Browsing by Author "Cardoso, Henrique José"
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- Biological treatments for temporomandibular joint disc disorders: strategies in tissue engineeringPublication . Trindade, Daniela; Cordeiro, Rachel; Cardoso, Henrique José; DF, Angelo; Alves, Nuno; Moura, CarlaThe temporomandibular joint (TMJ) is an important structure for the masticatory systemand the pathologies associated with it affect a large part of the population and impair people’slifestyle. It comprises an articular disc, that presents low regeneration capacities and the existingclinical options for repairing it are not effective. This way, it is imperative to achieve a permanentsolution to guarantee a good quality of life for people who suffer from these pathologies. Completeknowledge of the unique characteristics of the disc will make it easier to achieve a successful tissueengineering (TE) construct. Thus, the search for an effective, safe and lasting solution has alreadystarted, including materials that replace the disc, is currently growing. The search for a solutionbased on TE approaches, which involve regenerating the disc. The present work revises the TMJ disccharacteristics and its associated diseases. The different materials used for a total disc replacementare presented, highlighting the TE area. A special focus on future trends in the field and part of thesolution for the TMJ problems described in this review will involve the development of a promisingengineered disc approach through the use of decellularized extracellular matrices.
- Temporomandibular joint arterial variabilityPublication . Ângelo, David Faustino; Nogueira, Jonatas; Pinheiro, Carolina; Alves, Gonçalo; Cardoso, Henrique JoséThe study aimed to investigate temporomandibular joint (TMJ) arterial variability. In this prospective study, the vasculature variability was studied using a 3D volume rendering CT angiography including random patients at two hospitals. A 16-quadrant (A1-D4) evaluation grid was developed using the Frankfurt plan as main reference. For each quadrant, the number of arterial ramus or branches was scored as clearly visible (2), partially visible (1), or not visible (0). A total of 50 patients were enrolled (mean age of 62.9 ± 16.0); 21 (42%) were men, and 29 (58%) were women. The authors observed bilaterally higher arterial density in the posterior aspect of the ascending ramus of the mandible (p < 0.0001), corresponding to quadrants B2 (5.92 ± 2.27 and 6.14 ± 2.56), B3 (9.76 ± 2.97 and 11.18 ± 2.86) and B4 (7.38 ± 2.78 and 8.10 ± 2.42). A strong correlation was found between the number of vessels and the variability of the region (r ¼ 0.87, p ¼ 0.00001). No differences were observed between men and women. Within the limitations of the study, arterial variability was observed in the TMJ territory. The posterior zone of the condyle and ramus is the most vascularized area, with great variability, representing an increased risk for surgical bleeding. Therefore, this knowledge seems to be particularly relevant for surgeons dedicated to TMJ and other facial surgery or facial/cerebral radiologic interventions. The authors encourage future studies to include larger samples and to identify thoroughly the arterial branches in this area.
- Unilateral temporomandibular joint discectomy without interposal material in patients with disc perforation or fragmentation: a prospective studyPublication . Ângelo, David Faustino; Sanz, David; Cardoso, Henrique JoséObjective: Temporomandibular joint (TMJ) discectomy is one of the most popular surgical techniques for patients with an unsalvageable disc. Previous studies have demonstrated predictable results of dis-cectomy with optimal results in pain reduction and maximum mouth opening (MMO) improvement.However, those studies had most of the times wide-ranging inclusion criteria. This study was thereforeconducted to assess the role of unilateral TMJ discectomy in a well defined diagnosis.Methods: A 6-year prospective study was designed including patients treated with unilateral TMJ dis-cectomy without interposal material, preserving condyle and temporal fibrocartilage, for two specificintra-articular diagnosis: disc perforation and disc fragmentation.Results: A total of 19 patients were enrolled, with a mean age of 51.05 ± 13.71 (mean ± SD) years.Preoperative pain was 7.63 ± 1.89 (mean ± SD), MMO was 25.95 ± 10.27 mm (mean ± SD) and muscletenderness (MT) was 2.53 ± 0.77 (mean ± SD). The most common diagnosis was disc perforation. Afteran average of 37.9 months of follow-up time (range from 10 to 71 months), a statistically significant improvement of pain (P < 0.0001), MMO (P < 0.0001) and MT (P = 0.00011) was observed. Postoperatively,16 of 18 patients (89 %) showed a reduction in pain and improvement in MMO, fulfilling the criteria fora successful outcome of TMJ surgery. No second surgery was necessary. Conclusion: Unilateral TMJ discectomy without interposal material in patients with disc perforation or fragmentation seems to be an adequate technique. However, we encourage rigorous long-term studiesand new preclinical trials to pursuit a disc substitute, as relevant preclinical trials have demonstrated significant degenerative changes after TMJ discectomy.