m. imanimoghaddam

Temporomandibular joint osteoarthritis (TMJOA) appears to be more common in osteoporotic patients. Fractal analysis is a mathematical method that can be used to assess trabecular bone. The aim of this study was to assess the correlation of bone mineral density (BMD) and fractal dimension (FD) of the condyles in women with TMJOA using cone-beam computed tomography (CBCT).  

In this cross-sectional study, the FD and lacunarity of the condylar head were assessed on CBCT images of 39 women (20 healthy women with no signs/symptoms of TMJOA, and 19 TMJOA patients). The BMD and the T-score of the hip and lumbar vertebrae were determined using dual energy X-ray absorptiometry. Data were analyzed by t-test, chi-square test, and Pearson’s correlation coefficient.

TMJOA patients and healthy controls did not differ significantly in terms of the mean age (P=0.63), BMD and T-score (P>0.05), or FD and lacunarity (P>0.05). A significant correlation was observed, however, between lacunarity in the two condyles (r=0.47, P=0.003) and BMD of the lumbar vertebrae and the hip (r=0.40, P=0.01). 
 Conclusion

The mean BMD of total spine and hip did not differ significantly in the two groups of healthy controls and TMJOA patients. The FD and lacunarity also       showed no significant difference between the groups. FD based on CBCT images of the TMJ is not a reliable indicator for categorization of skeletal status.

Psoriatic arthritis (PSA) is a multifactorial disease that affects 5-8% of patients with psoriasis. This disease is rarely reported in temporomandibular joint (TMJ). Female patients are generally prone to temporomandibular disorders (TMDs), and disorders affecting this joint cause secondary symptoms such as general mouth and face pain, headache, masticatory myalgia, and sleep disturbance. A rare case of temporal bone and temporomandibular joint involvement in psoriatic arthritis is reported here.

 The patient is a 62-year-old woman who referred with pain in the right ear, physical imbalance, restricted mouth opening, along with the habit of clenching. CBCT findings showed evidence of reduced joint space on the right and left TMJ, the presence of erosive lesions on the right condylar head. Dehiscence of the roof of the middle ear was also present on the right and left sides. Also, the petrotympanic fissure or the foramen tympanicum was open on the right and left sides. She had previously used a soft night guard on the right side for TMJ pain, but due to the treatment failure, a prosthodontist recommended the use of a hard night guard.

Based on the results of this study, temporal bone involvement should also be considered in people with a history of psoriasis.

Idiopathic osteosclerosis is a common radiopaque lesion in the jaw bones, which is asymptomatic and usually detected accidentally in various radiographs. The purpose of this study was to determine the radiographic features of idiopathic osteosclerosis in the jawbones of patients referring to the maxillofacial radiology center of Mashhad Dental Faculty.

In this descriptive study, panoramic radiographs of 300 patients ( 125 males, 175 females ) who had referred to the maxillofacial radiology department were evaluated for the presence of idiopathic osteosclerosis. The radiographic information included location, number, shape, size, relationship with teeth, pattern of density ( trabecular-cortical ) and demographic data ( age, sex ) and evidence of disease in the gastrointestinal tract and kidneys were also recorded . Then data was analyzed using chi-square and t-student test.

A total of 27 patients (9%), exhibited 40 foci of idiopathic osteosclerosis with different shapes and sizes (4 cm2 to 1/09 cm 2 ), most of which had well defined borders (65%) and trabecular density (62/5%) . The most common region for these lesions was in the mandible, especially in the second premolar (47/5%) and first molar (42/5%) regions and the majority had no connection to the teeth (57/5%). The lesions were most prevalent in the second decade of life (29/6%) followed by third and fourth decades. (25/9%)

The results of this study were the same as that of previous similar studies. In addition, chronic renal failure was seen in 1/3 of patients with idiopathic osteosclerosis .