Cone Beam Computed Tomographic Findings in Temporomandibular Joint Disorders

AbstractTemporomandibular joint (TMJ) disorders are commonly encountered in the general population but often ignored or unrecognized. The detection and characterization of lesions has drastically improved over the years due to technological advances in cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). However, adequate knowledge of the normal imaging appearance on different imaging modalities as well as the broad variety of pathology is required to provide a proper radiologic assessment. This pictorial review focuses on TMJ pathology and its appearance on CBCT and MRI. A short overview of the technical aspects and normal anatomy are provided to round out this complete summary on the subject.

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Evaluation of temporomandibular joint disorders using cone beam computed tomography

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20172117 ◽

2017 ◽

Vol 3 (4) ◽

pp. 698

Author(s):

Sonam Kohli ◽

Rahul Krishan Sharma ◽

Anchal Goel ◽

M. K. Sunil

Keyword(s):

Computed Tomography ◽

Temporomandibular Joint ◽

Cone Beam Computed Tomography ◽

Joint Space ◽

Temporomandibular Joint Disorders ◽

Cone Beam ◽

Glenoid Fossa ◽

Significant Difference ◽

Mandibular Fossa ◽

Osseous Changes

Background: The aim of this study was to evaluate efficacy of segmental cone beam computed tomography (CBCT) in detecting bony changes in condyle and thickness of roof of glenoid fossa in temporomandibular joint (TMJ) disorders.Methods: The study group comprised of 10 temporomandibular disorders (TMD) patients of either sex between the age group of 20-60 years diagnosed as TMDs by clinical evaluation using the research diagnostic criteria was considered. After the clinical examination, radiographic investigations were carried out which included digital OPG, transcranial radiograph and CBCT scan. TMJ Evaluation included: (a) bony changes of the condyle (flattening, erosion, sclerosis, osteophytes, resorption); (b) joint space (normal, increased, reduced, bony contact between the condyle and the mandibular fossa); and (c) bony changes of mandibular fossa (normal, sclerosis, erosion, resorption). The radiographic findings were statistically analysed.Results: Significant difference between OPG, transcranial and CBCT were found for the presence of erosion (P =0.000), thickness of roof of glenoid fossa (P =0.000), deformed contour (P =0.001), joint space (P =0.011), subchondral sclerosis (P =0.011), irregularity of articular surface and eminence (P =0.000), flattening (P =0.050). Conclusions: Using CBCT as imaging technique in our study to detect osseous changes in the TMJ was proved to be effective as compared to the conventional radiographic techniques, the results achieved with CBCT was 100%.The results obtained in our study prove to be a full proof one and it seems to promise to go one step closer to detect progression and severity of the osseous changes in the condylar head and mandibular fossa in patients with TMDs.

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Imaging modalities for temporomandibular joint disorders: an update

Medicine and Pharmacy Reports ◽

10.15386/cjmed-970 ◽

2018 ◽

Vol 91 (3) ◽

pp. 280-287 ◽

Cited By ~ 4

Author(s):

Daniel Talmaceanu ◽

Lavinia Manuela Lenghel ◽

Nicolae Bolog ◽

Mihaela Hedesiu ◽

Smaranda Buduru ◽

...

Keyword(s):

High Resolution ◽

Temporomandibular Joint ◽

Imaging Technique ◽

Imaging Techniques ◽

Cone Beam Ct ◽

Conventional Radiography ◽

Temporomandibular Joint Disorders ◽

Joint Effusion ◽

Cone Beam ◽

High Resolution Ultrasonography

The diagnosis and management of temporomandibular disorders (TMD) require both clinical and imaging examinations of the temporomandibular joint (TMJ). A variety of modalities can be used to image the TMJ, including magnetic resonance imaging (MRI), computed tomography (CT), cone beam CT, ultrasonography, conventional radiography. The present review outlines the indications of the most frequently used imaging techniques in TMD diagnosis.Because of the anatomic complexity of the TMJ, imaging can be difficult. Choosing the proper imaging technique is essential. Conventional radiography, nowadays, is of limited interest. The use of flat plane films for TMJ pathology is not sufficient, because this joint requires three dimensional imaging views. Osseous changes are better visualized with CT and cone beam CT. Cone beam CT provides high-resolution multiplanar reconstruction of the TMJ, with a low radiation dose, without superimposition of the bony structures. MRI is a noninvasive technique, considered to be the gold standard in imaging the soft tissue components of the TMJ. MRI is used to evaluate the articular disc in terms of location and morphology. Moreover, the early signs of TMD and the presence of joint effusion can be determined. High-resolution ultrasonography is a noninvasive, dynamic, inexpensive imaging technique, which can be useful in diagnosing TMJ disc displacements. The diagnostic value of high-resolution ultrasonography is strictly dependent on the examiner’s skills and on the equipment used.

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