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Objective: This systematic review investigates the diagnostic, prognostic, and therapeutic implications of immunohistochemical markers in dentigerous cysts (DCs) and odontogenic keratocysts (OKCs) associated with impacted third molars. Materials and Methods: A comprehensive search strategy was employed across major databases including MEDLINE/PubMed, EMBASE, and Web of Science, from the inception of the databases to March 2024. Keywords and Medical Subject Heading (MeSH) terms such as "dentigerous cysts", "odontogenic keratocysts", "immunohistochemistry", "Ki-67", and "p53" were used. The PRISMA 2020 guidelines were followed to ensure methodological rigor. Inclusion criteria encompassed studies on humans and animals providing definitive diagnoses or specific signs and symptoms related to DCs and OKCs, with results on protein expression derived from immunohistochemistry, immune antibody, proteomics, or protein expression methods. Results: Of the 159 studies initially identified, 138 met the inclusion criteria. Our analysis highlighted significantly higher expressions of Ki-67 (22.1% ± 4.7 vs. 10.5% ± 3.2, p < 0.001), p53 (15.3% ± 3.6 vs. 5.2% ± 1.9, p < 0.001), and Bcl-2 (18.4% ± 3.2 vs. 8.7% ± 2.4, p < 0.001) in OKCs compared to DCs, indicating a higher proliferative index, increased cellular stress, and enhanced anti-apoptotic mechanisms in OKCs. Additionally, PCNA levels were higher in OKCs (25.6% ± 4.5 vs. 12.3% ± 3.1, p < 0.001). Genetic mutations, particularly in the PTCH1 gene, were frequently observed in OKCs, underscoring their aggressive behavior and potential malignancy. Conclusions: The findings emphasize the significant role of immunohistochemical markers in distinguishing between DCs and OKCs, with elevated levels of Ki-67, p53, Bcl-2, and PCNA in OKCs suggesting a higher potential for growth and recurrence. Genetic insights, including PTCH1 mutations, further support the need for personalized treatment approaches. These markers enhance diagnostic accuracy and inform targeted therapeutic strategies, potentially transforming patient management in oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Objective: Obesity is a growing epidemic in the world. It increases the risk for severe health conditions, including diabetes, heart disease and stroke. Recent research has found that obesity is associated with an increased risk for temporomandibular disorders (TMDs). The purpose of this literature review with meta‐analysis is to analyse the possible association between obesity and temporomandibular disorders. Materials and Methods: Pubmed, Web of Science and Lilacs were systematically searched until 01/03/2000. Articles dealing with TMD and obesity were selected, and numbers that might be useful in the meta‐analysis were extracted. Results: Fifty articles were chosen after using all three search engines. Thirty‐five articles were considered during the initial screening step. Four papers were chosen for title and abstract screening based on the PECO model. A manual search of bibliographies and the Cochrane database was also carried out, but no publications that matched the inclusion criteria were located. The articles and meta‐analysis did not show a clear association between obesity and temporomandibular disorders. Conclusion: There is no evidence regarding the reliability of either method. Both have superimposable results. [ABSTRACT FROM AUTHOR]

Background: Condylar hyperplasia (CH) is a rare condition characterised by excessive unilateral growth of the mandibular condyle after cessation of growth on the contralateral side causing facial asymmetry, being more prevalent in the second and third decades. Objective: The aim of this study was to determine the utility of vascular endothelial growth factor (VEGF‐A) as a diagnostic and prognostic factor in condylar hyperplasia, and to determine its potential viability as a therapeutic target. Methods: This is a case–control study, where 17 mandibular condyles specimens were collected from 17 patients treated for active mandibular condyle hyperplasia and three unaffected human mandibular condyles from cadavers will serve as the control group. The samples were immunostained with VEGF‐A antibody and evaluated on both quantity and intensity of staining. Results: VEGF‐A was qualitatively found to be greatly upregulated in patients with condylar hyperplasia. Conclusion: VEGF‐A was qualitatively found to be upregulated in patients affected by CH, validating VEGF‐A as a potential diagnostic, prognostic and therapeutic target. [ABSTRACT FROM AUTHOR]

Temporomandibular disorders (TMD) are a group of internal derangements encompassing dysfunction, displacement, degeneration of the temporomandibular joints and surroundings muscles of mastication, often accompanied by pain. Relationships between TMD and various chemical biomarkers have been examined throughout the years. This paper aims to gather evidence from the literature regarding other biomarkers and presenting them as one systematic review to investigate the potential links between TMD and different biochemical activity. To identify relevant papers, a comprehensive literature search was carried out in MEDLINE/PubMED, EMBASE, Web of Science and a manual search was performed in the International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial surgery, and Journal of Cranio-Maxillo-Facial Surgery. The literature review produced extensive results relating to the biochemical and immunohistochemical markers of TMD. Many enzymes, inflammatory markers, proteoglycans, and hormones were identified and organized in tables, along with a brief description, study design, and conclusion of each study. Through this review, recurring evidence provides confidence in suggesting involvement of certain biomarkers that may be involved in this complex pathogenesis, in addition to pointing to differences in gender prevalence of TMD. However, more organized research on large human samples needs to be conducted to delve deeper into the understanding of how this disease develops and progresses. [ABSTRACT FROM AUTHOR]

Osteochondroma manifests as a benign tumor that occurs as an abnormal bony development. This tumor is commonly asymptomatic and presents an exophytic outgrowth on bone surfaces, near synovial joints, a condition that invariably induces evident facial deformities. Treatment for this type of tumor usually involves a surgical approach promoting a total or partial resection of the affected anatomical area associated to prosthetic reconstruction of the bone area extracted. We present a case report about a giant mandibular condyle osteochondroma in a 37-year-old female patient. Her treatment involved a total condylectomy without immediate condylar reconstruction, which would be performed in a posterior surgical approach. During the patient's follow-up (every 6 months of post operation), a spontaneous and rudimentary condyle-like formation was observed. Because the stomatognathic function and facial harmony were satisfactory, we observed the condyle-like development for 5 years of follow-up. Also, because both the aesthetic aspect and functional evolution of the maxillary bone were considered satisfactory, no complementary reconstruction surgical treatment was required for the giant osteochondroma of the mandibular condyle. [ABSTRACT FROM AUTHOR]

Temporomandibular disorders (TMD) are progressive degenerative disorders that affect the components of the temporomandibular joint (TMJ), characterized by pain and limitations in function. Matrix metalloproteinases (MMP) are enzymes involved in physiological breakdown of tissue that can have a pathological effect from an increase in activity during inflammation. A PubMed search of the current literature (within the past 10 years) was conducted to identify human studies involving matrix metalloproteinases activity in TMJ components of patients with TMD. Two separate searches results in 34 studies, six of which met inclusion criteria. Immunohistochemistry and gene analysis were used to evaluate MMP expression in the study groups. This review showed the strongest evidence for involvement of MMP-1, MMP-2, and MMP-9 in TMD; however, limitations included low sample sizes and a lack of recent clinical studies. Future research with more definitive conclusions could allow for additional pharmaceutical targets in MMP when treating patients with temporomandibular disorders. [ABSTRACT FROM AUTHOR]

Objective Toll-like receptor 4 (TLR-4) is a transmembrane protein involved in the innate immune system and has been implicated in the pathogenesis of temporomandibular joint dysfunction (TMD). The purpose of this study was to histologically examine the level of expression of TLR-4 relative to severity of TMD. Methods Thirty-one human TMJ disc samples were immunostained for TLR-4 and evaluated for intensity of stain. Among the samples, 8 were control samples, 16 were from patients with anterior disc displacement with reduction (ADDwR), and 7 were from patients with anterior disc displacement without reduction (ADDwoR). Results There was no statistically significant difference in intensity of stain between groupings (p = 0.673). Conclusions The results indicate a negative correlation between TMD and the expression of TLR-4. [ABSTRACT FROM AUTHOR]

Objective Temporomandibular joint dysfunction (TMD) may affect a patient's quality of life, and one of the etiologies can be anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDWoR). Interleukin 1 Receptor 1 (IL-1R1) is a membrane receptor that plays an important role on initiating immune and inflammatory response by binding the agonists ligands of IL-1 alpha and IL-1 beta. Therefore, the aim of this study was to evaluate, through immunohistochemical analysis, the association of IL-1R1 with TMD. Methods Thirty-nine human disc samples were collected and composed three different groups: ADDwR (n = 19), ADDwoR (n = 12), and control group (n = 8). The samples were immunostained with IL-1R1 antibody and evaluated on both quantity and intensity of staining. Results There was a statistically significant difference (p < 0.05) between the control and test groups for both quantity and intensity of staining. Conclusion IL1-R1 was associated with ADDwR and ADDwoR in TMD discs of humans. [ABSTRACT FROM AUTHOR]

Objective: Temporomandibular disorders (TMD) are a group of conditions affecting the temporomandibular joint (TMJ), leading to jaw dysfunction, joint and muscle pain, and a decrease in quality of life. A communication network of pro- and anti-inflammatory mediators called cytokines maintains the homeostasis of the TMJ. This review will focus on the Interleukin (IL) family of cytokines, which have been quantified in TMJ synovial fluids in a variety of studies. IL-1α and IL-1β have pro-inflammatory effects, while the endogenous receptor antagonist (IL-1RA) inhibits the pro-inflammatory effects of IL-1.Methods: A literature search (2006-2016) to identify eligible studies was completed using the PubMed database. Studies identified used saline irrigation to quantify cytokine profiles in synovial fluid of healthy and/or dysfunctional joints.Results: The initial search yielded 111 articles, 5 of which met the inclusion criteria after inter-reviewer discussion.Conclusions: Articles that compared IL-1 concentrations in TMD vs. control groups found significant differences. [ABSTRACT FROM AUTHOR]

Objective: MMP-13 performs digestion of collagen, which is a primary component of the temporomandibular joint (TMJ) articular disc. This study evaluated the expression of MMP-13 in patients with anterior disc displacement with (ADDwR) and without reduction (ADDwoR), and in the presence of TMJ osteoarthrosis.Methods: Thirty-nine human temporomandibular joint disc samples were collected and divided in two ways: ADDwR (21 samples), ADDwoR (10 samples), and a control group (8 samples); and with osteoarthrosis (10 samples) and without osteoarthrosis (29 samples). Immunostaining of the TMJ discs was statistically compared between the groups.Results: There was no statistically significant difference for the area of MMP-13 immunostaining between the control group, ADDwR, and ADDwoR, nor between groups with and without osteoarthrosis.Conclusion: This study suggests MMP-13 is not significantly involved in collagen degradation in human TMJ disc displacement or osteoarthrosis. [ABSTRACT FROM AUTHOR]

Purpose: Interleukin-1 beta (IL-1β) is a cytokine that participates in the regulation of immune responses and inflammatory reactions. It is hypothesized that IL-1 levels may be elevated in patients suffering from temporomandibular joint dysfunction. The purpose of this study was to determine the association of IL-1β expression with TMD using an immunohistochemical approach to evaluate the joint disc.Materials and Methods: A total of 39 human temporomandibular joint disc samples were collected, with 31 samples in the test group. Nineteen of the test group samples were from discs of patients with anterior disc displacement with reduction, and 12 of the samples were from patients with anterior disc displacement without reduction. Eight control samples were used in the control group. The samples were immunostained and evaluated on both quantity and intensity of staining.Results: There was a statistically significant difference (p < 0.05) between the control and test groups for both quantity and intensity of staining.Conclusion: IL-1β plays a role in the inflammatory process and degradation of TMJ discs in patients with TMJ dysfunctions. [ABSTRACT FROM AUTHOR]

Condylar hyperplasia (CH) is a rare disorder characterized by excessive bone growth that almost always presents unilaterally, resulting in facial asymmetry. Classification of the different types of CH can differ depending on the authors. Correct diagnosis is critical in determining the proper treatments and timing. This paper is a review of the recent literature on the epidemiology, etiology, diagnosis, classification, and surgical treatments of CH. [ABSTRACT FROM AUTHOR]

Temporomandibular joint (TMJ) internal derangement (ID) is one of the most common form of temporomandibular disorders. There is evidence showing the increased expression of matrix metalloproteinases (MMPs) in the cells from degenerated TMJ disc. ADAMTS are a large family of metalloproteases which are responsible for proteoglycans degradation. The present study aimed to evaluate ADAMTS-4 and ADAMTS-5 immunohistochemical expression in human TMJ discs from patients affected by ID, and to find out if there is any correlation with the degree of histopathological changes. Eighteen temporomandibular displaced disc specimens and sixteen TMJ disc control were used for the present study. Specimens were immunohistochemically processed and ADAMTS-4 and ADAMTS-5 expression were obtained respectively for the anterior (AB), intermediate (IB) and posterior (PB) bands and compared to the histopathological degeneration score (HDS). Immunoreactivity for ADAMTS-4 and -5, was observed in both not degenerated and degenerated human TMJ discs. Both the percentage of ADAMTS-4 and -5 immunostained cells (ES) and the intensity of staining (IS) were significantly greater in affected specimens compared with those in control discs. The ADAMTS-5 ES and IS of the 3 bands of the disc correlated to the TMJ disc HDS (0.001 < P < 0.05), on the other hand only AB and IB, ADAMTS-4 immunostaining scores correlated to HDS. According to these findings it can be assumed in that the more histopathological changes in the disc are detected, the higher levels of ADAMTS are produced. This in turn can lead to ECM breakdown and in turn to a more advanced disc displacement. [ABSTRACT FROM AUTHOR]

INTRODUCTION Myositis ossificans (MO) is characterized as heterotopic bone formation within muscle. MO rarely occurs in the head and neck region. Excision of the heterotopic bone is the standard treatment. This report summarizes a case of a 12-year old female with MO involving the lateral pterygoid muscle. The heterotopic bone was excised using an intraoral incision. Despite intensive physical therapy, the operation failed as evidenced by new bone formation in the area within three weeks of the operation. PRESENTATION OF CASE A twelve years old female patient presenting with mouth opening of 10 mm, no facial asymmetry, and no jaw joint pain or other symptoms. Computer tomography (CT) exam was requested and revealed calcification of the left lateral pterygoid muscle. No other masticatory or head muscles showed any signs of calcification. The calcified muscle was completely removed beyond the ossified segment and a 35 mm mouth opening was achieved immediately after the procedure. One month after total bone structure removal (first surgery) the patient could not open her mouth anymore due to a significant calcified mass. DISCUSSION The surgical technique used in this case avoided invasive gap arthroplasty to access lateral pterygoid muscle and anaesthetic scarring formation, by using an intraorally incision accessing the muscle directly. The authors of these study did not see any relation with the condylar dislocation that the patient had five years prior to the pathology, and they could not find any real cause for the myositis ossificans of lateral pterygoid muscle. CONCLUSION The outcome of the surgical procedure was not successful, perhaps due to the expression of the disease, indicating the need to further physiologic and genetic studies to elucidate the aetiology of MO as well as to provide directions to an adequate treatment choice for such cases. [ABSTRACT FROM AUTHOR]

Background Apoptosis is a programme of cell death which does not induce an inflammatory response. Recent previous research has suggested a correlation between temporomandibular internal derangement and apoptosis. Fas ligand (Fas L) is an apoptosis-inducing factor, known to trigger apoptosis through distinct signal pathways. This study aims to examine, by immunohistochemistry, the expression of Fas L in temporomandibular joint ( TMJ) articular discs of patients with anterior disc displacement with reduction ( ADDwR) and without reduction ( ADDwoR) in patients with and without osteoarthrosis ( OA). Methods Forty-two ( n = 42) TMJ articular discs were divided into two cut-offs: (i) 8 control, 17 ADDwR, 17 ADDwoR, and (ii) without OA ( n = 25) and with OA ( n = 17). The area of immunostaining was compared statistically between groups ( P < 0.05). Results Statistically significant differences were found in the expression of Fas L in TMJ discs between the three groups ( P = 0.001). ADDw R presented significant higher Fas L expression when compared with ADDwo R ( P < 0.001). Significant higher Fas L expression was observed in the group without OA ( P = 0.001). All patients without OA presented ADDw R, while all the patients with OA presented ADDwo R. Conclusion A higher area of in situ immunostaining of Fas L was found in temporomandibular discs with reduction, which is the less severe condition. Moreover, a reduced expression of Fas L in the discs of patients with osteoarthrosis was found, suggesting that some aspects of apoptosis might underlie the progression of TMJ disorders. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: β-defensin-4 is a member of antimicrobial peptides (APs) of the immunity system. This molecule has antimicrobial activity but it seems to be involved in articular inflammatory processes too, as it happens during osteoarthritic disease (OA). Considering the possible relation existing between (OA) and temporomandibular disorders (TMD), the aim of our study was to evaluate immunohistochemically the presence of β- defensin-4 in pathological temporomandibular joint (TMJ) discs affected by internal derangement without reduction (ADDwoR). Design: Eighteen TMJ-displaced disc specimens were considered in this study and were analysed by immunohistochemical evaluation. They were compared with a control sample of sixteen healthy discs and two scores, intensity of staining (IS) and extent score (ES) were estimated. Results: Findings of our analysis showed a significant difference between control and study sample (P < 0.001). IS and ES of control sample and pathological sample were 1 and 4 respectively. Conclusion: Our results confirmed the presence of β-defensin-4 in human TMJ discs affected by ADDwoR, hypothesing a possible role of this molecule in articular bone disruption. [Copyright &y& Elsevier]

Objective. Two main apoptosis pathways have been identified: an extrinsic (or death receptor-mediated) and an intrinsic (or mitochondrial) pathway. Apoptotic cell death through the extrinsic pathway has just been described in temporomandibular joint disc (TMJ) with internal derangement (ID); in contrast, no data are available on the involvement of the intrinsic pathway in this tissue. The aim of this work was to investigate whether the intrinsic pathway participates in apoptosis activation in patients with TMJ ID and anterior disc displacement without reduction. Materials and methods. Apoptosis activation was studied in TMJ discs from 15 patients with ID and in six unaffected discs using bcl-2-associated X protein (bax), B-cell lymphoma 2 (bcl-2), cytochrome c and caspase 9 immunohistochemistry. A correlation was sought between immunohistochemical findings and degree of disc damage. Results. None of the pathological TMJ disc sections were immunopositive for bcl-2; negative bcl-2 immunostaining was detected in affected discs; cytochrome c and caspase 9 immunoreactivity was greater in pathological compared to unaffected discs; the difference was significant and correlated with histopathological degeneration score data (Spearman's rho = 0.617). Conclusion. The present findings suggest that in-human TMJ with ID and anterior disc displacement without reduction of cell apoptosis occurs, at least partly, via the mitochondrial pathway, which contributes to the subsequent disc degeneration. These data may have clinical implications and could help devise improved treatment strategies. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of probiotic proenzyme ®, added to the mineral mixture in a weight gain of cattle in extensive grazing system. We used 40 animals, Nelore bulls (Bos indicus) aged approximately 12 months, randomly divided into 2 groups (20 animals / group): control group (CG) received only mineral mixture and probiotic group (GP) with added probiotic. Calves were weighed on days 0 and 30 from 30 to 90 days and 00 to 90 days. The results showed a significant increase in weight gain in animals only GP in the first 30 days. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of probiotic supplementation on mineral mixture to the humoral immune response in cattle vaccinated with a single dose of rabies vaccine. Forty steers, Nellore, aged 12 months were randomly divided into 2 groups (20 animals / group): control group (CG) with 70 grams of mineral / animal / day and probiotic group (GP) with 70 grams of supplement mineral added with 4 grams of probiotic / animal. The individual titles of neutralizing antibodies were determined by neutralization technique based on the Rapid Fluorescent Focus Inhibition Test (RFFIT) and Fluorescent Inhibition Microtest (FIMT). There were no statistic significant differences between the mean serum concentrations between groups, concluding that the administration of probiotics does not interfere with the humoral immune response rabies. [ABSTRACT FROM AUTHOR]

Purpose: The Vitrea 2 imaging software (Vital Images Inc, Minnetonka, MN) was used for the volume analysis of the proximal tibial metaphysis. Materials and Methods: Eighteen computed tomography scans of the proximal tibia were processed through the software, and 3-dimensional imaging of the proximal tibia was reconstructed. Results: The volume and area of the proximal tibia that were generated resulted in a mean area of 127 cm2 and a mean volume of 77.2 cm2. Conclusion: This study supports the use of the proximal tibial metaphysis as a source of low to moderate volume of autologous bone. When compared with the accepted average volume of 25 cm2, the computed results showed that there could be up to 3 times the amount of bone available in the proximal tibial metaphysis. The reported volume of bone harvested from previous studies was based on need and not the total amount available; subsequently, the results showed the possibility of a larger resource of bone, which provides the surgeon with the volumetrical limits of the proximal tibia metaphysis. [Copyright &y& Elsevier]

Abstract: Enzymatic oxidation of dipyridamole (DIP) by horseradish peroxidase–hydrogen peroxide system (HRP–H2O2) in aqueous and micellar solutions was carried out. The reaction was monitored by optical absorption and fluorescence techniques. In aqueous solution at pH 7.0 and pH 9.0, the disappearance of the characteristic bands of DIP centered at 400 nm and 280 nm was observed. A new strong band at 260 nm is observed for the oxidation product (s) with shoulders at 322 nm and 390 nm. A non-fluorescent product is formed upon oxidation. In cationic cethyl trimethyl-1-ammonium chloride (CTAC) and zwitterionic 3-(N-hexadecyl-N,N-dimethylammonium) propane sulfonate (HPS) micellar solutions the same results are observed: three, well-defined, isosbestic points in the optical spectra suggest the transformation between two species. In anionic micellar sodium dodecylsulfate solution (SDS), the appearance of a new band centered around 506 nm was observed, associated to a solution color change from the usual yellow to deep blue/violet, characteristic of a radical species associated to the one-electron oxidation of DIP to its cation radical (DIP·+), observed previously in electrochemical oxidation. Experiments of radical decay kinetics monitoring the absorbance change at 506 nm were performed and analyzed in the frame of a kinetic model taking into account the species both in homogeneous and micellar media. The reaction medium is composed of bulk solution, SDS micelle/solution interface and enzyme catalytic site (s). The variation of DIP·+ concentration was analyzed assuming: (1) synthesis of DIP·+ by HRP through one-electron oxidation; (2) decomposition of DIP·+ by further one-electron oxidation; (3) direct two-electron oxidation of DIP by HRP; (4) bimolecular DIP·+ disproportionation. The main results of the analysis are as follows: (1) kinetic data can be divided in two phases, an HRP active phase and another phase which proceeds in the absence of enzyme activity due to consumption of all H2O2; (2) the reactions of DIP·+ formation, DIP·+ decomposition and DIP two-electron oxidation are HRP concentration dependent; (3) since DIP·+ formation constant seems to be overestimated, it is proposed that two-electron oxidation is another source of DIP·+, through the comproportionation reaction. Evidences for this reaction were also observed previously in electrochemical experiments; and (4) the kinetic analysis provides evidences that the bimolecular reaction of DIP·+ takes place mainly in the absence of active HRP and in this phase the combination of, at least, two second-order kinetic processes is needed to model the experimental data. Our data suggest that HRP oxidizes DIP in general by a two-electron process or that the cation radical is very unstable so that the one-electron process is only detected in the presence of anionic surfactant, which stabilizes significantly the DIP·+ intermediate. [Copyright &y& Elsevier]

(1) Background—The aim of the present study was to evaluate the correlation between the temporomandibular joint (TMJ) osseous morphology of normal skeletal pattern individuals with different dental malocclusions by using cone-beam computed tomography (CBCT). (2) Methods—The CBCT images of bilateral TMJs in 67 subjects with skeletal class I and average mandibular angle (26 males and 41 females, age range 20–49 years) were evaluated in this study. The subjects were divided into class I, class II division 1, and class II division 2 according to the molar relationship and retroclination of the maxillary incisors. Angular and linear measurements of TMJ were evaluated and the differences between the groups were statistically analyzed. (3) Results—Intragroup comparisons showed statistical differences for articular eminence inclination, the width of the glenoid fossa, the ratio of the width of the glenoid fossa to the depth of the glenoid fossa, the condylar angle, and the intercondylar angle between the malocclusion groups. The measurements of the glenoid fossa shape showed no significant difference between the left and right sides. Females showed more differences in the morphological parameters of TMJ between the three malocclusion groups than the males. (4) Conclusion—The present study revealed differences in the TMJ osseous morphology between dental class I and class II malocclusions in the normal skeletal pattern. [ABSTRACT FROM AUTHOR]

The Helkimo Clinical Dysfunction Index (HCDI) is a simple and quick test used to evaluate subjects affected by temporomandibular disorders (TMDs), and its psychometric properties have not been tested. The test evaluates movement, joint function, pain and musculature, providing a quick general overview that could be very useful at different levels of care. For this reason, the aim of this study was to validate the use of the HCDI in a sample of patients with TMD. Methods: The sample consisted of 107 subjects, 60 TMD patients and 47 healthy controls. The study evaluated concurrent validity, inter-rater concordance and predictive values. Results: The HCDI showed moderate to substantial inter-rater concordance among the items and excellent concordance for the total scores. The correlation with other TMD assessment tests was high, the correlation with dizziness was moderate and the correlation with neck pain, headache and overall quality of life was poor. The prediction of TMD showed a sensitivity of 86.67%, a specificity of 68.09% and an area under the curve (AUC) of 0.841. Conclusions: The HCDI is a valid and reliable assessment instrument; its clinimetric properties are adequate, and it has a good ability to discriminate between TMD-affected and TMD-unaffected subjects. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the correlation between metabolic bone activity measured by single photon emission computed tomography (SPECT) and the anatomic condylar characteristics acquired by computed tomography (CT), in patients with unilateral condylar hyperplasia (UCH). Method and Materials/Patients: Observational, descriptive study in a group of 71 patients with clinical diagnosis of UCH and indication of SPECT/CT. Bone SPECT images obtained in a gamma-camera GE Infina and processed in a station Xeleris 3 with the program Volumetrix MI Evolution for bone. CT images acquired in a PET/CT Biograph mcT20 equipment (Siemens) processed in a station Osirix V 7.5.1 (Pixmeo, Bomex, Switzerland). Results: The sample included 24 men (33.8%) and 47 women (66.2%). Active state UCH was detected in 40 (56.3%) cases (over 55% uptake in the affected condyle) and 38 (53.5%) presented mandibular deviation to the right side. No significant differences related to sex, age, or mandibular deviation side were found. Mandibular deviation was the only morphologic feature related to active/inactive UCH (p = 0.003). The likelihood of active CH was significantly higher in patients with mandibular deviation higher than 6 mm compared with <6 mm (odds ratio (OR): 3.51, confidence interval (CI) 95%: 1.27–9.72). Conclusion: There is a significant correlation between the magnitude of mandibular deviation quantified on CT and metabolic findings obtained by SPECT in patients with UCH. The risk of active UCH is 3.5 times higher in patients with a mandibular deviation ≥6 mm. [ABSTRACT FROM AUTHOR]

Temporomandibular disorders (TMD) are a group of orofacial pain conditions which are the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management. [ABSTRACT FROM AUTHOR]