Establishing better biological models to understand occlusion. I: TM joint anatomic relationships
Identifieur interne : 001816 ( Main/Exploration ); précédent : 001815; suivant : 001817Establishing better biological models to understand occlusion. I: TM joint anatomic relationships
Auteurs : A. Pullinger [États-Unis]Source :
- Journal of Oral Rehabilitation [ 0305-182X ] ; 2013-04.
Descripteurs français
- Wicri :
- topic : Société.
English descriptors
- KwdEn :
- Acta odontol scand, Adaptation demand, Anatomic, Angle orthod, Anterior, Anterior disc displacement, Anterior position, Anteriorly, Articular, Articular disc, Articular eminence, Asymmetry, Asymptomatic, Asymptomatic normals, Asymptomatic volunteers, Available sample size, Blackwell, Blackwell publishing, Centric, Centric relation, Clinical illustration, Clinical practice, Concentric, Conceptual model, Condylar, Condylar position, Condyle, Condyle position, Condyle positions, Craniofacial, Crossbite, Crossbites, Deeper fossae, Dent, Dental morphology, Dentistry, Dentition, Dentofacial, Derangement, Disc, Disc derangement, Disc derangements, Disc displacement, Disc displacements, Disc position, Disc shape, Disk displacement, Dysfunction, Eminence, Entry variables, False negatives, False positives, Fossa, Fossa depth, Fossa shape, Fossa width, Imaging, Increase risk, Intercuspal position, Internal derangement, Joint function, Joint loading, Joint space, Largest group, Lateral, Lateral pterygoid muscle, Logistic, Logistic regression, Logistic regression models, Magnetic resonance imaging, Mandible, Mandibular, Mandibular condyle position, Mandibular growth, Medial, Morphology, Multifactor, Multifactor analyses, Multifactor analysis, Multifactor models, Multifactor studies, Multifactorial, Normal function, Normals model, Occlusal, Occlusion, Optimum temporomandibular, Oral pathol, Oral rehabil, Oral surg, Organisation, Orofac pain, Orthod, Orthod dentofac orthop, Orthod dentofacial orthop, Orthodontic treatment, Orthop, Orthopaedic, Osseous, Osteoarthrosis, Physiological adaptation demand, Posterior, Posterior condyle position, Posterior crossbite, Posterior position, Posteriorly, Process height, Progression, Prosthet, Prosthet dent, Pterygoid, Pullinger, Radiol, Radiol endod, Reduction group, Reduction joints, Regression model, Relative risk, Remodelling, Sample size, Seligman, Subgroup, Subset, Surg, Symptom progression, Symptomatic patients, Temporomandibular, Temporomandibular disorders, Temporomandibular joints, Tomograms, Tomographic, Tree analysis, Unilateral, Unilateral crossbite, Univariate, Univariate analysis, Variance.
- Teeft :
- Acta odontol scand, Adaptation demand, Anatomic, Angle orthod, Anterior, Anterior disc displacement, Anterior position, Anteriorly, Articular, Articular disc, Articular eminence, Asymmetry, Asymptomatic, Asymptomatic normals, Asymptomatic volunteers, Available sample size, Blackwell, Blackwell publishing, Centric, Centric relation, Clinical illustration, Clinical practice, Concentric, Conceptual model, Condylar, Condylar position, Condyle, Condyle position, Condyle positions, Craniofacial, Crossbite, Crossbites, Deeper fossae, Dent, Dental morphology, Dentistry, Dentition, Dentofacial, Derangement, Disc, Disc derangement, Disc derangements, Disc displacement, Disc displacements, Disc position, Disc shape, Disk displacement, Dysfunction, Eminence, Entry variables, False negatives, False positives, Fossa, Fossa depth, Fossa shape, Fossa width, Imaging, Increase risk, Intercuspal position, Internal derangement, Joint function, Joint loading, Joint space, Largest group, Lateral, Lateral pterygoid muscle, Logistic, Logistic regression, Logistic regression models, Magnetic resonance imaging, Mandible, Mandibular, Mandibular condyle position, Mandibular growth, Medial, Morphology, Multifactor, Multifactor analyses, Multifactor analysis, Multifactor models, Multifactor studies, Multifactorial, Normal function, Normals model, Occlusal, Occlusion, Optimum temporomandibular, Oral pathol, Oral rehabil, Oral surg, Organisation, Orofac pain, Orthod, Orthod dentofac orthop, Orthod dentofacial orthop, Orthodontic treatment, Orthop, Orthopaedic, Osseous, Osteoarthrosis, Physiological adaptation demand, Posterior, Posterior condyle position, Posterior crossbite, Posterior position, Posteriorly, Process height, Progression, Prosthet, Prosthet dent, Pterygoid, Pullinger, Radiol, Radiol endod, Reduction group, Reduction joints, Regression model, Relative risk, Remodelling, Sample size, Seligman, Subgroup, Subset, Surg, Symptom progression, Symptomatic patients, Temporomandibular, Temporomandibular disorders, Temporomandibular joints, Tomograms, Tomographic, Tree analysis, Unilateral, Unilateral crossbite, Univariate, Univariate analysis, Variance.
Abstract
Belief in and rejection of a relationship of occlusion and temporomandibular joint (TMJ) condyle–fossa position with normal and abnormal function are still contentious issues. Clinical opinions can be strong, but support in most published data (mostly univariate) is problematic. Distribution overlap, low sensitivity and specificity are a common basis to reject any useful prediction value. Notwithstanding, a relationship of form with function is a basic tenet of biology. These are multifactor problems, but the questions mostly have not been analysed as such. This review moves the question forward by focusing on TM joint anatomic organisation as the multifactor system it is expected to be in a closed system like a synovial joint. Multifactor analysis allows the data to speak for itself and reduces bias. Classification tree analysis revealed useful prediction values and usable clinical models which are illustrated, backed up by stepwise logistic regression. Explained variance, R2, predicting normals from pooled TMJ patients was 32·6%, sensitivity 67·9%, specificity 85·7%; 37% versus disc displacement with reduction; and 28·8% versus disc displacement without reduction. Significant osseous organisational differences between TM joints with clicking and locking suggest that this is not necessarily a single disease continuum. However, a subset of joints with clicking contained characteristics of joints with locking that might contribute to symptom progression versus resistance. Moderately strong models confirm there is a relationship between TMJ osseous organisation and function, but it should not be overstated. More than one model of normals and of TM derangement organisation is revealed. The implications to clinical decision‐making are discussed.
Url:
DOI: 10.1111/joor.12032
Affiliations:
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Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acta odontol scand</term>
<term>Adaptation demand</term>
<term>Anatomic</term>
<term>Angle orthod</term>
<term>Anterior</term>
<term>Anterior disc displacement</term>
<term>Anterior position</term>
<term>Anteriorly</term>
<term>Articular</term>
<term>Articular disc</term>
<term>Articular eminence</term>
<term>Asymmetry</term>
<term>Asymptomatic</term>
<term>Asymptomatic normals</term>
<term>Asymptomatic volunteers</term>
<term>Available sample size</term>
<term>Blackwell</term>
<term>Blackwell publishing</term>
<term>Centric</term>
<term>Centric relation</term>
<term>Clinical illustration</term>
<term>Clinical practice</term>
<term>Concentric</term>
<term>Conceptual model</term>
<term>Condylar</term>
<term>Condylar position</term>
<term>Condyle</term>
<term>Condyle position</term>
<term>Condyle positions</term>
<term>Craniofacial</term>
<term>Crossbite</term>
<term>Crossbites</term>
<term>Deeper fossae</term>
<term>Dent</term>
<term>Dental morphology</term>
<term>Dentistry</term>
<term>Dentition</term>
<term>Dentofacial</term>
<term>Derangement</term>
<term>Disc</term>
<term>Disc derangement</term>
<term>Disc derangements</term>
<term>Disc displacement</term>
<term>Disc displacements</term>
<term>Disc position</term>
<term>Disc shape</term>
<term>Disk displacement</term>
<term>Dysfunction</term>
<term>Eminence</term>
<term>Entry variables</term>
<term>False negatives</term>
<term>False positives</term>
<term>Fossa</term>
<term>Fossa depth</term>
<term>Fossa shape</term>
<term>Fossa width</term>
<term>Imaging</term>
<term>Increase risk</term>
<term>Intercuspal position</term>
<term>Internal derangement</term>
<term>Joint function</term>
<term>Joint loading</term>
<term>Joint space</term>
<term>Largest group</term>
<term>Lateral</term>
<term>Lateral pterygoid muscle</term>
<term>Logistic</term>
<term>Logistic regression</term>
<term>Logistic regression models</term>
<term>Magnetic resonance imaging</term>
<term>Mandible</term>
<term>Mandibular</term>
<term>Mandibular condyle position</term>
<term>Mandibular growth</term>
<term>Medial</term>
<term>Morphology</term>
<term>Multifactor</term>
<term>Multifactor analyses</term>
<term>Multifactor analysis</term>
<term>Multifactor models</term>
<term>Multifactor studies</term>
<term>Multifactorial</term>
<term>Normal function</term>
<term>Normals model</term>
<term>Occlusal</term>
<term>Occlusion</term>
<term>Optimum temporomandibular</term>
<term>Oral pathol</term>
<term>Oral rehabil</term>
<term>Oral surg</term>
<term>Organisation</term>
<term>Orofac pain</term>
<term>Orthod</term>
<term>Orthod dentofac orthop</term>
<term>Orthod dentofacial orthop</term>
<term>Orthodontic treatment</term>
<term>Orthop</term>
<term>Orthopaedic</term>
<term>Osseous</term>
<term>Osteoarthrosis</term>
<term>Physiological adaptation demand</term>
<term>Posterior</term>
<term>Posterior condyle position</term>
<term>Posterior crossbite</term>
<term>Posterior position</term>
<term>Posteriorly</term>
<term>Process height</term>
<term>Progression</term>
<term>Prosthet</term>
<term>Prosthet dent</term>
<term>Pterygoid</term>
<term>Pullinger</term>
<term>Radiol</term>
<term>Radiol endod</term>
<term>Reduction group</term>
<term>Reduction joints</term>
<term>Regression model</term>
<term>Relative risk</term>
<term>Remodelling</term>
<term>Sample size</term>
<term>Seligman</term>
<term>Subgroup</term>
<term>Subset</term>
<term>Surg</term>
<term>Symptom progression</term>
<term>Symptomatic patients</term>
<term>Temporomandibular</term>
<term>Temporomandibular disorders</term>
<term>Temporomandibular joints</term>
<term>Tomograms</term>
<term>Tomographic</term>
<term>Tree analysis</term>
<term>Unilateral</term>
<term>Unilateral crossbite</term>
<term>Univariate</term>
<term>Univariate analysis</term>
<term>Variance</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en"><term>Acta odontol scand</term>
<term>Adaptation demand</term>
<term>Anatomic</term>
<term>Angle orthod</term>
<term>Anterior</term>
<term>Anterior disc displacement</term>
<term>Anterior position</term>
<term>Anteriorly</term>
<term>Articular</term>
<term>Articular disc</term>
<term>Articular eminence</term>
<term>Asymmetry</term>
<term>Asymptomatic</term>
<term>Asymptomatic normals</term>
<term>Asymptomatic volunteers</term>
<term>Available sample size</term>
<term>Blackwell</term>
<term>Blackwell publishing</term>
<term>Centric</term>
<term>Centric relation</term>
<term>Clinical illustration</term>
<term>Clinical practice</term>
<term>Concentric</term>
<term>Conceptual model</term>
<term>Condylar</term>
<term>Condylar position</term>
<term>Condyle</term>
<term>Condyle position</term>
<term>Condyle positions</term>
<term>Craniofacial</term>
<term>Crossbite</term>
<term>Crossbites</term>
<term>Deeper fossae</term>
<term>Dent</term>
<term>Dental morphology</term>
<term>Dentistry</term>
<term>Dentition</term>
<term>Dentofacial</term>
<term>Derangement</term>
<term>Disc</term>
<term>Disc derangement</term>
<term>Disc derangements</term>
<term>Disc displacement</term>
<term>Disc displacements</term>
<term>Disc position</term>
<term>Disc shape</term>
<term>Disk displacement</term>
<term>Dysfunction</term>
<term>Eminence</term>
<term>Entry variables</term>
<term>False negatives</term>
<term>False positives</term>
<term>Fossa</term>
<term>Fossa depth</term>
<term>Fossa shape</term>
<term>Fossa width</term>
<term>Imaging</term>
<term>Increase risk</term>
<term>Intercuspal position</term>
<term>Internal derangement</term>
<term>Joint function</term>
<term>Joint loading</term>
<term>Joint space</term>
<term>Largest group</term>
<term>Lateral</term>
<term>Lateral pterygoid muscle</term>
<term>Logistic</term>
<term>Logistic regression</term>
<term>Logistic regression models</term>
<term>Magnetic resonance imaging</term>
<term>Mandible</term>
<term>Mandibular</term>
<term>Mandibular condyle position</term>
<term>Mandibular growth</term>
<term>Medial</term>
<term>Morphology</term>
<term>Multifactor</term>
<term>Multifactor analyses</term>
<term>Multifactor analysis</term>
<term>Multifactor models</term>
<term>Multifactor studies</term>
<term>Multifactorial</term>
<term>Normal function</term>
<term>Normals model</term>
<term>Occlusal</term>
<term>Occlusion</term>
<term>Optimum temporomandibular</term>
<term>Oral pathol</term>
<term>Oral rehabil</term>
<term>Oral surg</term>
<term>Organisation</term>
<term>Orofac pain</term>
<term>Orthod</term>
<term>Orthod dentofac orthop</term>
<term>Orthod dentofacial orthop</term>
<term>Orthodontic treatment</term>
<term>Orthop</term>
<term>Orthopaedic</term>
<term>Osseous</term>
<term>Osteoarthrosis</term>
<term>Physiological adaptation demand</term>
<term>Posterior</term>
<term>Posterior condyle position</term>
<term>Posterior crossbite</term>
<term>Posterior position</term>
<term>Posteriorly</term>
<term>Process height</term>
<term>Progression</term>
<term>Prosthet</term>
<term>Prosthet dent</term>
<term>Pterygoid</term>
<term>Pullinger</term>
<term>Radiol</term>
<term>Radiol endod</term>
<term>Reduction group</term>
<term>Reduction joints</term>
<term>Regression model</term>
<term>Relative risk</term>
<term>Remodelling</term>
<term>Sample size</term>
<term>Seligman</term>
<term>Subgroup</term>
<term>Subset</term>
<term>Surg</term>
<term>Symptom progression</term>
<term>Symptomatic patients</term>
<term>Temporomandibular</term>
<term>Temporomandibular disorders</term>
<term>Temporomandibular joints</term>
<term>Tomograms</term>
<term>Tomographic</term>
<term>Tree analysis</term>
<term>Unilateral</term>
<term>Unilateral crossbite</term>
<term>Univariate</term>
<term>Univariate analysis</term>
<term>Variance</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Société</term>
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<front><div type="abstract" xml:lang="en">Belief in and rejection of a relationship of occlusion and temporomandibular joint (TMJ) condyle–fossa position with normal and abnormal function are still contentious issues. Clinical opinions can be strong, but support in most published data (mostly univariate) is problematic. Distribution overlap, low sensitivity and specificity are a common basis to reject any useful prediction value. Notwithstanding, a relationship of form with function is a basic tenet of biology. These are multifactor problems, but the questions mostly have not been analysed as such. This review moves the question forward by focusing on TM joint anatomic organisation as the multifactor system it is expected to be in a closed system like a synovial joint. Multifactor analysis allows the data to speak for itself and reduces bias. Classification tree analysis revealed useful prediction values and usable clinical models which are illustrated, backed up by stepwise logistic regression. Explained variance, R2, predicting normals from pooled TMJ patients was 32·6%, sensitivity 67·9%, specificity 85·7%; 37% versus disc displacement with reduction; and 28·8% versus disc displacement without reduction. Significant osseous organisational differences between TM joints with clicking and locking suggest that this is not necessarily a single disease continuum. However, a subset of joints with clicking contained characteristics of joints with locking that might contribute to symptom progression versus resistance. Moderately strong models confirm there is a relationship between TMJ osseous organisation and function, but it should not be overstated. More than one model of normals and of TM derangement organisation is revealed. The implications to clinical decision‐making are discussed.</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Californie</li>
</region>
<settlement><li>Los Angeles</li>
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