1.Research progress in bone marrow edema in the temporomandibular joint
Qi NING ; Huawei LIU ; Laiqing XU ; Min HU
Chinese Journal of Stomatology 2025;60(7):781-786
Bone marrow edema (BME) of the temporomandibular joint is an abnormal change within the bone marrow that appears as low signal intensity on T1-weighted images and high signal intensity on T2-weighted images in MRI. It is commonly seen in patients with temporomandibular joint osteoarthritis. Studies have shown that BME is closely related to joint pain, disc displacement and bony degeneration, but its specific mechanism is not yet fully understood, potentially involving abnormal mechanical loading, inflammatory responses and imbalances in bone metabolism. Although BME is considered an early sign of osteoarthritis, BME persists in approximately 71.4% of patients after pain resolution , suggesting the complexity of its association with clinical symptoms. In recent years, advanced MRI techniques (such as T2 mapping and fat suppression sequences) have improved the detection rate of BME and facilitated the assessment of its dynamic changes. However, the exact role of BME in temporomandibular disorders remains controversial. This article reviews the etiology and mechanism, pathology, imaging characteristics, and correlation with clinical symptoms of BME in the temporomandibular joint, and proposing future research directions to to elucidate its significance in disease progression and to provide guidance for clinical diagnosis and treatment.
2.Comparison of temporomandibular joint images with different fields of view in cone beam CT
Laiqing XU ; Jiazhu WANG ; Chen XU ; Jing ZHAO ; Min HU
Chinese Journal of Stomatology 2025;60(7):704-712
Objective:To observe and compare the application of different scanning fields of view (FOV) in cone beam CT (CBCT) imaging of the temporomandibular joint (TMJ), and to explore the advantages and disadvantages of different CBCT scanning FOV for TMJ imaging. The aim is to provide a reference for the rational selection of CBCT scanning FOV for TMJ imaging in clinical practice.Methods:A total of 46 patients with temporomandibular disorders [22 males, 24 females; median age 24.5 years (range from 12 to 84 years)] were enrolled from the Department of Stomatology,the First Medical Centre, Chinese PLA General Hospital, between January 2023 and January 2025. All patients underwent CBCT scanning of the temporomandibular joints with both large and small fields of view using the same CBCT device, Newtom 5G (QR S.r.l, Italy), including small-field-of-view (sFOV 6 cm×6 cm, 46 cases, 92 sides) and large-field-of-view (lFOV 15 cm×12 cm for 26 cases with 52 sides or 18 cm×16 cm for 20 cases with 40 sides). A self-matched design was used to compare imaging parameters (scan time, exposure time, reconstruction voxel, radiation dose, data volume), image quality, and lesion detection efficacy (articular surface flattening, surface erosion, osteophyte, subcortical sclerosis, subcortical cyst, intra-articular calcification). Additionally, differences in joint spaces, condylar head height, and condylar height were analyzed.Results:In the sFOV group, scan time (72 s vs. 24 s) and exposure time (14.6 s vs. 4.8 s) were significantly longer than those in the lFOV group, with smaller reconstruction voxels (0.15 mm vs. 0.3 mm). Radiation dose in the sFOV group [(199.94±5.52) mGy·cm] was significantly higher than that in the lFOV 15 cm×12 cm subgroup [(96.20±25.34) mGy·cm, t=-20.29, P<0.001] and the 18 cm×16 cm subgroup [(101.73±13.49) mGy·cm, t=-31.34, P<0.001]. In terms of data volume, the sFOV group [(274.18±1.74) MB] was larger than the lFOV 15 cm×12 cm subgroup [(208.83±20.13) MB, t=-16.75, P<0.001], while the lFOV 18 cm×16 cm subgroup [(386.39±1.63) MB] was significantly larger than the sFOV group [(274.83±1.78) MB, t=214.49, P<0.001]. sFOV images showed clearer anatomical margins, distinguishable trabecular bone, and fewer artifacts. The detection rate of subcortical cyst in the sFOV group (50.0%, 46/92) was significantly higher than that in the lFOV group (36.96%, 34/92, χ2=5.61, P=0.018), with a moderate agreement Kappa coefficient of 0.48. Detection rates of articular surface flattening (80.43%, 74/92) and osteophyte (55.43%, 51/92) were identical between groups, with a perfect agreement Kappa coefficient of 1. Detection rates of subcortical sclerosis (69.57% vs. 68.48%) and intra-articular calcification (5.43% vs. 4.34%) were slightly higher in sFOV but without statistical significance ( P>0.05), with high Kappa coefficients of 0.93 and 0.88, respectively. For subcortical erosion, sFOV detection rate (38.04%, 35/92) was higher than lFOV (26.09%, 24/92, Kappa=0.53, moderate agreement), with no significant difference in detection rate (χ2=2.97, P=0.085). There were no statistical differences in joint space or condylar head height measurements between groups ( P>0.05), but condylar height measurements in the sFOV group were significantly greater than those in the lFOV group ( t=4.52, P<0.001). Conclusions:Large FOV provides wide anatomical coverage, optimizes radiation dose and data processing efficiency, and is more convenient for quantitative TMJ measurements.Small FOV offers superior resolution for displaying subtle condylar structures and lesions.Clinically, the choice of scan field should be individualized based on examination objectives (large FOV for holistic assessment/quantitative analysis; small FOV for early bone lesion diagnosis), equipment performance, and patient characteristics.
3.Research progress in bone marrow edema in the temporomandibular joint
Qi NING ; Huawei LIU ; Laiqing XU ; Min HU
Chinese Journal of Stomatology 2025;60(7):781-786
Bone marrow edema (BME) of the temporomandibular joint is an abnormal change within the bone marrow that appears as low signal intensity on T1-weighted images and high signal intensity on T2-weighted images in MRI. It is commonly seen in patients with temporomandibular joint osteoarthritis. Studies have shown that BME is closely related to joint pain, disc displacement and bony degeneration, but its specific mechanism is not yet fully understood, potentially involving abnormal mechanical loading, inflammatory responses and imbalances in bone metabolism. Although BME is considered an early sign of osteoarthritis, BME persists in approximately 71.4% of patients after pain resolution , suggesting the complexity of its association with clinical symptoms. In recent years, advanced MRI techniques (such as T2 mapping and fat suppression sequences) have improved the detection rate of BME and facilitated the assessment of its dynamic changes. However, the exact role of BME in temporomandibular disorders remains controversial. This article reviews the etiology and mechanism, pathology, imaging characteristics, and correlation with clinical symptoms of BME in the temporomandibular joint, and proposing future research directions to to elucidate its significance in disease progression and to provide guidance for clinical diagnosis and treatment.
4.Comparison of temporomandibular joint images with different fields of view in cone beam CT
Laiqing XU ; Jiazhu WANG ; Chen XU ; Jing ZHAO ; Min HU
Chinese Journal of Stomatology 2025;60(7):704-712
Objective:To observe and compare the application of different scanning fields of view (FOV) in cone beam CT (CBCT) imaging of the temporomandibular joint (TMJ), and to explore the advantages and disadvantages of different CBCT scanning FOV for TMJ imaging. The aim is to provide a reference for the rational selection of CBCT scanning FOV for TMJ imaging in clinical practice.Methods:A total of 46 patients with temporomandibular disorders [22 males, 24 females; median age 24.5 years (range from 12 to 84 years)] were enrolled from the Department of Stomatology,the First Medical Centre, Chinese PLA General Hospital, between January 2023 and January 2025. All patients underwent CBCT scanning of the temporomandibular joints with both large and small fields of view using the same CBCT device, Newtom 5G (QR S.r.l, Italy), including small-field-of-view (sFOV 6 cm×6 cm, 46 cases, 92 sides) and large-field-of-view (lFOV 15 cm×12 cm for 26 cases with 52 sides or 18 cm×16 cm for 20 cases with 40 sides). A self-matched design was used to compare imaging parameters (scan time, exposure time, reconstruction voxel, radiation dose, data volume), image quality, and lesion detection efficacy (articular surface flattening, surface erosion, osteophyte, subcortical sclerosis, subcortical cyst, intra-articular calcification). Additionally, differences in joint spaces, condylar head height, and condylar height were analyzed.Results:In the sFOV group, scan time (72 s vs. 24 s) and exposure time (14.6 s vs. 4.8 s) were significantly longer than those in the lFOV group, with smaller reconstruction voxels (0.15 mm vs. 0.3 mm). Radiation dose in the sFOV group [(199.94±5.52) mGy·cm] was significantly higher than that in the lFOV 15 cm×12 cm subgroup [(96.20±25.34) mGy·cm, t=-20.29, P<0.001] and the 18 cm×16 cm subgroup [(101.73±13.49) mGy·cm, t=-31.34, P<0.001]. In terms of data volume, the sFOV group [(274.18±1.74) MB] was larger than the lFOV 15 cm×12 cm subgroup [(208.83±20.13) MB, t=-16.75, P<0.001], while the lFOV 18 cm×16 cm subgroup [(386.39±1.63) MB] was significantly larger than the sFOV group [(274.83±1.78) MB, t=214.49, P<0.001]. sFOV images showed clearer anatomical margins, distinguishable trabecular bone, and fewer artifacts. The detection rate of subcortical cyst in the sFOV group (50.0%, 46/92) was significantly higher than that in the lFOV group (36.96%, 34/92, χ2=5.61, P=0.018), with a moderate agreement Kappa coefficient of 0.48. Detection rates of articular surface flattening (80.43%, 74/92) and osteophyte (55.43%, 51/92) were identical between groups, with a perfect agreement Kappa coefficient of 1. Detection rates of subcortical sclerosis (69.57% vs. 68.48%) and intra-articular calcification (5.43% vs. 4.34%) were slightly higher in sFOV but without statistical significance ( P>0.05), with high Kappa coefficients of 0.93 and 0.88, respectively. For subcortical erosion, sFOV detection rate (38.04%, 35/92) was higher than lFOV (26.09%, 24/92, Kappa=0.53, moderate agreement), with no significant difference in detection rate (χ2=2.97, P=0.085). There were no statistical differences in joint space or condylar head height measurements between groups ( P>0.05), but condylar height measurements in the sFOV group were significantly greater than those in the lFOV group ( t=4.52, P<0.001). Conclusions:Large FOV provides wide anatomical coverage, optimizes radiation dose and data processing efficiency, and is more convenient for quantitative TMJ measurements.Small FOV offers superior resolution for displaying subtle condylar structures and lesions.Clinically, the choice of scan field should be individualized based on examination objectives (large FOV for holistic assessment/quantitative analysis; small FOV for early bone lesion diagnosis), equipment performance, and patient characteristics.
5.Experts consensus on standard items of the cohort construction and quality control of temporomandibular joint diseases (2024)
Min HU ; Chi YANG ; Huawei LIU ; Haixia LU ; Chen YAO ; Qiufei XIE ; Yongjin CHEN ; Kaiyuan FU ; Bing FANG ; Songsong ZHU ; Qing ZHOU ; Zhiye CHEN ; Yaomin ZHU ; Qingbin ZHANG ; Ying YAN ; Xing LONG ; Zhiyong LI ; Yehua GAN ; Shibin YU ; Yuxing BAI ; Yi ZHANG ; Yanyi WANG ; Jie LEI ; Yong CHENG ; Changkui LIU ; Ye CAO ; Dongmei HE ; Ning WEN ; Shanyong ZHANG ; Minjie CHEN ; Guoliang JIAO ; Xinhua LIU ; Hua JIANG ; Yang HE ; Pei SHEN ; Haitao HUANG ; Yongfeng LI ; Jisi ZHENG ; Jing GUO ; Lisheng ZHAO ; Laiqing XU
Chinese Journal of Stomatology 2024;59(10):977-987
Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.
6.Application of surface landmark positioning in assisting cone-beam CT scanning of temporomandibular joint
Gang WANG ; Jiazhu WANG ; Chen XU ; Jing ZHAO ; Laiqing XU
Chinese Journal of Stomatology 2024;59(12):1206-1212
Objective:To quantitatively measure the spatial relationship between the temporomandibular joint (TMJ) and surface landmarks such as the tragus and lateral canthus using cone-beam CT (CBCT), as to provide guidance for accurate positioning of CBCT scanning of the TMJ.Methods:DICOM format data from 112 patients (35 males and 77 females with 224 TMJs) were included in this study. The patients were between 12 and 66 years old, with a mean age of (25.6± 9.8) years and they underwent initial visits at the Department of Stomatology, General Hospital of Chinese PLA. CBCT images were imported into Mimics Medical 21.0 software for three-dimensional reconstruction. The distance between selected surface landmarks and corresponding projection points on the same side of the TMJ were measured in both the sagittal and coronal planes. In the frontal view, the distance from the lateral canthus to the perpendicular line passing through the center of the condyle (d x). In the lateral view, the vertical distance from the horizontal line through the rear edge convex of tragus to the roof of glenoid fossa (d y1); the vertical distance from the horizontal line through the rear edge convex of tragus to sigmoid notch (d y2); the distance from the tragus to the perpendicular line through the center of the condyle (d z). The results were compared between different genders and age groups (adolescent group aged 12 to 18 years, 33 cases; adult group aged>18 years, 79 cases). To verify the reliability and stability of the body surface landmarks obtained in this study, a comparison was made between the use of scout view positioning and the auxiliary positioning method that utilizes body surface landmarks to capture the mandibular condyle in a small field of view CBCT of the TMJ (scout view group, 25 cases; surface landmark-assisted positioning group, with 25 cases aged 12-18 years and 25 cases older than 18 years, totaling 50 cases), with regard to the deviation distance from the central point of the field of view to the central point of the mandibular condyle. Results:A total of 112 patients with 224 TMJs were included in this study. In the frontal view, d x was (8.59±3.13) mm, with no significant difference between the left and right sides, between males and females ( P>0.05). Notably, the d x in the adolescent group [(7.43±3.02) mm] was significantly smaller than that in the adult group [(9.07±3.06) mm] ( t=-3.68, P<0.001). In the lateral view, d y1 was (14.80±3.90) mm, showing no significant difference between the left and right sides, males and females, or different age groups( P>0.05). Similarly, d y2 was (6.82±3.95) mm, with no significant differences between the left and right sides or between males and females( P>0.05). However, the d y2 in the adolescent group [(5.88±4.13) mm] was significantly smaller than that in the adult group [(7.22±3.83) mm] ( t=-2.33, P=0.021). Regarding d z, the measurement was (11.73±3.16) mm, with no significant difference between the left and right sides, between males and females ( P>0.05). Meanwhile, the d z in the adolescent group[(10.92± 2.74) mm] was also significantly smaller than that in the adult group [(12.07±3.27) mm] ( t=-2.52, P=0.012). The verification results showed that both positioning methods could fully display the TMJ. The eccentricity in the scout view group [(8.84±3.79) mm ]was slightly greater than that in the body surface landmark-assisted positioning group[ (6.50±2.88) mm], and the difference between the two groups was statistically significant ( t=4.20, P=0.032). Conclusions:The TMJ can be accurately positioned using stable surface landmarks such as the tragus and lateral canthus for reference.
7.Effect analysis of treating osteoporotic vertebral fracture combined reduction vertebroplasty with kyphoplasty
Jiayin LIU ; Lanze LIU ; Rutao SUN ; Xu WANG ; Yuguo HUANG ; Laiqing SUN ; Xiaohui GUO ; Faming TIAN
Clinical Medicine of China 2022;38(3):250-255
Objective:To compare postural reduction combined with percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCFs).Methods:From January 2019 to January 2020,68 patients with OVCFs who met the inclusion and exclusion criteria in the Second Hospital of Tangshan Hebei Province were included in the observation study. A prospective randomized controlled study was used. The matched groups were divided into PVP combined group (adjust the overextension of the operating table by 20°-30°, if the posture reduction fails, pry the puncture needle on both sides in reverse according to the compression degree of the end plate before operation, and inject bone cement) and PKP group (do not adjust the operating table before operation, insert a balloon and expand on both sides after operation, and inject bone cement), with 34 cases in each group. The Cobb angle of the injured vertebrae was measured by taking the anterior and lateral X-ray film of the patient's lumbar spine before operation. The degree of pain and low back function were evaluated by visual analogue scale (VAS) and Oswetry disability index (ODI). The operation time and fluoroscopy times were recorded during the operation. On the second day after operation, the anterior and lateral X-ray of lumbar spine were taken to measure the Cobb angle of injured vertebrae. All patients were underwent computed tomography (CT) check the bone cement for leakage, record the VAS score, and record the ODI 3 months after operation to evaluate the patient's function. Follow up at the end of 12 months after operation to count the treatment cost and re-fracture of the patient. The data analysis and measurement data were compared by independent sample t-test between the two groups, paired sample t-test was used for intra-group comparison before and after operation. χ 2 test was used for counting data comparison between two groups. Results:All patients were followed up for 12 months. The operation time ((42.7±5.9) min), fluoroscopy times ((20.0±3.6) times) and treatment cost ((19 153±601) yuan) in the PVP combined group were better than those in the PKP Group ((67.4±7.3) min, (30.1±5.9) times, (27 496±669) yuan), and the difference was statistically significant ( t values were 15.39, 8.46, 54.12; all P<0.001). Cobb angle: Postoperative Cobb angle of injured vertebrae in the two groups (PVP combined group (10.7±4.5)°) and (PKP group (13.4±3.8)°) decreased compared with preoperative (PVP combined group (17.0±5.1)°) and (PKP group (16.7±5.1)°) ( t values were 10.61, 5.61; all P=0.001), and PVP combined group recovered better than PKP group, with statistically significant difference ( t=2.70, P=0.009). VAS score: Postoperative (PVP combined group (3.9±1.5) points) and (PKP group (4.1±1.6) points) was lower than preoperative the scores of (PVP combined group (6.9±1.1) points) and (PKP group (7.1±0.9) points), and the difference was statistically significant ( t values were 8.63, 8.88; all P=0.001). There was no significant difference in VAS scores between the two groups ( t=0.48, P=0.630). ODI scores: The scores of (PVP combined group (0.315±0.068)) and (PKP group (0.319±0.077)) after operation were lower than preoperative (PVP combined group (0.574±0.066), (PKP group (0.553±0.075)), and the difference was statistically significant ( t values were 18.54, 14.16, all P=0.001). There was no significant difference in ODI between the two groups ( t=0.25, P=0.803). There was no statistical significance in the two groups of postoperative bone cement leakage (χ 2=0.22, P=0.642). In PVP combined group, 1 case was re-fractured due to trauma, and there was no re-fracture in PKP group. Conclusion:Postural reduction combined with percutaneous needle prying reduction of PVP and PKP can alleviate the pain, improve the postoperative function and restore kyphosis in patients with OVCFs. Postural reduction combined with needle prying reduction of PVP has more advantages in operation time, radiation injury to doctors and patients, treatment cost, and the effect of correcting deformity is more significant.
8.Effect of leukocyte common antigen-related phosphatase receptors on the regulation of visual plasticity in rats
Laiqing XIE ; Guoxu XU ; Yong NI ; Ji ZHANG ; Xiaoyan JI ; Hui LOU ; E SONG
Chinese Journal of Experimental Ophthalmology 2020;38(6):476-481
Objective:To investigate the effects of leukocyte common antigen-related phosphatase receptor (LAR) on the regulation of visual plasticity in rats.Methods:Fourty newborn Wistar rats were randomly divided into 5 groups, with 8 rats in each group, and were executed at 1 week, 3, 5, 7 and 9 weeks postnatal, respectively.Thirty-two healthy and 10-week-old Wistar rats were randomly divided into a normal control group, a fluoxetine group, a binocular form deprivation (BFD) group and a BFD+ fluoxetine group, with 8 rats in each group.Rats in the fluoxetine group drinked water with the dosage of 0.2 mg/ml fluoxetine for 4 weeks.The rats in the BFD group received eyelids suture for 2 weeks to form BFD model.And the combination of fluoxetine administration and BFD was performed in the BFD+ Fluoxetine group.No intervention was conducted in the normal control group.The expressions of LAR and chondroitin sulfate proteoglycans (CSPGs) were detected by immunofluorescence.The expression of LAR in the visual cortex of rats was detected by Western blot.Results:LAR was distributed in the cell membrane, plasma and axon.CSPGs were distributed in the intercellular substance in visual cortex of rats.The fluorescence intensities of LAR and CSPGs increased with the postnatal development.The relative expression of LAR was (100.00±3.20)%, (108.37±2.26)%, (113.69±2.33)%, (131.83±3.78)% and (140.11 ±4.02)% at 1 week, 3, 5, 7 and 9 weeks postnatal, respectively, the difference was statistically significant ( F=31.70, P=0.001). The relative expression of LAR was increased according to the growth of age ( β=0.961, P=0.007). The relative expression of LAR was(100.00±2.96)%, (81.02±2.77)%, (71.99±3.09)% and (52.90±2.01)% in the normal control group, fluoxetine group, BFD group and fluoxetine+ BFD group, respectively, with a significantly difference among the groups ( F=18.16, P=0.015), the relative expressions of LAR protein in the fluoxetine group, BFD group and BFD+ fluoxetine group were significantly lower than that in the normal control group ( t=31.30, 36.10, 41.72; all at P<0.01). Conclusions:LAR may be involved in the regulation of visual plasticity as a specific receptor of CSPGs.
9.Calcifying epithelial odontogenic tumor: two cases report.
Kaili WANG ; Guangning ZHENG ; Li LIU ; Laiqing XU ; Wenhao GUO
West China Journal of Stomatology 2016;34(1):104-107
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial tumor of odontogenic origin. CEOT is a benign but a locally infiltrative tumor. CEOT has two clinical variants: intraosseous (central) CEOT and extraosseous (peripheral) CEOT. The peripheral type is rare. In this paper, we report two cases of CEOT. The diagnoses of the cases were verified by histopathology. This study aims to explore the clinical and imaging appearances of CEOT and improve the understanding of the disease.
Humans
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Odontogenic Tumors
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Skin Neoplasms
10.Calcifying epithelial odontogenic tumor:two cases report
Kaili WANG ; Guangning ZHENG ; Li LIU ; Laiqing XU ; Wen-Hao GUO
West China Journal of Stomatology 2016;(1):104-107
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial tumor of odontogenic origin. CEOT is a benign but a locally infiltrative tumor. CEOT has two clinical variants: intraosseous (central) CEOT and extraosseous (peripheral) CEOT. The peripheral type is rare. In this paper, we report two cases of CEOT. The diagnoses of the cases were verified by histopathology. This study aims to explore the clinical and imaging appearances of CEOT and improve the understanding of the disease.

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