ISSN : 0376-4672
Introduction : Patients with temporomandibular disorder may have various ear-related symptoms. If an excessive load is applied to the ear area due to the skeletal shape of the mandibular condyle or malposition of the disc, an auditory problems may occur. Case report : The patient was referred to our clinic due to the suspicion of temporomandibular disorder from the local otorhinolaryngology clinic. A few days ago, his right ear could not be heard. MRI showed that the left TMJ disc was anterior displacement with reduction, the right TMJ disc was anteromedial displacement without reduction. Also Right mandibular condyle showed sclerotic bone change, subchondral cyst and was compressing the frontal wall of the ear on MRI view. Right TMJ arthroplasty was done under the diagnosis of right TMJ osteoarthritis and osteochondroma. Postoperative intermaxillary fixation was done with SAS screw and elastics for 2 weeks. One month after the operation, hearing and TMJ discomfort were recovered without any complications. Conclusions As seen in this case, hearing loss due to benign tumor-like lesions of the temporomandibular joint should be treated surgically to restore the TMJ function and hearing.
Purpose: The aim of this study was to evaluate the red fluorescence characteristics of bacterial dental deposits assessed by quantitative light-induced fluorescence (QLF) technology and confirm whether the red fluorescence can distinguish and evaluate quantitatively accumulation of bacterial dental deposits. Methods: This retrospective cross-sectional study used QLF images captured at a dental clinic from January to December 2016. In each QLF image, a skilled examiner selected one region where the presence of deposits was suspected. Then, the regions were classified into three groups of not detectable deposits(ND), half detectable deposits (HD), and full detectable deposits (FD) by two examiners according to classification criteria. Only those images where the regions of bacterial dental deposits were classified identically by all examiners were used for analysis. The mean red fluorescence intensity (RFI) was defined as the mean value of R/G for all pixels in the regions. The RFI was compared between groups using Welch’s ANOVA test, and the Spearman correlation was calculated to assess the association between RFI and accumulation of deposits. Results: In this study, 351 images among the collected images of 605 subjects were finally selected. The mean age of subjects was about 44 years. The R/G values of the ND, HD and FD were 0.73, 1.26 and 1.83 respectively. There were significant differences between all groups (p<0.001), and strong positive correlation was identified between the R/G value and the accumulation of deposits (r = 0.90, p<0.001). Conclusion: The intensity of red fluorescence as observed in the QLF images correlated well with the accumulation maturation of the deposits, which indicates that the QLF technology can be used to evaluate the status of oral hygiene.
Injection therapy can be used to treat the refractory and chronic pain situations that are not well responded to conventional therapy in TMD-patients. The target of injection is the intra-articular- and peri-articular tissue of joint and adjacent tissue like muscle. For the success of injectional therapy, selection of injection solution and technique is essential, so discussion will be done about that and one of the promising techniques of intra-articular injection, , US-guided TMJ Intrar-articular injection, is also discussed.
Chronic orofacial pain is an umbrella term as a kind of painful regional syndromes to describe unremitting and prolonged pains in orofacial area. It is frequently characterized with the intractable pain without the proportionally corresponding tissue pathology over 3 months. Accordingly, it is difficult or almost impossible to establish the causally oriented treatment strategies in those cases, while multidisciplinary approaches were usually considered for preventing prolonged pain conditions from limiting daily life. Among a variety of approaches, pharmacological approach was clinically based on proper applications of several groups of drugs useful to relieve or alleviate pain. These drugs usually encompass several analgesics, muscle relaxants, anti-depressants, anticonvulsants and so on. Therefore, it is essential for dental clinician to be aware of the many peculiarities of these medications applied for management of chronic orofacial pain disorders. This review focused on the clinical considerations for the careful drug selection and application including dosages and adverse drug reactions.
Etiology of temporomandibular disorders is multifactorial origin and complex. therefore, reversible and conservative treatment is recommended in the initial approach of TMD. oral appliances are widely used to manage TMDs, while their mechanisms of action and its effects remain controversial and unclear. The purpose of this paper was to review information regarding the types, designs, and materials of occlusal appliances and the rationale for the continued use of OS for the management of TMDs.
