Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography

Abstract

There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ) region. The Computed Tomography (CT) scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT) using two protocols: 1) axial, coronal and sagittal multiplanar reconstruction (MPR); and 2) sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill # 1). From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis.

Temporomandibular joint diagnostics using CBCT

“…Extremely small defects, that is, ,2 mm, proved to be difficult to detect, 17 although the sensitivity for detecting condylar osseous defects overall was fairly high: 72.9-87.5%. These measurements corroborated those reported by Marques et al, 16 but they substantially exceeded those reported by Hintze et al, 12 who investigated morphological changes such as condylar flattening and osteophytes. It is thus suggested that erosion of the condylar surface may be easier to detect from CBCT images than other morphologic changes.…”

“…15 The sensitivity of CBCT for assessing bone defects is dependent on the size of the defects, as demonstrated by Marques et al 16 and confirmed by Patel et al 17 in their investigations of simulated condylar lesions. Extremely small defects, that is, ,2 mm, proved to be difficult to detect, 17 although the sensitivity for detecting condylar osseous defects overall was fairly high: 72.9-87.5%.…”

Bone mineral density in cone beam computed tomography: Only a few shades of gray

“…The advent of images acquired from computed tomography (CT) has made more precise quantitative and qualitative evaluation of the adjacent structures possible [1,2] . Although the use of CT is routine in medical practice, this examination has not been extensively widespread in dentistry, due to the presence of image artifacts, high cost, complexity of the examination and high dose radiation [3] . The development of cone beam computed tomography (CBCT), used for the evaluation of dentomaxillofacial structures, has allowed for more frequent use of these images in dentistry because it is a less complex device that produces images with satisfactory resolution, with little artifact incidence and lower dose of radiation [4] .…”

CBCT Diagnosis to the Athletic People Suffering TMJ Pain and/or Dysfunction before a Prolong Therapy with Platelet Rich Plasma

“…Complex etiologic factors like trauma, emotional stress, orthopedic instability, muscular hyperactivity, inflammatory and degenerative diseases, which compromise the equilibrium of the temporomandibular joint (TMJ), have been implicated in the development of temporomandibular joint disorders (TMD),cause of this disorder is not good understood [1,2].…”