Skip to main content
SpringerLink
Log in

Magnetic resonance imaging evaluation of the disc morphology of temporomandibular joint in patients with severe hemophilia

  • Original Article
  • Published:
Oral Radiology Aims and scope Submit manuscript

Abstract

Objectives

This study aimed to assess the morphological differences in the articular disc (AD) between hemophilic patients and healthy individuals of the control group for further association with signs and symptoms.

Methods

Fourteen severe hemophilic patients had their AD evaluated by magnetic resonance imaging (MRI). The morphological findings were compared to those of a control group consisting of 14 healthy individuals. MRI was used to evaluate all the components of the temporomandibular (TMJ), including the AD, resulting in sequential T1-weighted parasagittal images. All the images were acquired with teeth in maximum intercuspation position.

Results

Morphological alterations showed significant statistical differences (P-value = 0.0068), whereas no statistical differences were found in the other variables, including TMJ pain, headache, bruxism and mouth opening limitation. In the group of non-hemophilic individuals, only two (14.29%) presented AD with non-biconcave features, whereas in the group of hemophilic patients, nine (64.29%) presented AD with a morphology other than biconcave.

Conclusions

In patients with severe hemophilia, there seems to be a pattern of morphological alterations in the articular disc over time. The standard biconcave morphology of AD tends to change into other ones, particularly biplanar, hemiconvex and folded.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The data used to support the findings of this study are available to interested readers upon reasonable request.

References

  1. Coppola A, Di Capua M, Di Minno MN, et al. Treatment of hemophilia: a review of current advances and ongoing issues. J Blood Med. 2010;1:183–95. https://doi.org/10.2147/JBM.S6885.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Sharma V, Khalid A, Cohen AJ. Management of pregnancy in a patient with severe hemophilia type a. AJP Rep. 2013;3(1):29–32. https://doi.org/10.1055/s-0032-1331376.

    Article  PubMed  Google Scholar 

  3. Ferreira AA, Leite IC, Bustamante-Teixeira MT, et al. Hemophilia A in Brazil—epidemiology and treatment developments. J Blood Med. 2014;5:175–84. https://doi.org/10.2147/JBM.S68234.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Khokhrin DV, Gileva OS, Khaliavina IN, et al. TMJ pathology in hemophilia patients. Stomatologiia (Mosk). 2012;91(2):46–8.

    PubMed  Google Scholar 

  5. Lyons LP, Weinberg JB, Wittstein JR, et al. Blood in the joint: effects of hemarthrosis on meniscus health and repair techniques. Osteoarthr Cartil. 2021;29(4):471–9. https://doi.org/10.1016/j.joca.2020.11.008.

    Article  Google Scholar 

  6. Hardaker WT Jr, Garrett WE Jr, Bassett FH 3rd. Evaluation of acute traumatic hemarthrosis of the knee joint. South Med J. 1990;83(6):640–4. https://doi.org/10.1097/00007611-199006000-00011.

    Article  PubMed  Google Scholar 

  7. Heard BJ, Barton KI, Agbojo OM, et al. Molecular response of rabbit menisci to surgically induced hemarthrosis and a single intra-articular dexamethasone treatment. J Orthop Res. 2019;37(9):2043–52. https://doi.org/10.1002/jor.24346.

    Article  PubMed  Google Scholar 

  8. Kaneda T, Nagayama M, Ohmori M, et al. Hemarthrosis of the temporomandibular joint in a patient with hemophilia B: report of case. J Oral Surg. 1979;37(7):513–4.

    PubMed  Google Scholar 

  9. Nishioka GJ, Van Sickels JE, Tilson HB. Hemophilic arthropathy of the temporomandibular joint: review of the literature, a case report, and discussion. Oral Surg Oral Med Oral Pathol. 1988;65(2):145–50. https://doi.org/10.1016/0030-4220(88)90155-7.

    Article  PubMed  Google Scholar 

  10. Costa AL, Yasuda CL, Appenzeller S, et al. Comparison of conventional MRI and 3D reconstruction model for evaluation of temporomandibular joint. Surg Radiol Anat. 2008;30(8):663–7. https://doi.org/10.1007/s00276-008-0400-z.

    Article  PubMed  Google Scholar 

  11. Detamore MS, Athanasiou KA. Structure and function of the temporomandibular joint disc: implications for tissue engineering. J Oral Maxillofac Surg. 2003;61(4):494–506. https://doi.org/10.1053/joms.2003.50096.

    Article  PubMed  Google Scholar 

  12. Alomar X, Medrano J, Cabratosa J, et al. Anatomy of the temporomandibular joint. Semin Ultrasound CT MR. 2007;28(3):170–83.

    Article  PubMed  Google Scholar 

  13. Bag AK, Gaddikeri S, Singhal A, et al. Imaging of the temporomandibular joint: an update. World J Radiol. 2014;6(8):567–82. https://doi.org/10.4329/wjr.v6.i8.567.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Franchini M. The modern treatment of haemophilia: a narrative review. Blood Transfus. 2013;11(2):178–82. https://doi.org/10.2450/2012.0166-11.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301–55.

    PubMed  Google Scholar 

  16. Alonso MB, Gamba TO, Lopes SL, Cruz AD, Freitas DQ, Haiter-Neto F. Magnetic resonance imaging of the temporomandibular joint acquired using different parameters. J Morphol Sci. 2014;31(2):103–9. https://doi.org/10.4322/jms.062913.

    Article  Google Scholar 

  17. de Farias JF, Melo SL, Bento PM, et al. Correlation between temporomandibular joint morphology and disc displacement by MRI. Dentomaxillofac Radiol. 2015;44(7):20150023. https://doi.org/10.1259/dmfr.20150023.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Guimarães TB, Ferreira-Cabrini MB, Quaglio CL, et al. Temporomandibular disorder: prevalence among hemophiliac patients. Int J Odontostomatol. 2015;9:295–300.

    Article  Google Scholar 

  19. Yenel S, Cankal DA, Kayali SK, et al. Temporomandibular disorders in patients with inherited coagulation disorders: a clinical study. J Stomatol Oral Maxillofac Surg. 2022;123(4):473–7. https://doi.org/10.1016/j.jormas.2021.10.005.

    Article  PubMed  Google Scholar 

  20. Bennett GL, Leeson MC, Michael A. Extensive hemosiderin deposition in the medial meniscus of a knee. Its possible relationship to degenerative joint disease. Clin Orthop Relat Res. 1988;230:182–5.

    Article  Google Scholar 

  21. Murphy MK, MacBarb RF, Wong ME, et al. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. Int J Oral Maxillofac Implants. 2013;28(6):e393-414. https://doi.org/10.11607/jomi.te20.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kondrat W, Sierpinska T, Radke J. Assessment of the temporomandibular joint function in young adults without complaints from the masticatory system. Int J Med Sci. 2018;15(2):161–9. https://doi.org/10.7150/ijms.21665.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Shaffer SM, Brismee JM, Sizer PS, et al. Temporomandibular disorders. Part 1: anatomy and examination/diagnosis. J Man Manip Ther. 2014;22(1):2–12. https://doi.org/10.1179/2042618613Y.0000000060.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Nascimento Falcao I, Cal Alonso MBC, da Silva LH, et al. 3D morphology analysis of TMJ articular eminence in magnetic resonance imaging. Int J Dent. 2017;2017:5130241. https://doi.org/10.1155/2017/5130241.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was supported by FAPESP (São Paulo Research Foundation) Grants: 13/10999-5.

Author information

Authors and Affiliations

  1. Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade, São Paulo, SP, 01506-000, Brazil

    Lays Assolini Pinheiro de Oliveira, Adriana de Oliveira Lira & Andre Luiz Ferreira Costa

  2. Department of Anesthesiology, Oncology and Radiology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil

    Lays Assolini Pinheiro de Oliveira & Andre Luiz Ferreira Costa

  3. Division of General Pathology, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil

    João Pedro Perez Gomes

  4. Department of Neurology, Faculty of Medical Sciences, UNICAMP, Campinas, SP, Brazil

    Luciana Ramalho Pimentel-Silva

  5. Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos, São Paulo, SP, Brazil

    Sérgio Lúcio Pereira de Castro Lopes

  6. Hematology and Hemotherapy Center, UNICAMP, Campinas, Brazil

    Maria Elvira Pizzigatti Correa

Authors
  1. Lays Assolini Pinheiro de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. João Pedro Perez Gomes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luciana Ramalho Pimentel-Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sérgio Lúcio Pereira de Castro Lopes
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria Elvira Pizzigatti Correa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Adriana de Oliveira Lira
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Andre Luiz Ferreira Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andre Luiz Ferreira Costa.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board of UNICAMP, according to protocol number 24113913.3.0000.5404. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.

Informed consent

Written informed consent was obtained from all subjects for being included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Oliveira, L.A.P., Gomes, J.P.P., Pimentel-Silva, L.R. et al. Magnetic resonance imaging evaluation of the disc morphology of temporomandibular joint in patients with severe hemophilia. Oral Radiol 39, 759–765 (2023). https://doi.org/10.1007/s11282-023-00697-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11282-023-00697-4

Keywords

Search

Navigation