Usefulness of cone beam computed tomography in temporomandibular joints with soft tissue pathology

Abstract

Objective: The aim of the study was to evaluate the usefulness of cone beam CT (CBCT) in temporomandibular joints (TMJs) with soft tissue pathology. Methods: 106 TMJs of 55 patients with temporomandibular disorder (TMD) were examined by MRI and CBCT. MR images were used for the evaluation of disc displacement, disc deformity, joint effusion and obscurity of temporal posterior attachment (TPA). CBCT images were evaluated for the presence or absence of osseous abnormalities. The x 2 test was used to analyse the association between MRI and CBCT findings. Results: MRI of 106 TMJs revealed disc displacement, disc deformity, joint effusion and obscurity of the TPA in 68, 73, 28 and 27 joints, respectively. Of the 68 TMJs with disc displacement, anterior disc displacement without reduction (ADDWR) was seen most frequently (47/68). CBCT imaging found 65 TMJs were characterized by the presence of osseous abnormalities and were significantly associated with disc deformity and ADDWR (P , 0.05). There was no statistically significant association between the presence of joint effusion and obscurity of TPA and TMJ osseous abnormalities. Conclusions: TMD patients with confirmed ADDWR or disc deformity on MRI are at risk of having osseous abnormalities in the TMJ and further examination with CBCT is recommended.

Morphological Variations of the Condyle Using Cone Beam Computed Tomography – A Retrospective Study.

“…Diagnosis of the degenerative changes affecting the TMJ can be done more accurately using CBCT which provides images at a lower exposure than CT 2 The results of our study revealed that in coronal section, convex morphology was more commonly observed(49%) followed by round(23%).This was in accordance with the study conducted by Yale et.al(1966) 5 . However, in a study conducted by Subhashini et.al.…”

“…Anatomical knowledge of the temporomandibular joint is one of the foundations for the clinical practice that allows the understanding of pathological alterations, diagnostic evaluation and appropriate choice of therapeutic paths 1 .The temporomandibular joint is a unique joint that can be affected by different kinds of hard and soft tissue abnormalities 2 The bony components of TMJ need a careful study since the changes in these components may imply functional disorders and pain 1 . Temporomandibular joint disorders are a subdivision of musculoskeletal pathologies which act as a source of orofacial pain of non dental origin 3 .These temporomandibular joint disorders are frequently associated with certain degenerative bony changes that include; Flattening, Erosion, Osteophytes etc, all of which involve the bony components of TMJ.…”

Temporomandibular joint diagnostics using CBCT

“…33 This was substantiated in a clinical study comparing CBCT and MRI. 34 From these comparison studies and the accuracy studies in the previous section, it is clear that CBCT and CT are highly comparable regarding evaluation of the cortical bone. Thus, CBCT or CT is the method of choice, depending on the availability, for the assessment of cortical bone details of the TMJ because of the multiplanar reformation capabilities and high spatial resolution.…”

Utilização da tomografia computadorizada para o diagnóstico da articulação temporomandibular

“…The erosion process represents the initial stage of a bone degenerative process, it is possible to observe the density reduction area and the adjacent cortical bone, which leads deformity in the size or shape of the condyle 8,12,15 . It is not uncommon for the patient has multiple changes to the same condyle (flattening , erosion , osteophytes and subchondral cysts) (Figure 4) .…”