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Article
Osteoarthritis of the temporomandibularjoint

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Abstract

Osteoarthritis (OA) is a degenerativejoint disease marked by progressive lossof articular cartilage and damage of bony components. The clinical features include;joint pain, crepitus and limitation of movement. The exact cause of OA is unknownhowever some authors consider it as a multifaetorial disease. The age and over usageare the most common tactors, in addition to race and sex. ln case oftemporomandibular joint(TMJ), traumatic occlusion, and over load caused byparafunctions are additional factors. The purpose ofthis investigation was to study theTMJ) arthropathy among a group of Iraqi patients previously diagnosed as having(.OAOne hundred patients with OA are used in this study. They were examined.clinically and radiographically for effects of systemic OA on TMJResults of the study revealed that 39% of patients with OA have TMJ lesions ofdifferent degrees ranged between osteophytes, diminusion of joint space and bone.distruction ofglenoid fossa and head of condyleDental management of temporomandibular joints affected with OA usuallyaim to suppress the active disease, preserve functions, prevent deformity and relievepain. Early detection of the disease and early commencement of management greatly ireduce joint destruction and improve prognosis. Results of this study indicated thatl1% of patients had only TMJ lesions, with no other joints lesions. Because ofdifficulty of interpretation of TMJ radiographs we suggest criteria for radiographicdiagnosis of osteoarthritis ofthe TMJ


Article
Rheumatoid Arthritis of the Temporomandibular Joint, A Clinical and Radiographical Study

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Abstract

To determine the extent of temporomandibular joint (TMJ) involvement in patients with rheumatoid arthritis compared with a matched control group. And to evaluate the correlation between clinical findings and radiographical findings.The studied sample comprised 50 patients with rheumatoid arthritis, age ranged from 18 to 72 years with the mean age of 40.98 (± 13.67.The control group consisted of 63 subjects age–matched non rheumatic patients: Each patient was informed about the purpose of the investigation and that it would include questionnaire, clinical and radiographical examinations. The radiographic examination was done by using double TMJ lateral panoramic technique.It was found that 64% of RA patients complained of two or more clinical signs and symptoms compared with 44% of the control group ,the difference was statistically significant (P< 0.05), the most important clinical findings were pain on palpation and on opening and closing, crepitation, limitation of jaw opening and morning stiffness, difference were statistically significant (P< 0.05). Among the clinically involved subjects in study RA group 28 subjects (56%) had bilateral involvement, 3 subjects (6%) had right side involved and 1 subject (2%) had only left side involvement. The radiographic involvement of TMJ was found in 16 subjects (32.0 %) of the study group compared with 1subject (1.6 %) of the control group. There is a highly statistically significant difference between the study group and the control group (P< 0.05); the most common radiographical finding was erosion. Complete condylar destruction was found in 1 patient which resulted in anterior open bite. Among involved cases 11 subjects (22%) had bilateral involvement, 5 subjects (10%) had unilateral involvement (3subjects (6%) had left side involved and, 2 (4 %) subjects had only right side involved. There was no correlation between clinical and radiographic find ings. There was correlation between the extent of radiographical findings and duration of Rheumatoid Arthritis p value (P< 0.05).The clinical and radiographic findings were more common in RA group than in control individual. The clinical and radiographic findings are not always bilateral in TMJs of patients withrheumatoid arthritis.


Article
Etiological factors of temporomandibular joint disorders

Author: Hajer Ibrahem B.D.S., M.Sc د.هاجر ابراهيم
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2005 Volume: 2 Issue: 2 Pages: 290-297
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

The temporomandibular joint disorders are defined as a collective term embracinga number of clinical problems that involve the masticatory muscles, the TMJ andassociated structures. Myofacial pain dysfunction syndrome (MPDS) is the most common.functional disorder of TMJMany etiological factors have been blamed to produce pain and dysfunction of.TMJ such as stress, malocclusion and parafunctional habitsStress is thought to be responsible for hyperactivity of the muscles of mastication.which leads to muscle fatigue then muscle spasm and painThe purpose of this study was to determine the role of stress as an ctiological.)factor in (MPDSOne hundred dental students were used in this study and evaluated for havingMPDS. Another sample of one hundred persons from the general population were.evaluated in the same manner to be used as controlThe results of this study indicated that (55%) of participating students haveMPDS) because of the great amotmts of stress they are going through. While in control group there was only (7%).


Article
Correlation between Clinical Features & MRI Findings in Patients with Internal Derangement of Temporomandibular Joint

Authors: Dr. Shahrazaad Sami Saeed B.D.S., M.Sc. ** د. شهرزاد سامي --- Dr. Lamia Al – Nakib B.D.S.,M.Sc. * د. لمياء النقيب
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2007 Volume: 4 Issue: 2 Pages: 131-135
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Temporomandibular joint disorder (TMD) is a collective term embracing a number of clinically distinct problem including myalagia, internal derangement, arthritic problem & disorders of mobility & growth.Aim of study: The aim of this study is to make correlation analysis between clinical signs of temporomandibular internal derangement and magnetic imaging for diagnosis of disk displacement with or without reduction and disk configuration.Material and method: Eighteen patients were examined according to Helkimo index which include impaired TMJ function, impaired range of movement, TMJ tenderness muscle tenderness &pain during mandibular movement.Results: The results showed significant correlation between Helkimo index and MRI findings, in that as the severity of index increased, there was an increase in progression of disk displacement, and when the index was mild 88.9% of the joints were with normal disk position, the posterior band of disk was on 12 o’clock position on top of condyle and about 11.1% had disk displacement with reduction, the disk return to normal position relative to condyle in open mouth position and no patient had disk displacement without reduction.Conclusion: There is significant correlation between clinical signs and MRI findings.

Keywords

Key words: MRI --- TMJ.


Article
The Otological manifestation of temporomandibular disorders

Author: Mohammed Radef Dawood
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 1 Pages: 45-48
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Aims: To detect the frequency of TMD, analyzing its symptoms, and to determine its otological manifestations as otalgia, tinnitus, ear fullness, and hearing impairment. Patients and Methods: During 4 months period, 350 patients visiting ENT department for their ear complaints, only 72 patients were selected and submitted to this study by filling the questionnaire regarding their symptoms of TMD and their otological complaints, followed by full ENT examination (there is normal otoscopic finding) and clinical examination of the temporomandibular joint (TMJ) and adjacent area. Results: Among 350 patients, 72 patients had TMD (20.5%), 44 male (61.1%) and 28 female (38.9%). Regarding the most common TMD symptom TMJ pain (48.6%) was commonest, followed by joint clicking sounds (23.6%), pain on masticatory muscles (18.1%), and limitation of jaw movement with or without jaw deviation (9.7%), while the most common ear symptom was otalgia (52.7%),followed by ear fullness (23.6%), tinnitus (22.2%), and hearing impairment (1.3%). Conclusions: High frequency rate of TMD, the most common TMD symptom was TMJ pain and the most common ear symptom was otalgia.

Keywords

TMD --- Otological manifestation --- TMJ


Article
Arthrocentesis versus conservative treatments for TMJ dysfunctions: A preliminary prospective study
بزل المفصل مقابل العلاجات المحافظة لخلل وظائف المفصل الفكي الصدغي: دراسة مستقبلية أولية

Authors: Reiadh K. Al-Kamali --- Saeed Hameed Saeed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 2 Pages: 739-745
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The temporomandibular disorders present with a variety of signs and symptoms which include pain in the joint and its surrounding, jaw sounds, limited jaw opening, jaw deviation and headache. The aim of this study was to compare the results and efficacy of arthrocentesis with those of conservative treatments for temporomandibular joint disorders.Methods: In a clinical comparative prospective study, 45 patient of both sexes were enrolled in this study according to inclusion criteria’s. The arthrocentesis group consisted of 22 patients (31 joints). The conservative treatment group consisted of 23 patients (34 joints). For both groups, pretreatment and four months post treatment parameters (visual analogue scale for pain, maximum mouth opening and joint sounds score) were recorded.Results: The results revealed that highly statistically significant difference between all pretreatment and forth months post treatment parameter means for both groups (P < 0.001). Both arthrocentesis and conservative treatments were effective. There was a highly statistical significant difference between the four months post treatment parameter means for both groups (P < 0.001). Arthrocentesis was superior to conservative treatments. The overall success rate was 87.1% for arthrocentesis and 55.9% for conservative treatments.Conclusion: Both conservative treatment and arthrocentesis are effective in the treatment of temporomandibular joint dysfunctions. However, arthrocentesis seems to be superior.


Article
Electromyography evaluation of masseter and temporalis muscles in patients with temporomandibular joint dysfunction

Authors: Dr. Imad S. Noorali BDS FICMS د. عماد نور علي --- * Dr. Majeed A. Baheer BDS FICMS ** د. مجيد باهر
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2016 Volume: 13 Issue: 1 Pages: 85-91
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Aim: Temporomandibular disorders (TMD) are composed of heterogeneousmasticatory disorders which include muscle and joint disorders ،Majorprecipitating factors are occlusal, traumatic, psychosocial and systemic factors.The symptoms associated with this syndrome are due to hyper function and/ordysfunction of the masticatory muscles, rather than to degenerative orinflammatory changes of the TMJ .Various attempts have been made todemonstrate this hyperactivity via EMG recordings of the masticatory muscles .The aim of this investigation was to determine possible altered muscular functionin patients with TMD, as well as to determine the need for EMG application inTMD diagnosis.Methods: Thirty adults participated in this study :20 subjects with signs andsymptoms of TMD and 10 asymptomatic subjects .Surface EMG recordings wereobtained from left and right anterior temporal muscle, left and right massetermuscle.Results: of this investigation showed the presence of altered masticatory muscleactivity in TMD patients and confirmed the use of electromyography in TMDdiagnosis.Conclusion: The investigation has confirmed that EMG is a useful and non-invasivemethod in TMD diagnosis.


Article
The Value Of 3 Tesla Magnetic Resonance Imaging In Assessment Of Clinically Diagnosed Temporomandibular Joint Disorders

Authors: Zeinab Ghadhanfer Hammod زيبن غضنفر حمود --- Lamia Al – Nakib لمياء النقيب
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2017 Volume: 29 Issue: 2 Pages: 55-60
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Temporomandibular joint disorder (TMD) is a general term that describe a wide variety of conditions thatinclude myogenic pain, internalderangement, arthritic problem, ankylosis of the joint and growth disorders. The aims ofstudy was to evaluate the value of 3 Tesla magnetic resonance imaging in assessment of articular disc position andconfiguration in patients with temporomandibular joint disorders and to evaluate the correlations of these MRI findingswith the clinical signs and symptoms.Materials and methods: A total forty six (30 study and 16 control) participants aged between18 and 49 years, wereexamined according to Helkimo anamnestic index (questionnaire for anamnesis) and clinical dysfunction index scoringcriteria which include clinical examinations of the range of mandibular mobility, impaired TMJ function, muscle pain ,TMJpain and pain during mandibular movement.Results: There is statistically high significant difference between Helkimo anamnestic and clinical dysfunction indices inthe cases group (with temporomandibular joint disorders) and controls group with MRI findings of disc position and discconfiguration, that as the severity of indices increased, there were progression of disc displacement and disc deformityscore and shows positive association expressed by significant probability (p) value.Conclusion: There is a significant correlation between Helkimos’ anamnestic and clinical dysfunction indices and MRIfindings in patients with internal derangement of temporomandibular joint

Keywords

TMJ --- Helkimo indices --- 3 T MRI


Article
An Assessment of Sagittal Condylar Position of TMJ Dysfunction in Centric Occlusion by Using Cone Beam Computed Tomography

Authors: Lamia H. Al-Nakib لمياء حامد النقيب --- Ako Omer Abdullah --- Saeed A.Abd Al-Kareem --- Sangar Hamid Ali
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2016 Volume: 28 Issue: 2 Pages: 58-62
Publisher: Baghdad University جامعة بغداد

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Background: Temporomandibular joint (TMJ) is a compound articulation formed from the articular surfaces of thetemporal bone and the mandibular condyle.CBCT imaging of TMJ is that it allows accurate measurements of thevolume and surface of the condyle. The aim of the study is to assess the sagittal position of mandibular condyle inpatients with temporomandibulardysfunction using Cone Beam Computed Tomography in centric occlusion.Materials and Methods: CBCT images for all patients were obtained in an upright position using New Tom GianoCBCT with different field of view (11 x 8), (11 x 5), and (8 x 8) and exposure factors was changed accordingly usingNNT version 5.1 software for sagittal reconstruction, anterior, superior and posterior joint spaces was measured.Results: There was a significant change in the anterior, posterior and superior joint spaces when compared to normalfunctioning TMJ. The sagittal position of the condyle in glenoid fossa could be affected by TMJ dysfunction and itwould be positioned centrally but slightly inferior to the normal position according to the results of this study. Therewas no significant difference in the sagittal condylar position in glenoid fossa between sexes. There was significantdifference in the value of anterior, posterior and superior TMJ spaces between right and left sides of the mandible inboth normal cases and TMJD.Conclusion: Sagittal section of Temporomandibular joint revealed that TMJ dysfunction affects the joint spaces insagittal plane. It means significant changes occur in the value of anterior, posterior and superior joint spaces whencompared to normal functioning TMJ


Article
Assessment of cortisol as salivary psychological stress marker in relation to temporomandibular disorders among a sample of dental students

Authors: Sarmad Qays Ali سرمد قيس علي --- Raja Hadi رجاء هادي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2015 Volume: 27 Issue: 2 Pages: 86-92
Publisher: Baghdad University جامعة بغداد

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Background: University dental students perceived a higher level of stress prior to the final exam associated with raisedsalivary cortisol levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Usinga Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insightabout the association of this marker and temporomandibular joint disorders. The aim of this study was to evaluationlevel of salivary cortisol in stressor students with temporomandibular disorder and the relation between this marker inrelation to temporomandibular disorder severity. This might give a better understanding to the role of psychologicalstress as an etiological factor for developing temporomandibular joint problems.Materials and methods: A total eighty participants age between 20 to 24 were recruited for this study. Theparticipants were University dental students under graduate students at final examination period who wereexamined and gave saliva samples in final examination period. Salivary assay kits as cortisol was used to measurethose variables and a Helkimo anamnestic and clinical dysfunction scoring for TMD.Results: The group of participants with stress and temporomandibular disorder showed significantly higher levels ofsalivary cortisol than the control group, the salivary cortisol has statistically significant correlation with Helkimoanamnestic categories (Di-I mild, Di-II moderate and Di-III severe. Salivary cortisol levels show significant but weakassociation with two categories of clinical dysfunction criteria in Helkimo index system, which are Muscle pain andTMJ pain on palpation.Conclusion: This study demonstrated that University students perceived a high level of stress before the finalexamination. Salivary cortisol is the stress biomarker that is most often used to measure acute stress. Helkimoanamnestic and clinical dysfunction scoring criteria for still the pioneer for measuring a temporomandibular disorder

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