Diagnostic concordance between MRI and electrovibratography of the temporomandibular joint of subjects with disc displacement disorders

Abstract

Objectives: The aim of this study is to evaluate the diagnostic concordance of MRI and electrovibratography (EVG) of the temporomandibular joint (TMJ) in the diagnosis of articular disc displacement with reduction (ADDwR) and articular disc displacement without reduction (ADDw/oR). Methods: 50 patients (12 males, 38 females; mean age 37.46 6 15.64 years) with a hypothesis of disc displacement were selected. For each patient an MRI of the TMJ was performed. MRIs were evaluated sorting the 100 TMJs by kind of pathology (no pathology, ADDwR, ADDw/oR, and joint hypermobility). Afterwards, the patients had an EVG exam. The EVG exams were performed with vibration transducers over each TMJ, enabling simultaneous, bilateral recording of vibrations emanating from joint sounds during the opening and closing movements. The presence of a sound peak was compared with the MRI diagnosis of ADDwR, while a multipeak aspect was compared with ADDw/oR diagnosis using Cohen's kappa test. Results: The presence of a peak-shaped track has high specificity for ADDwR (90.27%). The Cohen's kappa calculated for the ADDwR was 0.5615 (good-moderate). The presence of a multipeak-shaped track has low specificity (65.22%) and sensitivity (70.42%). The Cohen's kappa calculated for the ADDw/oR was 0.2992 (poor). Conclusions:The present study recommends the use of EVG to support the clinical diagnosis of a disc displacement with reduction when MRI is not available or when subjects cannot be investigated by MRI.

Could different TMJ disc positions observed in MRI cause different sounds? Analysis on a group of subjects with ADD with reduction: a pilot study

“…In a previous study, 16 it was possible to show a good agreement between the MRI diagnosis of disc displacement with reduction and the ESG peak morphology with a Cohen's kappa coefficient of 0.56. Furthermore, a specificity of 90.24% and a PPV of 90% of the ESG peak morphology with respect to the MRI diagnosis of disc displacement with reduction, indicate 1) rare false positive cases and 2) the presence of this morphology is related to a diagnosis of ADDwR in 90% of the observed cases.…”

“…Electrosonography (ESG) may be a useful method in the assessment of the disc position in suspected cases of internal derangement. 13,14 In a previous paper 16 the authors demonstrated that the presence of a peak-shaped track in ESG has high specificity for Articular Disc Displacement with Reduction (ADDwR) (90.27%). The use of ESG to support the clinical diagnosis of a disc displacement with 5 reduction was thus recommended when MRI is not available or when subjects cannot be analyzed by MRI.…”

Joint Vibration Analysis A Functonal Tool in Diagnosis of Temporomandibular Disorders – Case Reports

“…Unfortunately, it is not so easy to detect the joint sounds clinically. 4 There are many objective and subjective methods have been developed to record and analyse the TMJ sounds ranging from simple palpation and auscultation to complex Electromyography (EMG), Jaw Tracking, Thermography, Sonography, Dopper Ultrasound, Magnetic Resonance Imaging (MRI), Arthrography, Arthroscopy, Computerized Tomography (CT) scan which are expensive and provide static information. In search of an inexpensive method which provides dynamic information about joint, a personal computer based tool -JVA was developed based on principles of motion and friction.…”

“…9 Deregibus, T Castroflorio et al showed 90 patiens with disc displacement, 90% specificity in disc displacement with reduction. 4 Ishigaki et al 7 reported a disc displacement with reduction generates a "click" in the lower frequencies (under 300 Hz) and a degenerative condition generates "crepitus" in the higher frequencies (over 300 Hz). 10…”

Comparison of TMJ vibration frequencies under different joint conditions

“…Many different systems, equipments and methods have been used in the past to accomplish the recording and analysis of TMJ vibration data. 5,10,13,18,20,21 More recent results from studies of electrovibratography, [23][24][25][26][27] joint vibration analysis (JVA), [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] sonography, [44][45][46] electro-sonography [47][48][49][50] and doppler auscultation [51][52][53][54] have been mixed, although far more successful classifications have been published than failures. However, a few dentists have been skeptical of the usefulness of TMJ vibration measurements.…”