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Revista Española de Cirugía Oral y Maxilofacial

On-line version ISSN 2173-9161Print version ISSN 1130-0558

Rev Esp Cirug Oral y Maxilofac vol.42 n.3 Madrid Jul./Sep. 2020  Epub Dec 13, 2020

https://dx.doi.org/10.20986/recom.2020.1194/2020 

EDITORIAL

Study on the prevalence of internal derangement of the TMJ and other new knowledge

Raúl González-García1  2  * 

1Director de RECOM. Facultativo Especialista de Área, Hospital Universitario de Badajoz, Badajoz, España.

2Hospital Quirónsalud Clideba, Badajoz, España.

This issue of Revista Española de Cirugía Oral y Maxilofacial (RECOM) addresses, among others, two fields that can be considered growing, due to the association of minimally invasive techniques in the case of internal disorder (ID) of the temporomandibular joint (TMJ) , and for the generation of a relatively new field of action for the medical specialist in Oral and Maxillofacial Surgery: maxillomandibular advancement surgery in the treatment of obstructive sleep apnea / hypopnea syndrome (OSAHS).

ID of the TMJ is defined as the abnormal relationship between the articular disc with respect to the mandibular condyle, the articular eminence and the glenoid fossa, and most authors assimilate it to disc displacement. Intuitively, disc displacement could be associated with the existence of painful joint symptoms. In fact, disc displacement is present in up to 80-90 % of symptomatic cases; however, there are patients (therefore, symptomatic) in whom the existence of disc displacement is not confirmed and, on the contrary, asymptomatic individuals in whom the existence of a displaced disc is demonstrated. This heterogeneity in the presentation of TMJ ID requires a detailed study of the prevalence of this entity in healthy population groups, an objective that has been scarcely studied, which is addressed by the authors of the first original article in the present issue. Subject of a doctoral thesis read in 2014 by the main author, the authors publish non yet reported results derived from the clinical and radiological analysis of a series of 72 TMJs belonging to asymptomatic voluntary subjects, correlating the prevalence of disc displacement with joint clinical and morphological features examined by magnetic resonance imaging.

The OSAHS treatment underwent a revolution several years ago with the active participation of the Oral and Maxillofacial Surgeon, especially for the patient refractory to treatment by CPAP (Continuous Positive Airway Pressure), through the indication of the use of mandibular advancement devices in the mildest cases, and by means of maxillomandibular advancement surgery (MMA) for the most severe cases, among other complementary procedures. The authors of one of the original articles in this issue present the results of a series of 20 OSAHS patients who underwent MMA with counterclockwise rotation, obtaining relevant clinical conclusions in terms of decreased apnea/hiponea index (AHI) and increased of the peripheral capillary oxygen saturation, evaluated in the polysomnography, as well as significant morphological changes in the parameters of volume increase and areas of the airway and position of the hyoid bone, evaluated by means of computed tomography.

The present issue also provides a double-blind randomized clinical trial in 75 patients on the anti-inflammatory effect of the use of dexamethasone and diclofenac versus dexamethasone and ketorolac in third molar surgery. Being the most frequent isolated surgical procedure in terms of number of patients treated within our specialty, the establishment of new knowledge with high scientific evidence is an invaluable aid in establishing effective post-operative treatment protocols.

Finally, trying to maintain the spirit of RECOM to provide new knowledge by means of the publication of clinical cases especially relevant for the reader from the clinical point of view or unusually infrequent, or by means of novel surgical techniques, this issue provides new data on the use of transmucosal osteosynthesis in the treatment of dentoalveolar fractures, the diagnosis of malignant peripheral nerve sheath malignant tumor, lymphangioma with inframilohydeal extension and chin hypoesthesia syndrome as a manifestation of a lymphoproliferative syndrome, aa well as on the treatment by minocycline of silicone facial edema.

We hope that these original articles and new clinical cases are of interest to the specialized reader and we encourage the authors (clinicians and researchers) to send their research to RECOM, to continue growing in order to provide new high-quality scientific knowledge, as RECOM constitutes the main scientific organ of our specialty at the national level and among all our Spanish-speaking brothers.

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