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1/60. SAPHO syndrome of the temporomandibular joint associated with sudden deafness.

    We report a case of arthritis of the temporomandibular joint (TMJ) associated with sclerosing osteomyelitis of the mandible and temporal bone, causing deafness. The presence of a palmoplantar pustulosis established the diagnosis of SAPHO syndrome. SAPHO (an acronym referring to synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis) syndrome is defined by the association of characteristic osteoarticular and dermatologic manifestations, with diffuse sclerosing osteomyelitis of the mandible being a part of this entity. We review the literature of SAPHO syndrome with mandibular manifestations and discuss the mechanisms of inflammatory spread from the TMJ to the cochlea. To our knowledge, this is the first description of skull base involvement in a patient with SAPHO syndrome leading to sudden deafness.
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ranking = 1
keywords = arthritis
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2/60. Rheumatoid arthritis-affected temporomandibular joint pain analgesia by linear polarized near infrared irradiation.

    PURPOSE: To describe a new short-term treatment for pain in rheumatoid arthritis (RA)-affected temporomandibular joint (TMJ). CLINICAL FEATURES: We investigated four female patients (age 42.8 /-26.0 yr) with chronic rheumatoid arthritis affecting a single TMJ. patients had received antirheumatic drugs such as sodium aurothiomalate, and as a result showed no symptoms in other body joints. Linear polarized near infrared radiation using Super Lizer was applied weekly with and/or without jaw movement to the unilateral skin areas overlying the mandibular fossa, anterior articular tubercle, masseter muscle and posterior margin of the ramus of the mandible. The duration of irradiation to each point was two seconds on and ten seconds off per cycle and the intensity at each point was approximately 138 J x cm(-2) at a wavelength of 830 nm. Interincisal distance was measured with maximal mouth opening in the absence and presence of pain before and after each treatment. Additionally, subjective TMJ pain scores assessed using a visual analog scale were performed for painful maximal mouth opening before and after each irradiation. TMJ pain disappeared after only four treatments. Moreover, painless maximal mouth opening without pain after irradiation in three patients was on average improved to 5.3 /-2.1 mm. However, one case was observed where the opening length prior to irradiation did not improve, despite the fact that the RA-affected TMJ pain had disappeared. CONCLUSION: Application of linear polarized near infrared irradiation to patients with RA-affected TMJ pain is an effective and non-invasive short-term treatment.
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ranking = 6
keywords = arthritis
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3/60. Rheumatoid arthritis of the temporomandibular joint with herniation into the external auditory canal.

    Previous authors have shown that soft tissue can present in the external auditory canal via a patent foramen of Huschke. One case represented a patient with psoriatic arthritis and a polyp in the external auditory canal. Typically, neoplastic, inflammatory, or degenerative lesions of the temporomandibular joint do not present in the external auditory canal. We present a patient with rheumatoid arthritis of the temporomandibular joint and soft tissue herniation into the external auditory canal. The case, and a discussion of possible causes, are presented.
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ranking = 6
keywords = arthritis
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4/60. An adult case of TMJ osteoarthrosis treated with splint therapy and the subsequent orthodontic occlusal reconstruction: adaptive change of the condyle during the treatment.

    This article reports treatment for a 21-year 11-month old female patient with severe osteoarthrosis of the TMJ with a special reference to adaptive changes of the condyle during the treatment. She had severe open bite with a Class II molar relationship; she had limited mouth opening, TMJ sounds, pain, and tinnitus. Lateral tomograms showed flattening and deep erosion on the left condyle, and an MRI revealed anterior disk displacement without reduction. By manipulation and splint therapy, TMJ pain and tinnitus were eliminated, then orthodontic treatment was initiated, maintaining the splint-induced position of the condyles. After 2 years of orthodontic treatment with a multibracket appliance, an acceptable occlusion was achieved with a Class I molar relationship. On lateral tomograms after treatment, bony deformation of the left condyle disappeared and adaptive remodeling was recognized with a uniform joint space in the left TMJ. However, repositioning of the disk was not achieved. Adaptive changes or functional remodeling experienced in this patient may be due to stable occlusion, uniform joint space, and the consequent biomechanical equilibrium in the TMJ.
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ranking = 39918.452599791
keywords = osteoarthrosis
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5/60. A case of anterior open bite developing during adolescence.

    Imaging studies have reported on the relationship between temporomandibular joint (TMJ) degeneration and facial deformity. These studies have suggested that mandibular growth is affected by TMJ degeneration, resulting in altered skeletal structure as mandibular retrusion. However, there are very few longitudinal case reports on TMJ osteoarthrosis (OA). Progressive open bite occurred in an adolescent patient with TMJ OA. Cephalometric analysis showed a downward and backward rotated mandible, and a labial inclination of the upper incisor. magnetic resonance imaging showed internal derangement without reduction and erosion in the right and the left condyles. Although the cause of open bite is unclear in this case, tongue thrusting, and internal derangements in the temporomandibular joint were suspected as causes of the open bite.
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ranking = 7983.6905199582
keywords = osteoarthrosis
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6/60. Isolated temporomandibular synovitis as unique presentation of juvenile idiopathic arthritis.

    temporomandibular joint (TMJ) involvement is quite frequent in juvenile idiopathic arthritis (JIA). We describe a 15-year-old girl with isolated TMJ arthritis presenting as a unique manifestation of JIA, and its successful treatment. She underwent arthroscopic synovectomy followed by intraarticular steroid injection. Early use of synovectomy and intraarticular steroids in TMJ arthritis may reduce pain, improve jaw function, and prevent irreversible deformities.
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ranking = 7
keywords = arthritis
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7/60. ankylosis of the temporomandibular joint caused by rheumatoid arthritis: a pathological study and review.

    Rheumatoid arthritis (RA) of the temporomandibular joint (TMJ) in a 59-year-old Japanese woman is reported, including details of clinical, histopathological and radiological findings. The patient had been diagnosed as having RA of the right knee joint 41 years previously, and suffered from arthralgia of the right TMJ. Radiological examination showed a radiopaque lesion of the mandibular head and mandibular fossa in the right TMJ and ankylosis of the right TMJ was diagnosed on the basis of the clinical and radiological findings. Condylectomy was performed. Pathological examination of material from the joint region revealed a marked increase of collagen fibers associated with slight capillary dilatation and hemorrhage. The final diagnosis was ankylosis of the right TMJ due to RA. The literature on TMJ ankylosis secondary to RA is reviewed and discussed.
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ranking = 5
keywords = arthritis
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8/60. Three-dimensional magnetic resonance image of the mandible and masticatory muscles in a case of juvenile chronic arthritis treated with the Herbst appliance.

    The present report documents, in a case of juvenile chronic arthritis (JCA) with mandibular retrognathia, three-dimensional (3D) changes in the mandible and the relationship between the mandible and the masticatory muscles resulting from treatment with the Herbst appliance after cessation of growth. Magnetic resonance scanning of the whole head was carried out before and after treatment. The mandible, the masseter, and the medial and lateral pterygoid muscles were segmented bilaterally and reconstructed in 3D for both stages. Superimposition of the datasets was carried out according to anatomical structures in the brain (cranial base). Mandibular superimposition was performed according to the mandibular symphysis and the lower mandibular border. The mandible moved forward and downward relative to the anterior cranial base. In addition, bone apposition was observed at the superior and posterior surfaces of both mandibular condyles and at the roof of the glenoid fossa. The masticatory muscles remained relatively stable in position in relation to the anterior cranial base. To our knowledge, such information in JCA patients has not previously been published in the literature. Using magnetic resonance imaging (MRI), it was possible to gain improved insight into the 3D morphology including soft tissues without the overlap of the surrounding tissues observed in the conventional radiographs. Accordingly, it is suggested that 3D magnetic resonance analysis is a more useful method for the follow-up of the JCA patients than radiographic techniques.
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ranking = 5
keywords = arthritis
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9/60. A three-dimensional method of visualizing the temporomandibular joint based on magnetic resonance imaging in a case of juvenile chronic arthritis.

    AIM: The purpose of this study was to present a new visualizing method for temporomandibular joint (TMJ) pathology in 3D at several condylar positions and to apply the method to a case of juvenile chronic arthritis (JCA) with previously diagnosed bilateral TMJ disorder and to a subject without signs and symptoms from the TMJ. SUBJECT: The 20-year-old female patient had suffered from polyarticular JCA from the age of 6 years 8 months. The present study is based on a follow-up examination after the completion of orthodontic treatment with the Herbst appliance. Both TMJs were examined using magnetic resonance imaging (MRI) at closed and open mouth positions. The mandibular condyle, the glenoid fossa and the articular disc were segmented and 3D reconstruction of these structures was carried out. RESULTS: The condyle was characterized by an increased sagittal diameter with osteophyte-like formation at the anterior aspect of the condylar head and flattening of the superior surface. The depth of the glenoid fossa was reduced and the articular eminence was remarkably flat. The articular disc was markedly diminished and posteriorly placed on the condylar head. The distance of the condylar path during mouth opening was reduced and the curvature of the condylar path was quite flat. The disc moved slightly posteriorly on the condylar head and remained in the glenoid fossa during mouth opening. CONCLUSION: The imaging modality described improves visualization of TMJ morphology and gains insight into the TMJ pathology of the JCA patient, adding to understanding of the clinical problems.
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ranking = 5
keywords = arthritis
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10/60. A suspected case of tuberculosis of the temporomandibular joint.

    Primary tuberculosis is symptomless in the great majority of individuals. The clinical appearance of tuberculosis (TB) of the temporomandibular joint is similar to that of ordinary arthritis of this joint and so, is unlikely to be diagnosed early in non-destructive disease, especially when there are no symptoms and signs of TB elsewhere in the body. The role of mycobacterium tuberculosis and other opportunistic organisms should not be overlooked in complicated head and neck infections as this is an ever increasing problem today, especially due to the emergence of multi-drug resistant strains of tuberculosis in some urban areas.
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ranking = 1
keywords = arthritis
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