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VOLUME 20 , ISSUE 12 ( December, 2019 ) > List of Articles

CASE REPORT

Mandibular Condyle Remodeling after Functional Orthopedic Treatment: A Clinical Report of Four Cases

Alain Aube, German O Ramirez-Yanez

Keywords : Bone loading, Bone remodeling, Cartilage, Cortical bone, Dental splint, Mandibular condyle, Osteoarthritis, Temporomandibular joint

Citation Information : Aube A, Ramirez-Yanez GO. Mandibular Condyle Remodeling after Functional Orthopedic Treatment: A Clinical Report of Four Cases. J Contemp Dent Pract 2019; 20 (12):1461-1465.

DOI: 10.5005/jp-journals-10024-2701

License: CC BY-NC 4.0

Published Online: 01-04-2016

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: This clinical report evaluated changes in the mandibular condyles of patients diagnosed with osteoarthritis (OA) at the temporomandibular joint (TMJ), who were treated with a modified dental splint. Materials and methods: Four adult patients (age range: 24–47 years) were treated with a dental splint appliance that delivered a low load at the molar region and permitted lateral and protrusive mandibular excursions. An initial magnetic resonance imaging (MRI) scan was performed for diagnosis purpose before treatment. A second MRI scan was conducted after 12 months of treatment to evaluate changes at the TMJ. Results: The observations from the MRI results in the four patients showed positive changes at the end of the study period. The results presented here suggest the treatment provided significantly reduced the forces damaging the tissues covering the surface of the mandibular condyle, such as cartilage and cortical bone, which may be the cause of the OA. In that context, it is suggested that that reduction in the overloading of the TMJ produced by the functional dental splint permitted the recovery of those tissues. Conclusion: The present results support the idea that the tissues composing the TMJ are viable and may respond to positive stimulus. In that way, this report proposes a way to treat those patients with TMJ OA, who may respond when the treatment aims to reduce the overloading forces affecting the TMJ. Clinical significance: This report proposes a noninvasive clinical treatment for patients with TMJ OA, who may respond when the treatment aims to reduce the overloading forces affecting the TMJ.


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  1. Mejersjö C, Hollender L. TMJ pain and dysfunction: relation between clinical and radiographic findings in the short and long-term. Scand J Dent Res 1984;92(3):241–248. DOI: 10.1111/j.1600-0722.1984.tb00886.x.
  2. Zarb G, Carlsson G. Temporomandibular disorders: osteoarthritis. J Orofac Pain 1999;13(4):295–306.
  3. Arnett G, Milam S, Gottesman L. Progressive mandibular retrusion-idiopathic condylar resorption. Part II. Am J Orthod Dentofacial Orthop 1996;110(2):117–127. DOI: 10.1016/S0889-5406(96)70099-9.
  4. Arnett G, Milam S, Gottesman L. Progressive mandibular retrusion: idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop 1996;110(1):8–15. DOI: 10.1016/S0889-5406(96)70081-1.
  5. Palla S, Gallo L. Biomechanics and mechanobology of the TMJ. In Greene C, Laskin D, ed. TMDs bridging the gap between advances in research and clinical patient management. Hanover Park, IL: Quintessence Publishing Co Inc.; 2013. pp. 101–112.
  6. Tanaka E, Detamore M, Mercuri L. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res 2008;87(4):296–307. DOI: 10.1177/154405910808700406.
  7. Nickel J, Spilker R, Iwasaki L, et al. Static and dynamic mechanics of the temporomandibular joint: plowing forces, joint load and tissue stress. Orthod Craniofac Res 2009;12(3):159–167. DOI: 10.1111/j.1601-6343.2009.01449.x.
  8. Beatty M, Nickel J, Iwasaki L, et al. Mechanical response of the porcine temporomandibular joint disc to an impact event and repeated tensile loading. J Orofac Pain 2003;17(2):160–166.
  9. Boyle WJ, Simonet WS, Lacey DL. Osteoclast differentiation and activation. Nature 2003;423(6937):337–342. DOI: 10.1038/nature01658.
  10. Larheim T. Role of magnetic resonance imaging in the clinical diagnosis of the temporomandibular joint. Cells Tissues Organs 2005;180(1):6–21. DOI: 10.1159/000086194.
  11. Summa S, Ursini R, Manicone P, et al. MRI assessment of temporomandibular disorders: an approach to diagnostic and therapeutic setting. Cranio 2014;32(2):131–138. DOI: 10.1179/0886963413Z.00000000021.
  12. Cortés D, Exss E, Marholz C, et al. Association between disk position and degenerative bone changes of the temporomandibular joints: an imaging study in subjects with TMD. Cranio 2011;29(2):117–126. DOI: 10.1179/crn.2011.020.
  13. Oliveira J, Rosa J, Dutra M, et al. Assessing joint effusion and bone changes of the head of the mandible in MR images of symptomatic patients. Braz Oral Res 2013;27(1):37–41. DOI: 10.1590/S1806-83242013000100007.
  14. Kuzmanovic Pficer J, Dodic S, Lazic V, et al. Occlusal stabilization splint for patients with temporomandibular disorders: meta-analysis of short and long term effects. PLoS One 2017;12(2):e0171296. DOI: 10.1371/journal.pone.0171296.
  15. Ramirez-Yanez G, Daley T, Symons A, et al. Incisor disocclusion in rats affects mandibular condylar cartilage at the cellular level. Arch Oral Biol 2004;49(5):393–400. DOI: 10.1016/j.archoralbio.2003.11.005.
  16. Petrovic A. Control of postnatal growth of secondary cartilages of the mandible by mechanisms regulating occlusion. Cybernetic model. Trans Eur Orthod Soc 1974; 69–75.
  17. Luder H. Age changes in the articular tissue of human mandibular condyles from adolescence to old age: a semiquantitative light microscopic study. Anat Rec 1998;251(4):439–447. DOI: 10.1002/(SICI)1097-0185(199808)251:4<439::AID-AR3>3.0.CO;2-N.
  18. Ramirez-Yanez G, Scott J. Architecture of the mandibular Condylar cartilage of elderly individuals: a semiquantitative light microscopic histological study. J Contemp Dent Pract 2019;20:768–772. DOI: 10.5005/jp-journals-10024-2594.
  19. Petrovic AG. Mechanisms and regulation of mandibular condylar growth. Acta Morphol Neerl Scand 1972;10(1):25–34.
  20. Thilander B, Carlsson G, Ingervall B. Postnatal development of the human temporomandibular joint. I. A histological study. Acta Odontol Scand 1976;34(2):117–126. DOI: 10.3109/00016357609026564.
  21. Petrovic A, Stutzmann J, Oudet C. Control processes in postnatal growth of condylar cartilage of the mandible. In: McNamara JAJ, ed., Determinants of mandibular form and growth, Monograph 4th ed., Ann Arbor: University of Michigan; 1975. pp. 14–57.
  22. Embree M, Chen M, Pylawka S, et al. Exploiting endogenous fibrocartilage stem cells to regenerate cartilage and repair joint injury. Nat Commun 2016;7:13073. DOI: 10.1038/ncomms13073.
  23. Katakami K, Shimoda S, Kobayashi K, et al. Histological investigation of osseous changes of mandibular condyles with backscattered electron images. Dentomaxillofac Radiol 2008;37(6):330–339. DOI: 10.1259/dmfr/93169617.
  24. Moffett B. The morphogenesis of the temporomadibular joint. Am J Orthod 1966;52(6):401–415. DOI: 10.1016/0002-9416(66)90120-5.
  25. Tanaka E, Kawai N, Tanaka M, et al. The frictional coefficient of the temporomandibular joint and its dependency on the magnitude and duration of joint loading. J Dent Res 2004;83(5):404–407. DOI: 10.1177/154405910408300510.
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