Flexure deformation of the temporomandibular joint disk in pseudodynamic magnetic resonance images

Yoshida, Hiroshi; Hirohata, Hiromi; Onizawa, Kojiro; Niitsu, Mamoru; Itai, Yuji

doi:10.1016/s1079-2104(00)80024-4

Cited by 13 publications

(10 citation statements)

References 24 publications

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“…In an MRI study of human TMJ discs of patients with anterior disc displacement, upward flexure was less common than downward flexure but more often associated with advanced clinical symptoms and non-reducing disc displacement that would result in permanent deformation (32). …”

Section: Discussionmentioning

confidence: 99%

Biomechanical and biochemical outcomes of porcine temporomandibular joint disc deformation

Matuska

Muller

Dolwick

et al. 2016

Archives of Oral Biology

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Objective The structure-function relationship in the healthy temporomandibular joint (TMJ) disc has been well established, however the changes in dysfunctional joints has yet to be systematically evaluated. Due to the poor understanding of the etiology of temporomandibular disorders (TMDs) this study evaluated naturally occurring degenerative remodeling in aged female porcine temporomandibular joint (TMJ) discs in order to gain insight into the progression and effects on possible treatment strategies of TMDs. Design Surface and regional biomechanical and biochemical properties of discal tissues were determined in grossly deformed (≥ Wilkes Stage 3) and morphologically normal (≤ Wilkes Stage 2) TMJ discs. Results Compared to normal disc structure the deformed discs lacked a smooth biconcave shape and characteristic ECM organization. Reduction in tensile biomechanical integrity and increased compressive stiffness and cellularity was found in deformed discs. Regionally, the posterior and intermediate zones of the disc were most frequently affected along with the inferior surface. Conclusions The frequency of degeneration observed on the inferior surface of the disc (predominantly posterior), suggests that a disruption in the disc-condyle relationship likely contributes to the progression of joint dysfunction more than the temporodiscal relationship. As such, the inferior joint space may be an important consideration in early clinical diagnosis and treatment of TMDs, as it is overlooked in techniques performed in the upper joint space, including arthroscopy and arthrocentesis. Furthermore, permanent damage to the disc mechanical properties would limit the ability to successfully reposition deformed discs, highlighting the importance of emerging therapies such as tissue engineering.

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Section: Discussionmentioning

confidence: 99%

Biomechanical and biochemical outcomes of porcine temporomandibular joint disc deformation

Matuska

Muller

Dolwick

et al. 2016

Archives of Oral Biology

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“…Sequences such as gradient echo, gradient recalled acquisition in steady state, fast low angle shot MRI 20°have been utilized. [3][4][5][6][7][8] These sequences were characterized by low SNR and low spatial resolution.…”

Section: Discussionmentioning

confidence: 99%

“…To reproduce joint movements, several authors performed MRI examinations with static examinations of the joint in different positions during the various phases of the movement, rebuilding then the movement of opening and closing the mouth through dedicated cinematographic software. [3][4][5][6][7][8] In these previous studies, cine MRI that relied on pseudodynamic images employing a bite block to control the mouth opening position for sequential step-by-step acquisitions was mostly used. The retrospective combination of images depicting static positions is physiologically not equivalent to the situation encountered during active jaw movement.…”

Section: Introductionmentioning

confidence: 99%

Comparing proton density and turbo spin echoT₂weighted static sequences with dynamic half-Fourier single-shot TSE pulse sequence at 3.0 T in diagnosis of temporomandibular joint disorders: a prospective study

Cassetta¹,

Barchetti²,

Marini³

2014

Dentomaxillofacial Radiology

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Objectives: The aim of this prospective study was to compare dynamic and static sequences in the evaluation of temporomandibular joint disorders using a 3.0 -T imaging unit. Methods: 194 patients were evaluated by static (double echo proton density weighted/turbo spin echo T 2 weighted sequences) and dynamic (half-Fourier single-shot turbo spin echo sequences) imaging. Two radiologists evaluated in consensus the quality of images, the disc position and morphological alterations. The Kendall rank correlation coefficient (t-b) was used to compare the qualitative rating between static and dynamic sequences. Cohen's kappa coefficient (k) was used to assess the agreement of disc position and morphological alterations between both sequences. The intraclass correlation coefficient was used to calculate the intraobserver variability. The significance was set at p # 0.05. Results: The correlation between both sequences in the qualitative evaluation was t-b 5 0.632. The agreement between both techniques in the evaluation of disc position was k 5 0.856. The agreement between both techniques in assessing the morphological alterations was k 5 0.487. In the static sequences, the intraclass correlation coefficient was 0.915 in the qualitative evaluation, 0.873 in the evaluation of disc position and 0.934 in the assessment of morphological alterations. In the dynamic sequences, the intraclass correlation coefficient was 0.785 in the qualitative evaluation, 0.935 in the evaluation of disc position and 0.826 in the assessment of morphological alterations. Conclusions: Static imaging remains the gold standard in the evaluation of the temporomandibular joint. Dynamic imaging is a valuable tool that can provide additional information about topographic changes in the disc-condyle relationship. Dentomaxillofacial Radiology (2014Radiology ( ) 43, 20130387. doi: 10.1259 Cite this article as: Cassetta M, Barchetti F, Pranno N, Marini M. Comparing proton density and turbo spin echo T 2 weighted static sequences with dynamic half-Fourier single-shot TSE pulse sequence at 3.0 T in diagnosis of temporomandibular joint disorders: a prospective study.

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“…We previously reported two types of flexure deformation of the disk in TMJ with anterior disk displacement on pseudodynamic magnetic resonance (MR) images obtained using a sagittal gradient recalled acquisition in steady state (GRASS) MR imaging sequence: one was upward flexure deformation (UD) of the disk, and the other downward flexure deformation (DD) of the disk (4, 5). These disk deformations were observed from the thin intermediate zone to the posterior band of the disk during jaw opening and closing phases.…”

Section: Introductionmentioning

confidence: 99%

“…These disk deformations were observed from the thin intermediate zone to the posterior band of the disk during jaw opening and closing phases. Although the clinical significance of the direction of the flexure deformation is unknown, TMJ with UD has been associated with a statistically higher incidence of clinical signs and symptoms than TMJ with DD (5). Consequently, disk deformation has been suggested to correlate with signs and symptoms in patients with anterior disk displacement.…”

Section: Introductionmentioning

confidence: 99%

Flexure deformation in temporomandibular joint disk displacement without reduction may predict treatment outcome

Yoshida

Hirohata

Onizawa

2005

J of Oral Rehabilitation

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To identify whether the direction of disk flexure deformation predicts the prognosis in cases of anterior disk displacement without reduction of painful temporomandibular joint (TMJ), the relationship between the direction of flexure, observed on pseudodynamic magnetic resonance (MR) images, and the outcome of conservative treatment using a flat occlusal splint was analysed in 40 female patients who perceived occasional or constant pain at unilateral TMJ with disk displacement without reduction. From the MR findings, 20 patients were classified as having upward flexure deformation of the disk and 20 as having downward flexure deformation. Patients' TMJ pain, masticatory muscle pain, amount of maximal mouth opening, and MR findings were evaluated before treatment. All patients were treated with a flat occlusal splint for 6 months. The patients' signs and symptoms were analysed statistically within each group before treatment and 3 and 6 months afterwards, and were also compared between the upward and downward flexure groups. There was no statistical difference between the groups before treatment, except in the amount of maximal mouth opening and the extent of disk displacement. The upward flexure group had persistent TMJ pain and tendency of delayed alleviation of masticatory muscle pain compared with the downward flexure group, although maximal opening gradually increased in both groups. Thus, the direction of the flexure in deformation of the disk, which can be observed only with pseudodynamic MR imaging, may predict the prognosis of painful disk displacement without reduction following treatment with a flat occlusal splint.

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Flexure deformation of the temporomandibular joint disk in pseudodynamic magnetic resonance images

Cited by 13 publications

References 24 publications

Biomechanical and biochemical outcomes of porcine temporomandibular joint disc deformation

Biomechanical and biochemical outcomes of porcine temporomandibular joint disc deformation

Comparing proton density and turbo spin echoT₂weighted static sequences with dynamic half-Fourier single-shot TSE pulse sequence at 3.0 T in diagnosis of temporomandibular joint disorders: a prospective study

Flexure deformation in temporomandibular joint disk displacement without reduction may predict treatment outcome

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Flexure deformation of the temporomandibular joint disk in pseudodynamic magnetic resonance images

Cited by 13 publications

References 24 publications

Biomechanical and biochemical outcomes of porcine temporomandibular joint disc deformation

Biomechanical and biochemical outcomes of porcine temporomandibular joint disc deformation

Comparing proton density and turbo spin echoT2weighted static sequences with dynamic half-Fourier single-shot TSE pulse sequence at 3.0 T in diagnosis of temporomandibular joint disorders: a prospective study

Flexure deformation in temporomandibular joint disk displacement without reduction may predict treatment outcome

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Comparing proton density and turbo spin echoT₂weighted static sequences with dynamic half-Fourier single-shot TSE pulse sequence at 3.0 T in diagnosis of temporomandibular joint disorders: a prospective study