Detectability of anterior displacement of the articular disk in the temporomandibular joint on helical computed tomographyThe value of open mouth position

Abstract

Objective. The purpose of this study was to establish the diagnostic reliability of anterior displacement of the articular disk in the temporomandibular joint on helical computed tomography. Study design. Ninety-four consecutive patients were examined through use of both computed tomography and magnetic resonance imaging. On axial computed tomography, anterior disk displacement was defined as the presence of an area of soft tissue density that was semilunar in shape and located in front of the mandibular condyle. Results. With magnetic resonance imaging taken as the diagnostic gold standard in evaluation of articular disk position, the sensitivity, specificity, and accuracy for computed tomography were 91%, 100%, and 97%, respectively, in the closed mouth position and 96%, 99%, and 98%, respectively, in the open mouth position. Conclusions. The detectability on axial helical computed tomography of anterior displacement of the articular disk in the temporomandibular joint in the open mouth position was almost equal to that on magnetic resonance imaging. It is recommended that the open mouth position be added when helical computed tomography is used to evaluate patients with temporomandibular joint disease. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88: 106-11)