Background & Aims

This study focuses on Temporomandibular joint disease (TMJd) within temporomandibular disorder (TMD), highlighting symptoms such as clicking, crepitation and muscle/joint pain. TMJd patients with degenerative conditions that have developed heterotopic ossification (HO), which is muscle/ soft tissue calcification, are examined in this study. This is a multicenter project in collaboration with the Haukeland University Hospital (HUH), Bergen, University Hospital of North Norway, Tromsø, Norway and Massachusetts General Hospital, Boston, USA, primarily emphasizing Bergen site data and findings.
The etiology of HO in the TMJ is unknown, though it is recognized that trauma could be one cause but also heritage. We aim to elucidate the outcome of arthroplasty surgery in the TMJ.

Methods

The study targets the descriptive parts of the project. Out of 22 invited patients that had been treated with TMJ arthroplasty at HUH, 16 participated, retrospectively included over a ten-year period (2013-2023). The retrospective study is divided into different parts. IA analyzing patient records, IB histopathological/x-ray findings, II self-reported questionnaires, and III clinical examinations. Furthermore, a control group with TMJ samples from autopsy, presently with 13 TMJ controls, is expanding and aiming to become Norway´s first TMJ tissue biobank. The function of the mandible and pain were assessed pre- and postoperatively with the Maximum interincisal Opening (MIO, mm), Mandibular Function Impairment Questionnaire (MFIQ, 0-28 p) and pain intensity in rest and at movement, measured on a visual analogue scale (VAS, 0-10) one and three years after surgery.

Results

A high response rate for participating in the study was obtained. 73% consented to participate in the study, of those 81% said yes to participate in all parts of the study.
Demographic data in the patients’ records showed the mean age of the patients to be 50.5 years, the ratio between men and women 1:2.2, leading to a higher occurrence of females with TMJd HO. Comparing preoperatively- one year- three years MIO increased (29 mm- 36 mm-34 mm), MFIQ decreased (16 p-9 p-3 p), pain in rest decreased (VAS 4-VAS 2-VAS 1) and pain at movement decreased (VAS 7-VAS 2-VAS 1). Preliminary results of the histopathological samples from the TMJ in the retrospective study differed from TMJ samples in the control group.

Conclusions

Arthroplasty surgery for HO in the TMJ, was successful. The function of the mandible and pain intensity were improved one and three years after surgery.

References

Sweeney K, Handa S, August M, Keith DA. Are There Identifiable Risk Factors Associated With Heterotopic Ossification of the Temporomandibular Joint? J Oral Maxillofac Surg. 2022;80(8):1318-30.

Presenting Author

Jenny Rajkumar

Poster Authors

Annika Rosén

Prof. Dr. med.

Universitetet i Bergen

Lead Author

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Jenny Rajkumar

University of Bergen, Bergen, Norway

Lead Author

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Torbjørn Østvik Pedersen

Haukeland University Hospital, University of Bergen, Bergen, Norway

Lead Author

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Kathrine Skarstein

Haukeland University Hospital, University of Bergen, Bergen, Norway

Lead Author

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Topics

  • Joint Pain