Magnetic Resonance Imaging and Cone Beam CT Image Registration for Osseous and Soft Tissue Abnormalities of Temporomandibular Joint: A Systematic Review (original) (raw)
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Imaging modalities for temporomandibular joint disorders: an update
Medicine and Pharmacy Reports, 2018
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...
Three-Dimensional Assessment of Temporomandibular Joint Using MRI-CBCT Image Registration
PloS one, 2017
To introduce a new approach to reconstruct a 3D model of the TMJ using magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) registered images, and to evaluate the intra-examiner reproducibility values of reconstructing the 3D models of the TMJ. MRI and CBCT images of five patients (10 TMJs) were obtained. Multiple MRIs and CBCT images were registered using a mutual information based algorithm. The articular disc, condylar head and glenoid fossa were segmented at two different occasions, at least one-week apart, by one investigator, and 3D models were reconstructed. Differences between the segmentation at two occasions were automatically measured using the surface contours (Average Perpendicular Distance) and the volume overlap (Dice Similarity Index) of the 3D models. Descriptive analysis of the changes at 2 occasions, including means and standard deviation (SD) were reported to describe the intra-examiner reproducibility. The automatic segmentation of the condy...
Asian Pacific Journal of Health Sciences
Background: Because of the anatomic complexity of the temporomandibular joint (TMJ) clinician cannot arrive at the accurate diagnosis only by clinical evaluation of TMJ hence would require some special imaging methods and techniques which would facilitate the accurate clinical diagnosis. One such imaging method is orthopantomography (OPG) of TMJ. Even though OPG has various limitations, it provides valuable information of TMJ and seems to be the primary choice of imaging modality for the diagnosis of TMJ pathologies. Magnetic Resonance Imaging (MRI) is considered to be the one of the best imaging technology to assess the soft tissue structures surrounding the TMJ and evolved as the best imaging modality for the diagnosis of disc displacement of TMJ. Aim: The aim of the study is to evaluate the clinical findings of the TMJ pathologies and to compare the findings of the OPG and MRI of the TMJ pathologies. Methodology: This is a cross-sectional observational study with comprised of mul...
Usefulness of cone beam computed tomography in temporomandibular joints with soft tissue pathology
Dentomaxillofacial Radiology, 2010
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.
A technique for magnetic resonance imaging of the temporomandibular joint
Clinical Radiology, 1993
Tl-weighted Magnetic Resonance Imaging (MRI) of 72 temporomandibular joints (TMJs) of symptomatic patients and normal subjects was performed after they had been clinically classified. The images were then interpreted by two radiologists, blinded to the clinical classification. The technique of imaging used a head coil for bilateral imaging, allowing a 3position study in under 1 h. Correlation between MRI and clinical classification at the level of normal vs abnormal was achieved in 61/72 joints, giving a sensitivity of 79% and a specificity of 91% for MRI relative to the clinical assessment. True coronal images were of no added value. The addition of supplemental gradient-echo images was helpful in 12/15 joints. Osseous condylar abnormalities were present in 15 joints, all of which had otherwise identifiable disc abnormalities. Diminished condylar translation was a useful indirect sign of non-reducing disc displacement. We conclude that MRI is a very useful and reliable technique in TMJ imaging. The technique described is applicable to any MR unit, without the need for dedicated coils.
Dentomaxillofacial Radiology
The aim of this systematic review was to answer the focus question: "In subjects with degenerative joint disease (DJD) of the temporomandibular joint (TMJ), what is the diagnostic validity of CT or cone-beam CT (CBCT) compared with clinical protocols"? methods: DJD should be assessed through clinical diagnosis according to RDC/TMD or DC/TMD. Search strategies were specifically developed to the following electronic databases: Cochrane, Latin American And Caribbean Health Sciences (LILACS), PubMed (including Medline), Scopus and Web of Science. Furthermore, partial grey literature search through Google Scholar, OpenGrey and ProQuest was performed. The risk of bias was evaluated using the second version of Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). Results: The databases search revealed 454 records. After applying the eligibility criteria, four studies were included in this review. All studies were methodologically acceptable, although none of the them fulfilled all criteria of risk of bias according to QUADAS-2. Despite there were some high values for sensitivity and specificity, they were not homogeneous between studies. Regarding specificity outcomes, there were three studies with poor values and only one considered as excellent. conclusions: CBCT could be a good image to evaluate DJD progression over time, but should not be used as a screening tool in healthy individuals.
Oral Radiology, 2004
Objective. The purpose of this study was to estimate the inter-and intraobserver agreement for interpreting magnetic resonance (MR) images of the temporomandibular joint (TMJ). Methods. The study was based on MR images of 30 TMJs. The images were interpreted by seven observers for disk configuration, disk position, joint fluid, bone marrow changes, and diagnosis. The observers were not calibrated. Kappa statistics were used. Results. The kappa values were, for interobserver agreement of disk configuration, 0.10; for disk position in the sagittal plane with closed mouth, 0.35; for a combination of closed mouth and open mouth, 0.44; for disk position in the coronal plane, 0.17; for joint fluid, 0.36; for bone marrow changes, 0.01; and for diagnosis, 0.39. Intraobserver agreement was generally higher than interobserver agreement. Conclusion. Agreement on disk position in the sagittal plane, on presence and amount of joint fluid, and on diagnosis was fair to moderate. Agreement on disk configuration, on disk position in the coronal plane, and on bone marrow changes was poor.
National Journal of Maxillofacial Surgery, 2012
The complexity of structure and functions of the Temporomandibular Joint (TMJ) make the diagnosis of its diseases/disorders difficult. Remarkable progress made in the field of imaging of this joint led us to compare four imaging modalities viz. plain radiographs, CT scan, MRI and ultrasound. We found that MRI was most specific and sensitive for interpretation of soft tissue and inflammatory conditions in the joint, whereas CT examination produced excellent image for osseous morphology and pathology. Plain X-rays are useful for destructive bony changes and sonography is a good in aid in diagnosing disc derangement and is very economical.
Imaging of the temporomandibular joint: An update
World journal of radiology, 2014
Imaging of the temporomandibular joint (TMJ) is continuously evolving with advancement of imaging technologies. Many different imaging modalities are currently used to evaluate the TMJ. Magnetic resonance imaging is commonly used for evaluation of the TMJ due to its superior contrast resolution and its ability to acquire dynamic imaging for demonstration of the functionality of the joint. Computed tomography and ultrasound imaging have specific indication in imaging of the TMJ. This article focuses on state of the art imaging of the temporomandibular joint. Relevant normal anatomy and biomechanics of movement of the TMJ are discussed for better understanding of many TMJ pathologies. Imaging of internal derangements is discussed in detail. Different arthropathies and common tumors are also discussed in this article.
Oral Radiology, 2017
Cone-beam computed tomography • Articular eminence • Temporomandibular dysfunction • Temporomandibular joint morphology cific clinical parameters and temporomandibular dysfunction (TMD) [4-7]. The widely studied variables include the articular eminence inclination, condyle position, condyle shape, and fossa shape [5, 6, 8, 9]. Many methods have been used to examine the TMJ morphology. Standard two-dimensional projections of the TMJ, taken for example from the transcranial view, are of limited clinical utility. For example, superimposition of overlying structures can limit the ability to visualize pathological changes in the TMJ [10, 11]. Cone-beam computed tomography (CBCT) is often recommended as a dosesparing technique for maxillofacial imaging [12]. Previous reports have suggested that CBCT can provide accurate and Abstract Objective We examined the bone components of the temporomandibular joint (TMJ) in asymptomatic individuals and patients with temporomandibular dysfunction (TMD) using cone-beam computed tomography (CBCT). Methods Two hundred asymptomatic individuals and 200 patients with TMD were included in this study. Condyle position, eminence height, eminence inclination, condyle shape, and fossa shape were assessed on CBCT images of the 800 temporomandibular joints. Results The eminence inclination (P < 0.05), eminence height (P < 0.0001), mediolateral width of condyle (P < 0.0001), and anterior joint space (P < 0.0001) were significantly greater in male subjects compared with female subjects in both the asymptomatic group and TMD group. Comparisons of the asymptomatic group and TMD group revealed significant differences in the anterior joint space (P < 0.0001), ratio of anterior joint space to posterior joint space (P < 0.001), posterior joint space (P < 0.05), eminence inclination (P < 0.05), eminence height (P < 0.05), condyle shape (P < 0.0001), and fossa shape (P < 0.05). Conclusions The present analyses suggest that a steeper articular eminence inclination may be risk factor for TMD. The presence of TMD was associated with the condyle position in the TMJ.