Temporomandibular Joint Soft-Tissue Pathology, I: Disc Abnormalities

Objectives: The aim of the study was to establish the changes in posteroanterior cephalometric variables in subjects with temporomandibular joint disorders (TMDs). Methods: Posteroanterior cephalograms of 61 subjects (age range 16-36.6 years, standard deviation 4.88 years) were used to determine cephalometric differences. Subjects were classified according to the Research Diagnostic Criteria for Temporomandibular Joint Disorders into three groups: unilateral TMD, bilateral TMD and no TMD. 14 linear and angular measurements were assessed on the posteroanterior cephalogram. For assessing facial asymmetry, the asymmetry index for bilateral measurements was calculated between the right and the left side. In cases with unilateral TMD, the asymmetry index was calculated using the difference between the unaffected and affected side. The differences among multiple groups were analysed using the one-way analysis of variance test and Scheffé post hoc test. Results: 47 subjects were females (77%) and 14 were males (23%). 19 subjects had unilateral TMDs and 16 subjects had bilateral TMDs. The asymmetry index of the distance from the horizontal plane to the antegonion was higher in subjects with unilateral TMD than in patients with bilateral or no TMD (p , 0.05). Also, the asymmetry index of the distances from the vertical plane to the condyle (p 5 0.05), gonion (Go) (p 5 0.0004), antegonion (p 5 0.002) and chin (Ch) (p 5 0.02) was higher in subjects with unilateral TMDs. The asymmetry index of the O point-Go-Go9 and O point-Ch-Ch9 angles differed significantly in subjects with unilateral TMDs (p , 0.05). Conclusions: Unilateral TMDs are associated with changes in posteroanterior cephalometric measurements. The assessment of posteroanterior cephalometric variables could be used as a key factor for evaluating the presence of TMDs.

Section: Discussionmentioning

confidence: 99%

Posteroanterior cephalometric changes in subjects with temporomandibular joint disorders

Almășan

Băciuţ²,

Hedeșiu³

et al. 2013

“…It is divided into three parts: the anterior band, posterior band and intermediate zone. 1,3 In a healthy joint, the disc is perfectly placed between the articular surfaces throughout the mandibular movement. 1,6 When the disc is normally positioned, the intermediate zone lies interposed between the condyle and the articular eminence, and the posterior band above the head of the mandible.…”

Section: Introductionmentioning

confidence: 99%

“…Changes in disc morphology are a characteristic factor of internal TMJ derangement. 1,3 The prevalence of discs with normal morphology in our sample may indicate that this is a sample in the early stages of internal derangement. The results showed an association between disc displacement and changes in the morphology of the articular disc, in agreement with the literature.…”

mentioning

confidence: 99%

Correlation between temporomandibular joint morphology and disc displacement by MRI

Farias¹,

Melo²,

Bento³

et al. 2015

Objectives:The aim was to evaluate the morphology of the temporomandibular joint's (TMJs) disc and condyle as well as its correlation with disc displacement, using MRI. Methods: 190 TMJs were retrospectively analysed. The condyle morphology of each TMJ was evaluated by two observers using both axial and coronal views, as were their disc morphology and displacement, using sagittal view. Condyle morphology was classified as flat, convex, angled or rounded in the coronal sections and as anterior side flat/posterior side convex, biconvex, anterior side concave/posterior side convex, flat or biconcave in the axial view. Disc morphology was determined as biconcave, biplanar, biconvex, hemiconvex or folded. x 2 , Fisher exact and Bonferroni correction tests were used to evaluate the data. ANOVA followed by post hoc Tukey's test was used to evaluate the interaction between age and disc displacement. Results: Anterior disc displacement with reduction; convex condyle morphology in the coronal view; anterior side concave/posterior side convex morphology in the axial view; and biconcave discs were found to be the most prevalent findings. An association was observed between disc morphology and disc displacement (p , 0.001). No correlation between condyle morphology and TMJ disc displacement was found (p 5 0.291 for axial and p 5 0.14 for coronal views). Conclusions:The results of this study suggest that TMJ disc morphology is associated with disc displacement.

“…Multidirectional TMJ disc displacements are equally as frequent as unidirectional ones. 9,17 The method of assessment of TMJ disc position in the sagittal and coronal planes of MRI, presented by Larheim, 9 Molinari et al 21 and Ikeda et al, 20 and used in our study, seems to be most accurate in determining disc position in the TMJ. Consequently, a detailed analysis of both sagittal and coronal MR images is necessary to determine the position of the disc.…”

Section: Discussionmentioning

confidence: 95%

Correlation between the lateral pterygoid muscle attachment type and temporomandibular joint disc position in magnetic resonance imaging

Litko¹,

Szkutnik²,

Berger³

et al. 2016

Objectives: The aim of this study was to investigate the correlation between the lateral pterygoid muscle (LPM) attachment type and temporomandibular joint (TMJ) disc position on sagittal and coronal MR scans. Methods: 191 patients (148 females, 43 males), aged 14-60 years, underwent MR investigations of the TMJs in the intercuspal position (IP) and open-mouth position (OMP). The disc position was evaluated on oblique sagittal and coronal images in the IP and OMP on many MRI sections showing all portions of the joint. Relationships between the LPM attachment patterns and articular disc positions were evaluated by z and x 2 tests. Results: Three types of the LPM attachment were found. There was a statistically significant correlation between the LPM attachment type and the disc position in IP (x 2 5 24.29; p , 0.01). The type of muscle attachment did not determine the prevalence of normal, lateral and medial disc positions. There were differences between the muscle attachment types in the anterior, anteromedial and anterolateral disc positions. There was a statistically significant association between TMJ disc position in OMP and particular attachment types in the sagittal plane (x 2 5 9.702; p , 0.01). Conclusions: Certain types of the LPM insertion are correlated with TMJ disc position.