosis and long-term conservative management: a topic review. J Indian Prosthodont Soc 2014;14:6-15. https://doi.org/ 10.1007/s13191-013-0321-3.
  • 12. Hatcher DC, Aboudara CL. Diagnosis goes digital. Am J Orthod Dentofacial Orthop 2004;125:512-515. https://doi.org/ 10.1016/j.ajodo.2003.12.009.
  • 13. Honda K, Larheim TA, Maruhashi K, Matsumoto K, Iwai K. Osseous abnormalities of the mandibular condyle: diagnostic reliability of cone beam computed tomography compared with helical computed tomography based on an autopsy material. Dentomaxillofac Radiol 2006;35:152-157. https://doi.org/ 10.1259/dmfr/15831361.
  • 14. Tsiklakis K, Syriopoulos K, Stamatakis H. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofac Radiol 2004;33:196-201.
  • 15. Helkimo M. Studies on function and dysfunction of the masticatory system. IV. Age and sex distribution of symptoms of dysfunction of the masticatory system in Lapps in the north of Finland. Acta Odontol Scand 1974;32:255-267. https://doi.org/ 10.3109/00016357409026342.
  • 16. Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:844-860.
  • 17. Arnett G, Milam S, Gottesman L. Progressive mandibular retrusion—idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop 1996;110:8-15.
  • 18. Widmalm SE, Westesson PL, Kim IK, Pereira FJ, Jr., Lundh H, Tasaki MM. Temporomandibular joint pathosis related to sex, age, and dentition in autopsy material. Oral Surg Oral Med Oral Pathol 1994;78:416-425. https://doi.org/ 10.1016/0030-4220(94)90031-0.
  • 19. Yasuoka T, Nakashima M, Okuda T, Tatematsu N. Effect of estrogen replacement on temporomandibular joint remodeling in ovariectomized rats. J Oral Maxillofac Surg 2000;58:189-196; discussion 196-187. https://doi.org/ 10.1016/s0278-2391(00)90337-9.
  • 20. Kiliç SC, Kiliç N, Sümbüllü M. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. Int J Oral Maxillofac Surg 2015;44:1268-1274.
  • 21. Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol 2009;38:141-147.
  • 22. Bae S, Park M-S, Han J-W, Kim Y-J. Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints. Maxillofacial plastic and reconstructive surgery 2017;39:19.
  • 23. Ishibashi H, Takenoshita Y, Ishibashi K, Oka M. Age-related changes in the human mandibular condyle: a morphologic, radiologic, and histologic study. J Oral Maxillofac Surg 1995;53:1016-1023; discussion 1023-1014. https://doi.org/ 10.1016/0278-2391(95)90117-5.
  • 24. Gabriela Cortese S, Elizabeth Fridman D, Liliana Farah C, Bielsa F, Grinberg J, María Biondi A. Frequency of oral habits, dysfunctions, and personality traits in bruxing and nonbruxing children: a comparative study. CRANIO® 2013;31:283-290.
  • 25. Lelis ER, Guimaraes Henriques JC, Tavares M, de Mendonca MR, Fernandes Neto AJ, Almeida Gde A. Cone-beam tomography assessment of the condylar position in asymptomatic and symptomatic young individuals. J Prosthet Dent 2015;114:420-425. https://doi.org/ 10.1016/j.prosdent.2015.04.006.
  • 26. Von Korff MR, Howard JA, Truelove EL, Sommers E, Wagner EH, Dworkin S. Temporomandibular disorders. Variation in clinical practice. Med Care 1988;26:307-314.
  • 27. De Kanter RJ, Truin GJ, Burgersdijk RC, Van 't Hof MA, Battistuzzi PG, Kalsbeek H, et al. Prevalence in the Dutch adult population and a meta-analysis of signs and symptoms of temporomandibular disorder. J Dent Res 1993;72:1509-1518. https://doi.org/ 10.1177/00220345930720110901.
  • 28. Crusoé-Rebello IMR, Campos PSF, Rubira IRF, Panella J, Mendes CMC. Evaluation of the relation between the horizontal condylar angle and the internal derangement of the TMJ-a magnetic resonance imaging study. Braz Oral Res 2003;17:176-182.
  • 29. Khojastepour L, Vojdani M, Forghani M. The association between condylar bone changes revealed in cone beam computed tomography and clinical dysfunction index in patients with or without temporomandibular joint disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2017;123:600-605.
  • 30. Nanthaviroj S, Omnell KA, Randow K, Oberg T. Clicking and temporary "locking" in the temporomandibular joint. A clinical, radiographical and electromyographical study. Dentomaxillofac Radiol 1976;5:33-38. https://doi.org/ 10.1259/dmfr.1976.0005.
  • 31. Koyama J, Nishiyama H, Hayashi T. Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofac Radiol 2007;36:472-477.
  • 32. Yamada K, Hiruma Y, Hanada K, Hayashi T, Koyama J-i, Ito J. Condylar bony change and craniofacial morphology in orthodontic patients with temporomandibular disorders (TMD) symptoms: a pilot study using helical computed tomography and magnetic resonance imaging. Clin Orthod Res 1999;2:133-142.
  • 33. Wiberg B, Wanman A. Signs of osteoarthrosis of the temporomandibular joints in young patients: a clinical and radiographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:158-164. https://doi.org/ 10.1016/s1079-2104(98)90118-4.
  • 34. Talaat W, Al Bayatti S, Al Kawas S. CBCT analysis of bony changes associated with temporomandibular disorders. Cranio 2016;34:88-94. https://doi.org/ 10.1179/2151090315Y.0000000002.
  • 35. Al-Juhani HO, Alhaidari RI, Alfaleh WM. Comparative study of the prevalence of temporomandibular joint osteoarthritic changes in cone beam computed tomograms of patients with or without temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2015;120:78-85.
  • 36. Alkhader M, Al-Shawaf R. Cone-beam computed tomography findings of temporomandibular joints with osseous abnormalities. Oral Radiol 2012;28:82-86.
  • 37. Larsson E, Ronnerman A. Mandibular dysfunction symptoms in orthodontically treated patients ten years after the completion of treatment. Eur J Orthod 1981;3:89-94. https://doi.org/ 10.1093/ejo/3.2.89.
  • 38. Su N, Liu Y, Yang X, Luo Z, Shi Z. Correlation between bony changes measured with cone beam computed tomography and clinical dysfunction index in patients with temporomandibular joint osteoarthritis. J Craniomaxillofac Surg 2014;42:1402-1407.
There are 38 citations in total.

Details

Primary Language Turkish
Subjects Radiology and Organ Imaging
Journal Section Research Article
Authors

Umut Pamukçu 0000-0001-8356-8344

Bülent Altunkaynak 0000-0002-7571-2155

İlkay Peker 0000-0002-2888-2979

Project Number Yok
Publication Date January 4, 2021
Submission Date June 20, 2020
Acceptance Date October 23, 2020
Published in Issue Year 2021 Volume: 14 Issue: 1

Cite

AMA Pamukçu U, Altunkaynak B, Peker İ. Temporomandibular eklem disfonksiyonu açısından Helkimo disfonksiyon indeksine göre semptomatik ve asemptomatik hastalardaki, konik-ışınlı bilgisayarlı tomografide belirlenen kemik değişikliklerinin karşılaştırılması ve bu klinik indeksin radyografideki kemik değişiklikleriyle ilişkisi. Pam Med J. January 2021;14(1):155-165. doi:10.31362/patd.755539

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