Temporomandibular joint condylar changes following maxillomandibular advancement and articular disc repositioning. 2013

Joao Roberto Goncalves, and Larry Miller Wolford, and Daniel Serra Cassano, and Guilherme da Porciuncula, and Beatriz Paniagua, and Lucia Helena Cevidanes
Department of Pediatric Dentistry, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista, Araraquara, Brazil. Electronic address: joaogonc2002@yahoo.com.br.

OBJECTIVE To evaluate condylar changes 1 year after bimaxillary surgical advancement with or without articular disc repositioning using longitudinal quantitative measurements in 3-dimensional (3D) temporomandibular joint (TMJ) models. METHODS Twenty-seven patients treated with maxillomandibular advancement (MMA) underwent cone-beam computed tomography before surgery, immediately after surgery, and at 1-year follow-up. All patients underwent magnetic resonance imaging before surgery to assess disc displacements. Ten patients without disc displacement received MMA only. Seventeen patients with articular disc displacement received MMA with simultaneous TMJ disc repositioning (MMA-Drep). Pre- and postsurgical 3D models were superimposed using a voxel-based registration on the cranial base. RESULTS The location, direction, and magnitude of condylar changes were displayed and quantified by graphic semitransparent overlays and 3D color-coded surface distance maps. Rotational condylar displacements were similar in the 2 groups. Immediately after surgery, condylar translational displacements of at least 1.5 mm occurred in a posterior, superior, or mediolateral direction in patients treated with MMA, whereas patients treated with MMA-Drep presented more marked anterior, inferior, and mediolateral condylar displacements. One year after surgery, more than half the patients in the 2 groups presented condylar resorptive changes of at least 1.5 mm. Patients treated with MMA-Drep presented condylar bone apposition of at least 1.5 mm at the superior surface in 26.4%, the anterior surface in 23.4%, the posterior surface in 29.4%, the medial surface in 5.9%, or the lateral surface in 38.2%, whereas bone apposition was not observed in patients treated with MMA. CONCLUSIONS One year after surgery, condylar resorptive changes greater than 1.5 mm were observed in the 2 groups. Articular disc repositioning facilitated bone apposition in localized condylar regions in patients treated with MMA-Drep.

UI MeSH Term Description Entries
D007091 Image Processing, Computer-Assisted A technique of inputting two-dimensional or three-dimensional images into a computer and then enhancing or analyzing the imagery into a form that is more useful to the human observer. Biomedical Image Processing,Computer-Assisted Image Processing,Digital Image Processing,Image Analysis, Computer-Assisted,Image Reconstruction,Medical Image Processing,Analysis, Computer-Assisted Image,Computer-Assisted Image Analysis,Computer Assisted Image Analysis,Computer Assisted Image Processing,Computer-Assisted Image Analyses,Image Analyses, Computer-Assisted,Image Analysis, Computer Assisted,Image Processing, Biomedical,Image Processing, Computer Assisted,Image Processing, Digital,Image Processing, Medical,Image Processings, Medical,Image Reconstructions,Medical Image Processings,Processing, Biomedical Image,Processing, Digital Image,Processing, Medical Image,Processings, Digital Image,Processings, Medical Image,Reconstruction, Image,Reconstructions, Image
D008137 Longitudinal Studies Studies in which variables relating to an individual or group of individuals are assessed over a period of time. Bogalusa Heart Study,California Teachers Study,Framingham Heart Study,Jackson Heart Study,Longitudinal Survey,Tuskegee Syphilis Study,Bogalusa Heart Studies,California Teachers Studies,Framingham Heart Studies,Heart Studies, Bogalusa,Heart Studies, Framingham,Heart Studies, Jackson,Heart Study, Bogalusa,Heart Study, Framingham,Heart Study, Jackson,Jackson Heart Studies,Longitudinal Study,Longitudinal Surveys,Studies, Bogalusa Heart,Studies, California Teachers,Studies, Jackson Heart,Studies, Longitudinal,Study, Bogalusa Heart,Study, California Teachers,Study, Longitudinal,Survey, Longitudinal,Surveys, Longitudinal,Syphilis Studies, Tuskegee,Syphilis Study, Tuskegee,Teachers Studies, California,Teachers Study, California,Tuskegee Syphilis Studies
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008335 Mandibular Condyle The posterior process on the ramus of the mandible composed of two parts: a superior part, the articular portion, and an inferior part, the condylar neck. Condyle, Mandibular,Condyles, Mandibular,Mandibular Condyles
D008437 Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the ORBIT, and contains the MAXILLARY SINUS. Maxillae,Maxillary Bone,Bone, Maxillary,Bones, Maxillary,Maxillary Bones,Maxillas
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008953 Models, Anatomic Three-dimensional representation to show anatomic structures. Models may be used in place of intact animals or organisms for teaching, practice, and study. Anatomic Models,Models, Surgical,Moulages,Models, Anatomical,Anatomic Model,Anatomical Model,Anatomical Models,Model, Anatomic,Model, Anatomical,Model, Surgical,Moulage,Surgical Model,Surgical Models
D010012 Osteogenesis The process of bone formation. Histogenesis of bone including ossification. Bone Formation,Ossification, Physiologic,Endochondral Ossification,Ossification,Ossification, Physiological,Osteoclastogenesis,Physiologic Ossification,Endochondral Ossifications,Ossification, Endochondral,Ossifications,Ossifications, Endochondral,Osteoclastogeneses,Physiological Ossification
D001862 Bone Resorption Bone loss due to osteoclastic activity. Bone Loss, Osteoclastic,Osteoclastic Bone Loss,Bone Losses, Osteoclastic,Bone Resorptions,Loss, Osteoclastic Bone,Losses, Osteoclastic Bone,Osteoclastic Bone Losses,Resorption, Bone,Resorptions, Bone

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