Condylar hyperplasia is one of the causes of facial asymmetry and malocclusion, characterized by enlargement of the lower jaw due to excessive condyle growth activity. The aim of this study was to use micro-computed tomography (micro-CT) to evaluate the bone architecture of the condylar head and determine whether there are differences between patients with various forms of unilateral condylar hyperplasia (UCH): hemimandibular hyperplasia, elongation, and mixed form. The cohort consisted of 28 patients with a mean age of 21.9 years. All patients underwent surgical treatment (condylar shaving) for active pathological growth activity. The portion of the condylar head removed was imaged by micro-CT and subsequently evaluated. Micro-CT imaging and semiquantitative and quantitative evaluation of the bone structure (percentage bone volume, surface density, trabecular thickness, trabecular separation, degree of anisotropy, and porosity of the subchondral bone) did not reveal significant differences between the individual types of condylar hyperplasia (P > 0.05). There were no significant differences in bone structure between the anterior and posterior portions of the condylar head. No statistically significant differences between individual groups of UCH were found in the micro-CT evaluation of the condylar head bone architecture.

• MeSH
• asymetrie obličeje * diagnostické zobrazování   chirurgie   etiologie   MeSH
• dospělí MeSH
• hyperplazie diagnostické zobrazování   patologie   MeSH
• lidé MeSH
• mandibula patologie   MeSH
• mladý dospělý MeSH
• processus condylaris mandibulae * diagnostické zobrazování   chirurgie   patologie   MeSH
• rentgenová mikrotomografie škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: The aim of this study was to determine the efficacy of arthroscopic lysis and lavage on pain in patients with unilateral Wilkes stage III derangement of the temporomandibular joint. Authors retrospectively evaluated whether the arthroscopic lysis and lavage has an impact on pain decrease in patients with moderate osteoarthritis. METHODS: Patients with unilateral Wilkes III of temporomandibular joint were included in this study. All patients underwent arthroscopic lysis and lavage (ASC-L), assessed pain before and after the procedure (primary outcome variable), maximal interincisal opening (MIO) was recorded as secondary outcome variable. The patients also subjectively assessed whether they were satisfied with the outcome of the arthroscopy or whether their condition required further interventions. The disc position was evaluated by magnetic resonance imaging (MRI) 24 months after the arthroscopy and compared with the disc position on the MRI prior to the arthroscopy. The R Project for Statistical Computing 3.4.1 and the Gretl Pro programs were used for statistical analysis. In addition to the descriptive statistics methods, the Shapiro-Wilk normality test was used to verify data normality and the two sample t test used to test the hypotheses themselves. RESULTS: The sample consisted of 62 patients who underwent arthroscopic lysis and lavage (ASC-L) in 2015 and 2016. It included 6 men and 56 women with an average age of 34.37. Pain and MIO were recorded during regular check-ups 1, 3, 6, 12, and 24 months. A therapeutic effect (MIO over 34 mm, VAS score 0-1) was recorded in 69% of cases 24 months after the ASC-L. Nonetheless, the work demonstrated the importance of subjective assessment, as 87% of patients perceived their condition as satisfactory after 24 months and not requiring further intervention, while 8 patients (13%) perceived it as unsatisfactory. Disc reposition 24 months following the ASC-L was recorded in only 44% of patients who assessed their condition as satisfactory. Patients with persistent disc dislocation 24 months after the arthroscopy were older, had a lower average maximal interincisal opening value before the ASC-L and a longer duration of mandibular movement restriction before the ASC-L (evaluated as a statistically significant difference). CONCLUSION: In this study, the authors confirmed that ASC-L is an effective therapeutic method in patients with WIII, from both clinical and subjective perspectives. This work demonstrated that improvement in patients with Wilkes stage III is not related to disc reposition. Postoperative physiotherapy is an integral component of ASC-L and is reflected in the final results.

• MeSH
• bolest MeSH
• dospělí MeSH
• léčebná irigace * MeSH
• lidé MeSH
• management bolesti MeSH
• nemoci temporomandibulárního kloubu * chirurgie   MeSH
• retrospektivní studie MeSH
• rozsah kloubních pohybů MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Septic arthritis of the temporomandibular joint (TMJ) is an unusual disease in adults. Inoculation of the pathogen may occur through traumatic or iatrogenic injuries, or more often by haematogenous spread from a distant focus. The cause of infection is unknown in most cases. A case of ostensibly mild septic arthritis of the TMJ with a good response to antibiotic therapy and lavage, but that finally led to fatal destruction of the joint structures in a 38-year-old female patient, is reported herein. The infection was caused by Raoultella ornithinolytica - a rare bacterial species in humans, which has not been reported previously in any patients with joint problems. The arthritis manifested 5 weeks after an arthroscopy procedure, so the cause was not clear.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• artroplastiky kloubů MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• Enterobacteriaceae izolace a purifikace   MeSH
• enterobakteriální infekce diagnostické zobrazování   farmakoterapie   mikrobiologie   MeSH
• infekční artritida diagnostické zobrazování   farmakoterapie   mikrobiologie   MeSH
• léčebná irigace MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nemoci temporomandibulárního kloubu farmakoterapie   mikrobiologie   chirurgie   MeSH
• rentgendiagnostika panoramatická MeSH
• temporomandibulární kloub diagnostické zobrazování   mikrobiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The aim of this study was to evaluate disc perforation diagnosed in patients undergoing arthroscopy of the temporomandibular joint (TMJ). A retrospective analysis of 33 patients with disc perforation (35 joints) was performed. Patients and joints were divided into two groups: those with distal perforation (DP; perforation of the retrodiscal tissue, or the distal area of the disc at the site of ligament insertion into the retrodiscal tissue) and those with central perforation (CP; central and anterior part of the disc). The retrospective evaluation included aetiological factors, clinical symptoms, arthroscopic findings, and the effects of arthroscopic lavage. The most frequent aetiological factors in patients with disc perforation were stress and related parafunctional activities. The most frequent arthroscopic finding in both groups was hyperaemia of the bilaminar zone and synovial tissue. Other predominant arthroscopic findings were the presence of adhesions and anterior disc dislocation in the DP group and synovial hyperplasia in the CP group. Better outcomes of arthroscopic lysis and lavage were found in the CP group than in the DP group. At 12 months after arthroscopic lavage, the results showed that the therapy was satisfactory for 72% of the joints. The most common cause of distal perforation is anterior disc dislocation, whilst chronic inflammatory changes account for central perforation.

• MeSH
• artroskopie MeSH
• discus articularis čelistního kloubu patologie   chirurgie   MeSH
• dospělí MeSH
• léčebná irigace MeSH
• lidé středního věku MeSH
• lidé MeSH
• měření bolesti MeSH
• nemoci temporomandibulárního kloubu diagnóza   etiologie   patologie   chirurgie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• artroskopie metody   MeSH
• artroskopy * MeSH
• design vybavení MeSH
• kostní dráty MeSH
• léčebná irigace přístrojové vybavení   metody   MeSH
• lidé MeSH
• mikrochirurgie přístrojové vybavení   MeSH
• miniinvazivní chirurgické výkony přístrojové vybavení   metody   MeSH
• nemoci temporomandibulárního kloubu chirurgie   MeSH
• nerezavějící ocel chemie   MeSH
• temporomandibulární kloub chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Total joint replacement of the temporomandibular joint (TJR) can be associated with intraoperative and postoperative complications. We report herein the occurrence of a postoperative open bite malocclusion, the result of condylar hyperplasia affecting the non-operated joint at 1 year after unilateral total joint replacement.

• MeSH
• artroplastiky kloubů škodlivé účinky   MeSH
• dospělí MeSH
• hyperplazie patologie   MeSH
• lidé MeSH
• počítačová rentgenová tomografie MeSH
• processus condylaris mandibulae patologie   radiografie   MeSH
• protézy kloubů škodlivé účinky   MeSH
• temporomandibulární kloub patologie   radiografie   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

A procedure for ultrasound-guided injection into the lower joint space of the temporomandibular joint is presented.

• MeSH
• injekce intraartikulární metody   MeSH
• intervenční ultrasonografie * MeSH
• lidé MeSH
• nemoci temporomandibulárního kloubu farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

In 2004, total alloplastic temporomandibular joint (TMJ) replacement began in the Czech Republic and Slovakia. This paper presents initial subjective and objective data compiled between 2005 and 2009 from those cases. Data were collected from 27 patients (38 joints) reconstructed with the Biomet-Lorenz stock and custom TMJ prostheses during a mean follow-up period of 24 months. The variables of pain and mouth opening were evaluated pre- and postoperatively. Patients classified pain on a scale of 0-5 (none - unbearable). The extent of opening was investigated by a physician (the distance between the points of the incisors on the upper and lower jaw was measured). The most common indication for replacement was ankylosis. There was an improvement in pain score in 15 patients. 4 patients reported worsening of pain and 8 patients did not complain of pre- or postoperative pain. Mandibular opening increased from a mean of 17.7 mm preoperatively to a mean of 29.1mm postoperatively. There were complications related to the surgery, but no significant complications related to the devices. Total alloplastic TMJ replacement appears to be a safe and effective method of reconstruction in the patients in this initial study.

• MeSH
• ankylóza chirurgie   MeSH
• artralgie chirurgie   MeSH
• artroplastiky kloubů metody   MeSH
• dospělí MeSH
• lidé MeSH
• nemoci temporomandibulárního kloubu chirurgie   MeSH
• neparametrická statistika MeSH
• obličejová bolest chirurgie   MeSH
• osteoartróza chirurgie   MeSH
• pooperační komplikace MeSH
• protézy kloubů MeSH
• rozsah kloubních pohybů MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Slovenská republika MeSH

The authors prospectively analysed 50 patients with chronic anterior disc displacement without reduction, who underwent arthroscopic lysis and lavage of the temporomandibular joint (TMJ). Patients with symptoms lasting less than 1 year were assigned to Group A (n=28) and patients with symptoms lasting more than 1 year to Group B (n=22). The most common problems were inflammatory changes of synovial and retrodiscal tissue (Group A, 71%; Group B, 82%). Fibrous adhesions were present in 14% of Group A patients and 45% of Group B patients. Degenerative changes of the disc and articular surface were present in 4% of Group A patients and 32% of Group B patients. Mouth opening increased 123% from baseline in Group A, and 112% in Group B (P<0.05). Pain decreased significantly in both groups (Group A, 2.5 points; Group B, 1.68 points; P<0.05). In conclusion, almost all patients with chronic anterior disc displacement without reduction benefited from arthroscopic lysis and lavage of the TMJ. Patients with a shorter duration of symptoms problems benefited more than those with a longer duration. Arthroscopic lysis and lavage of the TMJ is safe and beneficial in chronic anterior disc displacement without reduction.

• MeSH
• adheze tkání chirurgie   MeSH
• artroskopie metody   MeSH
• časové faktory MeSH
• chronická nemoc MeSH
• discus articularis čelistního kloubu chirurgie   MeSH
• dislokace kloubu chirurgie   MeSH
• léčebná irigace metody   MeSH
• lidé MeSH
• měření bolesti MeSH
• nemoci temporomandibulárního kloubu chirurgie   MeSH
• obličejová bolest chirurgie   MeSH
• osteoartróza chirurgie   MeSH
• prospektivní studie MeSH
• rozsah kloubních pohybů fyziologie   MeSH
• synovitida chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

Autoři prezentují své první zkušenosti s vyšetřením temporomandibulárního kloubu pomocí ultrasonografie. Hodnoceno bylo 30 pacientů s diagnózou intrakapsulární poruchy nebo zánětlivě degenerativního onemocnění, přičemž se práce zaměřila na intraartikulární změny. Každý pacient podstoupil nejdříve vyšetření ultrazvukem a následně magnetickou rezonancí, přičemž výsledky získané magnetickou rezonanci í^yly považovány jako přesné. Z výsledku práce pak vyplývá, že při srovnání ultrasonografie s magnetickou rezonancí dosahuje UZ přesnosti 90 % při diagnostice degenerativních změn disku, 71 % při diagnostice dislokace disku. Je tedy zřejmé že ultrasonografie se stává alternativou k vyšetření pomocí magnetické rezonance, nicméně ji v současné době nenahrazuje.

The authors present their first experience with temporomandibular joint examination with ultrasound. A group of thirty patients with the diagnosis of intracapsular lesion or inflammatory-degenerative disease was evaluated, focusing mainly on intraarticu lar pathologic changes. Each of the patients underwent first of all ultrasound examination followed by magnetic resonance imaging (MRI). The results provide led by MRI were considered to be precise and were used as a standard for further comparison. The results of the work show that ultrasonography compared to MRI reaches 90% accuracy in diagnostics of the degenerative disc changes and 71% in case of the disc dislocation. Therefore it can be said that ultrasonography becomes an alternative diagnostic method to MRI, which nevertheless currently cannot be fully replaced by that and remains a "golden standard".

• MeSH
• artrografie metody   využití   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   přístrojové vybavení   využití   MeSH
• nemoci temporomandibulárního kloubu diagnóza   etiologie   ultrasonografie   MeSH
• radiografie metody   využití   MeSH
• tomografie spirální počítačová metody   přístrojové vybavení   využití   MeSH
• ultrasonografie metody   trendy   využití   MeSH
• Check Tag
• lidé MeSH