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Mandibular fractures are very common in maxillofacial trauma surgery. While previous studies have focused on possible risk factors related to post-operative complications, none have tried to identify pre-existing conditions that may increase the risk of mandibular fractures. We hypothesized, through clinical observation, that anatomical conditions involving poor dental contacts, such as malocclusions, may increase the risk of mandibular fractures. This work was subdivided into two parts. In the first part, Digital Imaging and Communications in Medicine (DICOM) data of four healthy patients characterized by different dentoskeletal occlusions (class I, class II, class III, and anterior open bite) have been used to develop four finite element models (FEMs) that accurately reproduce human bone structure. A vertical and lateral impact have been simulated at increasing speed on each model, analyzing the force distribution within the mandibular bone. Both vertical and lateral impact showed higher level of stress at the impact point and in the condylar area in models characterized by malocclusion. Specifically, the class III and the open bite models, at the same speed of impact, had higher values for a longer period, reaching critical stress levels that are correlated with mandibular fracture, while normal occlusion seems to be a protective condition. In the second part of this study, the engineering results were validated through the comparison with a sample of patients previously treated for mandibular fracture. Data from 223 mandibular fractures, due to low-energy injuries, were retrospectively collected to evaluate a possible correlation between pre-existing malocclusion and fracture patterns, considering grade of displacement, numbers of foci, and associated CFI score. Patients were classified, according to their occlusion, into Class I, Class II, Class III, and anterior open bite or poor occlusal contact (POC). Class I patients showed lower frequencies of fracture tha

Introduction: Anterior open bite (AOB) is a type of malocclusion that exhibit no anterior guidance resulting in a lack of occlusal equilibrium in static and dynamic aspects, which could induce more stress for the temporomandibular joint (TMJ) than a normal occlusion. However, the effect of orthodontic treatment to obtain anterior guidance for patients with AOB on TMJ condyle remained poorly studied. This study aims to analyze the condylar changes in AOB patients by comparing their CBCT data pre- and post-orthodontic treatment. Methods: The 108 AOB patients underwent orthodontic treatment included had cone-beam computed tomography (CBCT) scans taken before orthodontic (T1) and after orthodontic treatment (T2). We divided them into 3 different severity groups (Mild, Moderate, and Severe) and 3 different treatment modalities groups (ALN, FFA, and Sx). Measurements were conducted using InVivo 6 for the condylar joint space, depth of fossa, condylar position, and condylar dimension. Pre-treatment and post-treatment three-dimensional (3D) volume of bilateral condylar head were calculated, and the representative 3D models were superimposed using voxel-based registration on the mandibular stable region. Results: After orthodontic treatment for AOB, the condyles tend to seat more posteriorly and superiorly for about 0.17-0.21mm and 0.09-0.12mm respectively; the depth of fossa increased 0.22mm on the right side; the asymmetry of the condylar position improved; the condylar width increased for 0.44mm; the condylar height increased for 0.40mm; and the 3D condylar volume increased for 98.29 mm3. Teenage AOB patients have significant condylar changes (joint space, laterolateral condylar position, height, width, and 3D volume) after treatment while adult patients generally do not experience many changes except for the surgical patients. As patient ages, the dimensional and volumetric changes after treatment decreased. Surgical patients experienced the most volumetric increase afte

ObjectiveThis systematic review aimed to summarize the morphologic changes in the temporomandibular joint (TMJ) in patients who underwent orthodontic treatment and were assessed by 3-dimensional (3D) imaging techniques (e.g., magnetic resonance imaging, cone beam computed tomography, and multidetector computed tomography).Study designThe authors searched PubMed, Web of Science, and Embase databases to identify original articles from 2014 to 2021 containing keywords for morphologic changes in the TMJ, orthodontic treatment, and three-dimensional imaging methods. Prospective and retrospective studies, including observational, cross-sectional, randomized, and nonrandomized clinical trials, cohort studies, and case-control studies, were reviewed. The review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The risk of bias was assessed in studies selected for the full-text review.ResultsThe search strategy yielded 294 publications. After an initial screening and the application of exclusion criteria, 13 studies were selected for the final review.ConclusionDifferences were found in condylar positioning, typically in an anterior position; condylar morphology, primarily with increased diameter or head height; and articular disk position within the anterior-posterior plane post-treatment. Changes in the glenoid fossa were not consistent between the studies. The overall risk of bias among studies was moderate. The influence of orthodontic treatment on morphologic changes in the TMJ remains unclear.

Introduction: Mandibular fractures are the most common facial fractures affecting various anatomical sites of the mandible. Among the various mandibular fractures, management of condylar fractures remains a challenging task for surgeons. Case Report: We report the case of a 28 year old male patient who presented with pain in the chin and restricted mouth opening. Computed tomography revealed a sagittal fracture of the right condylar head with medial displacement of the fractured fragments. Management of diacapitular fractures includes open reduction and internal fixation of the right condyle using a single lag-screw. Results: The postoperative outcomes were favorable, where normal mandibular movements, desired dental occlusion and exact positioning of the condyle with rigid fixation were established thereby maintaining the shape of the condyle. Conclusion: Use of single lag screw fixation is highly recommended as it greatly supports the stabilized fracture fragments and also aid in prevention of fracture fragment rotation medially., Introducción: Las fracturas mandibulares son las fracturas faciales más comunes que afectan a diversos sitios anatómicos de la mandíbula. Entre las diversas fracturas mandibulares, el manejo de las fracturas condilares sigue siendo una tarea desafiante para los cirujanos.Reporte del Caso: Presentamos el caso de un paciente masculino de 28 años que consultó por dolor en el mentón y restricción de la apertura de la boca. La tomografía computarizada reveló una fractura sagital de la cabeza condilar derecha con desplazamiento medial de los fragmentos fracturados. El tratamiento de las fracturas diacapitulares incluye la reducción abierta y la fijación interna del cóndilo derecho con un solo tirafondo. Resultados: Los resultados postoperatorios fueron favorables, donde se establecieron los movimientos mandibulares normales, la oclusión dentaria deseada y el posicionamiento exacto del cóndilo con fijación rígida manteniendo así la forma del cóndilo.Conclusión: Se recomienda encarecidamente el uso de una fijación con un solo tornillo de tracción, ya que soporta en gran medida los fragmentos de fractura estabilizados y también ayuda a prevenir la rotación medial de los fragmentos de fractura.

Aim: To determine the association between the level of temporomandibular disorder (TMD) and the condylar position in a university population. Material and Methods: A cross-sectional study was carried out in 41 university students between 18 and 27 years old (21±2.28). The level of TMD was determined using the Helkimo index modified by Maglione, whereas the condylar position was found radiographically by lateral scan. The association was evaluated using the Chi-square statistical test. Results:Statistically significant association was found between the TMD level and the condylar position in the female gender (p=0.003). The central condylar position was the most frequent in females (70.00%), while in males the highest frequency of condylar positions was posterior and anterior, 40.48% and 35.71% respectively. In mild TMD, the most frequent condylar position was central (46.34%), whilst non-centric positions were prevalent in moderate TMD, with 2.44%. There was no statistically significant association between the TMD level and the condylar position of the participants, nor in males (p>0.05). Conclusion: The TMD was associated with the condylar position in females of the university population studied, analyzed in lateral temporomandibular joint scans. Non-centric condylar positions were more frequent in the moderate TMD level and centric positions in mild TMD., Objetivo:Determinar la asociación entre el nivel de trastorno temporomandibular (TTM) y la posición condilar en una población universitaria. Material y Métodos: Se realizó un estudio transversal en 41 individuos universitarios entre 18 y 27 años (21±2.28). Se determinó el nivel de TTM mediante el índice de Helkimo modificado por Maglione, mientras que la posición condilar fue hallada radiográficamente mediante escanografía lateral. La asociación fue evaluada mediante la prueba estadística Chi-cuadrado. Resultados: Se halló asociación estadísticamente significativa entre el nivel de TTM y la posición condilar en el género femenino (p= 0.0 03). La posición condilar central fue la más frecuente en las mujeres con un 70.00% de aparición, mientras que en los hombres la mayor frecuencia de posiciones condilares fue posterior y anterior con 40.48% y 35.71% respectivamente. En el TTM leve la posición condilar más frecuente fue la central con un 46.34% de aparición, mientras que las posiciones no-céntricas lo fueron en el TTM moderado con un 2.44%. No hubo asociación estadísticamente significativa entre el nivel de TTM y la posición condilar en el total de participantes, ni tampoco en el género masculino (p>0.05). Conclusión: Se encontró asociación entre el nivel de TTM y la posición condilar en escanografías laterales de articulación temporomanibular en el género femenino de la población universitaria estudiada, mientras que no se encontró en el total de muestra, ni en el género masculino. Las posiciones condilares no-céntricas fueron más frecuentes en el nivel de TTM moderado y las céntricas en el TTM leve.

PURPOSE: In the mandible, the condylar neck vascularization is commonly described as mainly periosteal; while the endosteal contribution is still debated, with very limited anatomical studies. Previous works have shown the contribution of nutrient vessels through accessory foramina and their contribution in the blood supply of other parts of the mandible. Our aim was to study the condylar neck's blood supply from nutrient foramina. METHODS: Six latex-injected heads were dissected and two hundred mandibular condyles were observed on dry mandibles searching for accessory bone foramina. RESULTS: Latex-injected dissections showed a direct condylar medular arterial supply through foramina. On dry mandibles, these foramina were most frequently observed in the pterygoid fovea in 91% of cases. However, two other accessory foramina areas were identified on the lateral and medial sides of the mandibular condylar process, confirming the vascular contribution of transverse facial and maxillary arteries. CONCLUSIONS: The maxillary artery indeed provided both endosteal and periosteal blood supply to the condylar neck, with three different branches: an intramedullary ascending artery (arising from the inferior alveolar artery), a direct nutrient branch and some pterygoid osteomuscular branches.

Condylar fractures of mandible are not very easy to diagnose radiographicaly. If fracture is vertical, it would be much more difficult to diagnose. Since treatment depends on type of fracture, CT scan is advised rather than conventional radiographs to diagnose condylar fractures.The cases reporting to the hospital during the period of July 2019 to April 2020 were enrolled, of which 2 cases have been reported here. It was observed that there are chances of missing the diagnosis of the condylar fracture if only the conventional radiographs are used. CT along with conventional radiographs should be considered for better treatment and management of the patients with maxillofacial injuries.

Condylar fractures of mandible are not very easy to diagnose radiographicaly. If fracture is vertical, it would be much more difficult to diagnose. Since treatment depends on type of fracture, CT scan is advised rather than conventional radiographs to diagnose condylar fractures.The cases reporting to the hospital during the period of July 2019 to April 2020 were enrolled, of which 2 cases have been reported here. It was observed that there are chances of missing the diagnosis of the condylar fracture if only the conventional radiographs are used. CT along with conventional radiographs should be considered for better treatment and management of the patients with maxillofacial injuries.

Condylar fractures of mandible are not very easy to diagnose radiographicaly. If fracture is vertical, it would be much more difficult to diagnose. Since treatment depends on type of fracture, CT scan is advised rather than conventional radiographs to diagnose condylar fractures.The cases reporting to the hospital during the period of July 2019 to April 2020 were enrolled, of which 2 cases have been reported here. It was observed that there are chances of missing the diagnosis of the condylar fracture if only the conventional radiographs are used. CT along with conventional radiographs should be considered for better treatment and management of the patients with maxillofacial injuries.

Evaluar la dimensión antero- posterior (A-P)/medio-lateral (M–L), y la morfología del cóndilo mandibular en pacientes de 18 a 65 años con patrón esquelético Clase I en tomografías computarizadas Cone Beam. Material y Métodos: 71 tomografías fueron evaluadas mediante el software RealScan 2.0. La dimensión fue determinada por los puntos A (más anterior en el plano sagital), P (más posterior en el plano sagital), M (más interno en el plano coronal), L (más externo en plano coronal). Se evaluó la morfología del cóndilo en dos planos coronal y sagital, clasificándose en: redonda, aplanada, convexa y mixta. La dimensión del cóndilo fue analizada por estadística descriptiva y la morfología mediante distribución de frecuencias. Para el análisis bivariado, se aplicó la prueba de t de Student. Resultado: Se obtuvieron las medidas del diámetro A-P del cóndilo derecho (CD) (8,72mm ± 1,25mm) y el izquierdo (CI) (8,50mm ± 1,50mm), el diámetro M-L del CD (19,24mm ± 2,03mm) y el CI (18,97mm ± 1,87mm). Hubo diferencias significativas en la dimensión M-L del CI del sexo masculino en comparación al femenino (p=0.002). La morfología más prevalente del CD (35,21) y CI (23,94) en plano coronal fue de tipo redonda. Conclusión: La dimensión A-P del cóndilo derecho e izquierdo es similar en ambos sexos; sin embargo, existen diferencias en la dimensión M-L del cóndilo izquierdo del sexo masculino. La morfología del cóndilo derecho e izquierdo más prevalente fue la redonda en plano sagital a excepción del plano coronal., To evaluate the anterior-posterior (A-P)/medial-lateral (M-L) dimension, and morphology of the mandibular condyle in patients aged 18 to 65 years with Class I skeletal pattern on Cone Beam Computed Tomography scans (CBCTs). Materials and Methods: Seventy one CBCTs were evaluated using RealScan 2.0 software. The dimension was determined by points A (most anterior in the sagittal plane), P (most posterior in the sagittal plane), M (most interior in the coronal plane), L (most exterior in the coronal plane). The morphology of the condyle was evaluated in two coronal and sagittal planes, being classified as: round, flat, convex or mixed. The size of the condyle was analyzed by descriptive statistics and the morphology by frequency distribution. For the bivariate analysis, the Student’s t-test was applied. Results: Measurements were obtained for the A-P diameter of the right condyle (RC) (8.72mm ± 1.25mm) and the left condylar (LC) (8.50mm ± 1.50mm), the M-L diameter of the RC (19.24mm ± 2.03mm) and the LC (18.97mm ± 1.87mm). There were significant differences in the male M-L dimension of the LC compared to the female (p=0.002). The most prevalent morphology of RC (35.21) and IQ (23.94) in the coronal plane was round.. Conclusion: The A-P dimension of the right and left condyle is similar in both genders; however, there are differences in the M-L dimension of the left male condyle. The most prevalent morphology of the right and left condyle was round in the sagittal plane with the exception of the coronal plane., Revisión por pares

Condylar fractures of mandible are not very easy to diagnose radiographicaly. If fracture is vertical, it would be much more difficult to diagnose. Since treatment depends on type of fracture, CT scan is advised rather than conventional radiographs to diagnose condylar fractures.The cases reporting to the hospital during the period of July 2019 to April 2020 were enrolled, of which 2 cases have been reported here. It was observed that there are chances of missing the diagnosis of the condylar fracture if only the conventional radiographs are used. CT along with conventional radiographs should be considered for better treatment and management of the patients with maxillofacial injuries. Keywords: Sagittal fracture; Mandibular condyle; Conventional radiographs; Axial & Coronal CT.

Condylar fractures of mandible are not very easy to diagnose radiographicaly. If fracture is vertical, it would be much more difficult to diagnose. Since treatment depends on type of fracture, CT scan is advised rather than conventional radiographs to diagnose condylar fractures.The cases reporting to the hospital during the period of July 2019 to April 2020 were enrolled, of which 2 cases have been reported here. It was observed that there are chances of missing the diagnosis of the condylar fracture if only the conventional radiographs are used. CT along with conventional radiographs should be considered for better treatment and management of the patients with maxillofacial injuries. Keywords: Sagittal fracture; Mandibular condyle; Conventional radiographs; Axial & Coronal CT.

To evaluate the anterior-posterior (A-P)/medial-lateral (M-L) dimension, and morphology of the mandibular condyle in patients aged 18 to 65 years with Class I skeletal pattern on Cone Beam Computed Tomography scans (CBCTs). Materials and Methods: Seventy one CBCTs were evaluated using RealScan 2.0 software. The dimension was determined by points A (most anterior in the sagittal plane), P (most posterior in the sagittal plane), M (most interior in the coronal plane), L (most exterior in the coronal plane). The morphology of the condyle was evaluated in two coronal and sagittal planes, being classified as: round, flat, convex or mixed. The size of the condyle was analyzed by descriptive statistics and the morphology by frequency distribution. For the bivariate analysis, the Student's t-test was applied. Results: Measurements were obtained for the A-P diameter of the right condyle (RC) (8.72mm ± 1.25mm) and the left condylar (LC) (8.50mm ± 1.50mm), the M-L diameter of the RC (19.24mm ± 2.03mm) and the LC (18.97mm ± 1.87mm). There were significant differences in the male M-L dimension of the LC compared to the female (p=0.002). The most prevalent morphology of RC (35.21) and IQ (23.94) in the coronal plane was round. . Conclusion: The A-P dimension of the right and left condyle is similar in both genders; however, there are differences in the M-L dimension of the left male condyle. The most prevalent morphology of the right and left condyle was round in the sagittal plane with the exception of the coronal plane., Evaluar la dimensión antero- posterior (A-P)/medio-lateral (M–L), y la morfología del cóndilo mandibular en pacientes de 18 a 65 años con patrón esquelético Clase I en tomografías computarizadas Cone Beam. Material y Métodos: 71 tomografías fueron evaluadas mediante el software RealScan 2.0. La dimensión fue determinada por los puntos A (más anterior en el plano sagital), P (más posterior en el plano sagital), M (más interno en el plano coronal), L (más externo en plano coronal). Se evaluó la morfología del cóndilo en dos planos coronal y sagital, clasificándose en: redonda, aplanada, convexa y mixta. La dimensión del cóndilo fue analizada por estadística descriptiva y la morfología mediante distribución de frecuencias. Para el análisis bivariado, se aplicó la prueba de t de Student. Resultado: Se obtuvieron las medidas del diámetro A-P del cóndilo derecho (CD) (8,72mm ± 1,25mm) y el izquierdo (CI) (8,50mm ± 1,50mm), el diámetro M-L del CD (19,24mm ± 2,03mm) y el CI (18,97mm ± 1,87mm). Hubo diferencias significativas en la dimensión M-L del CI del sexo masculino en comparación al femenino (p=0.002). La morfología más prevalente del CD (35,21) y CI (23,94) en plano coronal fue de tipo redonda. Conclusión: La dimensión A-P del cóndilo derecho e izquierdo es similar en ambos sexos; sin embargo, existen diferencias en la dimensión M-L del cóndilo izquierdo del sexo masculino. La morfología del cóndilo derecho e izquierdo más prevalente fue la redonda en plano sagital a excepción del plano coronal.

Evaluar la dimensión antero- posterior (A-P)/medio-lateral (M–L), y la morfología del cóndilo mandibular en pacientes de 18 a 65 años con patrón esquelético Clase I en tomografías computarizadas Cone Beam. Material y Métodos: 71 tomografías fueron evaluadas mediante el software RealScan 2.0. La dimensión fue determinada por los puntos A (más anterior en el plano sagital), P (más posterior en el plano sagital), M (más interno en el plano coronal), L (más externo en plano coronal). Se evaluó la morfología del cóndilo en dos planos coronal y sagital, clasificándose en: redonda, aplanada, convexa y mixta. La dimensión del cóndilo fue analizada por estadística descriptiva y la morfología mediante distribución de frecuencias. Para el análisis bivariado, se aplicó la prueba de t de Student. Resultado: Se obtuvieron las medidas del diámetro A-P del cóndilo derecho (CD) (8,72mm ± 1,25mm) y el izquierdo (CI) (8,50mm ± 1,50mm), el diámetro M-L del CD (19,24mm ± 2,03mm) y el CI (18,97mm ± 1,87mm). Hubo diferencias significativas en la dimensión M-L del CI del sexo masculino en comparación al femenino (p=0.002). La morfología más prevalente del CD (35,21) y CI (23,94) en plano coronal fue de tipo redonda. Conclusión: La dimensión A-P del cóndilo derecho e izquierdo es similar en ambos sexos; sin embargo, existen diferencias en la dimensión M-L del cóndilo izquierdo del sexo masculino. La morfología del cóndilo derecho e izquierdo más prevalente fue la redonda en plano sagital a excepción del plano coronal., To evaluate the anterior-posterior (A-P)/medial-lateral (M-L) dimension, and morphology of the mandibular condyle in patients aged 18 to 65 years with Class I skeletal pattern on Cone Beam Computed Tomography scans (CBCTs). Materials and Methods: Seventy one CBCTs were evaluated using RealScan 2.0 software. The dimension was determined by points A (most anterior in the sagittal plane), P (most posterior in the sagittal plane), M (most interior in the coronal plane), L (most exterior in the coronal plane). The morphology of the condyle was evaluated in two coronal and sagittal planes, being classified as: round, flat, convex or mixed. The size of the condyle was analyzed by descriptive statistics and the morphology by frequency distribution. For the bivariate analysis, the Student’s t-test was applied. Results: Measurements were obtained for the A-P diameter of the right condyle (RC) (8.72mm ± 1.25mm) and the left condylar (LC) (8.50mm ± 1.50mm), the M-L diameter of the RC (19.24mm ± 2.03mm) and the LC (18.97mm ± 1.87mm). There were significant differences in the male M-L dimension of the LC compared to the female (p=0.002). The most prevalent morphology of RC (35.21) and IQ (23.94) in the coronal plane was round.. Conclusion: The A-P dimension of the right and left condyle is similar in both genders; however, there are differences in the M-L dimension of the left male condyle. The most prevalent morphology of the right and left condyle was round in the sagittal plane with the exception of the coronal plane., Revisión por pares

Condylar fractures of mandible are not very easy to diagnose radiographicaly. If fracture is vertical, it would be much more difficult to diagnose. Since treatment depends on type of fracture, CT scan is advised rather than conventional radiographs to diagnose condylar fractures.The cases reporting to the hospital during the period of July 2019 to April 2020 were enrolled, of which 2 cases have been reported here. It was observed that there are chances of missing the diagnosis of the condylar fracture if only the conventional radiographs are used. CT along with conventional radiographs should be considered for better treatment and management of the patients with maxillofacial injuries. Keywords: Sagittal fracture; Mandibular condyle; Conventional radiographs; Axial & Coronal CT.

The human temporomandibular joint (TMJ) is involved in vital functions such asfeeding and talking, while its disorder prevalence is reported to be between 5% and 12%.Functional evaluation using quantitative motion analysis tools is interesting in order to betterunderstand normal and abnormal TMJ behavior. But, for the same mandibular displacement,left and right condyles will most certainly give different motion representation: both condylesshowing a different shape and volume, being most of the time asymmetric and highly individual.This study performs quantification on relative left and right condyle orientation and positionusing the spatial location of palpated anatomical landmarks (ALs) and anatomical frames (AFs),on three-dimensional (3D) models created from computerized tomography (CT) performed on94 mandibles from Université Libre de Bruxelles bone repository, and magnetic resonance imag-ing (MRI) performed on 11 living subjects. Our aim was to gather as much data as possible onthe morphological aspect of the condyle’s orientation asymmetry within the same mandible, inorder to better address the difference of motion representation that will be observed for theright and left condyles in further kinematic studies., info:eu-repo/semantics/published

Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma due to anatomical and biomechanical factors. Due to the proximity of the mandibular condyle to the middle cranial fossa and middle meningeal artery, there is the risk of serious sequelae in case of trauma. The authors report the case of a 31-year-old female patient, who was beaten up in a family dispute. Computer tomography results demonstrated a basilar skull fracture, pneumocephalus, the dislocation of the mandible into the middle cranial fossa. The patient was hospitalized in the neurosurgical department; anti-edema treatment and antibiotic therapy were prescribed. During the first day, deterioration of the condition presented with rising headache and a gradual suppression of consciousness (GCS 13). The control tomography of the brain revealed negative dynamics in the form of development of intracerebral hemorrhage in the right temporal lobe, subdural hematoma to the right and lateral dislocation of the median structures to the left.The patient was operated in critical situation. Right-sided subtemporal approach and cranial trepanation were performed. There were removed numerous bone fragments of a multi-fragile fracture of the petrous part of the right temporal bone. A reposition of the mandibular condyle was performed by pull-through of the latter from the middle cranial fossa. The intracerebral hemorrhage of the right temporal lobe was removed, and a thorough hemostasis was performed. In addition, skull base reconstruction was performed. Rapid diagnosis and a multidisciplinary approach are needed to minimize complications. The modern opportunities of reconstruction of imaging using the CT method were applied. Treatment options should be individualized in case of suspicion of intracranial hematoma formation., Дислокация головки нижней челюсти в среднюю черепную ямку – редкое осложнение травмы нижней челюсти из-за анатомических и биомеханических факторов. Вследствие близости головки нижней челюсти к средней черепной ямке и менингиальным артериям существует риск серьезных последствий в случае травмы. Описан клинический случай. Пациентка в возрасте 31 год была избита во время семейного спора. По данным спиральной компьютерной томографии головного мозга обнаружен перелом основания черепа, пневмоцефалии, дислокация нижней челюсти в среднюю черепную ямку. Больную госпитализировали в нейрохирургическое отделение. Назначили противоотечную, антибактериальную терапию. В течение первых суток отмечено ухудшение состояния в виде нарастания головной боли и постепенного угнетения сознания до умеренного оглушения (13 баллов по шкале комы Глазго). По данным контрольной томографии головного мозга обнаружена отрицательная динамика в виде появления внутримозгового кровоизлияния в правую височную долю, субдуральной гематомы справа и латеральной дислокации срединных структур влево.Пациентке проведена операция по жизненным показаниям. Выполнены правосторонний подвисочный доступ и костно-пластическая трепанация черепа. Удалены многочисленные осколки многооскольчатого перелома пирамиды правой височной кости. Проведена репозиция головки нижней челюсти путем низведения последней со средней черепной ямки. Удалено внутримозговое кровоизлияние в правой височной доли и выполнен тщательный гемостаз. Дополнительно проведена реконструкция основания черепа аутотканями и Тахокомбом. Для минимизации осложнений необходимы быстрое установление диагноза и мультидисциплинарный подход. Применены современные возможности реконструкции изображения методом спиральной компьютерной томографии. В случае подозрения на формирование внутричерепной гематомы метод лечения выбирают индивидуально., Дислокація головки нижньої щелепи в середню черепну ямку – рідкісне ускладнення травми нижньої щелепи через анатомічні та біомеханічні чинники. Внаслідок близькості головки нижньої щелепи до середньої черепної ямки та менінгіальних артерій існує ризик серйозних наслідків у разі травми. Описано клінічний випадок. Пацієнтку віком 31 рік було побито під час сімейної суперечки. За даними спіральної комп’ютерної томографії головного мозку виявлено перелом основи черепа, пневмоцефалію, дислокацію нижньої щелепи в середню черепну ямку. Хвору госпіталізовано до нейрохірургічного відділення. Призначено протинабрякову, антибактеріальну терапію. Протягом першої доби відзначено погіршення стану у вигляді наростання головного болю та поступового пригнічення свідомості до помірного приглушення (13 балів за шкалою коми Глазго). За даними контрольної томографії головного мозку виявлено негативну динаміку, зокрема появу внутрішньомозкового крововиливу в праву скроневу частку, субдуральну гематому праворуч та латеральну дислокацію серединних структур ліворуч.Пацієнтці проведено операцію за життєвими показаннями. Виконано правобічний підскроневий доступ і кістково-пластичну трепанацію черепа. Видалено численні уламки багатоуламкового перелому піраміди правої скроневої кістки. Проведено репозицію головки нижньої щелепи шляхом зведення донизу останньої із середньої черепної ямки. Видалено внутрішньомозковий крововилив у правій скроневій частці та виконано ретельний гемостаз. Додатково проведено реконструкцію основи черепа автотканинами і Тахокомбом. Для мінімізації ускладнень необхідні швидке встановлення діагнозу та мультидисциплінарний підхід. Застосовано сучасні можливості реконструкції зображення методом спіральної комп’ютерної томографії. У разі підозри щодо формування внутрішньочерепної гематоми метод лікування вибирають індивідуально.

Introduction: The presence of the pericondylar vein in the area of the temporomandibular joint is scarcely reported in the literature; however, it is present in anatomical dissected preparations and during surgical procedures.Objective: To determine the characteristics of the pericondylar vein located in the area of the temporomandibular joint, related to the parotid region.Material and Methods: A cross-sectional, prospective study that included 30 human cadavers that were dissected at the temporomandibular joint level was conducted. The variables analyzed were the distribution of the pericondylar vein, its shape, dimensions and the relationships existing between bony structures.Results: The 30 cases presented the pericondylar vein that surrounded the external face of the neck of the mandibular condyle; 73,3 % of the veins ended at the level of the retromandibular vein; 38,3 % of them presented an oblique path. The average length of the vein was 2,37 cm and its average diameter was 1.82 mm. The presence of the pericondyleal artery was found in two cases, among other relationships.Conclusions: The pericondyleal vein was present in all cases, mostly unique and located around the outside of the neck of the mandibular condyle. It most frequently runs into the retromandibular vein. Up to its mouth, it often has an oblique path, from top to bottom and backwards., Introducción: La presencia de la vena pericondílea en la zona de la articulación temporomandibular es escasamente reportado en la literatura, sin embargo se encuentra presente en los preparados anatómicos disecados, y durante los procedimientos quirúrgicos.Objetivo: Determinar las características de la vena pericondílea ubicada en la zona de la articulación temporomandibular, relacionadas con la región parotídea.Material y Métodos: Se diseñó un estudio transversal, prospectivo que incluyó 30 cadáveres humanos que fueron diseccionados a nivel de la articulación temporomandibular. Se analizó las variables de distribución de la vena pericondílea, forma, dimensiones y relaciones con las estructuras adyacentes. Resultados: Los 30 casos presentaron la vena pericondílea que rodeó la cara externa del cuello del cóndilo mandibular. El 73,3 % de venas desembocó a nivel de la vena retromandibular. El 38,3 % de venas presentaron trayecto oblicuo. La longitud promedio fue de 2,37 cm y su diámetro promedio de 1,82 mm. Entre las relaciones, se encontró la presencia de la arteria pericondílea en dos casos.Conclusiones: La vena pericondílea estuvo presente en todos los casos en su mayoría única y localizada rodeando por fuera el cuello del cóndilo mandibular; desemboca con mayor frecuencia en la vena retromandibular y hasta su desembocadura presenta frecuentemente trayecto oblicuo, de arriba hacia abajo y hacia atrás.

Bifidism of mandibular condyle is an uncommon anomaly of unknown etiology and uncertain pathogenesis. Usually it is asymptomatic and detected incidentally on a panoramic radiograph. However, it may be symptomatic where panoramic radiograph should be supplemented with computed tomography or magnetic resonance if surgical treatment is planned. The literature has reviewed many cases of bifid condyle mostly unilateral. The association of other dental abnormalities associated with bifid condyle has not been reported. We present a rare case of bilateral bifid condyle along with anterior disc displacement with reduction which also showed multiple missing teeth and retained deciduous teeth. This case report signifies the importance of both developmental and occlusal factors as an etiology for symptomatic temporomandibular joint.

Bifidism of mandibular condyle is an uncommon anomaly of unknown etiology and uncertain pathogenesis. Usually it is asymptomatic and detected incidentally on a panoramic radiograph. However, it may be symptomatic where panoramic radiograph should be supplemented with computed tomography or magnetic resonance if surgical treatment is planned. The literature has reviewed many cases of bifid condyle mostly unilateral. The association of other dental abnormalities associated with bifid condyle has not been reported. We present a rare case of bilateral bifid condyle along with anterior disc displacement with reduction which also showed multiple missing teeth and retained deciduous teeth. This case report signifies the importance of both developmental and occlusal factors as an etiology for symptomatic temporomandibular joint.

Objective: To compare condylar dimensions of young adults with Class II and Class III skeletal patterns using cone-beam computed tomography (CBCT). Materials and methods: 124 CBCTs from 18-30 year-old patients, divided into 2 groups according to skeletal patterns (Class II and Class III) were evaluated. Skeletal patterns were classified by measuring the ANB angle of each patient. The anteroposterior diameter (A and P) of the right and left mandibular condyle was assessed from a sagittal view by a line drawn from point A (anterior) to P (posterior). The coronal plane allowed the evaluation of the medio-lateral diameter by drawing a line from point M (medium) to L (lateral); all distances were measured in mm. Results: In Class II the A-P diameter was 9.06±1.33 and 8.86±1.56 for the right and left condyles respectively, in Class III these values were 8.71±1.2 and 8.84±1.42. In Class II the M-L diameter was 17.94±2.68 and 17.67±2.44 for the right and left condyles respectively, in Class III these values were 19.16±2.75 and 19.16±2.54. Conclusion: Class III M-L dimensions showed higher values than Class II, whereas these differences were minimal in A-P., Revisión por pares

Objective: To compare condylar dimensions of young adults with Class II and Class III skeletal patterns using cone-beam computed tomography (CBCT). Materials and methods: 124 CBCTs from 18-30 year-old patients, divided into 2 groups according to skeletal patterns (Class II and Class III) were evaluated. Skeletal patterns were classified by measuring the ANB angle of each patient. The anteroposterior diameter (A and P) of the right and left mandibular condyle was assessed from a sagittal view by a line drawn from point A (anterior) to P (posterior). The coronal plane allowed the evaluation of the medio-lateral diameter by drawing a line from point M (medium) to L (lateral); all distances were measured in mm. Results: In Class II the A-P diameter was 9.06±1.33 and 8.86±1.56 for the right and left condyles respectively, in Class III these values were 8.71±1.2 and 8.84±1.42. In Class II the M-L diameter was 17.94±2.68 and 17.67±2.44 for the right and left condyles respectively, in Class III these values were 19.16±2.75 and 19.16±2.54. Conclusion: Class III M-L dimensions showed higher values than Class II, whereas these differences were minimal in A-P., Revisión por pares

Mandibularni prognatizam je deformitet lica i vilica koji objedinjuje različite oblike skeletnih devijacija u odnosima vilica i proporcijama lica koje su toliko izrazite da skreću pažnju okoline i predstavljaju hendikep za dotičnu osobu. Suština ove anomalije se sastoji u izrazitoj razlici u veličini gornje i donje vilice. Shodno etiološkoj klasifikaciji, mandibularni prognatizam je primarno skeletna nepravilnost koja se manifestuje neadekvatnom veličinom, oblikom i položajem donje a često i gornje vilice. Kod najvećeg broja pacijenata sa mandibularnim prognatizmom optimalan funkcionalni i estetski rezultat može pružiti samo kombinovana ortodontsko-hirurška terapija, pri čemu je u pojedinim slučajevima indikovana bimaksilarna hirurška korekcija. Smatra se da ortognatska hirurgija može da promeni poziciju kondila, a to može biti jedan od faktora koji doprinosi ranom skeletnom recidivu i pojavi temporomandibularnih disfunkcija. Iz tih razloga, uradili smo originalnu analizu profilnih telerentgenskih snimaka i sproveli interviju sa pacijentima u okviru istraživackog kartona koji su prikazani u rezultatima ovog istraživanja. Na telerendgenskim snimcima 21 ispitanika sa mandibularnim prognatizmom mereni su angularni i linearni parametri koji opisuju promene u položaju kondila, pre ortodontske pripreme i šest meseci nakon hirurške korekcije mandibularnog prognatizma. Takođe, cilj ove studije je bio da proceni promene pozicije kondila kao i da ne korelišu promene pozicije kondila sa angularnim skeletnim promenama nakon bimaksilarne hirurgije. Ustanovljena je statistička značajnost razlika u vrednosti parametara između grupa. Tačka DI – najdistalnija tačka na glavi kondila, pomerila se unazad 1,38 mm (p = 0,02), a tačka DC – tačka koja označava centar collum mandibulae, pomerila se, takođe, unazad za 1,52 mm (p = 0,007). Vrednost pomeranja tačke DI naviše bila je 1,62 mm (p = 0,04). Došlo je do smanjenja vrednosti ugla ArGoMe što indirektno ukazuje na prednju rotaciju kondi, Mandibular prognathism is a deformity of the face and jaw which combines various forms of skeletal deviation in relations of jaws and facial proportions that are so pronounced that draw the attention of the environment and represent a handicap for the patient. The essence of this anomaly consists in a difference in the size of the upper and lower jaw. According to etiologic classification, mandibular prognathism is primarily skeletal abnormality that is manifested by inadequate size, shape and position of the lower and often the upper jaw. In the majority of patients with mandibular prognathism, optimal functional and aesthetic result can only be provided with a combined orthodontic-surgical therapy, where in some cases, bimaxillary surgical correction is indicated. It is believed that orthognathic surgery can change the position of the condyle, and this may be one of the factors contributing to early skeletal relapse and occurrence of temporomandibular dysfunction. For these reasons, we did the original analysis of cephalograms and conducted an interview with the patients, as shown in the results of this research. On the radiograms of 21 patients with mandibular prognathism, angular and linear parameters were measured to describe the changes in position of the condyle, before orthodontic preparation and six months after the surgical correction of mandibular prognathism. The purose of this study was to assess changes in condylar position and to correlate changes in condylar position with angular skeletal changes after bimaxillary surgery. There were statistically significant differences in values between the groups. Point DI - the most distal point of the condyle head, moved back to 1.38 mm (p = 0.02), a DC point - a point that marks the center collum mandible, moved back to 1.52 mm (p = 0.007 ). DI point moved upward for 1.62 mm (p = 0.04). There was a decrease in the value of the angle ArGoMe which indirectly shows the front of the rotation of the condyle...

Mandibular prognathism is a deformity of the face and jaw which combines various forms of skeletal deviation in relations of jaws and facial proportions that are so pronounced that draw the attention of the environment and represent a handicap for the patient. The essence of this anomaly consists in a difference in the size of the upper and lower jaw. According to etiologic classification, mandibular prognathism is primarily skeletal abnormality that is manifested by inadequate size, shape and position of the lower and often the upper jaw. In the majority of patients with mandibular prognathism, optimal functional and aesthetic result can only be provided with a combined orthodontic-surgical therapy, where in some cases, bimaxillary surgical correction is indicated. It is believed that orthognathic surgery can change the position of the condyle, and this may be one of the factors contributing to early skeletal relapse and occurrence of temporomandibular dysfunction. For these reasons, we did the original analysis of cephalograms and conducted an interview with the patients, as shown in the results of this research. On the radiograms of 21 patients with mandibular prognathism, angular and linear parameters were measured to describe the changes in position of the condyle, before orthodontic preparation and six months after the surgical correction of mandibular prognathism. The purose of this study was to assess changes in condylar position and to correlate changes in condylar position with angular skeletal changes after bimaxillary surgery. There were statistically significant differences in values between the groups. Point DI - the most distal point of the condyle head, moved back to 1.38 mm (p = 0.02), a DC point - a point that marks the center collum mandible, moved back to 1.52 mm (p = 0.007 ). DI point moved upward for 1.62 mm (p = 0.04). There was a decrease in the value of the angle ArGoMe which indirectly shows the front of the rotation of the condyle..., Mandibularni prognatizam je deformitet lica i vilica koji objedinjuje različite oblike skeletnih devijacija u odnosima vilica i proporcijama lica koje su toliko izrazite da skreću pažnju okoline i predstavljaju hendikep za dotičnu osobu. Suština ove anomalije se sastoji u izrazitoj razlici u veličini gornje i donje vilice. Shodno etiološkoj klasifikaciji, mandibularni prognatizam je primarno skeletna nepravilnost koja se manifestuje neadekvatnom veličinom, oblikom i položajem donje a često i gornje vilice. Kod najvećeg broja pacijenata sa mandibularnim prognatizmom optimalan funkcionalni i estetski rezultat može pružiti samo kombinovana ortodontsko-hirurška terapija, pri čemu je u pojedinim slučajevima indikovana bimaksilarna hirurška korekcija. Smatra se da ortognatska hirurgija može da promeni poziciju kondila, a to može biti jedan od faktora koji doprinosi ranom skeletnom recidivu i pojavi temporomandibularnih disfunkcija. Iz tih razloga, uradili smo originalnu analizu profilnih telerentgenskih snimaka i sproveli interviju sa pacijentima u okviru istraživackog kartona koji su prikazani u rezultatima ovog istraživanja. Na telerendgenskim snimcima 21 ispitanika sa mandibularnim prognatizmom mereni su angularni i linearni parametri koji opisuju promene u položaju kondila, pre ortodontske pripreme i šest meseci nakon hirurške korekcije mandibularnog prognatizma. Takođe, cilj ove studije je bio da proceni promene pozicije kondila kao i da ne korelišu promene pozicije kondila sa angularnim skeletnim promenama nakon bimaksilarne hirurgije. Ustanovljena je statistička značajnost razlika u vrednosti parametara između grupa. Tačka DI – najdistalnija tačka na glavi kondila, pomerila se unazad 1,38 mm (p = 0,02), a tačka DC – tačka koja označava centar collum mandibulae, pomerila se, takođe, unazad za 1,52 mm (p = 0,007). Vrednost pomeranja tačke DI naviše bila je 1,62 mm (p = 0,04). Došlo je do smanjenja vrednosti ugla ArGoMe što indirektno ukazuje na prednju rotaciju kondi

学位の種類: 博士（歯学）. 報告番号: 乙第2177号. 学位記番号: 新大（歯）乙第187号. 学位授与年月日: 平成26年1月31日, 日本口腔科学会雑誌. 2013, 62(3), 215-223, 博士（歯学）, 新潟大学

The purpose of this study is to compare the condyle morphology utilizing the panoramic radiography vs. magnetic resonance image (MRI) in asymptomatic volunteers and symptomatic temporomandibular joints disorder (TMJD) patients. Methods: This retrospective study included 247 individuals (494 joints) divided into two groups: the control group consists of 16 subjects (32 Joints) with no history of TMJD symptoms and the symptomatic group of 231 subjects (462 Joints) with TMJD symptoms. Existing panoramic radiography and magnetic resonance image (MRI) of controls and TMJD patients were studied by one blinded examiner. The examiner was calibrated to identify radiographic abnormalities of the condyles. Power analysis was calculated with a significance level set at 0.05 and our study had 84% power to detect flattening difference between panoramic x-ray and MRI. Three different types of radiographic abnormalities in the condyles were recorded as present or absent: articular surface flattening, sclerosis, and osteophytes. Results: This study found flattening, sclerosis and osteophytes in both control and symptomatic populations. Flattening was found in 32% of controls and 32% of the symptomatic population. Sclerosis was found in 22% of controls and 26% of symptomatics. Osteophytes were found in 25% of controls and 26% of the symptomatic population. The osseous changes of flattening, sclerosis and osteophytes were detected less often on the panoramic radiograph than the MRI for the both groups. Using MRI as Gold standard the McNemar test showed significance differences between the flattening, sclerosis and osteophyte detected on MRI and panoramic radiograph. Conclusion: Our results confirmed that osseous changes such as flattening, osteophytes and sclerosis are present in control patients and patients with TMJ dysfunction. Panoramic radiography may be useful to detect gross osseous changes of the TMJ, but careful evaluation is necessary.

This study investigated the interobserver variability of dynamic magnetic resonance (MR) imaging of the temporomandibular joint (TMJ).

This study investigated the interobserver variability of dynamic magnetic resonance (MR) imaging of the temporomandibular joint (TMJ).

The authors of this study propose a new informed consent form for orthognathic surgery. In a previous study from 2004, a careful review of the international literature and clinical practice suggested the feasibility of dividing the informed consent form into 2 parts, one describing diagnostic procedures and therapeutic/surgical times, and another describing possible problems. During these 4 years, we noticed that this model has 2 setbacks. We replaced point 2, "temporomandibular joint disorders," with "postoperative temporomandibular joint derangement," so that the surgeon is now supposed to inform the patient on the possibility of condylar dislocations, condylar sag, and clockwise/anticlockwise rotations of occlusal surface after surgery. We also changed point 5, "tooth and periodontal disease," in "tooth damage, avulsion, and periodontal disease" because we believe patients should be informed better on the risk of injuries to the dental elements such as fractures, luxations, or avulsions, especially to incisors. In the opinion of the authors, this new informed consent form allows the patient to know the risks related to the orthodontic/surgical therapy better, thus preserving the surgeons from the civil risk and penalties of omission.

The purpose of this study was to compare a computed tomographic (CT) three-dimensional analysis with a model analysis to use it as diagnostic aid for the evaluation of occlusal plane tilting in facial asymmetry. Ten patients with facial asymmetry underwent CT three-dimensional examination, plaster cast analysis, and two-dimensional cephalometric analysis. The distance between a reference plane to the upper first molar and upper canine was measured on three-dimensional CT, on models, and on cephalograms to assess occlusal plane tilting. Measurements taken on three-dimensional CT were compared with those taken on articulator and cephalograms, and the level of discordance between the different analyses was evaluated. Quantitative data on the occlusal tilting are similar, but three-dimensional CT gives a better representation of anatomy, thus reducing interpretative problems about altered individual anatomy. Three-dimensional CT seems to be so helpful in detecting individual anatomical variations that it can be adopted in the diagnosis for severe craniofacial asymmetry.

A rare case of aneurysmal bone cyst (ABC) located in the mandibular condyle in a 10-year-old boy is presented. The patient came to our attention for a sudden swelling in the right temporomandibular region, the mouth opening was not reduced. A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found. Clinically and radiographically it resembled to a malignant lesion. The surgical excision of the mandibular condyle allowed a complete removal of the lesion. The histological examination revealed a pseudocystic expanding osteolytic lesion containing blood-filled space separated by connective tissue and many osteoclastic giant cells, which was a conventional vascular ABC. The ABC is an infrequent bone lesion which can only be found very rarely at the craniofacial skeleton. There have been described about 160 cases of ABC originated in the molar region or in upper maxilla and even more rare is the location of this cyst in the mandibular condyle. Only 6 cases were reported in the literature to date. A complete surgical resection of this osteolytic lesion is the treatment of choice considering its high recurrence rate. The condyle was not replaced with any graft. Therefore a functional device was used after surgery to overcome the lack of the condyle and to stimulate the growth of the ramus.

The mandibular condyle is an important growth site in the developing mandible. The growth of the condyle is known to be highly adaptable to functional factors. This property is exploited in orthodontics for the treatment of class II malocclusions and mandibular asymmetries. However, there is an ongoing debate on the efficacy of functional appliances. The comparison of experimental studies is complicated by the lack of detailed analyses of the load distribution within the condyle. In spite of this, there is a large body of evidence showing that mechanical manipulation of the condyle induces metabolic changes, and changes in the expression of growth factors and other signalling molecules. This review aims to give an overview of the role of growth factors in the condyle with special emphasis on their responsiveness to mechanical perturbation. (C) 2008 Elsevier Ltd. All rights reserved.

The mandibular condyle is a major growth site and is known to adapt to functional factors. Numerous studies have been performed on the effects of growth factors on the metabolism of primary cartilages, but only a few investigations have examined their action on primary and secondary cartilages. Therefore, the purpose of this study was to compare the effects of insulin-like growth factor-I (IGF-I), transforming growth factor-beta(1) (TGF-beta(1)), and fibroblast growth factor-2 (FGF-2) on the growth of secondary cartilage from the mandibular condyle and primary cartilage from the femoral head of new-born rats. In addition, synergy between these growth factors was investigated. The level of glycosaminoglycan (GAG) and DNA synthesis was analysed after 5 days in culture with the growth factors. The effects of TGF-beta(1) and FGF-2 on growth, tissue organization, and the GAG and collagen content were also evaluated.The stimulation of cell proliferation by the growth factors was higher in the mandibular condyles than in the femoral heads. The content of the matrix components was reduced more by FGF-2 in the mandibular condyles than in the femoral heads. Both TGF-beta(1) and FGF-2 antagonized the stimulatory effects of IGF-I on GAG synthesis in the two types of cartilage. In contrast, the total growth of mandibular condyles was not affected by TGF-beta(1) and FGF-2 while that of femoral heads was strongly reduced. This was mainly due to the inhibition of chondrocyte hypertrophy. These results show that in spite of the extensive effects of growth factors on the metabolism of mandibular condyles, their dimensional growth was not affected.

The secondary cartilage of the mandibular condyle is considered to be adaptive to functional factors. In the last decades, growth factors have also been shown to be potent regulators of cartilage metabolism. Moreover, it has been suggested that growth factors may differentially regulate the growth of primary and secondary cartilages. However, only a few studies have made a direct comparison of the effects of growth factors on both cartilages. Therefore, the aim here was to compare the effects of FGF-2 on secondary cartilage of the mandibular condyle and primary cartilage of the femoral head from 4-day-old rats in vitro. Cartilages were cultured for 1, 7 and 14 days with 0 and 100 ng/mL FGF-2. We evaluated the effects of FGF-2 on growth, tissue organisation, DNA and glycosaminoglycan (GAG) synthesis and GAG and collagen content. With FGF-2, the morphology of the mandibular condyles changed and the GAG and collagen contents were reduced. However, the growth of the mandibular condyles was not affected. On the contrary, the growth of the femoral heads was strongly reduced due to an inhibition of chondrocyte hypertrophy. In both cartilages, FGF-2 stimulated DNA synthesis in short-term cultures and reduced it in long-term cultures. In conclusion, FGF-2 had a larger effect on the metabolism of the mandibular condyles as compared to the femoral heads. However, the growth of the femoral heads was strongly reduced while that of the mandibular condyles was not affected.

Primary and secondary cartilages differ in embryonic origin and in histological organization, and are generally considered to have a different mode of growth. However, few studies have directly compared the two types of cartilage of the same animal at the same age. Therefore, we analysed several histological and biochemical differences between secondary cartilage of the mandibular condyle and primary cartilage of the femoral head of 4-d-old rats. We evaluated the tissue organization, the level of DNA and glycosaminoglycan (GAG) synthesis, and the GAG and collagen content. The expression of collagen types I, II and III and of receptors for insulin-like growth factor (IGF)-I, fibroblast growth factor (FGF), and transforming growth factor (TGF)-beta were investigated by immunohistochemistry. The ex vivo DNA and GAG synthesis as well as the GAG content of femoral heads were much higher than that of mandibular condyles. Mandibular condyles expressed both collagen types I and II, while femoral heads expressed only type II collagen. In the mandibular condyles, receptors for IGF-I, FGF, and TGF-beta were observed mainly in the superficial layers, whereas they were found throughout the entire femoral head. In conclusion, major differences were found between both types of cartilage, which might be related to their specific functional demands.

The aim was to compare the trabecular bone volume (TBV) and the total bone volume (TOBV) of human temporomandibular joints (TMJ) with erosive changes with those of joints without erosive changes. We examined 35 TMJ autopsy specimens from 19 individuals aged 66 88 years. Sagittal sections of the joints were analyzed microscopically for erosive hard-tissue changes. The TBV and the TOBV of the sections were assessed with the aid of computerized image analysis. A significant increase in trabecular and total bone volume was found in condyles with erosive changes (TBV = 21%, TOBV = 54%) as compared with condyles without erosive changes (TBV = 15%, TOBV = 40%). The trabecular bone volume of the temporal component was also increased (TBV = 24%) in joints with erosive changes in the condyle as compared with joints with unaffected condyles (TBV = 16%). The findings indicate that the relative bone mass may play a role in the development of erosive changes in the TMJ.

Clinical and radiologic examinations were carried out after a mean 7 year follow up of functional conservative treatment of a mandibular condyle fracture in 16 patients. Anatomic and functional recovery was excellent in children and was often very good in adolescents. Signs of dysfunction were a frequent finding in adults, but these were not considered as important by the patients and their specific treatment was not required.