Metastases of the articular process, temporomandibular joint (TMJ), are rare findings. Their frequency is around 5% of patients with metastatic involvement of the mandible. The most common primary tumor is adenocarcinoma of the lung in women and adenocarcinoma of the prostate in men. The authors present 3 patients with TMJ metastasis. These were metastasis of breast adenocarcinoma, prostate adenocarcinoma, and lung adenocarcinoma. TMJ metastases are rare but complicated to diagnose because their presence may be accompanied by symptoms typical of other TMJ diseases (discopathy, arthritis, osteoarthritis). However, the authors recommend the unequivocal exclusion of a metastatic process in cases where the patient has a positive cancer history and their complaints do not respond to usual therapy.

• Klíčová slova
• Adenocarcinoma, TMJ metastasis, limited jaw mobility,
• MeSH
• adenokarcinom * sekundární   patologie   MeSH
• diferenciální diagnóza MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory mandibuly * sekundární   MeSH
• nádory plic * patologie   MeSH
• nádory prostaty * patologie   MeSH
• nádory prsu * patologie   MeSH
• nemoci temporomandibulárního kloubu MeSH
• počítačová rentgenová tomografie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Fibroblasts, the most abundant cell type in the human body, play crucial roles in biological processes such as inflammation and cancer progression. They originate from the mesoderm or neural-crest-derived ectomesenchyme. Ectomesenchyme-derived fibroblasts contribute to facial formation and do not express HOX genes during development. The expression and role of the HOX genes in adult fibroblasts is not known. We investigated whether the developmental pattern persists into adulthood and under pathological conditions, such as cancer. We collected adult fibroblasts of ectomesenchymal and mesodermal origins from distinct body parts. The isolated fibroblasts were characterised by immunocytochemistry, and their transcriptome was analysed by whole genome profiling. Significant differences were observed between normal fibroblasts from the face (ectomesenchyme) and upper limb (mesoderm), particularly in genes associated with limb development, including HOX genes, e.g., HOXA9 and HOXD9. Notably, the pattern of HOX gene expression remained consistent postnatally, even in fibroblasts from pathological tissues, including inflammatory states and cancer-associated fibroblasts from primary and metastatic tumours. Therefore, the distinctive HOX gene expression pattern can serve as an indicator of the topological origin of fibroblasts. The influence of cell position and HOX gene expression in fibroblasts on disease progression warrants further investigation.

• Klíčová slova
• Cancer-associated fibroblasts, Ectomesenchyme, Expression pattern, Fibroblasts, Homeobox genes, Mesoderm,
• MeSH
• dospělí MeSH
• fibroblasty * metabolismus   cytologie   MeSH
• homeoboxové geny * MeSH
• homeodoménové proteiny * genetika   MeSH
• kultivované buňky MeSH
• lidé MeSH
• mezoderm * metabolismus   cytologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• homeodoménové proteiny * MeSH

AIM: Dental anxiety and well-being significantly influence patients' oral health and quality of life. This study investigated whether providing paper information leaflets (PILs) before performing dental procedures improved psychological well-being and reduced anxiety in Czech patients. MATERIALS AND METHODS: This parallel-group, single-blind randomized, prospective clinical trial was conducted at a private dental clinic in the Czech Republic in 2020. A total of 167 adult patients were randomly assigned to either the experimental group (n = 82), receiving both verbal information and a PIL, or the control group (n = 85), receiving only verbal information before their dental procedure (fillings, endodontic treatment, prosthetic restorations, or extractions). Pre- and post-procedure psychological well-being and anxiety were assessed using study-specific questionnaires. Data analysis was conducted in R using RStudio, with a significance level set at P < 0.05. Between-group differences were assessed while controlling for gender and education. Linear regression was used to analyze pre-procedure anxiety, and logistic regression was used to analyze post-procedure well-being outcomes (reporting "everything was fine," "unpleasant mouth sensations," and "quick adjustment"). The Benjamini-Hochberg correction was applied to control for multiple comparisons. Sensitivity analysis used the "best-worst and worst-best case" method to evaluate nonrandom missing data. Power analysis determined a minimum of 64 participants per group for a two-tailed t test. RESULTS: Baseline anxiety levels, measured on a 1-6 scale, were similar between the PIL group (mean 4.26, SD 1.11) and the control group (mean 4.36, SD 1.17; β = -0.11, P = 0.54). Post-procedure, while fewer patients in the PIL group reported that "everything was fine" (28/82 vs. 39/85), this difference was not statistically significant after correction for multiple comparisons (uncorrected P = 0.038, α FDR = 0.01). No significant differences were found between groups regarding "unpleasant mouth sensations" (P = 0.84) or "quick adjustment" (P = 0.52). CONCLUSION: Providing PILs in addition to verbal information did not significantly impact pre-procedure anxiety or post-procedure well-being in this sample of Czech dental patients. These findings indicate that verbal communication alone may be sufficient for managing patient anxiety and promoting well-being in this context. Further research using validated instruments and exploring different communication strategies is warranted.

• Klíčová slova
• Anxiety management, dental anxiety, dental care, doctor-patient communication, information leaflet, patient education, well-being,
• Publikační typ
• časopisecké články MeSH

Osteosarcoma of the jaw is uncommon, occurring in about 6% to 8% of cases. The authors present the case report of a (woman 72-year-old) with osteosarcoma involving the temporomandibular joint (TMJ). Radical surgery was chosen with resection of the tumor together with the condyle, the coronoid process, the zygomatic arch and eroded bone of the skull base at the site of the joint cavity. Contact of the tumor with the dura mater was not confirmed perioperatively.Reconstruction of the TMJ was 24 months after resection. The fossa component was concurrently formed in such a way as to cover the defect in the skull base and allow the reconstruction of the fossa and resected zygomatic arch. Four years after tumor resection there are no signs of local recurrence or metastases. Two years after TMJ reconstruction, the patient is symptom-free-occlusion is satisfactory, jaw movement is within normal range.

• MeSH
• baze lební chirurgie   MeSH
• lidé MeSH
• nemoci temporomandibulárního kloubu * diagnóza   chirurgie   MeSH
• osteosarkom * chirurgie   MeSH
• protézy kloubů * MeSH
• senioři MeSH
• temporomandibulární kloub chirurgie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The authors present a group of patients who were treated for exacerbation of temporomandibular joint disorders (TMD) following Covid-19 infection and who in the past had successfully undergone surgery of the temporomandibular joint (TMJ). The group consisted in total of 21 patients who relapsed after contracting Covid-19. There were 4 men and 17 women, the average age was 45.6 years (28-63). The most common complaint was pain. In all cases, the pain was located in the preauricular area, 4 patients had pain in the lateral side of the neck, 1 patient had pain of the nasal alae. During clinical examination, pain was present on palpation of the masseter muscle (19 patients), temporal muscle (4 patients) and the TMJ area (4 patients). In 4 cases, pain on palpation was present in the area of the nape and sternocleidomastoid muscles. Treatment in all cases was the same: thermotherapy, muscle relaxation massage and non-steroidal anti-inflammatory drugs. Symptoms subsided in all cases within 2 weeks. In light of the Covid-19 pandemic, it is also necessary to expect an increased number of patients with TMD. The authors recommend targeted patient histories regarding Covid-19 infection when examining patients with TMD symptoms - this will certainly facilitate determining the etiology of the pain.

• Klíčová slova
• Covid-19, Pain, Temporomandibular joint,
• MeSH
• COVID-19 * komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci temporomandibulárního kloubu * diagnóza   etiologie   terapie   MeSH
• obličejová bolest diagnóza   MeSH
• pandemie MeSH
• temporomandibulární kloub MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The authors evaluated effects of physiotherapy in patients experiencing Wilkes III temporomandibular joint (TMJ) derangement with clinically limited joint mobility, but no pain. The group consisted of 31 patients with unilateral temporomandibular joint involvement, 3 men and 28 women (average age was 30.93, ranging from age 12 to 61). None of the patients in the group had experienced any previous TMJ therapy. The patients underwent conservative therapy in the form of home exercise (mobilisation and isometric exercises) as the first step in treatment. The authors evaluated the improvement in jaw movement (maximal interincisal opening - MIO) and the patients' subjective assessments of their condition. Disc position before and after two months of exercise was also evaluated using ultrasound examination. The average MIO value in patients before starting the exercises was 33.5 mm, and after two months of exercises, 42.4 mm. Subjective assessment by patients: 26 patients (83%) described their condition as completely satisfactory, not requiring further therapy. Of these patients, ultrasound examination showed 10 patients with complete disc reduction, 9 patients with a change in disc displacement with reduction, and 7 patients with a continuing (unchanged) state of disc displacement. Results of our study show the effect of conservative therapy in patients with painless TMJ due to disc displacement (WIII). Effect of home exercises which were easy to perform, simple and acceptable to the patient were demonstrated.

• Klíčová slova
• Temporomandibular joint conservative physiotherapy treatment,
• MeSH
• dítě MeSH
• dospělí MeSH
• konzervativní terapie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• temporomandibulární kloub * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH

The increasing incidence of trauma in medicine brings with it new demands on the materials used for the surgical treatment of bone fractures. Titanium, its alloys, and steel are used worldwide in the treatment of skeletal injuries. These metallic materials, although inert, are often removed after the injured bone has healed. The second-stage procedure-the removal of the plates and screws-can overwhelm patients and overload healthcare systems. The development of suitable absorbable metallic materials would help us to overcome these issues. In this experimental study, we analyzed an extruded Zn-0.8Mg-0.2Sr (wt.%) alloy on a rabbit model. From this alloy we developed screws which were implanted into the rabbit tibia. After 120, 240, and 360 days, we tested the toxicity at the site of implantation and also within the vital organs: the liver, kidneys, and brain. The results were compared with a control group, implanted with a Ti-based screw and sacrificed after 360 days. The samples were analyzed using X-ray, micro-CT, and a scanning electron microscope. Chemical analysis revealed only small concentrations of zinc, strontium, and magnesium in the liver, kidneys, and brain. Histologically, the alloy was verified to possess very good biocompatibility after 360 days, without any signs of toxicity at the site of implantation. We did not observe raised levels of Sr, Zn, or Mg in any of the vital organs when compared with the Ti group at 360 days. The material was found to slowly degrade in vivo, forming solid corrosion products on its surface.

• Klíčová slova
• absorbable metals, alloy accumulation, biocompatibility, in vivo, internal organs, magnesium, strontium, systemic reactions, toxicity, zinc,
• MeSH
• fraktury tibie * metabolismus   chirurgie   MeSH
• hořčík chemie   farmakokinetika   farmakologie   MeSH
• králíci MeSH
• lidé MeSH
• slitiny * chemie   farmakokinetika   farmakologie   MeSH
• stroncium chemie   farmakokinetika   farmakologie   MeSH
• testování materiálů * MeSH
• tibie metabolismus   patologie   MeSH
• vstřebatelné implantáty * MeSH
• zinek chemie   farmakokinetika   farmakologie   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• hořčík MeSH
• slitiny * MeSH
• stroncium MeSH
• zinek MeSH

Although condylar dislocation is not uncommon, terminology, diagnostics, and treatment concepts vary considerably worldwide. This study aims to present a consensus recommendation based on systematically reviewed literature and approved by the European Society of TMJ Surgeons (ESTMJS). Based on the template of the evidence-based German guideline (register # 007-063) the ESTMJS members voted on 30 draft recommendations regarding terminology, diagnostics, and treatment initially via a blinded modified Delphi procedure. After unblinding, a discussion and voting followed, using a structured consensus process in 2019. An independent moderator documented and evaluated voting results and alterations from the original draft. Although the results of the preliminary voting were very heterogenous and differed significantly from the German S3 guideline (p < 0.0005), a strong consensus was achieved in the final voting on terminology, diagnostics, and treatment. In this voting, multiple alterations, including adding and discarding recommendations, led to 24 final recommendations on assessment and management of TMJ dislocation. To our knowledge, the ESTMJS condylar dislocation recommendations are the first both evidence and consensus-based international recommendations in the field of TMJ surgery. We recommend they form the basis for clinical practice guidelines for the management of dislocations of the mandibular condyle.

• Klíčová slova
• clinical practice guideline, condylar dislocation, evidence-based medicine, joint dislocations, temporomandibular joint, terminology,
• Publikační typ
• časopisecké články MeSH

PURPOSE: Alloplastic total temporomandibular joint replacement (TMJR) is now considered to be a standard procedure for temporomandibular joint (TMJ) reconstruction. TMJR can improve mandibular mobility, restore the dental occlusion and improve facial aesthetics. The purpose was to assess the presence of intraoperative and post-operative complications, including the presence of post-operative chronic pain. METHODS: This retrospective study evaluated the use of 62 stock TMJR devices implanted in 45 patients who underwent surgery between the years 2006 and 2015 by the same surgeon at the Department of Oral and Maxillofacial Surgery, Stomatology Clinic, General Teaching Hospital (VFN) Charles University, Prague, Czech Republic. RESULTS: Intraoperative and post-operative complications recorded were facial nerve dysfunction (14-22%), open bite/malocclusion (2-3.2%), condylar component dislocation (1-1.6%), infection requiring revision surgery (1-1.6%) and (27-43%) reported chronic pain 24 months after surgery. CONCLUSIONS: As with any surgical procedure, TMJR can have complications. The results of this study demonstrate that the most common post-operative complication was continued pain. Chronic pain after TMJR was more common in patients with a preoperative diagnosis of degenerative joint disease. Also, the incidence of post-operative TMJR pain increased with the duration of symptoms prior to TMJR, leading to a question of the best timing for TMJR.

• Klíčová slova
• Complications, Stock prosthesis, Temporomandibular joint,
• MeSH
• artroplastiky kloubů * MeSH
• estetika stomatologická MeSH
• lidé MeSH
• nemoci temporomandibulárního kloubu chirurgie   MeSH
• retrospektivní studie MeSH
• temporomandibulární kloub chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Discectomy with replacement of disc is one possibility for treating disc perforation where conservative, mini-invasive therapy and arthroscopy has had no effect. Allogenic or autologous materials are used to replace the disc. The authors assess the use of a free fat flap (FFF) in 19 patients who in 2015-2016 underwent a unilateral discectomy with disc replacement. In the retrospective 24-month follow-up study a total of 16 patients (84%) were free of difficulties. 24 months after the operation mouth opening was on average 39.3 mm, pain (VAS - visual analog scale (0-10) was assessed on average at 0.3). Crepitus was present after 24 months in 37.5% of patients (6 patients). An assessment of changes in joint structures on cone beam computed tomography (CBCT) for these patients 24 months after the operation showed the progression of flattening of the joint head, in one case unevenness of the joint head. In 3 cases (16%) there was a recurrence of the state within 24 months - in all cases with clinical manifestations of pain and limited mobility, for these patients on the CBCT significant unevennesses of the joint head, subchondral cysts were noted. The authors find discectomy with use of FFF to be an effective method of treatment with a minimum of complications. However, one should take into account the relatively short time of monitoring after the operation (2 years) and limited number of patients in the cohort (19 patients).

• Klíčová slova
• Disc perforation, Discectomy, Free fat flap, Temporomandibular joint,
• MeSH
• discus articularis čelistního kloubu * MeSH
• diskektomie * MeSH
• lidé MeSH
• měření bolesti MeSH
• následné studie MeSH
• nemoci temporomandibulárního kloubu * chirurgie   MeSH
• retrospektivní studie MeSH
• temporomandibulární kloub MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH