Diagnostic accuracy and reliability of panoramic temporomandibular joint (TMJ) radiography to detect bony lesions in patients with TMJ osteoarthritis

Abstract

Background/purpose The value of the temporomandibular joint (TMJ) projections of panoramic radiography for diagnosing TMJ osteoarthritis is not completely elucidated. This study aimed to assess the diagnostic accuracy and reliability of panoramic TMJ radiography to detect bony lesions in patients with TMJ osteoarthritis. Materials and methods This study included 55 TMJs of 44 subjects who were diagnosed with TMJ osteoarthritis. They underwent panoramic radiography (PanRad), lateral (LatTMJ) and frontal (FrnTMJ) projection panoramic TMJ radiography, and cone-beam computed tomography (CBCT). All images were examined by two observers for flattening, erosion, and osteophytes on the condylar head and articular eminence of the TMJ. Results For detecting flattening lesions on the mandibular condyle, the sensitivities of PanRad, LatTMJ, and FrnTMJ were less than 67% and the combination of LatTMJ and FrnTMJ (ComTMJ) had the highest sensitivity for both observers (67.6% and 79.7%, respectively). For erosion lesions, the sensitivity of ComTMJ for observer 1 was the highest, at 84.3%, whereas the specificity of ComTMJ was the lowest, at 37.5%. The sensitivities of all four methods for observer 2 were less than 54% and the specificities ranged from 75.0% to 100%. The overall diagnostic accuracy was highest for ComTMJ (64.3%), followed by LatTMJ (59.5%). The intraobserver reliability was good for one observer and excellent for the other, and the interobserver reliability was fair or moderate. Conclusion Panoramic TMJ radiography demonstrated limited diagnostic accuracy and acceptable reliability in detecting bony lesions of the TMJ, although it was better than conventional panoramic radiography.

CircGCN1L1 promotes synoviocyte proliferation and chondrocyte apoptosis by targeting miR-330-3p and TNF-α in TMJ osteoarthritis

“…Transfect miR-330-3p mimics or inhibitor with different concentrations separately into human synoviocytes from the control patients. Collect the cell supernatant at different time points (1,2,4,8,16,32, and 48 h). The secretion of the TNF-α protein was subsequently detected as described in the TNF-α ELISA Kit (Multiscience, Hangzhou, China) with the sensitivity of 0.16 pg/ml.…”

“…3e). Besides, we collected the cell supernatant of synoviocytes, which transfected with miR-330-3p mimics/ inhibitor (50 nM) described above at various time points (1,2,4,8,16,32, and 48 h), and TNF-α protein levels were then detected using ELISA. The level of TNF-α secreted by synoviocytes did not change significantly with miR-330-3p overexpression during the first 8 h, but decreased rapidly from 70 to 55 pg/ml thereafter.…”

“…The molecular mechanisms inducing the joint inflammation that leads to TMJOA remain unclear, and clinical treatment effects for TMJOA were limited. Hence, elucidating these mechanisms may facilitate the discovery of more effective therapies for TMJOA that delay or halt its progression at an early stage 4,5 .…”

Knee orthopedics as a template for the temporomandibular joint

“… 26 For TMJ-OA, panoramic radiography has a low sensitivity for diagnosis. 27 Cone beam computed tomography (CBCT), a widely used imaging modality, is used as a more reliable diagnostic technique, 28 and MRI can be used to assess different signs of dysfunction. 29 Dynamic MRI scoring algorithms, similar to those used to evaluate cardiac wall motion, 30 can be used for the TMJ, for example, to assess the causes of reduced joint mobility.…”

Bentuk dan posisi kondilus sebagai marker pada Temporomandibular Disorder (TMD) melalui radiografi panoramik

“…Radiografi TMJ konvensional hanya menunjukkan gambaran dari TMJ saja dan tidak memberikan informasi lainnya seperti pada radiografi panoramik. 8 Selain kelainan pada bentuk kepala kondilus, TMD juga dapat melibatkan kelainan pada posisi kondilus. TMJ memiliki struktur anatomis berupa jaringan lunak yaitu diskus artikularis dimana diskus ini menjadi bagian yang juga penting untuk dilakukan pemeriksaan ada atau tidaknya perpindahan diskus.…”