CLINICAL AND RADIOLOGICAL PARALLELS IN DIAGNOSIS OF DISEASES AND DYSFUNCTION OF TEMPOROMANDIBULAR JOINT

Abstract

Introduction. Dysfunction of the temporomandibular joint is a rather widespread disorder and occupies a leading place among all other joint disorders.
 Subjects and methods. The study was conducted at the Department of Propaedeutics of Surgical Dentistry. 10 people with clinical signs of temporomandibular joint (TMJ) dysfunction were selected, and subjected to radiological and magnetic resonance imaging in order to clarify the final diagnosis.
 Results and discussion. The main criterion for magnetic resonance imaging diagnostics in dysfunctional TMJ conditions is visualization of the intra-articular cartilage disc.
 When comparing radiograms and magnetic resonance imaging, the main criteria were:
 
 Distortion between research methods;
 The presence of any bone formation and its importance in making a diagnosis. Comparing the series of radiograms and magnetic resonance imagings shows the distortion of the imaging results. In four patients, radiograms showed narrowing of the joint space in the anterior-posterior sections, but this did not occur on magnetic resonance imaging. In this case, patients should feel pain irradiating to the ear. This option is possible due to compression of the bilaminar zone, where the auriculotemporal nerve is located. Characteristic pathological symptoms were determined in one patient out of four that prompts the question about the correctness of determining the joint space on a series of radiograms. In these research methods, the following features were common: 1. The articular head was flattened (4 patients), had a dumbbell-like shape (6 patients). 2. With the mouth open, attention was drawn to the placement of the articular head in relation to the articular tubercle. Subluxation of one of the joints was found 8 patients; joint hypermobility was detected in 2 patients. Magnetic resonance imaging of the TMJ joint in 3 patients showed anatomical instability, namely degenerative changes in the articular discs, and bony growths. Degenerative changes of the meniscus did not occur in the other 7 patients.
 
 Conclusion. Undoubtedly, the best diagnosis when choosing the right method is based on the doctor's experience in correct image interpreting. Radiogram is a relatively cheap method compared to magnetic resonance imaging, but it is far from being exceptionally effective because it does not visualize the connective tissue elements of the joint. Magnetic resonance imaging fully characterizes all bone and soft tissue elements that helps the doctor to clearly determine the final diagnosis based on which the treatment plan will be made up.