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PubMed1977

Posterior unilateral condylar displacement: its diagnosis and treatment.

The treatment procedure for posterior unilateral condylar displacement has been described. An acrylic resin repositioning prosthesis may be used to decrease trismus. Occlusal adjustment permits lateral freedom for mandibular movement to the opposite side which provides a dual, or a therapeutic, centric occlusion as well as the existing dysfunctional centric relation. This permits the patient's physiologic adaptive mechanism to choose between the existing dysfunctional centric relation, which resulted in unilateral condylar retrusion and pain, or a therapeutic centric occlusion which is aimed at anterior unilateral condylar repositioning. Over long period of time, muscle reprogramming produces maximum intercuspation of teeth in the planned therapeutic centric occlusion rather than in the original dysfunctional position. No explanation has been established for this phenomenon. It is important, however, to provide a technique that permits physiologic adaptability over a period of time. It should be emphasized that this is not TMJ "remodeling" but a functional change in the position of the jaw. The treatment objectives of bilateral and unilateral posterior condylar displacement are similar, but the clinical techniques are completely different. In either instance, TMJ radiographs are necessary to establish the diagnosis and treatment, as well as to document the postoperative results.

Acrylic Resins↗
PubMed1983

Histologic changes in rat masticatory muscles subsequent to experimental increase of the occlusal vertical dimension.

Histologic changes in various masticatory muscles were studied in Wistar rats from 12 hours to 84 days after an experimental increase of the occlusal vertical dimension. The increases applied (1 to 2 mm) were based on the amount of interocclusal space (1 mm) in the rat. A sequence of tissue reaction from early acute inflammatory destruction of myofibers to healing with myofiber regeneration was most pronounced in the deep masseter muscle of the 2 mm group (12 hours to 21 days). A similar sequence was also observed to a lesser degree in the superficial masseter and anterior temporal muscles, while no changes were detectable in the posterior temporal, medial pterygoid, and anterior digastric muscles of this group. Variable severity of tissue response in different masticatory muscles might be attributable to the amount of stretching of myofibers as a result of an increased occlusal vertical dimension. On the other hand, degenerative atrophy of myofibers in the lateral pterygoid muscle occurred within 2 days with no sign of inflammation, and these condensed myofibers persisted as late as 84 days. Based on these findings, it was suggested that displacement of the mandibular condyle would exert an important influence on the prognosis after an increase in the occlusal vertical dimension. Only a transient acute inflammation occurred in the deep and superficial masseter muscles in the 1 mm group. Except for a small number of condensed myofibers in the lateral pterygoid muscle, degenerative changes of myofibers were not revealed. Therefore, increasing the occlusal vertical dimension within the extent of the interocclusal space might be regarded as appropriate for prosthodontic practices.

Animals↗
PubMed1992

The effect of age on condylar asymmetry in patients with craniomandibular disorders of arthrogenous origin.

A group of patients with a craniomandibular disorder of arthrogenous origin demonstrated an age-related variation of condylar asymmetry with age. This may reflect a greater depletion of the mesenchymal cell layer, which is responsible for adaptation of the articular surface as age increases. This would then result in greater deterioration of the articular surfaces and a consequent decrease in condylar asymmetry.

Adolescent↗
PubMed1987

Developmental changes in responsiveness to vitamin D metabolites.

We have demonstrated that epiphyseal chondroblasts contain specific receptors for 24R,25-dihydroxy vitamin D3(24,25(OH)2D3) while diaphyseal osteoblasts contain specific receptors for 1 alpha 25-dihydroxy vitamin D3(1,25(OH)2D3). Both metabolites induce DNA synthesis and creatine kinase (CKBB) activity. We have also found that the responsiveness of rat kidney to these metabolites changes during development. In embryonic and early postnatal stages, the kidney responds to 24,25(OH)2D3, later to both 24,25(OH)2D3 and 1,25(OH)2D3, and the mature kidney only to 1,25(OH)2D3. These responses correlate with changes in the specific receptors present in the kidney. Furthermore, we have compared developmental changes in skeletal (epiphysis, diaphysis and mandibular condyle) and non-skeletal (kidney, cerebellum, cerebrum, liver and pituitary) tissue in both rat (a postnatal developer) and rabbit (a perinatal developer). Epiphyseal or diaphyseal chondroblasts at any stage of development were predominantly responsive to 24,25(OH)2D3, whereas osteoblasts were responsive to 1,25(OH)2D3. In contrast, condylar chondroblasts, kidney, cerebellum and pituitary responded to 24,25(OH)2D3 during early development and subsequently developed responsiveness to 1,25(OH)2D3. Using primary cell cultures from kidneys at different stages of maturation, we showed the same developmental pattern as in vivo. Chronic treatment of the cells with 24,25(OH)2D3, but not 1,25(OH)2D3, caused precocious development of responsiveness to 1,25(OH)2D3 in culture. We suggest that 24,25(OH)2D3 acts as a maturation factor, during early development in kidney, and probably in other tissues, possibly by induction of receptor to 1,25(OH)2D3, accompanied by down-regulation of its own receptor.

24,25-Dihydroxyvitamin D 3↗
PubMed1975

Odontogenic myxoma. A clinical and ultrastructural study.

The odontogenic myxoma is an uncommon neoplasm of the jaws that is believed to arise from the primitive, mesenchymal portion of the tooth germ. This study surveys nine cases of odontogenic myxoma of the jaws. Analysis of the clinical material revealed that the myxoma occurred most frequently in the posterior regions of the mandible and will recur if initial therapy is too conservative. The average age of the patients in this series was 26.5 years. Five cases involved females and four involved males. Electron microscope findings revealed that the tumor cells are probably responsible for the secretion of the myxomatous intercellular material of the neoplasm.

Adolescent↗