Impact of TMJ radiographs on clinician decision making

White, Stuart C.; Pullinger, Andrew G.

doi:10.1016/s1079-2104(05)80232-x

Cited by 25 publications

(8 citation statements)

References 5 publications

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“…The primary assessment tool is often the clinical examination . But it is usually considered insufficient and unreliable for diagnosing the condition of the temporomandibular joint (TMJ), particularly if the clinical examination or patient history indicates a recent or progressive pathologic joint condition . Thus, after a thorough history and clinical examination, current recommendations are supplementary radiographic imaging when imaging can be suspected to have a substantial impact on the clinician's diagnosis and treatment approach …”

Section: Introductionmentioning

confidence: 99%

Assessment of a training programme on detection of temporomandibular joint osseous changes applying pre‐defined 2D multiplane cone beam computed tomography reconstructions

Iskanderani

Alstergren

Hellén‐Halme

2018

J of Oral Rehabilitation

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Section: Introductionmentioning

confidence: 99%

Assessment of a training programme on detection of temporomandibular joint osseous changes applying pre‐defined 2D multiplane cone beam computed tomography reconstructions

Iskanderani

Alstergren

Hellén‐Halme

2018

J of Oral Rehabilitation

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“…From all publications selected ( n = 257) for full‐text reading, only 47 used diagnostic criteria to establish the clinical diagnoses of the patient samples (16, 18, 42–44, 59, 63, 66, 67, 71, 78, 79, 81–83, 88, 89, 91, 93, 98–124). Of these 47 studies, 17 (18, 79, 81–83, 88, 89, 91, 98–104) used RDC/TMD (2), 11 (42, 59, 66, 105–111, 124) listed the criteria but did not refer to any validated criteria or TMD study, 14 (16, 43, 44, 63, 71, 93, 111–118) used criteria from other published TMD studies, and six (67, 68, 119–122) used the Helkimo Index (125). Among the efficacy studies (Table 4), 17 used diagnostic criteria (18, 42–44, 59, 63, 66–68, 71, 79, 81–83, 88, 89, 91), eight (18, 79, 81–83, 88, 89, 91) RDC/TMD (2), three (42, 59, 66) listed the criteria in the publication but did not refer to any validated criteria or TMD published study, four (43, 44, 63, 71) used criteria from previously published TMD studies, and two (67, 68) used the Helkimo Index (125).…”

Section: Resultsmentioning

confidence: 99%

“…From the 256 excluded publications, two reported therapeutic efficacy from other imaging methods on TMJD (124, 127). Epstein et al.…”

Section: Discussionmentioning

confidence: 99%

“…White et al. (124) examined the influence of lateral and frontal TMJ tomograms on the initial diagnosis and treatment plans of patients with facial or preauricular pain or TMJD – derangement, osteoarthritis, or myalgia. The authors found that TMJ tomograms changed or modified the diagnosis in 65% of the judgments and influenced treatment recommendations in 40%.…”

Section: Discussionmentioning

confidence: 99%

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Do computed tomography and magnetic resonance imaging add to temporomandibular joint disorder treatment? A systematic review of diagnostic efficacy

Ribeiro-Rotta

Marques

Pacheco

et al. 2010

J of Oral Rehabilitation

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A question frequently asked in the clinical practice of the professional who treats temporomandibular joint disorders (TMJD) is 'To make the cost/benefit ratio worthwhile for the patient, when should I request a temporomandibular joint (TMJ) computed tomography (CT) or magnetic resonance imaging (MRI)?' To evaluate the evidence of the efficacy of CT and MRI in the diagnosis of disc displacement, local inflammatory disorders, and arthrosis of the TMJ at therapeutic efficacy level, PubMed and Cochrane literature searches with specific indexing terms and a hand search were made. From the retrieved titles and abstracts, three examiners selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a previously established protocol. Publications considered relevant were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool and publications that critically evaluate systematic reviews. The literature search yielded 584 titles and abstracts, of which 257 were selected and read in full text. One study was judged relevant. This study evaluated evidence of the efficacy of MRI in the diagnosis of disc position and configuration, disc perforation, joint effusion, and osseous and bone marrow changes in the temporomandibular joint, but no publication reported diagnostic thinking efficacy or therapeutic efficacy. In conclusion, the absence of studies on the therapeutic efficacy of MRI and CT on TMJD reinforces the need for investment in decision-making studies; meanwhile, sectional imaging tests should be prescribed with caution, especially when health budgets are limited.

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“…Some studies found that conventional tomography seemed to have a minor impact on management of TMD patients (41, 42), but the radiological findings could not predict treatment outcome (43). Another study, however, indicated that tomography may play a valuable role in influencing clinician’s diagnosis and treatment plan of patients with TMJ disorders (44). No studies using CT or CBCT have been performed, but results from these techniques would probably not differ from those for tomography.…”

Section: Therapeutic Efficacy and Patient Outcome Efficacymentioning

confidence: 99%

What you can and cannot see in TMJ imaging - an overview related to the RDC/TMD diagnostic system

Petersson

2010

Journal of Oral Rehabilitation

143

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In the current version (I) of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), imaging of the temporomandibular joint (TMJ) is not required for a diagnosis. Research has shown that radiological findings of the TMJ do not always support the clinical findings of the RDC/TMD diagnosis. But imaging should only be performed when it is known that it could contribute to (i) a proper diagnosis and (ii) treatment with a better prognosis. Several techniques are used to image the TMJ: panoramic radiography, plain radiography, conventional and computed tomography (CT), digital volume tomography or cone-beam computed tomography (CBCT), arthrography and magnetic resonance imaging (MRI). Osseous changes are best visualized in tomography, and the newly developed CBCT is a promising method but must be evaluated in a comparative analysis with other tomographic techniques. And although MRI is the method of choice for imaging the disc, a systematic review found the evidence grade for the diagnostic efficacy of MRI to be insufficient. Today, there is no clear evidence for when TMD patients should be examined with imaging methods. Future research designs should be randomized controlled trials where various radiological examination findings are analysed in relation to therapeutic outcome. In future versions of the RDC/TMD diagnostic system, recommended radiographic techniques must be evaluated and defined, diagnostic criteria well defined and observers calibrated.

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Impact of TMJ radiographs on clinician decision making

Cited by 25 publications

References 5 publications

Assessment of a training programme on detection of temporomandibular joint osseous changes applying pre‐defined 2D multiplane cone beam computed tomography reconstructions

Assessment of a training programme on detection of temporomandibular joint osseous changes applying pre‐defined 2D multiplane cone beam computed tomography reconstructions

Do computed tomography and magnetic resonance imaging add to temporomandibular joint disorder treatment? A systematic review of diagnostic efficacy

What you can and cannot see in TMJ imaging - an overview related to the RDC/TMD diagnostic system

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