Publikasjoner
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Nysæther, Ingvild; Haugen, Håvard Jostein; Khassawna, Thaqif El; Jamous, Reem; Afnan, Shoresh & Santacroce, Marco
[Vis alle 10 forfattere av denne artikkelen]
(2025).
Clinical Performance of Ultra‐Porous TiO2 Scaffold as Bone Graft Substitute in Human Alveolar Ridge Preservation—A Feasibility Study.
Clinical Oral Implants Research.
ISSN 0905-7161.
doi:
10.1111/clr.70074.
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Objectives
This study evaluates the safety and osteoconductive potential of a ceramic TiO2 scaffold in human alveolar bone, hypothesising that placement in human extraction sockets is safe, supports bone ingrowth and preserves ridge dimensions.
Material and Methods
Nine subjects requiring the extraction of ≥ 1 premolar or molar tooth were enrolled. Full-thickness mucoperiosteal flaps were elevated. Following tooth extraction, porous ceramic TiO2 scaffolds were adjusted chair-side, placed into the extraction socket and covered by a resorbable collagen membrane. After 6 months of healing, before dental implant placement, a biopsy was performed at the site where the scaffold had been placed. Histomorphometric and micro-CT analyses were made. CBCT images were made at baseline and at 6 months to assess alveolar ridge dimensional changes. Implants placed in regenerated bone were followed for 21 months.
Results
Scaffold customisation with chairside adjustment was straightforward. No serious adverse events were observed during the 6 months following scaffold implantation. One scaffold was removed due to an early exposure, while the remaining 9 scaffolds successfully integrated. Two sites presented with minor soft tissue dehiscences at 1–2 weeks, which healed spontaneously. Micro-CT and histology confirmed new bone formation. Soft tissue healing was favourable, with no adverse reactions. Dimensional analysis revealed minimal changes in alveolar ridge width and height, indicating effective preservation of volume.
Conclusions
This clinical study confirms that TiO2 scaffolds are a safe and effective option for promoting bone regrowth and preserving volume in human alveolar bone, thereby facilitating bone formation and maintaining ridge dimensions post-extraction.
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Collin, Malin; Christidis, Nikolaos; Hagelberg, Stefan; Arvidsson, Linda Zamoline; Larheim, Tore Arne & Ernberg, Malin
[Vis alle 7 forfattere av denne artikkelen]
(2024).
Temporomandibular involvement in children and adolescents with juvenile idiopathic arthritis: a 2-year prospective cohort study.
Scientific Reports.
14(1).
doi:
10.1038/s41598-024-56174-3.
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This study aimed to clinically evaluate temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) and the ability to identify and/or predict development of TMJ-deformities over time using cone beam computed tomography (CBCT). The predictive value of self-reported TMJ pain was also assessed. A prospective longitudinal cohort study comprising 54 children with JIA, 39 girls and 15 boys, was performed. All children had active disease at baseline, 50% with the subtype oligoarthritis. Repeated clinical orofacial and CBCT examinations were performed over a two-year period. At baseline, 39% had radiographic TMJ deformities (24% unilateral, 15% bilateral), at 2-year follow-up, 42% (p > 0.05). Both progressing and improving TMJ deformities were observed. An association was found between TMJ-deformities and self-reported TMJ pain at baseline (p = 0.01). Maximum unassisted mouth opening (MUO) was smaller for children with TMJ-deformities (p < 0.05). The prevalence of palpatory muscle pain was high (48–59%) but not predictive of development of TMJ-deformities. TMJ noises increased over time and crepitations were associated with TMJ-deformities (p < 0.05). In conclusion, in children with JIA, self-reported TMJ pain and dysfunction were common and predictive of TMJ deformities. TMJ deformities were associated with smaller MUO and palpatory TMJ pain as well as crepitations. Trial registration. ClinicalTrials.gov Protocol id: 2010/2089-31/2.
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Larheim, Tore Arne; Hol, Caroline; Løseth, Guro Engvig & Arvidsson, Linda Zamoline
(2024).
Temporomandibular joint pathologies: pictorial review.
British Journal of Radiology (BJR).
ISSN 0007-1285.
97(1153),
s. 53–67.
doi:
10.1093/bjr/tqad021.
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In this pictorial review, an introductory paragraph emphasizes the significance of some anatomical aspects for optimal imaging of the temporomandibular joint (TMJ). The most frequent pathologies: internal derangement (ID) and osteoarthritis (OA) are comprehensively discussed and illustrated. Less common conditions: ID and OA-like changes in children and adolescents, idiopathic condylar resorption, inflammatory arthritis, and juvenile idiopathic arthritis are briefly discussed. A short paragraph on differential diagnostics in young patients is included followed by a brief comment on expansile lesions that occasionally may occur in the TMJ.
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Hol, Caroline; Mork-Knutsen, Peer Olaf; Larheim, Tore Arne; Bjørnland, Tore & Arvidsson, Linda Zamoline
(2024).
Temporomandibular Joint Discectomy in Patients With Disc Displacement: Assessment of Osteoarthritis at 10- and 30-Year Follow-Up.
Journal of Oral Rehabilitation.
ISSN 0305-182X.
doi:
10.1111/joor.13854.
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Background Few ≥ 10-year follow-up studies of temporomandibular joint (TMJ) discectomy without replacement in patients with disc displacement (DD) analyse the relationship between the surgery and osteoarthritis (OA) exist. Objectives To radiologically evaluate bony joint changes and OA development 10 and 30 years after TMJ discectomy as well as 30-year clinical outcome. Methods Twenty-two discectomy patients at the University of Oslo, Norway, with records confirming initial TMJ diagnosis and attendance of 10-year radiological follow-up were evaluated and eligible for 30-year follow-up. Primary variables: discectomy and CT-/CBCT-diagnosed OA at follow-ups. Secondary variables: perioperative TMJ diagnoses and remodelling at follow-up. Unoperated TMJs (Unop-TMJs) in unilaterally operated patients were controls. Statistical association and correlation analyses were performed for the 10-year follow-up (significance level p < 0.05). Results Twenty-two patients attended the 10-year follow-up (mean follow-up 11 years) with 27 operated TMJs (Op-TMJs) and 17 Unop-TMJs. OA perioperatively was associated with DD without reduction (p = 0.001) and additional disc abnormalities (p = 0.016). Although statistically non-significant, the number of TMJs with OA had increased at 10-year follow-up (p = 0.114, Op-TMJs: 14 to 20 joints; Unop-TMJs: 2 to 5 joints). Remodelling was correlated with discectomy (p = 0.003) and to OA (p = 0.006). Nine patients attended the 30-year follow-up (mean follow-up 32 years, 11 Op-TMJs). All TMJs with OA at 30-year follow-up had OA at 10-year follow-up. Mean maximal interincisal opening was 39 mm. No DC-TMD-diagnosed arthralgia was found. Conclusion Osteoarthritis developed similarly between Op- and Unop-TMJs. Only remodelling, not OA, was correlated to the surgery. The clinical results were still favourable at final follow-up.
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Ottersen, Margareth Kristensen; Larheim, Tore Arne; Hove, Lene Hystad & Arvidsson, Linda Zamoline
(2023).
Imaging signs of temporomandibular joint osteoarthritis in an urban population of 65-year-olds: A cone beam computed tomography study.
Journal of Oral Rehabilitation.
ISSN 0305-182X.
doi:
10.1111/joor.13547.
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Stoustrup, Peter; Resnick, Cory M.; Abramowicz, Shelly; Pedersen, Thomas K.; Michelotti, Ambra & Küseler, Annelise
[Vis alle 30 forfattere av denne artikkelen]
(2022).
Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus-Based Recommendations.
Arthritis & Rheumatology.
ISSN 2326-5191.
doi:
10.1002/art.42338.
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Involvement of the temporomandibular joint (TMJ) is common in juvenile idiopathic arthritis (JIA). TMJ arthritis can lead to orofacial symptoms, orofacial dysfunction, and dentofacial deformity with negative impact on quality of life. Management involves interdisciplinary collaboration. No current recommendations exist to guide clinical management. We undertook this study to develop consensus-based interdisciplinary recommendations for management of orofacial manifestations of JIA, and to create a future research agenda related to management of TMJ arthritis in children with JIA. Recommendations were developed using online surveying of relevant stakeholders, systematic literature review, evidence-informed generation of recommendations during 2 consensus meetings, and Delphi study iterations involving external experts. The process included disciplines involved in the care of orofacial manifestations of JIA: pediatric rheumatology, radiology, orthodontics, oral and maxillofacial surgery, orofacial pain specialists, and pediatric dentistry. Recommendations were accepted if agreement was >80% during a final Delphi study. Three overarching management principles and 12 recommendations for interdisciplinary management of orofacial manifestations of JIA were outlined. The 12 recommendations pertained to diagnosis (n = 4), treatment of TMJ arthritis (active TMJ inflammation) (n = 2), treatment of TMJ dysfunction and symptoms (n = 3), treatment of arthritis-related dentofacial deformity (n = 2), and other aspects related to JIA (n = 1). Additionally, a future interdisciplinary research agenda was developed. These are the first interdisciplinary recommendations to guide clinical management of TMJ JIA. The 3 overarching principles and 12 recommendations fill an important gap in current clinical practice. They emphasize the importance of an interdisciplinary approach to diagnosis and management of orofacial manifestations of JIA.
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Tolend, Mirkamal; Doria, Andrea S.; Meyers, Arthur B.; Larheim, Tore Arne; Abramowicz, Shelly & Aguet, Julien
[Vis alle 27 forfattere av denne artikkelen]
(2021).
Assessing the reliability of the OMERACT juvenile idiopathic arthritis magnetic resonance scoring system for temporomandibular joints (JAMRIS-TMJ).
Journal of Clinical Medicine.
10(18),
s. 1–17.
doi:
10.3390/jcm10184047.
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Contrast-enhanced magnetic resonance imaging (MRI) remains the most comprehensive modality to assess juvenile idiopathic arthritis (JIA)-related inflammation and osteochondral damage in the temporomandibular joints (TMJ). This study tested the reliability of a new JIA MRI scoring system for TMJ (JAMRIS-TMJ) and the impact of variations in calibration and reader specialty. Thirty-one MRI exams of bilateral TMJs were scored independently using the JAMRIS-TMJ by 20 readers consisting of radiologists and non-radiologist clinicians in three reading groups, with or without a calibrating atlas and/or tutorial. The inter-reader reliability in the multidisciplinary cohort assessed by the generalizability coefficient was 0.61–0.67 for the inflammatory and 0.66–0.74 for the damage domain. The atlas and tutorial did not improve agreement within radiologists, but improved the agreement between radiologist and non-radiologist groups. Agreements between different calibration levels were 0.02 to 0.08 lower by the generalizability coefficient compared to agreement within calibration levels; agreement between specialty groups was 0.04 to 0.10 lower than within specialty groups. Averaging two radiologists raised the reliability above 0.8 for both domains. Therefore, the reliability of JAMRIS-TMJ was moderate-to-good depending on the presence of specialty and calibration differences. The atlas and tutorial are necessary to improve reliability when the reader cohort consists of multiple specialties.
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Tolend, Mirkamal; Junhasavasdikul, Thitiporn; Cron, Randy Q.; Inarejos, Emilio C; Kalle, Thekla von & Kellenberger, Christian J.
[Vis alle 27 forfattere av denne artikkelen]
(2021).
Discrete Choice Experiment on a Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis.
Arthritis care & research.
ISSN 2151-464X.
74(2),
s. 308–316.
doi:
10.1002/acr.24577.
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Objective To determine the relative importance weights of items and grades of a newly developed additive outcome measure called the juvenile idiopathic arthritis (JIA) magnetic resonance imaging (MRI) scoring system for the temporomandibular joint (TMJ) (JAMRIS-TMJ). Methods An adaptive partial-profile, discrete choice experiment (DCE) survey using the 1000Minds platform was independently completed by members of an expert group consisting of radiologists and non-radiologist clinicians to determine the group-averaged relative weights for the JAMRIS-TMJ. Subsequently, an image-based vignette ranking exercise was done, during which experts individually rank ordered 14 patient vignettes for disease severity while blinded to the weights and unrestricted to JAMRIS-TMJ assessment criteria. Validity of the weighted JAMRIS-TMJ was tested by comparing the consensus-graded, DCE-weighted JAMRIS-TMJ score of the vignettes with their unrestricted image-based ranks provided by the experts. Results Nineteen experts completed the DCE survey, and 21 completed the vignette ranking exercise. Synovial thickening and joint enhancement showed higher weights per raw score compared to bone marrow items and effusion in the inflammatory domain, while erosions and condylar flattening showed nonlinear and higher weights compared to disk abnormalities in the damage domain. The weighted JAMRIS-TMJ score of the vignettes correlated highly with the ranks from the unrestricted comparison method, with median Spearman's ρ of 0.92 (interquartile range [IQR] 0.87–0.95) for the inflammation and 0.93 (IQR 0.90–0.94) for the damage domain. Conclusion A DCE survey was used to quantify the importance weights of the items and grades of the JAMRIS-TMJ. The weighted score showed high convergent validity with an unrestricted, holistic vignette ranking method.
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Abrahamsson, Anna-Karin; Småstuen, Milada Cvancarova; Arvidsson, Linda Zamoline & Larheim, Tore Arne
(2020).
Improvement of Bone-Erosive Temporomandibular Joint (TMJ) Abnormalities in Adolescents Undergoing Non-Surgical Treatment: A Longitudinal Study.
Dentomaxillofacial Radiology.
ISSN 0250-832X.
49(5).
doi:
10.1259/dmfr.20190338.
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Objectives: To investigate the longitudinal changes of the imaging temporomandibular joint (TMJ) characteristics in young patients with TMJ-related symptoms and treated with non-surgical methods. The severity of self-reported symptoms at follow-up was also investigated. Methods: A cone beam CT (CBCT)/CT follow-up examination [median follow-up 4.1 (1.3–6.4) years] was performed in 22 patients with erosive TMJ abnormalities [baseline median age 16 (12–18) years]. Imaging characteristics were analyzed and the changes between the examinations were categorized as (A) improvement, (B) no change, or (C) worsening. Severity of follow-up symptoms was evaluated using Jaw Functional Limitation Scale (JFLS-8) and Graded Chronic Pain Scale (Grade 0–IV). Analyses were performed separately for left and right TMJ. Findings at baseline and follow-up were compared using McNemar test to account for dependencies. Changes in proportions of hard tissue findings between examinations were assessed using Wilcoxon signed ranks test. Results: A significant reduction in the proportion of patients with erosive abnormalities was found [59.1%, 95% CI (36.4–79.3) %]. Baseline erosions improved in 9/12 (75%) right and 14/15 (93%) left TMJs. About half repaired; developed an intact cortical outline. Number of joints with osteophytes increased (right: p < 0.04, left: p < 0.003). New osteophytes were mostly found in joints with erosive findings. Low or no limitation of jaw function (Jaw Functional Limitation Scale) was found in 12/22 (55%) and no or low intensity of pain (Graded Chronic Pain Scale Grade 0 or I) in 19/22 (86%) at follow-up. Conclusion: We found a high potential for repair of erosive TMJ abnormalities. However, the patient series was small. The majority of patients assessed their symptom severity at follow-up as low.
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Stoustrup, Peter; Resnick, Cory M; Pedersen, Thomas Klit; Abramowicz, Shelly; Michelotti, Ambra & Küseler, Annelise
[Vis alle 28 forfattere av denne artikkelen]
(2019).
Standardizing Terminology and Assessment for Orofacial Conditions in Juvenile Idiopathic Arthritis: International, Multidisciplinary Consensus-based Recommendations.
Journal of Rheumatology.
ISSN 0315-162X.
45(5),
s. 518–522.
doi:
10.3899/jrheum.180785.
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<i>Objective</i> - To propose multidisciplinary, consensus-based, standardization of operational terminology and method of assessment for temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA).<p> <p><i>Methods</i> - Using a sequential expert group–defined terminology and methods-of-assessment approach by (1) establishment of task force, (2) item generation, (3) working group consensus, (4) external expert content validity testing, and (5) multidisciplinary group of experts final Delphi survey consensus.<p> <p><i>Results</i> - Seven standardized operational terms were defined: <i>TMJ arthritis</i>, <i>TMJ involvement</i>, <i>TMJ arthritis management</i>, <i>dentofacial deformity</i>, <i>TMJ deformity</i>, <i>TMJ symptoms</i>, and <i>TMJ dysfunction</i>.<p> <p><i>Conclusion</i> - Definition of 7 operational standardized terms provides an optimal platform for communication across healthcare providers involved in JIA-TMJ arthritis management.
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Ottersen, Margareth Kristensen; Abrahamsson, Anna-Karin; Larheim, Tore & Arvidsson, Linda Zamoline
(2019).
CBCT characteristics and interpretation challenges of temporomandibular joint osteoarthritis in a hand osteoarthritis cohort.
Dentomaxillofacial Radiology.
ISSN 0250-832X.
48(4).
doi:
10.1259/dmfr.20180245.
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OBJECTIVES: To characterise osteoarthritis (OA) in the temporomandibular joints (TMJs) by means of cone beam CT in a hand OA population, and identify interpretation challenges. METHODS: The TMJs of 54 individuals (mean age 71.3) recruited from the “The Oslo hand OA cohort”, independently of TMJ-related symptoms, were examined with cone beam CT (ProMax MidCBCT). Images were analysed for bone change characteristics and each joint was diagnosed with either OA, no OA or as indeterminate for OA. The image analysis criteria developed for the Research Diagnostic Criteria for Temporomandibular Disorders were used. Frequencies of bone changes, joint diagnoses and severity grades (1–2) were calculated, as well as κ values for observer agreement. RESULTS: In the OA joints, the most frequent bone changes occurred in the condyle: flattening (79%), osteophyte (72%) and subcortical sclerosis (70%). The most frequent changes in the fossa/eminence were flattening (57%), erosion (49%) and subcortical sclerosis (47%). 53 (49%) of the 108 joints were diagnosed with TMJ OA (68 % Grade 2), 29 joints (27%) with no OA, and 26 joints (24%) were indeterminate for OA. Inter- and intraobserver agreement showed mean κ values of 0.67 and 0.62, respectively. CONCLUSIONS: TMJ changes were common in elderly with hand OA and characterised by bone productive changes. The radiologic features indicated a late stage TMJ OA. Interpretation challenges related to subtle changes were identified and are reflected by the rather low observer agreement. The diagnosis of TMJ OA should be based on evident and clear abnormalities only.
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Larheim, Tore Arne; Hol, Caroline; Ottersen, Margareth Kristensen; Knutsen, Bjørn Mork & Arvidsson, Linda Zamoline
(2018).
The role of imaging in the diagnosis of temporomandibular joint pathology.
Oral and Maxillofacial Surgery Clinics of North America.
ISSN 1042-3699.
30(3),
s. 239–249.
doi:
10.1016/j.coms.2018.04.001.
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Stoustrup, Peter Bangsgaard; Ahlefeldt-Laurvig-Lehn, Nicole; Kristensen, Kasper Dahl; Arvidsson, Linda Zamoline; Twilt, Marinka & Cattaneo, Paolo M.
[Vis alle 10 forfattere av denne artikkelen]
(2018).
No Association between types of unilateral mandibular condylar abnormalities and facial asymmetry in orthopedic-treated patients with juvenile idiopathic arthritis.
American Journal of Orthodontics and Dentofacial Orthopedics.
ISSN 0889-5406.
153(2),
s. 214–223.
doi:
10.1016/j.ajodo.2017.05.037.
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Introduction: Dentofacial asymmetries are often observed in patients with juvenile idiopathic arthritis (JIA) and temporomandibular joint (TMJ) involvements. The aim of this split-face study was to associate types of radiologic TMJ abnormalities with the degree of dentofacial asymmetry in patients with unilateral TMJ involvements assessed with cone-beam computed tomography. Methods: Forty-seven JIA patients and 19 nonarthritic control subjects were included in the study. Normal condylar radiologic cone-beam computed tomography appearance in at least 1 TMJ was the inclusion criterion for all patients with JIA. The contralateral TMJ was thereafter scored as either “normal,” “deformed,” or “erosive,” consistent with predefined criteria. Based on the bilateral radiologic TMJ appearances, 3 JIA groups were assigned: normal/normal, normal/deformed, and normal/erosive. The severity of the dentofacial asymmetry was compared between the JIA groups and control subjects. Dentofacial asymmetry was expressed as interside ratios and angular measurements. Results: Eighty-seven percent of the JIA patients were being treated or had previously received treatment with a functional orthopedic appliance at the time of the cone-beam computed tomography. Significantly greater dentofacial asymmetries were observed in the 2 groups of JIA patients with unilateral condylar abnormalities (deformation or erosion) than in the other groups. A similar degree of dentofacial asymmetry was observed in JIA patients with bilateral normal TMJs and in the nonarthritic control group. Conclusions: JIA patients with unilateral condylar abnormalities (deformation or erosion) exhibited significantly more severe dentofacial asymmetries than did the JIA patients without condylar abnormalities and the control subjects. We found the same degree of dentofacial asymmetry when dividing patients with condylar abnormalities into deformation and erosion groups.
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Johansen, Anna Karin; Ottersen, Margareth Kristensen; Arvidsson, Linda Zamoline; Kvien, Tore Kristian; Larheim, Tore Arne & Haugen, Ida Kristin
(2017).
Frequency of temporomandibular joint osteoarthritis and related symptoms in a hand osteoarthritis cohort.
Osteoarthritis and Cartilage.
ISSN 1063-4584.
25(5),
s. 654–657.
doi:
10.1016/j.joca.2016.12.028.
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Objective: The prevalence of osteoarthritis (OA) in the temporomandibular joints (TMJs) in hand OA patients is largely unknown. Our aims were to explore (1) The frequency of TMJ-related symptoms and clinical findings; (2) The TMJ OA frequency defined by cone beam computed tomography (CBCT); and (3) The relationship between TMJ-related symptoms/clinical findings and CBCT-defined TMJ OA, in a hand OA cohort. Methods: We calculated the frequencies of TMJ-related symptoms, clinical findings and diagnosis of TMJ OA by CBCT and clinical examination in 54 patients from the Oslo hand OA cohort (88% women, mean (range) age 71 (61–83) years). Participants with and without CBCT-defined TMJ OA were compared for differences in proportions (95% confidence interval (CI)) of symptoms and clinical findings. Sensitivity and specificity of the clinical TMJ OA diagnosis were calculated using CBCT as reference. Results: Self-reported symptoms and clinical findings were found in 24 (44%) and 50 (93%) individuals (93%), respectively, whereas 7 (13%) had sought healthcare. Individuals with CBCT-defined TMJ OA (n = 36, 67%) reported statistically significantly more pain at mouth opening (22%, 95% CI 4–40%), clicking (33%, 95% CI 14–52%) and crepitus (25%, 95% CI 4–46%). By clinical examination, only crepitus was more common in TMJ OA (33%, 95% CI 29–77%). Clinical diagnosis demonstrated low sensitivity (0.42) and high specificity (0.93). Conclusions: CBCT-defined TMJ OA was common in hand OA patients, suggesting that TMJ OA may be part of generalized OA. Few had sought healthcare, despite high burden of TMJ-related symptoms/findings. Clinical examination underestimated TMJ OA frequency.
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Kirkhus, Eva; Arvidsson, Linda Zamoline; Smith, Hans-Jørgen; Flatø, Berit; Hetlevik, Siri Opsahl & Larheim, Tore Arne
(2016).
Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis.
Pediatric Radiology.
ISSN 0301-0449.
46(3),
s. 331–341.
doi:
10.1007/s00247-015-3493-7.
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Background
MRI manifestation of temporomandibular
joint arthritis is frequently reported in children with juve-
nile idiopathic arthritis. However, little attention has been
paid to temporomandibular joint disk abnormalities.
Objective
To assess combinations of MRI findings in the
symptomatic temporomandibular joint in children with ju-
venile idiopathic arthritis with focus on disk abnormalities.
Materials and methods
This was a retrospective study of 46
patients with juvenile idiopathic arthritis, mean age 12 years
(range: 5-17 years). Mean disease duration was 70 months
(standard deviation: 61 months). MR images of 92 tempo-
romandibular joints were scored for thickness of abnormal-
ly enhancing synovium (synov
itis), joint effusion, bone
marrow oedema, abnormal bone shape, bone erosion and
disk abnormalities.
Results
The 92 temporomandibular joints were categorized
as A: No synovitis and normal bone shape (30/92; 33%), B:
Synovitis and normal bone shape (14/92: 15%), C: Synovi-
tis and abnormal bone shape (38/92; 41%) and D: No syno-
vitis but abnormal bone shape (10/92; 11%). Thirty-six of
the 46 patients (78%) had synovitis and 33/46 (72%) had
abnormal bone shape, most frequently in combination (30/
46; 65%). Disk abnormalities (flat disk, fragmented disk,
adherent disk and displaced disk) were found in 29/46 pa-
tients (63%). Disk abnormalities were found in all catego-
ries of juvenile idiopathic arthritis involved temporoman-
dibular joints (B: 8/14 [57%]; C: 25/38 [66%] and D: 7/10
[70%]). Disk displacement was found in half of the joints
(7/14) in category B. Synovitis was most pronounced in this
category.
Conclusion
Disk abnormalities were frequent. Disk displace-
ment also occurred in joints with early temporomandibular
joint arthritis, i.e., with normal bone shape. Other disk abnor-
malities were found in joints with bone abnormalities. Atten-
tion should be paid to disk abnormalities both in early and
long-standing temporomandibular joint arthritis in children
with juvenile idiopathic arthritis
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Kirkhus, Eva; Gunderson, Ragnhild B.; Smith, Hans-Jørgen; Flatø, Berit; Hetlevik, Siri Opsahl & Larheim, Tore Arne
[Vis alle 7 forfattere av denne artikkelen]
(2016).
Temporomandibular joint involvement in childhood arthritis: comparison of ultrasonography-assessed capsular width and MRI-assessed synovitis.
Dentomaxillofacial Radiology.
ISSN 0250-832X.
45(8).
doi:
10.1259/dmfr.20160195.
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Objectives:
Ultrasonography is an effective, low-cost, low-threshold and convenient diagnostic tool in childhood arthritis, but its value in temporomandibular joint (TMJ) involvement is not clear. The purpose of our study was to explore the reliability of ultrasonography to assess TMJ inflammation using contrast-enhanced MRI as reference standard, in order to deduce cut-off values for TMJ capsular width to detect enhanced synovial thickening (synovitis).
Methods:
124 ultrasonography and MRI examinations in 55 patients [mean age 12.4 ± 3.5 years (±standard deviation)], the majority obtained within 1 day, were scored for subcondylar and condylar capsular width (ultrasonography images) and amount of synovitis (MR images). The correlations of these findings were calculated. A receiver operating characteristic (ROC) curve analysis, with MRI findings as reference standard, was obtained.
Results:
The correlation between ultrasonography-assessed capsular width and MRI-assessed amount of synovitis was moderate both at the subcondylar and condylar level [Spearman's rho (ρ): 0.483; p < 0.001 and 0.347; p < 0.001 respectively]. The ROC curve indicated the best discriminatory ability at the subcondylar level with an area under the curve of 0.77 (95% confidence interval 0.69–0.85) and a cut-off value of 1.2 mm (sensitivity 72%, specificity 70%) for the capsular width.
Conclusions:
A moderate correlation between ultrasonography-assessed capsular width and MRI-assessed synovitis was found in childhood arthritis with the best discriminatory ability at the subcondylar level. This indicates that ultrasonography may be a valuable diagnostic tool in the initial assessment of TMJ inflammation.
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Larheim, Tore Arne; Doria, Andrea S.; Kirkus, Eva; Parra, Dimitri A.; Kellenberger, Christian J. & Arvidsson, Linda Zamoline
(2015).
TMJ imaging in JIA patients - An overview.
Seminars in orthodontics.
ISSN 1073-8746.
21(2),
s. 102–110.
doi:
10.1053/j.sodo.2015.02.006.
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Kellenberger, Christian J.; Arvidsson, Linda Zamoline & Larheim, Tore Arne
(2015).
Magnetic resonance imaging of temporomandibular joints in juvenile idiopathic arthritis.
Seminars in orthodontics.
ISSN 1073-8746.
21(2),
s. 111–120.
doi:
10.1053/j.sodo.2015.02.007.
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Fjeld, Morten; Birkeland, Kari; Arvidsson, Linda Zamoline; Stabrun, Anne Elisabeth; Larheim, Tore Arne & Øgaard, Bjørn
(2014).
Dento-alveolar Changes and Need of Orthodontic Treatment in JIA Patients.Followed from Childhood to Adulthood.
Dentistry.
doi:
10.4172/2161-1122.S2-003.
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Larheim, Tore Arne; Abrahamsson, Anna-Karin; Kristensen, Margareth & Arvidsson, Linda Zamoline
(2014).
Temporomandibular joint diagnostics using CBCT.
Dentomaxillofacial Radiology.
ISSN 0250-832X.
44(1).
doi:
10.1259/dmfr.20140235.
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Jensen, Janicke Liaaen; Solheim, Tore; Koppang, Hanna Strømme & Arvidsson, Linda Zamoline
(2012).
Aggressive extrenal root resorption of the entire dentition accompanied by osteolysis: a case report.
International Journal of Prosthodontics.
ISSN 0893-2174.
25(5),
s. 459–464.
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Arvidsson, Linda Zamoline; Smith, Hans-Jørgen; Flatø, Berit & Larheim, Tore Arne
(2010).
Temporomandibular Joint Findings in Adults with Long-standing Juvenile Idiopathic Arthritis: CT and MR Imaging Assessment.
Radiology.
ISSN 0033-8419.
256(1),
s. 191–200.
doi:
10.1148/radiol.10091810.
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Fjeld, Morten; Arvidsson, Linda Zamoline; Smith, Hans-Jørgen; Flatø, Berit; Øgaard, Bjørn & Larheim, Tore Arne
(2010).
Relationship between disease course in the temporomandibular joints and mandibular growth rotation in patients with juvenile idiopathic arthritis followed from childhood to adulthood.
Pediatric Rheumatology.
s. 13–13.
doi:
10.1186/1546-0096-8-13.
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Objective To investigate the relationship between radiographic JIA disease course in the TMJs and mandibular growth rotation, compared with growth in healthy individuals. Methods From a larger series of JIA patients followed from childhood to adulthood, 26 were included; 11 without and 15 with bilateral radiographic TMJ involvement. Joint morphology and function were assessed at baseline, 2-, 4-, 6- and 27 years follow-up. Mandibular growth rotation (anterior, posterior or none) was assessed from cephalometric evaluations at childhood and adulthood, with observations from 16 healthy individuals as controls. TMJ disease course and mandibular growth rotation were assessed independently and their relationship analysed. Non-parametric statistical methods were applied to test differences between groups. Results In the normal TMJ group of JIA patients the joint morphology was similar at the follow-ups and all patients had good function both in childhood and in adulthood. The mandibular growth rotation was similar to that of healthy controls, i.e. predominantly in anterior direction. In the abnormal TMJ group different JIA TMJ disease courses were observed and associated with changes in the mandibular growth rotation (p = 0.007). Progressing JIA TMJ disease course was related to posterior mandibular growth rotation and improving disease course to anterior mandibular growth rotation. Conclusion A relationship was found between JIA disease course in the TMJs and mandibular growth rotation, suggesting that a favourable growth could be regained in patients with improvement in TMJ morphology and/or TMJ function. To confirm this, further research on larger patient series is needed.
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Arvidsson, Linda Zamoline; Fjeld, Morten; Smith, Hans-Jørgen; Flatø, Berit; Øgaard, Bjørn & Larheim, Tore Arne
(2010).
Craniofacial growth disturbance is related to temporomandibular joint abnormality in patients with juvenile idiopathic arthritis, but normal facial profile was also found at the 27-year follow-up.
Scandinavian Journal of Rheumatology.
ISSN 0300-9742.
39(5),
s. 373–379.
doi:
10.3109/03009741003685624.
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Arvidsson, Linda Zamoline; Flatø, Berit & Larheim, Tore Arne
(2009).
Radiographic TMJ abnormalities in patients with juvenile idiopathic arthritis followed for 27 years.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics.
ISSN 1079-2104.
108(1),
s. 114–123.
doi:
10.1016/j.tripleo.2009.03.012.
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Fjeld, Morten; Arvidsson, Linda Zamoline; Stabrun, Anne Elisabeth; Birkeland, Kari; Larheim, Tore Arne & Øgaard, Bjørn
(2009).
Average craniofacial development from 6 to 35 years of age in a mixed group of patients with juvenile idiopathic arthritis.
Acta Odontologica Scandinavica.
ISSN 0001-6357.
67(3),
s. 153–160.
doi:
10.1080/00016350902740506.
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Arvidsson, Linda Zamoline; Knutsen, Bjørn Mork; Hol, Caroline; Abrahamsson, Anna-Karin; Ottersen, Margareth Kristensen & Larheim, Tore
(2019).
High-Grade Inflammatory TMJ Diseases and Traumatic TMJ Conditions.
Springer Nature.
ISBN 9783319994680.
15 s.
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Arvidsson, Linda Zamoline; Knutsen, Bjørn Mork; Hol, Caroline; Abrahamsson, Anna-Karin; Ottersen, Margareth Kristensen & Larheim, Tore
(2019).
Other Pathologic Conditions of the TMJ.
Springer Nature.
ISBN 9783319994680.
10 s.
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Larheim, Tore; Knutsen, Bjørn Mork; Hol, Caroline; Abrahamsson, Anna-Karin; Ottersen, Margareth Kristensen & Arvidsson, Linda Zamoline
(2019).
TMJ Disc Disorders and Osteoarthritis.
Springer Nature.
ISBN 9783319994680.
19 s.
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Engebråten, Christian Andersson; Torgersen, Gerald R. & Arvidsson, Linda Zamoline
(2025).
AI-Derived Metrics for Assessing Panoramic Radiograph Quality.
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Purpose
Panoramic radiographs are widely used in dental diagnostics, yet image quality remains highly variable due to frequent patient positioning errors, impacting diagnostic reliability and workflow efficiency. While artificial intelligence (AI) has shown promise in automating quality assessment, current evaluation methods often rely on subjective or limited landmark-based criteria, which may not fully leverage the capabilities of modern AI systems.
This project aims to develop and explore novel, AI-adapted metrics for the objective assessment of panoramic image quality, focusing on patient positioning parameters such as head tilt and rotation. Positioning errors compromise diagnostic accuracy and necessitate image retakes. The resulting framework will serve both clinical practice and educational settings, providing more objective quality assessment tools that may help improve diagnostic reliability and reduce unnecessary radiation exposure.
Methods
Using deep learning models architectures, we automatically detect and segment relevant anatomical structures to enable geometric and symmetry-based analyses. These AI-derived metrics will be compared with established evaluation methods and validated against assessments done by a human expert to determine clinical relevance.
Results
We have fine-tuned deep learning models for segmentation of the mandible, maxilla, and teeth, enabling automated anatomical identification and classification. We compared the AI-derived metrics with traditional landmark-based methods to evaluate their agreement and practical application.
Conclusions
Our preliminary work demonstrates the feasibility of using AI-based segmentation to support objective image quality assessment in panoramic radiography. We discuss the potential of these new geometric metrics and their similarities and differences compared to established evaluation approaches.
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Hol, Caroline; Arvidsson, Linda Zamoline; Larheim, Tore Arne; Bjørnland, Tore & Mork-Knutsen, Peer Olaf
(2022).
Radiologically diagnosed temporomandibular joint osteoarthritis 10 and 30 years after diskectomy.
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Hol, Caroline; Mork-Knutsen, Peer Olaf; Larheim, Tore Arne; Bjørnland, Tore & Arvidsson, Linda Zamoline
(2022).
Temporomandibular joint diskectomy without disk replacement: Radiological 10- and 30-year follow-up. Clinical 30-year follow-up.
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Hol, Caroline; Larheim, Tore Arne & Arvidsson, Linda Zamoline
(2019).
Bony abnormalities consistent with osteoarthritis is common 10 years after discectomy in the TMJ. A preliminary report.
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Larheim, Tore Arne; Arvidsson, Linda Zamoline; Ottersen, Margareth Kristensen; Abrahamsson, Anna-Karin & Hol, Caroline
(2018).
Radiologisk utredning.
I Julsvoll, Elisabeth Heggem (Red.),
Temporomandibulær dysfunksjon: Teori, undersøkelse og behandling.
Cappelen Damm Akademisk.
ISSN 9788202557799.
s. 148–160.
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Kellenberger, Christian J.; Abramowicz, S; Arvidsson, Linda Zamoline; Kirkhus, Eva Astrid; Tzaribachev, N & Larheim, Tore Arne
(2018).
Recommendations for a Standard Magnetic Resonance Imaging Protocol of Temporomandibular Joints in Juvenile Idiopathic Arthritis.
Journal of oral and maxillofacial surgery.
ISSN 0278-2391.
76(12),
s. 2463–2465.
doi:
10.1016/j.joms.2018.06.027.
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Arvidsson, Linda Zamoline; Hol, Caroline; Torgersen, Gerald R. & Wikan, Kristine
(2017).
Workshop om strålevern i tannhelseprofesjonsutdanningene.
Den norske tannlegeforenings Tidende.
ISSN 0029-2303.
127(11),
s. 1016–1017.
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Torgersen, Gerald R.; Arvidsson, Linda Zamoline & Kristine, Wikan
(2017).
Workshop om strålevern i tannhelseprofesjonsutdanningene.
Tannstikka : tidsskrift for Norsk tannpleierforening.
ISSN 1501-8636.
s. 26–27.
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Fjeld, Morten; Birkeland, Kari; Stabrun, Anne Elisabeth; Arvidsson, Linda Zamoline & Øgaard, Bjørn
(2013).
Malocclusion and need for orthodontic treatment in young juvenile idiopathic arthritis patients.
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Johansen, Anna Karin; Arvidsson, Linda Zamoline; Larheim, Tore Arne & Kirkhus, Eva
(2013).
Juvenile idiopathic arthritis and juvenile osteoarthritis of the TMJ: a differential diagnostic challenge.
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Johansen, Anna Karin; Larheim, Tore Arne; Arvidsson, Linda Zamoline & Smith, Hans-Jørgen
(2012).
TMJ osteoarthritis development - does disc displacement play a role?
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Arvidsson, Linda Zamoline; Fjeld, Morten; Smith, Hans-Jørgen; Flatø, Berit; Øgaard, Bjørn & Larheim, Tore Arne
(2010).
Relationship between disease course in the temporomandibular joints and mandibular growth rotation in patients with juvenile idiopathic arthritis followed from childhood to adulthood.
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Arvidsson, Linda Zamoline
(2010).
Juvenil Idiopatisk Artritt i kjeveleddet i et langtidsperspektiv.
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Arvidsson, Linda Zamoline
(2009).
Juvenil idiopatisk artritt og kjeveledd i et langtidsperspektiv.
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Arvidsson, Linda Zamoline; Fjeld, Morten; Smith, Hans-Jørgen; Flatø, Berit; Øgaard, Bjørn & Larheim, Tore Arne
(2009).
Associations between CT and MRI assessments of the temporomandibular joint and craniofacial growth disturbances: a 27 year follow-up of patients with juvenile idiopathic arthritis.
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Riis, Ulf; Redfors, Eva Maria Cecil; Hol, Caroline; Arvidsson, Linda Zamoline; Larheim, Tore Arne & Hopp, Einar
(2009).
Florid osseous dysplasia of the jaw skeleton: CT and MRI observations.
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Fjeld, Morten; Arvidsson, Linda Zamoline; Larheim, Tore Arne & Øgaard, Bjørn
(2009).
Craniofacial morphology in adult juvenile idiopathic arthritis (JIA) patients with and without TMJ involvement.
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Arvidsson, Linda Zamoline; Fjeld, Morten; Smith, Hans-Jørgen; Flatø, Berit; Øgaard, Bjørn & Larheim, Tore Arne
(2009).
Temporomandibular joint involvement and craniofacial morphology in 60 adult patients with juvenile idiopathic arthritis.
Fulltekst i vitenarkiv
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Arvidsson, Linda Zamoline; Fjeld, Morten; Smith, Hans-Jørgen; Flatø, Berit; Øgaard, Bjørn & Larheim, Tore Arne
(2009).
Temporomandibular joint involvement and craniofacial morphology in 60 adult patients with juvenile idiopathic arthritis.
Fulltekst i vitenarkiv
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Fjeld, Morten; Arvidsson, Linda Zamoline; Stabrun, Anne Elisabeth; Larheim, Tore Arne & Øgaard, Bjørn
(2008).
CRANIOFACIAL DEVELOPMENT IN JUVENILE ARTHRITIS FROM 6 TO 35 YEARS OF AGE.
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Fjeld, Morten; Øgaard, Bjørn; Larheim, Tore Arne; Arvidsson, Linda Zamoline & Stabrun, Anne Elisabeth
(2007).
CRANIOFACIAL DEVELOPMENT IN JUVENILE ARTHRITIS; A 28 YRS FOLLOW-UP STUDY.
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Larheim, Tore Arne; Redfors, Eva Maria Cecil & Arvidsson, Linda Zamoline
(2007).
Kjeve- og ansiktsradiologi anno 2007.
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Arvidsson, Linda Zamoline
(2007).
Juvenile arthritis manifestations in the facial skeleton: out-come at 23 - 30 year follow-up with analysis of contributing factors.
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Arvidsson, Linda Zamoline; Flatø, Berit; Vinje, Odd & Larheim, Tore Arne
(2007).
A longitudinal TMJ study of JIA and healthy controls.
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Arvidsson, Linda Zamoline; Smith, Hans-Jørgen; Flatø, Berit; Vinje, Odd & Larheim, Tore Arne
(2005).
TMJ abnormalities in juvenile arthritis: 25 years follow-up.
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Arvidsson, Linda Zamoline; Larheim, Tore Arne & Vinje, Odd
(2004).
Facial skeleton and TMJs in juvenile arthritis: 25-year follow-up study.
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Arvidsson, Linda Zamoline; Larheim, Tore Arne & Smith, Hans-Jørgen
(2004).
TMD disc displacement and osteoarthritis: a long term follow-up study.
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Koppang, Hanna Strømme; Arvidsson, Linda Zamoline; Knudsen, B Mork & Jensen, Janicke Cecilie L
(2003).
Monostotic fibrous dysplasia.
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Arvidsson, Linda Zamoline; Larheim, Tore Arne & Vinje, Odd
(2002).
Facial skeleton and TMJs in juvenile arthritis: 25-year follow-up study.
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Juvenile arthritis is characterized by chronic inflammation in one or
more joints in children or adolescents. We will present the
radiographic changes that have occurred in the TMJs in these patients
during the 25-year period, and the influence on the facial skeleton.
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Publisert
3. nov. 2010 12:38
- Sist endret
9. jan. 2025 15:08