To determine the diagnostic accuracy, sensitivity, and specificity of magnetic resonance (MR) imaging of the temporomandibular joint (TMJ) in the assessment of disk position, disk form, and changes in the osseous components, 55 fresh cadaver joints were imaged. A 1.5-T imager was used in the sagittal and coronal planes. After MR imaging, the joints were cryosectioned in the coronal plane corresponding to the coronal image through the center of the joint. The joints were then remounted and sectioned serially in the sagittal plane from lateral to medial, corresponding to the sagittal MR images. MR images were interpreted by the two authors together, without knowledge about cryosectional findings. The cryosections were interpreted by the authors together, without knowledge of the MR imaging findings. MR imaging was 95% accurate in the assessment of disk position and disk form and 93% accurate in the assessment of osseous changes. Coronal images helped avoid a false-negative diagnosis in 13% (n = 7) of the joints. MR imaging with a surface coil appears to be an accurate method for the assessment of soft and hard tissues of the TMJ.
The purpose of this autopsy study was to test the hypotheses that temporomandibular joint (TMJ) arthrosis is more common in women than in men, increases with age, and is more common in edentulous persons than in those with natural teeth. Two hundred forty-eight TMJs removed at autopsy from 224 fresh cadavers were investigated macroscopically with dissection or cryosectioning. Age was found to be a significant factor in prediction of TMJ arthrosis (p < 0.001) and of disk perforation (p < 0.05). No significant association was found between morphologic changes in the TMJ and the factor of sex for the whole group. Disk displacement and disk perforation were, however, more common in the joints of women than men in the group of persons 80 years of age or older (p < 0.05). There were significant associations (p < 0.001) between arthrosis, disk displacement, disk deformation, and disk perforation. There were no statistically significant differences in the prevalence of morphologic changes in the joints from persons with 10 or more natural teeth in each jaw compared with those from persons without natural teeth. The results of this study showed that TMJ arthrosis is more frequent in older than in younger persons. TMJ disk displacement generally appears necessary for the development of perforations. The findings of this study indicate that sex and dentition are not major factors for the development of TMJ pathosis in elderly individuals.
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