The temporomandibular joint in children after breech delivery

In an effort to explain the aetiology of early temporomandibular joint (TMJ) injuries, their incidence in children born by vaginal breech delivery and possible correlation with such deliveries were investigated. The study covered 156 children aged from 4 to 6 years, eighty-three of them born by vaginal breech delivery under application of the classical Mauriceau manoeuvre in seventeen cases and the Bracht manoeuvre in sixty-six. Seventy-three children delivered spontaneously in vertex presentation served as the control group. Signs of TMJ injury were found in 59.6% of the total group, the by-birth percentages being 67.5 in those after breech delivery and 50.7 in those after spontaneous delivery--the difference is statistically significant. The difference was even more significant for the more severe TMJ disorders, their percentages being in two groups respectively 48.2 and 29.7. In the children born by breech delivery the TMJ disorders were invariably attended by severe forms of distocclusion, among which the unilateral form deserves particular attention. The authors conclude that vaginal breech delivery is probably among the factors responsible for early TMJ abnormalities. They call the attention of paediatricians and obstetricians to this fact and urge examination of this joint as a very important part of oral examination in children born by vaginal breech delivery.     

Malocclusion in children caused by temporomandibular joint effusion

Two unusual cases of temporomandibular joint effusion in children are presented. The differential diagnosis, radiographic imaging, treatment, and possible etiologies are described.     

Rehabilitating children with temporomandibular joint ankylosis.

Although the probability of ankylosis following injury of the temporomandibular joint is small, patients, especially children with temporomandibular joint ankylosis, are greatly handicapped. Of the 42 cases of ankylosis seen in our clinic, six occurred in the adult, and 36 in children under 14 years of age. Treatment in all cases was surgical, and the results were beneficial, although the greatest difficulty in the treatment had been the early recurrence of ankylosis. Based on our experience, osteoarthrotomy for temporomandibular joint ankylosis in children has been advocated.     

A clinical study on temporomandibular joint ankylosis in children

Temporomandibular joint (TMJ) ankylosis is a disabling condition of the masticatory system and is most commonly due to trauma, infections, and some systemic diseases. Hypomobility affects the surrounding structures as well as the joint itself. Ankylosis arising in early childhood usually leads to facial asymmetry. Ankylosis in children usually occurs from an intracapsular compression fracture or rarely from a suppurative arthritis of middle ear infection.Treatment of the ankylosis is probably one of the greatest challenges in TMJ surgery, and the treatment of TMJ ankylosis in children is much more challenging than in adults because of high recurrence and the probable change in the unpredictable growth of the mandible. In treatment of TMJ ankylosis in children, to maintain a normal growth and the development of the face is as important as to provide a satisfactory mouth opening with free movement of the mandible.A variety of techniques and various success rates in the treatment of TMJ ankylosis both in adults and in children have been reported. However, no single method has produced uniformly successful results. In this study, gap arthroplasty was applied in 6 patients, and 2 different types of fossa implants were used as interpositional material in the other 8 patients, and the results of the treatments have been evaluated retrospectively.     

Radiology of the temporomandibular joint. Diagnostic imaging of the temporomandibular joint

Diagnostic imaging plays an important role in the diagnosis of disorders of the masticatory system. The most frequent disorders are osteoarthrosis and internal derangements. The clinical diagnosis of these disorders may be confirmed by diagnostic imaging. In addition, diagnostic imaging contributes to the staging of the degenerative changes. Techniques for examination of the temporomandibular joint, including conventional (panoramic, transpharyngeal, transcranial) as well as more sophisticated techniques (tomography, fluoroscopy, arthrography, computed tomography, scintigraphy and magnetic resonance imaging) are briefly described. The interpretation of the radiological image of the joint in health and when affected by osteoarthrosis and internal derangement is presented.     

Growth after construction of the temporomandibular joint in children with hemifacial microsomia

Free costochondral grafts have been used to construct the absent ascending ramus and condylar head of 22 children with hemifacial microsomia (HFM) who were less than 14 years of age. Evidence of continued growth was demonstrated in all patients. Growth was determined by measurement of cephalograms or by inference; if the patient grew extensively in height but his/her face remained symmetric, the graft was inferred to have grown. In two patients, considerable overgrowth occurred, displacing the chin to the opposite side and causing a class III malocclusion. Variations in age or type of adjunctive operations did not affect growth. There appears to be no single explanation for all findings. Because all of the grafts grew, early joint construction and correction of hemifacial microsomia are advocated.     

MRI characteristics of the asymptomatic temporomandibular joint in patients with unilateral temporomandibular joint disorder

Oral Radiology - To determine the association between unilateral temporomandibular joint disorder (TMD) and the presence of imaging abnormalities in the contralateral, asymptomatic joint. MRI...     

小儿颞颌关节强直手术的麻醉处理

目的 探讨小儿颞下颌关节强直手术的麻醉方法及并发症的防治。方法 31例病人全部经鼻腔盲探插管。结果 麻醉插管成功30例，气管切开1例，全麻诱导与插管期间发生低氧6例，鼻出血2例，导管插入后出现呛咳5例。结论 充分的鼻腔准备和完善的咽喉表面麻醉是经鼻腔插管成功的关健。患者年龄越小麻醉的风险越大，并发症越多。     

A clinico-genetic analysis of functional temporomandibular joint lesions in children]

The authors review the results of a clinical genealogic investigation of 130 families with children suffering from abnormalities of the temporomandibular joints presenting as recurrent subluxations and/or arthrosis. A genetic statistic study, carried out by proband Weinberg's method in sibs families, has lead the authors to a conclusion on the monogenic autosomal dominant type of inheriting the temporomandibular joint abnormalities. A high incidence of diseases due to connective tissue failure in the body (lower limb varicose veins, spinal deformations, platypodia, hernias, hemorrhoids, etc.) in the families with children suffering from temporomandibular joint abnormalities has permitted the authors regard recurrent subluxations and/or arthrosis of the temporomandibular joints as a component of the total involvement of the connective tissue.     

Relationship between pathogenic factors and the prevalence of temporomandibular joint dysfunctions in children

PurposeThe purpose of the research is to study the relationship between the certain pathogenic factors and the prevalence of functional disorders of TMJ in children and adolescents with mental development delay (MDD), in practically healthy persons of similar age living in children’s homes and in a family.MethodsThe study was carried out using the method of observation, systematization, analysis and synthesis of the results obtained in the course of laboratory experiments.ResultsSymptoms of TMD include decreased mandibular range of motion, muscle and joint pain, joint crepitus, and functional limitation or deviation of jaw opening. The mentioned symptoms were revealed in 40.1% of children and adolescents with MDD, less frequently in 32.62% of children and adolescents living in children’s homes, and in 35.32% of practically healthy persons living in families and their rate increased with ageing. More often it was revealed in girls.ConclusionsAccording to the results of the study, the authors found that children and adolescents with MDD, symptoms of TMJ dysfunctions occur more often and begin at an earlier age than in practically healthy ones.     

Radiology of the temporomandibular joint

When evaluating the current status of a patient with diseases of the TMJ, certain guidelines must be followed. It is of the utmost importance to take into consideration the total picture. This must include the history, physical examination, x-rays, films, and any other pertinent information. As stated previously, the TMJ is demonstrated with a great deal of clarity by modern tomographic x-ray techniques. This, however, provides only part of the total evidence. It is indeed unfortunate that some medical and dental consultants for insurance companies and other health groups base their criteria for eligibility on the evidence provided only by the x-ray films, without taking into consideration other important data. Another source of error is the fact that the total duration of the patient's symptoms is not given enough consideration. This is shown in patients with a history lasting many months or years, associated with definite x-ray changes, who are misdiagnosed as having myofascial pain dysfunction syndrome. The fact that this is an acute process of short duration involving primarily muscles of mastication and other related soft tissues is overlooked. When presented with a patient with a long history of TMJ discomfort, it is essential to consider an intrinsic organic process of the joint. It should be stressed that osteoarthritis or degenerative joint disease is a condition frequently found in the TMJ when examined with modern tomographic techniques. It occurs in individuals of all ages. Osteoarthritis of the TMJ is basically a medical or orthopedic condition similar to that found in other joints of the body affected by this primary joint disease. For this reason, osteoarthritis cannot be considered purely a dental condition when it occurs in the TMJ. However, because of the close proximity, both anatomically and physiologically, to the teeth and related structures, these conditions are frequently labeled as dental.(ABSTRACT TRUNCATED AT 400 WORDS)