Imaging of the temporomandibular joint

Brooks, Sharon L.; Brand, John W.; Gibbs, S. Julian; Hollender, L; Lurie, Alan G.; Omnell, Karl‐Åke; Westesson, Per‐Lennart; White, Stuart C.

doi:10.1016/s1079-2104(97)90128-1

Cited by 229 publications

(48 citation statements)

References 67 publications

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“…Detection and evaluation of these bony changes are fundamental for successful diagnosis of DJD [6]. The condition of TMJ can be evaluated by a variety of imaging modalities [7–9]. Cone-beam computed tomography (CBCT) is a fairly new imaging modality that can produce images of high diagnostic quality with a lower radiation dose than medical computed tomography [10–12].…”

Section: Introductionmentioning

confidence: 99%

Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints

Bae

Park

Han

et al. 2017

Maxillofac Plast Reconstr Surg

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BackgroundThe aim of this study was to assess correlation between pain and degenerative bony changes on cone-beam computed tomography (CBCT) images of temporomandibular joints (TMJs).MethodsTwo hundred eighty-three temporomandibular joints with degenerative bony changes were evaluated. Pain intensity (numeric rating scale, NRS) and pain duration in patients with degenerative joint disease (DJD) were also analyzed. We classified condylar bony changes on CBCT into five types: osteophyte (Osp), erosion (Ero), flattening (Fla), subchondral sclerosis (Scl), and pseudocyst (Pse).ResultsDegenerative bony changes were the most frequent in the age groups of 10~19, 20–29, and 50~59 years. The most frequent pain intensity was “none” (NRS 0, 34.6%) followed by “annoying” (NRS 3–5, 29.7%). The most frequent condylar bony change was Fla (219 joints, 77.4%) followed by Ero (169 joints, 59.7%). “Ero + Fla” was the most common combination of the bony changes (12.7%). The frequency of erosion was directly proportional to NRS, but the frequency of osteophyte was inversely proportional. The prevalence of Ero increased from onset until 2 years and gradually decreased thereafter. The prevalence of Osp, Ero, and Pse increased with age.ConclusionsOsp and Ero can be pain-related variables in degenerative joint disease (DJD) patients. “Six months to 2 years” may be a meaningful time point from the active, unstable phase to the stabilized late phase of DJD.

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Section: Introductionmentioning

confidence: 99%

Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints

Bae

Park

Han

et al. 2017

Maxillofac Plast Reconstr Surg

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“…The decision to image is determined by practitioner preference and/or on a case-by-case basis, as no set guidelines for imaging exist. The American Academy of Oral and Maxillofacial Radiology suggests evaluating the entire clinical picture and determining whether imaging would assist with diagnosis given the risks of radiation exposure and cost [10, 11]. The general practice in the ED is to first start with plain film X-rays.…”

Section: Discussionmentioning

confidence: 99%

“…The general practice in the ED is to first start with plain film X-rays. The most important views are panoramic, transpharyngeal, transcranial, and submental-vertex views with recommendations for transcranial views [11, 12]. …”

Section: Discussionmentioning

confidence: 99%

A Missed Case of Occult Bilateral Temporomandibular Dislocation Mistaken for Dystonia

Lee

Shoenberger

Wagner

2015

Case Reports in Emergency Medicine

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A 24-year-old male with a history of psychiatric disorder and no prior significant temporomandibular joint (TMJ) pathology presented to the emergency department for “lockjaw.” Plain film X-rays of the mandible were read as unremarkable by an attending radiologist, leading to the initial diagnosis of medication-induced dystonic reaction. Following unsuccessful medical treatment a maxillofacial computed tomography (CT) was ordered. CT confirmed bilateral dislocation, illustrating the importance of clinical judgment, and limitations of certain radiographic images. The authors believe this case to be the first reported case in the medical literature of bilateral anterior TMJ dislocation with a false negative X-ray.

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“…Moreover, the anatomic relations of the TMJ bony structures are not seen properly on panoramic images. However, these images are considered suitable for an initial diagnosis 68…”

Section: Introductionmentioning

confidence: 99%

“…Since it involves lower doses of radiation, however, CBCT is preferred over CT, and it is now the modality of choice for evaluating osseous structures of the TMJ 112. Yet, these techniques expose patients to more radiation than panoramic radiography 8. On the contrary, DSR acquisition requires only 2 panoramic radiography exposures, which leads to considerably lower doses of radiation.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint

Kocasaraç

Çelenk

2017

Imaging Sci Dent

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PurposeErosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ.Materials and MethodsFive intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods.ResultsThe area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes.ConclusionThe accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (P<.05). DSR improved the accuracy of detection using panoramic images.

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Imaging of the temporomandibular joint

Cited by 229 publications

References 67 publications

Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints

Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints

A Missed Case of Occult Bilateral Temporomandibular Dislocation Mistaken for Dystonia

Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint

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