• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.127-132
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• 2019

Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.4
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• pp.227-230
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• 2016

Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.

• Journal of Oral Medicine and Pain
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• v.46 no.3
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• pp.69-74
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• 2021

As for temporomandibular joint arthritis (TMJ OA), managing the contributing factors at an early stage through accurate diagnosis is necessary to prevent irreversible bone changes. TMJ OA, which is a multi-organ disease caused by various pathophysiological mechanisms, is developed mainly due to mechanical overload. It is a disease characterized by degeneration of articular cartilage and subchondral bone as a low-level inflammatory arthritis condition developed by dysregulation of catabolic and anabolic activity of chondrocytes. Age, mechanical overload sensing of cartilage, chondrocyte apoptosis, catabolic enzymes, inflammatory factors, abnormal remodeling of subchondral bone, and estrogens may be involved in the pathogenesis of arthritis. Therefore, a comprehensive evaluation is needed to diagnose and manage progressive cartilage degeneration, subchondral bone remodeling, and associated symptoms of TMJ OA.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.203-207
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• 2013

Psoriatic arthritis is a chronic inflammatory form of arthritis that is associated with psoriasis. A 54-yr-old male with chronic psoriatic temporomandibular joint arthritis and myofascial pain was treated using methotrexate and a myofascial pain protocol. Jaw pain improved after 3 weeks, however, tenderness to palpation of muscles remained. Comprehensive evaluation and multidisciplinary clinical treatment is required for the treatment of patients with psoriatic temporomandibular joint arthritis.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.14 no.1
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• pp.61-69
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• 1984

For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosed as rheumatoid arthritis through the clinical, radiographic examination and laboratory findings. Temporomandibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.497-503
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• 2010

Purpose: The purpose of this study is to induce artificial arthritis on rabbit TMJ by injecting collagenase. Materials and Methods: An experimental animal model of arthritis induced by surgical method or intraarticular injection of chemical agent like LDH, papain, ketorolac. Surgical method is complex and needs a long time in inducing arthritis. Intra-articular injection of chemical agent like LDH, papain, ketorolac is simple. But chemical agent like LDH, papain, ketololac needs multiple injections to induce arthritis and mechanism inducing arthritis was known. Collagenase destroys helical domain of type II collagen in extracellular matrix produced by chondrocyte and then induces arthritis. We injected collagenase (0.5, 1.0, 2.0 mg) into the temporomandibular joint of rabbit. In the control group saline was intra-articularly injected. The condylar cartilage, disk and synovia were histologically examined at 1, 2, 4, 6 weeks after the initiation of collagenase injections. Results: Four weeks after injection of 2.0 mg collagenase, we could see histologic change like arthritis. In other groups, we couldn't see arthritis-like change. Conclusion: In our study, we produce arthritis on temporomandibular joint of rabbit by using injection of collagenase in temporomandibular joint of rabbit. And this experimental osteoarthritis is a useful animal model.

• The Journal of the Korean dental association
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• v.19 no.11 s.150
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• pp.901-905
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• 1981

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.510-514
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• 2011

An intracapsular and pericapsular infection of the temporomandibular joint (TMJ) is rare. The invasion of bacteria into the joint space can occur through several routes. Among them, hematogenous spread is most common. This report describes three cases of abscess formation in the TMJ (intracapsular and pericapsular infection). The patients were treated with supportive care and surgical intervention (incision and drainage) under hospitalization, and their symptoms had improved. Pain of the TMJ is a typical symptom of temporomandibular joint disorders (TMD). On the other hand, an infection of the TMJ can also cause pain on the affected side, and can be misdiagnosed as routine TMD. Therefore, the possibility of an infection of the TMJ cavity should be considered when treating TMD.

• Journal of Oral Medicine and Pain
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• v.48 no.1
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• pp.31-36
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• 2023

This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.237-243
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• 2006

The aims of this study was to investigate the clinical and radiographic features of temporomandibular dysfunction in the patients with RA to elucidate whether the RA patients would be a risk group for TMD. The 35 patients with temporomandibular joint dysfunction were included for this study, of which 15 had rheumatoid arthritis diagnosed by a rheumatologist, and other 20 was control group and they didn't have any history or clinical signs related to it. Clinical symptoms and signs of temporomandibular joint disorders, radiographic and MRI findings of temporomandibular joint were investigated. The results were compared between two groups. In RA group bilateral pain, morning stiffness, reduced opening range, and crepitations were more frequently reported than control group. Radiologic findings such as sclerosis and flattening of condylar head, marginal proliferation, and erosion of glenoid fossa were more frequently observed in RA group than control group. Disk destruction, cortical bone erosion, and intraarticular enhancement were more prominenet in RA group. From theses results, it can be concluded that many RA patients will develop TMD symptoms and the structural changes of TMJ is more extensive than the usual TMD cases.