How Should the Articular Disk Position Be Analyzed?

Provenzano, Marcia de Mello; Chilvarquer, Israel; Fenyo-Pereira, Marlene

doi:10.1016/j.joms.2011.08.004

Cited by 16 publications

(5 citation statements)

References 21 publications

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“…However, the accuracy of determining disc position and morphology is challenging and has been the subject of many studies. 11,12,[25][26][27] Proper classification of the disc position improves the diagnostic interpretation of the imaging modality and allows comprehensive use of the provided information. This study used standardized classification of the disc position to improve the consistency of the examiners' disc evaluation.…”

Section: Discussionmentioning

confidence: 99%

Assessing the reliability of MRI-CBCT image registration to visualize temporomandibular joints

Al-Saleh

Jaremko

Alsufyani

et al. 2015

Dentomaxillofacial Radiology

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Objectives: To evaluate image quality of two methods of registering MRI and CBCT images of the temporomandibular joint (TMJ), particularly regarding TMJ articular disc-condyle relationship and osseous abnormality. Methods: MR and CBCT images for 10 patients (20 TMJs) were obtained and co-registered using two methods (non-guided and marker guided) using Mirada XD software (Mirada Medical Ltd, Oxford, UK). Three radiologists independently and blindly evaluated three types of images (MRI, CBCT and registered MRI-CBCT) at two times (T 1 and T 2 ) on two criteria: (1) quality of MRI-CBCT registrations (excellent, fair or poor) and (2) TMJ disc-condylar position and articular osseous abnormalities (osteophytes, erosions and subcortical cyst, surface flattening, sclerosis). Results: 75% of the non-guided registered images showed excellent quality, and 95% of the marker-guided registered images showed poor quality. Significant difference was found between the non-guided and marker-guided registration (x 2 5 108.5; p , 0.01). The interexaminer variability of the disc position in MRI [intraclass correlation coefficient (ICC) 5 0.50 at T 1 , 0.56 at T 2 ] was lower than that in MRI-CBCT registered images [ICC 5 0.80 (0.52-0.92) at T 1 , 0.84 (0.62-0.93) at T 2 ]. Erosions and subcortical cysts were noticed less frequently in the MRI-CBCT images than in CBCT images. Conclusions: Non-guided registration proved superior to marker-guided registration. Although MRI-CBCT fused images were slightly more limited than CBCT alone to detect osseous abnormalities, use of the fused images improved the consistency among examiners in detecting disc position in relation to the condyle.

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Section: Discussionmentioning

confidence: 99%

Assessing the reliability of MRI-CBCT image registration to visualize temporomandibular joints

Al-Saleh

Jaremko

Alsufyani

et al. 2015

Dentomaxillofacial Radiology

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“…To date, the interpretation of MRI is essential for determining the disc position, amount of joint effusion, and bone abnormalities [27]. To ensure accurate diagnosis of TMJ disorders, the combination of MRI findings with clinical examination is critical [28]. The MITEK technique cannot be applied to all types of displaced TMJ discs.…”

Section: Discussionmentioning

confidence: 99%

Temporomandibular joint disc plication with MITEK mini anchors: surgical outcome of 65 consecutive joint cases using a minimally invasive approach

Lee

Hong

2020

Maxillofac Plast Reconstr Surg

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Background The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

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“…[10] Mehra and Wolford evaluated patient satisfaction and outcomes of the Mitek mini anchors for TMJ disc repositioning and found statistically significant reduction in TMJ pain, facial pain, headaches, TMJ noises and disability, and improvement in jaw function and diet. [6] Valero et al , showed long-term results with the use of Mitek mini anchors for surgical treatment of internal derangements.…”

Section: Discussionmentioning

confidence: 99%

“…This method analyzes the location of the intermediate zone of the disk in relation to the mandibular head and the articular tubercle [Figure 1]. [10] OPTGs were obtained at the 1 st post-op week, 6 th month and 12 th month. The post-op OPTGs were superimposed for assessment of positional changes due to resorption and anchor stability [Figure 2].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of temporomandibular joint disc-repositioning surgery with Mitek mini anchors

Göçmen¹,

Varol

Karatas

et al. 2013

Natl J Maxillofac Surg

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Purpose:The aim of this study is to evaluate outcome of Mitek mini anchors (DePuy Mitek, Raynham, MA) in TMJ discopexy and assess patient satisfaction based on MRI findings.Patients and Methods:7 patients suffered from significant pain and dysfunction diagnosed on MRI findings as anterior disc displacement without reduction selected for this study. Anchor stability, assessment of positional changes and roofing were evaluated by postop MRI and OPTGs. Satisfaction was assessed with VAS. Preop and postop maximum interincisal opening measurements were compared.Results:There was significant difference between preop and posto P values of MIO and VAS. All 7 patients noted complete absence of pain at the postop 1-year follow-up. Only 1 patient had postop clicking but showed remarkable improvement of jaw functions (MIO). The articular disk was observed at its normal position in 6 patients except one patient whom MRI confirmed postop partial roofing. OPTGs reveal neither radiologic changes around the mini anchors in the condylar head nor any positional shifts.Conclusion:Disc repositioning with Mitek mini anchors represent improvement in post-op VAS scores and clinical findings (MIO) based on comparison preop and postop MRI scans and panoramic films. However, our study group consists of limited number of patients, further studies with more number of cases are required to evaluate the outcomes

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How Should the Articular Disk Position Be Analyzed?

Cited by 16 publications

References 21 publications

Assessing the reliability of MRI-CBCT image registration to visualize temporomandibular joints

Assessing the reliability of MRI-CBCT image registration to visualize temporomandibular joints

Temporomandibular joint disc plication with MITEK mini anchors: surgical outcome of 65 consecutive joint cases using a minimally invasive approach

Evaluation of temporomandibular joint disc-repositioning surgery with Mitek mini anchors

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