Evaluation of temporomandibular joint spaces and condylar position: A CBCT study (original) (raw)
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Evaluation of condylar position from temporomandibular joint radiographs
The Journal of Prosthetic Dentistry, 1985
T he position of the mandibular condyles in the glenoid fossae is an important factor in treatment planning for temporomandibular joint (TM J) disorders, myofascial pain-dysfunction, and occlusal rehabilitation. However, the interpretation of condylar position from radiographs and the usefulness of such radiographic information relative to various treatment procedures are still controversial."9 Several investigatorsi0-'2 have indicated that the wide range of normal anatomic variation makes it impossible to predict the precise location of the condyle or to measure the actual distances between points on the condyle and fossa. On the other hand, WeinbergI reported that condylar asymmetry does not affect the superior portion of the joint, and he concluded that condylar position can be determined if radiographic measurements are limited to this region. Other investigator.?' reported that TM J radiogiaphs can only record the relative position of joint structures and that no attempt should be made to obtain direct measurements of the joint space.
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...
Indian Journal of Radiology and Imaging
Background The temporomandibular joint (TMJ) is included in the category of ginglymoarthrodial synovial joints. The mandibular condyle plays a vital part in the development of the craniofacial complex. Hence, the evaluation and assessment of the condylar volume and its morphology are of utmost importance. Aim The aim of this research was to use cone beam computed tomography (CBCT) imaging modality to evaluate the morphology of the mandibular condyle and glenoid fossa in a selected population and document any morphometric changes. Setting and Design It is an observational study. Materials and Methods A retrospective CBCT analysis was performed on 119 patients. The length, width, height, linear measurements of the joint spaces (anterior, posterior, and superior), volume of the condyle, and roof of glenoid fossa thickness were evaluated on both the left and right sides in both males and females. Results The height, width, and length of mandibular condyle were significantly increased in...
Journal of Oral and Maxillofacial Surgery, 2012
The aim of our study was to analyze magnetic resonance imaging criteria in assessment of TMJ disorders and evaluate the important MRI role in comparison with arthroscopy. Patients and methods: The study was performed on eighty TMJs. TMJs are examined by 1.5 tesla MRI machine using sagittal oblique T1, PD & T2 weighted images & coronal oblique T1 and PD weighted images. The disk position, configuration, presence or absence of joint effusion, osteo-arthritis and mandibular condyle morphology were assessed. Comparison was done with arthroscopy in 49 joints. Results: Disk displacement was found in all cases symptomatic 80 joints, 60% bilateral and 40% unilateral. Joint pain and tenderness were the most clinical symptom followed by joint noise/ clicking. Thirty-five joints showed anterior disk displacement with reduction, while forty-five joints showed anterior disk displacement without reduction and one of them shows stuck disk in displaced position. MRI has sensitivity of 95, specificity of 88 and accuracy of 94 in comparison with arthroscopy. Conclusion: MRI is proper diagnostic modality for TMJ disorders due to non invasiveness, excellent soft tissue contrast and multiplaner capabilities.
Imaging Science in Dentistry, 2016
Purpose: This study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT). Materials and Methods: In the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined. results: The mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group. conclusion: The average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients.
Folia Morphologica, 2015
Background: To examine the detailed anatomy of the normal temporomandibular joint in a large series of patients divided into different age groups. Methods: Cone-beam computed tomography (CBCT) images of 100 patients included the study. Morphometric analysis regarding mandibular condyle and mandibular fossa, articular tubercle and the zygomatic arch was done. The volumetric and surface measurements of mandibular condyles (total tissue volume (TV), total bone volume (BV), bone surface area (BS) and percentage of bony tissue of the mandibular condyle (BV/TV)) were also measured. Results: Statistical analysis was performed, and statistically significant differences according to the side of the joint, sex, and age groups were reported. Additionally, correlations between aging and all of these parameters were also determined. Conclusions: TV, BV, BS and BV/TV parameters according to side, age, and sex groups were 2 defined for normal TMJ which may help to understand the onset and progress of TMJ disorders.
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...
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.
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.
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.