The Clinical and Radiographic Features of Patients with Temporomandibular Joint Osteoarthritis: Comparison of Adolescents and Middle-Old Aged Koreans원문보기
Purpose: The purpose of this study was to compare the clinical and radiographic features of temporomandibular joint (TMJ) osteoarthritis (OA) between adolescents and middle-old aged patients. Methods: The subjects were chosen among the patients who presented to the Department of Oral Medicine of Pus...
Purpose: The purpose of this study was to compare the clinical and radiographic features of temporomandibular joint (TMJ) osteoarthritis (OA) between adolescents and middle-old aged patients. Methods: The subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital and were diagnosed with TMJ OA by clinical exam, X-ray and cone-beam computed tomography (CBCT) from 2010 to 2011. We investigated 93 adolescent patients (12-19 years) and 53 middle-old aged (>45 years) patients who observed the erosive bony changes in TMJ. CBCT scans were retaken at intervals at an average of 8 months. Results: The adolescent patients showed unilateral degenerative changes more often, and the middle-old aged patients showed degenerative changes more frequently on both sides. The transition of bone changes to the improved group occurred most commonly in both the adolescent and middle-old aged patients. The adolescent patients were more likely to improve than middle-old aged patients. In the adolescent patients, loss of erosion and subjective symptoms occurred in shorter periods than in the middle-old aged patients. In the adolescent patients, the transition of erosion was distributed into proliferative, normal, and shortening in order. In the middle-old aged patients, the transition of erosion was distributed into shortening, proliferative, and normal in order. Conclusions: The clinical and radiographic features of TMJ OA are a significantly different between the adolescent and middle-old aged patients. Moreover, the difference by age of the adaptive and regenerative capacity of TMJ affects the prognosis of TMJ OA and adolescent patients have a better prognosis after treatment.
Purpose: The purpose of this study was to compare the clinical and radiographic features of temporomandibular joint (TMJ) osteoarthritis (OA) between adolescents and middle-old aged patients. Methods: The subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital and were diagnosed with TMJ OA by clinical exam, X-ray and cone-beam computed tomography (CBCT) from 2010 to 2011. We investigated 93 adolescent patients (12-19 years) and 53 middle-old aged (>45 years) patients who observed the erosive bony changes in TMJ. CBCT scans were retaken at intervals at an average of 8 months. Results: The adolescent patients showed unilateral degenerative changes more often, and the middle-old aged patients showed degenerative changes more frequently on both sides. The transition of bone changes to the improved group occurred most commonly in both the adolescent and middle-old aged patients. The adolescent patients were more likely to improve than middle-old aged patients. In the adolescent patients, loss of erosion and subjective symptoms occurred in shorter periods than in the middle-old aged patients. In the adolescent patients, the transition of erosion was distributed into proliferative, normal, and shortening in order. In the middle-old aged patients, the transition of erosion was distributed into shortening, proliferative, and normal in order. Conclusions: The clinical and radiographic features of TMJ OA are a significantly different between the adolescent and middle-old aged patients. Moreover, the difference by age of the adaptive and regenerative capacity of TMJ affects the prognosis of TMJ OA and adolescent patients have a better prognosis after treatment.
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문제 정의
The aim of the present study was to compare the clinical and radiographic features of TMJ OA between adolescents and middle-old aged patients. This study also reports the results of CBCT follow-up observation of TMJ OA in adolescents and middle-old aged patients.
The aim of the present study was to compare the clinical and radiographic features of TMJ OA between adolescents and middle-old aged patients. This study also reports the results of CBCT follow-up observation of TMJ OA in adolescents and middle-old aged patients.
제안 방법
All subjects received conservative treatments such as medications, behavioral therapy, physical therapy and splint therapy. During the follow-up period, a recall exam was performed every 2 or 4 weeks, recording subjective pain, joint sound (noise), the limitation of motion (LOM) and maximum comfortable opening (MCO). This study was approved by the Institutional Review Board of Pusan National University Dental Hospital (IRB No.
For this purpose, we retrospectively reviewed clinical data and radiographs taken of two age groups (12-19 years, >45 years) with erosive bony changes of the TMJ.
Once a patient was suspected of having TMJ OA by panoramic and transcranial projections at the first visit, CBCT imagery was taken to evaluate the bony condition of the TMJ. After CBCT confirmation of TMJ OA by experienced radiologists, patients with erosive bony changes on CBCT images were selected.
Pain intensity, joint sound and LOM were assessed with a numeric rating scale (NRS) from 0-10 where 0 was ‘no pain, noise and limitation’ and 10 was ‘the worst pain, noise and limitation imaginable’.
Subjective symptoms and clinical findings were investigated at the first, the second and the last CBCT examinations to evaluate and compare the data before and after conservative treatment. Pain intensity, joint sound and LOM were assessed with a numeric rating scale (NRS) from 0-10 where 0 was ‘no pain, noise and limitation’ and 10 was ‘the worst pain, noise and limitation imaginable’.
The inclusion criteria were that patients were clinically diagnosed with TMJ OA and exhibited erosive bony changes in the TMJ on CBCT images. The diagnosis of TMJ OA was based on history and clinical examinations performed by an experienced orofacial pain specialist and CBCT readings by experienced oral radiologists. We excluded patients who had any skeletal deformity, condyle fracture, TMJ tumor or systemic disease possibly related to TMJ, such as rheumatoid arthritis.
대상 데이터
The subjects were divided into adolescent patients (12-19 years) and middle-old aged (>45 years) patients.
데이터처리
Correlations between the period of alleviation of subjective symptoms and erosion were calculated with Pearson’s correlation.
Statistics were analyzed by chi-square test.
The results obtained were presented in mean±standard deviation or in percentages after descriptive statistical analysis.
p-value was determined by independent t-test and Mann-Whitney U test.
p-value was determined by independent t-test, Mann-Whitney U test and means of Pearson’s correlation coefficient.
성능/효과
In conclusion, our retrospective study indicated that the clinical and radiographic features of TMJ OA are a significantly different between the adolescent and middle-old aged patients. In the adolescent patients, the period of alleviation of subjective clinical symptoms and erosion was shorter than that of the middle-old aged patients.
The results of this study indicated that the mean periods of the alleviation of subjective clinical symptoms and erosion were 10 months (10.36±6.70 months) and 12 months (12.33±6.87 months), respectively, and the state remained relatively stable.
후속연구
In the present study, the qualitative analysis of bony changes of TMJ OA has been performed. Further studies should consider the quantification of bony changes in TMJ OA based on a larger sample and will provide a better understanding of TMJ OA.
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