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Biomedical subjects

R L Christiansen

Publications and source records attributed to R L Christiansen.

At least 19 recordsLinked to original sources
PubMed1999

Crepitation and clicking as signs of TMD in preschool children.

Children [N = 540, age 5.1 +/- 0.72 (SD)], were tested for association between temporomandibular (TM) joint sounds and symptoms of TM disorder (TMD). The prevalence of TMJ sounds as found by auscultation and confirmed by self-report was 16.7%. There was significant association after Bonferroni correction between the presence of TM joint sounds, as reported by the children, and all but one of the eleven pain/dysfunction variables. There was significant association also between crepitation as heard at auscultation and palpation tenderness in the TMJ and masseter areas (p < 0.001), but not between clicking and any of the TMD variables. Agreement between subjects and examiners regarding the presence of TMJ sounds was poor (kappa = 0.097). The results indicate that joint sounds and TMD symptoms are common already in small children and thus demonstrate a possible early onset of TMD. Patients' own reports of TMJ sounds may have more clinical relevance than auscultation findings.

Age of Onset↗
PubMed1998

Effects of a myofunctional appliance on orofacial muscle activity and structures.

The aim of the study was to examine the effect of an oral shield treatment on orofacial muscle activity and facial morphology in children with lip and/or tongue dysfunction. The sample consisted of 7 girls and 2 boys, 7 to 12 years old. EMG recordings with and without the shield in situ were obtained when the shield was placed, and 3, 6, and 12 months later. Lateral cephalograms were obtained at the initial and 1-year stages. The lip muscles showed dominant activity when the subjects were sucking on an empty straw and during swallowing; this was strongest during the first 3 months. The mentalis, buccinator, and digastric muscles generally showed weaker activity. The anterior temporal muscle showed dominant activity during maximal clench, but after the 3-month stage a significant decrease was noted. After 1 year of treatment, no significant changes in overjet or overbite were observed. Most of the craniofacial growth changes were normal for the age group. The results indicate that treatment with an oral shield caused a decrease in orofacial muscle activity during oral functions. Although there was a slight average retraction of the maxillary incisors, the change in position was not statistically significant.

Cephalometry↗
PubMed1997

Stress-related molar responses to the transpalatal arch: a finite element analysis.

The finite element method of analysis (FEM) was used to analyze theoretically the effects of a transpalatal arch (TPA) on periodontal stresses of molars that were subjected to typical retraction forces. The purposes of this investigation were (1) to construct an appropriate finite element model, (2) to subject the model to orthodontic forces and determine resultant stress patterns and displacements with and without the presence of a TPA, and (3) to note any differences in stress patterns and displacements between models with and without a TPA. Because anchorage is stress-dependent, a TPA must be able to modify periodontal stresses as a prerequisite for increasing orthodontic anchorage. A finite element model, consisting of two maxillary first molars, their associated periodontal ligaments and alveolar bone segments, and a TPA, was constructed. The model was subjected to simulated orthodontic forces (2 N per molar) with and without the presence of the TPA. Resultant stress patterns at the root surface, periodontal ligament, and alveolar bone, as well as displacements with and without a TPA, were calculated. Analysis of the results revealed minute differences of less than 1% of the stress range in stress values with respect to the presence of a TPA. Modification of bone properties to allow for increased displacement levels confirmed the ability of the TPA to control molar rotations; however, no effect on tipping was noted. Results suggested that the presence of a TPA has no effect on molar tipping, decreases molar rotations, and affects periodontal stress magnitudes by less than 1%. The final results suggest an inability of the TPA to modify orthodontic anchorage through modification of periodontal stresses.

Alveolar Process↗
PubMed1996

Classification of temporomandibular joint sounds based upon their reduced interference distribution.

Temporomandibular joint (TMJ) sounds were recorded in 98 orthodontic retention patients, mean age 19 +/- 8.6 (s.d.) years, by interview, auscultation and electronic recording. Sounds were found by auscultation in 41% and by interview in 32% of the subjects, more often in females than in males (P < 0.05). A new method for time-frequency analysis, the reduced interference distribution (RID), was used to classify the electronic sound recordings into five subclasses, RID types 1-5, based upon location and number of their energy peaks. RID types 1-3 had a few energy peaks close in time. RID types 4-5, typical of subjects with crepitation, had multiple energy peaks occurring close in time for a period of 20-300 ms. RID type 1, found in 45% of the subjects, typical of patients with clicking, had its dominant energy peak located in a frequency range < 600 Hz and was significantly more common in the female than in the male subjects (P < 0.01). RID type 2, found in 68% of the subjects, with the dominant peak in the range 600-1200 Hz, and RID type 3, found in 38% of the subjects, with the peak in the frequency range > 1200 Hz, were found to have a similar gender distribution. RID type 4, found in 49% of the subjects, had the energy peaks distributed in the frequency range < 600 Hz. RID type 5, found in 43% of the subjects, more often in females than in males (P < 0.05), had the peaks distributed over the whole frequency range from about 30 Hz up to about 3000 Hz. In conclusion, a more detailed classification could be made of the TMJ sounds by displaying the RIDs than by auscultation. This suggests that RID classification methods may provide a means for differentiating sounds indicating different types of pathology.

Adolescent↗
PubMed1995

The TMJ-ear connection.

This article documents the existence of three structures that traverse through the petrotympanic fissure. These structures are the mandibular malleolar ligament, the chorda tympani nerve and the anterior tympanic artery. The mandibular malleolar ligament or the disk-malleolar ligament originates on the anterior process of the mallous. It traverses through the petro-tympanic fissure and attaches to the posterior portion of the capsule and disk of the temporomandibular joint. The chorda tympani nerve supplies sensory feeling to the posterior two thirds of the tongue. The anterior tympanic artery supplies blood to the area of the tympanic membrane. Clinical experience with implants that impinge or cover ear problems and other symptoms. Removal of these implants and placements with devices that do not cover these structures often relieve these symptoms.

Arteries↗
PubMed1995

Race and gender as TMD risk factors in children.

The aim of this study was to record the prevalence in preschool children of oral/facial pain symptoms of clinical interest in the diagnoses of temporomandibular disorders (TMD) and to analyze the association with the race and gender factors. Children, 525 4-6 year olds, mean age 5.1 +/- 0.65 (SD), 326 Caucasian and 199 African American, from a preschool and kindergarten program in a low income industrial area, who participated in a voluntary oral health examination, were examined. Comparisons were made using Chi-Square test. An alpha-level of 5% was chosen, and the effect of making multiple comparisons was compensated for by Bonferroni correction. No gender differences were found, but racial differences were observed regarding six of the 10 variables. Twenty-five percent of the children had recurrent (at least one to two times per week) headache. Thirteen percent had recurrent earache, African-American children more often than Caucasian children (p approximately 0.0038). Thirteen percent had recurrent temporomandibular joint (TMJ) pain, and 11% had recurrent neck pain. Pain or tiredness in the jaws during chewing was reported by 29% of the children, more often by African-American than by Caucasian (p < 0.00001). Pain at jaw opening occurred in 13% of the children, more often in the African-American than in the Caucasian children (p approximately 0.00004). Palpation pain was found in the posterior TMJ area in 28%, in the lateral TMJ area in 22%, in the masseter area in 19%, in the anterior temporalis area in 15% and was found more often in all of those regions in the African-American than in the Caucasian children (p approximately 0.00001), except for the temporalis area. In conclusion, this study showed that mild, but distinct, TMD-related oral/facial pain symptoms occur already by ages 4-6 with significant differences in distribution observed between the African-American and the Caucasian races. While gender seems to play a negligible role in this age group, this does not necessarily mean that race is a causative factor. The pain symptoms may be caused by other factors with different distribution in the two racial subgroups.

Black People↗
PubMed1995

Oral parafunctions as temporomandibular disorder risk factors in children.

Oral parafunctions are generally considered to be important factors in the etiology of temporomandibular disorders (TMDs) and many reports have been published about their prevalence in adults and schoolchildren. However, few have included significant numbers of children below the age of 7. The aim of this study was to examine the association between parafunctions and oral/facial TMD-related pain in preschool children. Bruxism, nail biting, and thumb sucking were found to be significantly associated with important oral/facial pain symptoms of clinical interest in the diagnoses of TMD indicating that those parafunctions are risk factors. The study included 525 4- to 6-year-old African-American and Caucasian children, mean age 5.1 +/- 0.65 (SD). An alpha level of 5% was chosen for comparison with a Pearson Chi-Square test. Bonferroni correction was made and a p-value of < 0.005 was accepted as significance level. Only 28% of the children had no history of any parafunction. More girls (82%) than boys (63%) in the Caucasian subgroup had at least one parafunction (p approximately 0.00017). No such difference was found in the African-American subgroup where the corresponding figures were 71% for girls and 73% for boys. Thumb sucking was reported by 57% of the children, more often by Caucasian girls (69%) than by Caucasian boys (43%) (p < 0.00001). Thirty percent still had the habit. Forty-one percent had a history of nail biting. Bruxism was noted in 20% of the children, but occurred mostly in combination with other parafunctions and was seldom (in 3.4%) the only parafunction. Of the 10 pain variables, bruxism was significantly associated with eight, thumb sucking with three, and nail biting with two. Analysis with logistic regression confirmed the results. Association does not, however, tell if a parafunction is the cause or the consequence of pain, or if a third factor is causing both pain and increased prevalence of oral parafunctions. Further prospective longitudinal studies including higher age groups are needed to clarify those relations and to determine if there are long-term effects of childhood parafunctions.

Black or African American↗
PubMed1995

Prevalence of signs and symptoms of craniomandibular disorders and orofacial parafunction in 4-6-year-old African-American and Caucasian children.

Children, 4-6 years old, 153 Caucasian and 50 African-American, from a pre-school and kindergarten programme in a low income industrial area, who participated in a voluntary oral health examination, were questioned and examined for signs and symptoms of craniomandibular disorders (CMD) and of oral parafunctions. Most of the CMD signs and symptoms were mild. Eight per cent had recurrent (at least 1-2 times per week) TMJ pain, and 5% had recurrent neck pain, African-American children more often than Caucasian children (P < 0.05). Seventeen per cent had recurrent headache. Three per cent had recurrent earache. Pain or tiredness in the jaws during chewing was reported by 25% of the children, more often by African-American than by Caucasian children (P < 0.001) and more often by girls than by boys (P < 0.05). Pain at jaw opening occurred in 10% of the children, more often in the African-American than in the Caucasian group (P < 0.001). Thirteen per cent of the children had problems in opening the mouth. Deviation during opening was observed in 17% and reduced opening in 2%. Reduced lateral movements, locking or luxation were not observed in any child. Palpation pain was found in the lateral TMJ area in 16%, in the posterior TMJ area in 25%, in the temporalis and masseter areas in 10%, and pain for all regions was found more often in the African-American than in the Caucasian children (P < 0.01). Thirty-four per cent of the African-American, and 15% of the Caucasian children admitted to having ear noises (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Black People↗
PubMed1995

Association between CMD signs and symptoms, oral parafunctions, race and sex, in 4-6-year-old African-American and Caucasian children.

The associations between oral parafunctions, signs and symptoms of craniomandibular disorders (CMD), race, and sex were analysed in recordings from 203 4-6-year-old African-American and Caucasian children. Significant correlations were found between bruxism, nail biting, thumb sucking and most of the CMD signs and symptoms. There were also significant associations between most of the signs and symptoms and race, while significant association with sex was found only regarding headache, TMJ sounds and chewing pain. Significant associations were found between most CMD signs and TMJ sounds supporting the view that joint sound recordings have diagnostic value. There were also significant associations between the pain variables recorded by questionnaire and those recorded by palpation, which indicates that reliable data can be obtained by interviewing children as young as five. The results of this study support the concept that oral parafunctions have a significant role in the aetiology of CMD. The results also show that race and sex need to be considered when analysing the possible aetiological role of oral parafunctions in CMD. Longitudinal studies, beginning with low age groups are needed to better determine the role of childhood oral parafunctions in CMD aetiology.

Black People↗
PubMed1993

Disseminated intravascular coagulation following orthognathic surgery.

When performing any type of surgery, the surgeon must be cognizant of hidden bleeding. In the case presented, Le Fort I osteotomy is performed to correct a disharmonious maxillomandibular relationship of a 19-year-old man with diabetes insipidus. Postoperatively, excessive bleeding is seen at the surgical site, IV catheter insertion area, and rectum. It was later determined that the blood originated from the oral structure and traveled through the stomach and rectum. Examination of the blood revealed disseminated intravascular coagulation.

Adult↗
PubMed1989

Condylar penetration into the middle cranial fossa.

This article describes two cases of condylar penetration into the middle cranial fossa in which a similar surgical procedure is used, namely, a rib graft for closure of the fossa. The rib graft, being an autogenous substance, does not present the problems associated with alloplastic materials. If care is taken not to contaminate the graft, and if the bone used has adequate thickness to prevent penetration and resorption, the graft will prove a superior option to repair damage in the middle cranial fossa.

Adult↗
PubMed1985

A computerized multi-use craniofacial patient record.

A computerized craniofacial patient record reinforces the link between clinical research and the treatment process. The availability of microcomputers and appropriate software has made it feasible for most craniofacial groups to organize patient data for easy retrieval and analysis. Selection of the computer system and programs follows careful planning and systematic delineation of the desired functions of the system. An example of a working computerized craniofacial patient record system is described.

Child↗
PubMed1981

Hypoplasia of the nose and eyes, hyposmia, hypogeusia, and hypogonadotrophic hypogonadism in two males.

Two males, 9-11 and 29-31 years of age, with severe hypoplasia of the nose, hypoplasia of the eyes, sensory abnormalities of taste and smell, and hypogonadism were studied. The nasal septum, cribriform plates and foramina of the vomeronasal (vn) nerves were demonstrated in both; the capsule of the vn organ was shown in one. Their nasal skeleton, demonstrated by tomoradiography, had grown in early embryological form. The nose was not patent in either patient. In both, the cranial vaults, orbits, epipharynges, and oral cavities were indented toward the hypoplastic nasal composite and the peripheral dimensions of their faces were normal for their respective ages. Each patient had impaired visual function with cataracts and colobomata. Each was unable to recognize the smell of any vapor (Type I hyposmia), and had severe impairment of recognition of any tastant (recognition hypogeusia); detection of vapors and of tastants were in appropriate anatomical areas. Each was unable orally to recognize standard plastic forms (astereognosis) though each could recognize the forms manually. Each patient had bilateral inguinal hernias, one or two undescended testes, and hypogonadotrophic hypogonadism. These patients do not fall within the spectrum of arrhinencephaly because of the presence of medial structure of attachment of the falx cerebri and because of their normal intelligence. Distinction of patients with this pattern of abnormalities from arrhinencephaly is important by reason of their potentiality of normal mental development. We hypothesize that their abnormalities resulted from an embryological disruption that occurred in the first trimester of pregnancy. The embryogenesis of the nasal composite is presumed to have been adequate for reciprocal induction of the anlagen of the forebrain. Development of their faces to normal peripheral dimensions indicates that the nasal composite is not essential for gross facial enlargement.

Adult↗