Hand-Carried Ultrasonography Instrumentation in the Diagnosis of Temporomandibular Joint Dysfunction.

Marco Severino,Sofia Rastelli,Silvia Caruso,Alessandro Nota,Simona Tecco,Roberto Gatto,Tommaso Cutilli,Laura Pittari

doi:10.3390/mps4040081

Marco Severino, Sofia Rastelli + Show 6 more

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https://doi.org/10.3390/mps4040081

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Abstract

Internal derangement (ID) in the temporomandibular joint (TMJ) is defined as a mechanical problem of the joint that interferes with its function. It is attributed to an abnormal interaction among the articular disc, condyle, and joint eminence. The aim of this study is to evaluate diagnostic efficacy of non-invasive hand-carried ultrasonography instrumentation (US) to provide high-level images for a correct diagnosis of ID. Twenty-eight ID patients, 15 female and 13 males, were examined both clinically and by MRI images in order to achieve a diagnosis of ID (using Helkimo index). Then, they were submitted to US examination with a 12 MHz transducer by using hand-carried instrumentation by a clinician that was blind to their diagnosis and clinical data. TMJ US examination was performed with the mouth closed and mouth open, with proper technique. Each position was then evaluated with two different orientations of the transducer. US showed acceptable results in identifying bone structures. Lower values of diagnostic efficacy were obtained for disc position during joint movements with respect to MRI images. MRI still represents the gold standard for the identification of joint structures. If not corroborated by clinical and anamnestic data, the diagnostic efficacy of US in identifying the position of the disc during opening and closing jaw movements appears limited than compared to MRI.

Highlights

Temporomandibular joint (TMJ) is a synovial articulation between the mandibular condyle and the glenoid fossa in the temporal bone
In the open mouth position, it returns to its normal position while it remains anteriorly displaced in Anterior disc displacement (ADD) without reductions
Low values were recorded for sensitivity in the assessment of disc position (65% of ultrasonography instrumentation (US) respect to 89% of MRI)

Summary

Introduction

Temporomandibular joint (TMJ) is a synovial articulation between the mandibular condyle and the glenoid fossa in the temporal bone. TMJ disorders (TMD) constitute structural and/or functional disorders that affect TMJ, masticatory muscles, and related structures These disorders may present with clinical signs such as articular noises, TMJ pain, and/or limitations in opening and closing the mouth [1]. Among TMDs, internal derangement (ID) is defined as a mechanical problem of the joint, characterized by disc dislocation, that interferes with the function of the joint itself [1,2]. This is attributed to an abnormal interaction of the articular disc, condyle, and joint eminence. The examination should include both closed and open mouth positions [2,3,4]

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