Magnetic Resonance Imaging Of Temporomandibular Joint Research Articles

Detunable wireless resonator arrays for TMJ MRI: A comparative study

Temporomandibular Joint Magnetic Resonance Imaging (TMJ MRI) is crucial for diagnosing temporomandibular disorders (TMDs). This study advances the use of inductively coupled wireless coils to enhance imaging quality in TMJ MRI. After investigating multiple wireless resonator configurations, including a 1-loop design with a loop diameter of 9 cm, a 2-loop design with each loop having a diameter of 7 cm, and a 3-loop design with each loop having a diameter of 5 cm, our findings indicate that the 3-loop configuration achieves the optimal signal-to-noise ratio (SNR), surpassing other wireless arrays. Bilateral deployment of wireless coils further amplifies SNR, enabling superior visualization of TMJ structures, particularly with the 3-loop design. This cost-effective and comfortable solution, featuring a detunable design, eliminates the need for system parameter adjustments. The study indicates broad adaptability across MRI platforms, enhancing TMJ imaging for routine clinical diagnostics of TMDs.

A Three-branch Jointed Feature and Topology Decoder guided by game-theoretic interactions for temporomandibular joint segmentation

Segmentation of the temporomandibular joint (TMJ) disc and condyle from magnetic resonance imaging (MRI) is a crucial task in TMJ internal derangement research. The automatic segmentation of the disc structure presents challenges due to its intricate and variable shapes, low contrast, and unclear boundaries. Existing TMJ segmentation methods often overlook spatial and channel information in features and neglect overall topological considerations, with few studies exploring the interaction between segmentation and topology preservation. To address these challenges, we propose a Three-Branch Jointed Feature and Topology Decoder (TFTD) for the segmentation of TMJ disc and condyle in MRI. This structure effectively preserves the topological information of the disc structure and enhances features. We introduce a cross-dimensional spatial and channel attention mechanism (SCIA) to enhance features. This mechanism captures spatial, channel, and cross-dimensional information of the decoded features, leading to improved segmentation performance. Moreover, we explore the interaction between topology preservation and segmentation from the perspective of game theory. Based on this interaction, we design the Joint Loss Function (JLF) to fully leverage the features of segmentation, topology preservation, and joint interaction branches. Results on the TMJ MRI dataset demonstrate the superior performance of our TFTD compared to existing methods.

Metabolic profiling of synovial fluid in human temporomandibular joint osteoarthritis.

Temporomandibular joint (TMJ) osteoarthritis (OA) is a common TMJ degenerative disease with an unclear mechanism. Synovial fluid (SF), an important component of TMJ, contains various proteins and metabolites that may directly contribute to OA. The present study aimed to investigate the influence of SF in TMJOA at the metabolite level. Untargeted and widely targeted metabolic profiling were employed to identify metabolic changes in SF of 90 patients with different TMJOA grades according to TMJ magnetic resonance imaging. A total 1498 metabolites were detected. Most of the metabolites were amino acids and associated metabolites, benzene and substituted derivatives, and lipids. Among patients with mild, moderate and severe TMJOA, 164 gradually increasing and 176 gradually decreasing metabolites were identified, indicating that biosynthesis of cofactors, choline metabolism, mineral absorption and selenocompound metabolism are closely related to TMJOA grade. Combined metabolomics and clinical examination revealed 37 upregulated metabolites and 16 downregulated metabolites in patients with pain, of which 19 and 26 metabolites were positively and negatively correlated, respectively, with maximum interincisal opening. A model was constructed to diagnose TMJOA grade and nine biomarkers were identified. The identified metabolites are key to exploring the mechanism of TMJOA. In the present study, a metabolic profile was constructed and assessed using a much larger number of human SF samples from patients with TMJOA, and a model was established to contribute to the diagnosis of TMJOA grade. The findings expand our knowledge of metabolites in human SF of TMJOA patients, and provide an important basis for further research on the pathogenesis and treatment of TMJOA.

Detecting anteriorly displaced temporomandibular joint discs using super-resolution magnetic resonance imaging: a multi-center study.

Background: Magnetic resonance imaging (MRI) plays a crucial role in diagnosing anterior disc displacement (ADD) of the temporomandibular joint (TMJ). The primary objective of this study is to enhance diagnostic accuracy in two common disease subtypes of ADD of the TMJ on MRI, namely, ADD with reduction (ADDWR) and ADD without reduction (ADDWoR). To achieve this, we propose the development of transfer learning (TL) based on Convolutional Neural Network (CNN) models, which will aid in accurately identifying and distinguishing these subtypes. Methods: A total of 668 TMJ MRI scans were obtained from two medical centers. High-resolution (HR) MRI images were subjected to enhancement through a deep TL, generating super-resolution (SR) images. Naive Bayes (NB) and Logistic Regression (LR) models were applied, and performance was evaluated using receiver operating characteristic (ROC) curves. The model's outcomes in the test cohort were compared with diagnoses made by two clinicians. Results: The NB model utilizing SR reconstruction with 400 × 400 pixel images demonstrated superior performance in the validation cohort, exhibiting an area under the ROC curve (AUC) of 0.834 (95% CI: 0.763-0.904) and an accuracy rate of 0.768. Both LR and NB models, with 200 × 200 and 400 × 400 pixel images after SR reconstruction, outperformed the clinicians' diagnoses. Conclusion: The ResNet152 model's commendable AUC in detecting ADD highlights its potential application for pre-treatment assessment and improved diagnostic accuracy in clinical settings.

A study on the arthroscopic temporomandibular joint disc reduction on the outcome of orthodontic patients with anterior disc displacement without reduction

Objective: To investigate the arthroscopic temporomandibular joint disc reduction on the outcome of orthodontic patients with anterior disc displacement without reduction. Methods: From January 2012 to December 2021, forty treated orthodontic patients with anterior disc displacement without reduction (unilateral/bilateral) and no obvious articular cartilage absorption were selected from Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The patients were (17.5±3.8) years old (12-25 years old), including 8 males and 32 females. Twenty patients who had completed arthroscopic temporomandibular joint disc reduction were included in the control group, and twenty patients with untreated temporomandibular joint disc were included in the experimental group. Model measurement (including overjet, etc.), cephalometric analysis (including ANB angle, which was formed by subspinale, nasion and supramental, etc.) and temporomandibular joint magnetic resonance imaging (including measurement of the condyle height of the displacement sides) were used to compare the difference of two groups. Objective grading system was used to evaluate the efficacy of orthodontic treatment. Results: The overjet of the experimental group and the control group after orthodontic treatment was (2.19±0.76) and (1.92±0.94) mm, respectively. Both two groups achieved ideal overjet with no statistical difference (t=1.02, P=0.314). The ANB angle difference before and after treatment in the control group (-1.97°±2.87°) was greater than that in the experimental group (0.09°±1.82°), and the difference was statistically significant (t=2.72, P=0.010). The variation of condyle height before and after treatment was (0.30±1.11) mm in the experimental group and (0.82±1.25) mm in the control group, with no statistical significance (t=1.80, P=0.076). The post-treatment objective grading system scores of the experimental group and the control group were 21.00 (16.00, 24.00) and 21.00 (17.00, 25.00), respectively, which had no statistical difference (U=0.24, P=0.808). Conclusions: In orthodontic patients with anterior disc displacement without reduction and no obvious articular cartilage absorption, whether displaced discs are repositioned after arthroscopic surgery has no significant effect on the orthodontic treatment outcome.

High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females.

(1) Background: The aim of this study was to investigate the agreement between a clinical diagnosis based on research diagnostic criteria/temporomandibular disorders (RDC/TMD) and high-field magnetic resonance imaging (MRI) findings of temporomandibular joints (TMJs) in asymptomatic females. (2) Methods: A prospective study on 100 females (200 TMJs) was performed, using clinical examinations (RDC/TMD) and same-day MRIs of TMJs on a 3T MR unit. The inclusion criteria were as follows: females, age > 18, the presence of upper and lower incisors, and an understanding of the Serbian language. Descriptive statistics (means and standard deviations) and ANOVA with a post hoc Tukey test for differences among the patient subgroups was performed. The agreement between the clinical and MRI findings was determined using Cohen's kappa coefficient (k < 0.21 slight, 0.21-0.4 fair, 0.41-0.6 moderate, 0.61-0.8 substantial, and 0.81-1 almost perfect). The statistical significance was set at p ≤ 0.05. (3) Results: Normal findings were observed in 86.7%, disc dislocation (DD) was observed in 9.2%, and arthralgia/osteoarthritis/osteoarthrosis was observed in 2.6% of TMJs using RDC/TMD. On the MRI, normal findings were observed in 50.5%, disc dislocation was observed in 16.3%, and arthralgia/osteoarthritis/osteoarthrosis was observed in 23.5% of TMJs. The anterior DD with reduction showed fair agreement of the clinical and MRI findings (k = 0.240, p < 0.001) compared with the DD without reduction (k = 0.355, p < 0.001). Both showed high specificity (94.9% and 99.4%) but low sensitivity (24.2% and 25.0%). The sensitivity in osteoarthritic changes was low (4.8%), but the specificity remained high (96.2%). (4) Conclusions: The sensitivity of the clinical examination remains low compared with 3T MRI, especially in osteoarthritic changes and anterior DD with reduction. However, the number of false positive diagnoses using RDC/TMD is low in asymptomatic patients. RDC/TMD remains a sensible method for establishing a clinical diagnosis and avoiding the overtreatment of asymptomatic patients.

Does Magnetic Resonance Imaging Distinguish Juvenile Idiopathic Arthritis From Other Causes of Progressive Temporomandibular Joint Destruction?

Similarities in initial presentations of temporomandibular joint (TMJ) involvement from juvenile idiopathic arthritis (JIA), idiopathic condylar resorption, and other forms of progressive TMJ destruction in children create diagnostic confusion. Treatment pathways, however, depend on determination of etiology. The purpose of this study was to compare TMJ magnetic resonance images (MRIs) of patients with joint degeneration localized to the TMJs to those with JIA and TMJ involvement. This is a retrospective cross-sectional study including subjects younger than 18years that presented from February 2008 to October 2019 with clinical TMJ degeneration, a gadolinium-enhanced TMJ MRI and a negative pediatric rheumatologic workup ("non-JIA" group), and a series of age and sex-matched subjects with TMJ degeneration on gadolinium-enhanced MRI and JIA ("JIA group"). MRIs were evaluated in a blinded fashion by 1 pediatric radiologist. The primary outcome variable was the radiologist's accuracy in predicting study grouping, assessed in 1 randomly-selected joint per patient. Secondary outcome variables included MRI characteristics of inflammation, osseous damage and articular disc morphology. Independent samples t-tests, sensitivity/specificity, Fisher's exact and Mann-Whitney tests were computed as applicable, and P<.05 was considered significant. The sample included 34 subjects: 16 non-JIA (75% female, age 13.9±2.8years) and 18 JIA (77% female, age 13.6±2.8years) (P≥.738). The radiologist correctly classified 64.7% of subjects as non-JIA or JIA (P=.078, sensitivity=94.4%, specificity=31.3%). Inflammatory and osseous findings were similar between groups (P≥.073). The disc was anteriorly displaced in 9 non-JIA and 0 JIA joints (P<.001, sensitivity=100%, specificity=100%) and flattened in 3 non-JIA and 14 JIA joints (P=.006, sensitivity=38.9%, specificity=90.6%). Inflammatory and osseous findings on gadolinium-enhanced TMJ MRIs are insufficient to determine the etiology of progressive TMJ destruction. Disc characteristics, however, significantly differ between JIA and non-JIA etiologies and may be important in differentiating these conditions.

Does Temporomandibular Joint Magnetic Resonance Imaging Diagnosis Support Clinical Examination Diagnosis Following Diagnostic Criteria for Temporomandibular Disorders?

The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) has been validated as a clinical diagnostic guideline with high-sensitivity and -specificity in identifying TMDs. The purpose of this study was to evaluate the agreement between DC/TMD diagnoses and magnetic resonance imaging (MRI) diagnoses in patients with TMD. A prospective cohort study was conducted on patients with TMD. The predictor variable was the clinical diagnosis of TMD based on DC/TMD criteria. The outcome variable was the MRI diagnosis of TMD. The diagnoses used for both the predictor variable and the outcome variable were the same. They were normal, disc displacement with reduction (DDWR), DDWR with intermittent locking, disc displacement without reduction (DDWOR) with limited opening, DDWOR without limited opening, degenerative joint disease, and subluxation. Age and gender of the patients and number of joints evaluated were covariates. Each subject had clinical examination performed by two independent Oral and Maxillofacial Surgeons. All subjects had a bilateral temporomandibular joint (TMJ) MRI performed which was evaluated by a radiologist. The correlation between the clinical and MRI diagnoses was calculated using Cohen's kappa value with a P value of <.05 considered significant. A total of fifty patients (100 TMJs) were enrolled with 38 females and 12 males. The mean ages were 31.92 and 31.75years, respectively, with a total of 100 TMJs analyzed. Internal derangement was clinically identified in 76% of the joints and with MRI in 69% of joints. The Cohen's kappa value between DC/TMD and MRI diagnoses was found to be κ=0.720 (P<.01). The respective sensitivity and specificity in determining disc position clinically for DDWR was 1 and 0.96; for DDWR with intermittent locking 0.78 and 0.91; for DDWOR with limited opening 0.9 and 0.98; for DDWOR without limited opening 1 and 0.9; for degenerative joint disease 0.63 and 0.97 and for subluxation 0.28 and 1.00. The DC/TMD clinical examination performed well in all types of disc displacement but is less reliable than MRI in detecting the presence of degenerative disc diseases and subluxation.

Role of Dynamic 3 Tesla MRI in the Evaluation of Temporomandibular Joint Dysfunction.

The internal derangement of the temporomandibular joint (TMJ) is the most common type of dysfunction. Internal derangement can be divided into anterior and posterior disc displacement. Anterior disc displacement is the most common type, which is further classified into anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR). Temporomandibular joint dysfunction (TMD) symptoms are pain, reduced mouth opening, and joint sound. The main aim of this study was to correlate the clinical findings and magnetic resonance imaging (MRI) diagnosis of TMD in symptomatic and asymptomatic TMJs. This prospective observational study was conducted in a tertiary care hospital on a 3T Philips Achieva MRI machine with 16-array channel coils after obtaining approval from the institutional ethical committee. A total of 60 TMJs of 30 patients were included in the study. After the clinical examination of each patient, an MRI of both right and left TMJs was done. In patients with unilateral TMD, the asymptomatic side was used as the asymptomatic joint, and the affected side as the symptomatic joint. Asymptomatic patients without any symptoms of TMD were used as controls for bilateral TMD cases. MRI with high-resolution specific serial sections was obtained in both open- and closed-mouth positions. A p-value of <0.05 was considered a statistically significant agreement between clinical and MRI diagnoses of internal derangement. Out of a total of 30 clinically asymptomatic TMJs, only 23 were normal on MRI. On MRI, 26 TMJs showed ADDWRand 11 showed ADDWoR. The most common shape of the disc was biconcave and the displacement was anterior in symptomatic joints. The most common type of articular eminence shape was sigmoid in ADDWR and flattened in ADDWoR. Agreement between clinical and MRI diagnosis in this study was 87.5% (p < 0.001). The study concluded substantial agreement between clinical and MRI diagnosis of TMJ internal dysfunction and suggests that the diagnosis of the internal dysfunction can be made clinically but the exact position, shape, and type of disc displacement can be assessed precisely with the help of MRI.

Automatic temporomandibular disc displacement diagnosis via deep learning

Temporomandibular joint (TMJ) disc displacement is a common condition that required magnetic resonance imaging (MRI) for diagnosis. However, it has occasionally been challenging for doctors to make a firm diagnosis based on TMJ MRI due to imaging concerns and the significant requirement for clinical competence. As a result, a Multimodal Stepped Attention Net (MSANet) was built in this study, and a deep learning network was used to train the assisted diagnosis AI model (TMJ MRI-Net).A total of 600 patients were recruited, including 1200 lateral joint MRI sequences, which are made up of eight consecutive images for each lateral joint. 11 sides of cases with poor image quality were excluded. MSANet combining multimodal technology and attention mechanism was proposed and designed for this study, which mainly included Area Detection Module and Feature Network.The whole experiment was designed according to stard standard. There is statistically significant difference between the least square mean of diagnosis time for the physicians (from TMJ, Orthodontics and General Dentistry) with AI (TMJ MRI-Net) assistance group (16.15, 95% CI:10.88–21.41) and the physician only group (21.01, 95%CI: 15.74–26.28). The AUC, sensitivity and specificity of patients whether is disc displacement and patients whether the disc displacement is with/without reduction for the physicians' diagnoses were all statistically improved by the assistance of AI. In addition, AUC and specificity were improved for three different specialties with the AI assistance. Meanwhile, AI can help to save reading time for physicians from all three departments, and the increment was statistically significant.To conclude, the AI-assisted strategy significantly improved the diagnostic accuracy of physicians (especially in General Dentistry) on anterior disc displacement in TMJ MRI and improve diagnostic efficiency.

Juvenile idiopathic arthritis and the temporomandibular joint: a case-control study of magnetic resonance imaging findings in relation to clinical and psychosocial factors.

In juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) is a particularly challenging joint to assess both clinically and with imaging. The aim of this article is to investigate TMJ magnetic resonance imaging (MRI) findings in relation to clinical and psychosocial factors in patients with JIA and healthy individuals related to TMJ arthritis in JIA. In total, 45 patients (6-16 years) with JIA and 16 healthy age- and sex-matched controls were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered questionnaires about psychosocial factors (pain intensity, pain-related disability, depression, stress, catastrophising, pain locations, and jaw function) and underwent bilateral MRI of the TMJ. This study indicates a substantial overlap of TMJ MRI findings in both the inflammatory domain and the damage domain between JIA patients and healthy individuals. In JIA patients, the inflammatory MRI sign of bone marrow oedema seems to influence orofacial pain intensity.

What is the image appearance of juvenile idiopathic arthritis in MRI, CT, and CBCT of TMJ? A systematic review.

We performed a systematic review to investigate the appearance of imaging signs on magnetic resonance imaging (MRI), cone-beam computed tomography (CBCT), and conventional computed tomography (CT) scans of the temporomandibular joints (TMJs) of patients with juvenile idiopathic arthritis (JIA). We performed electronic searches of the PubMed, Embase, Web of Science, Scopus, Lilacs, and the Cochrane Library databases to identify studies investigating JIA and its related imaging findings. Inclusion criteria were as follows: original article studies based on humans and systematic reviews, studies enrolling patients under 18years of age with a diagnostic of JIA, the use of International League of Associations for Rheumatology (ILAR) criteria and one type of medical imaging (MRI, CBCT, or CT), and papers published in the English language. A total of six studies met the inclusion criteria, four involving MRI and two involving CBCT. Additionally, all six studies analyzed the imaging findings of pathological TMJ affected by JIA. The results showed that synovial membrane enhancement, condylar erosions, and condylar flattening were the most prevalent imaging findings in JIA. MRI examinations are more specific for detecting anomalies in the TMJ than CBCT and CT. Additionally, these results must be correlated with clinical signs to verify the correct diagnosis. This study identified the most prevalent imaging signs of JIA to provide an early and correct diagnosis of the disease.

Synthesis of T2-weighted images from proton density images using a generative adversarial network in a temporomandibular joint magnetic resonance imaging protocol.

This study proposed a generative adversarial network (GAN) model for T2-weighted image (WI) synthesis from proton density (PD)-WI in a temporomandibular joint (TMJ) magnetic resonance imaging (MRI) protocol. From January to November 2019, MRI scans for TMJ were reviewed and 308 imaging sets were collected. For training, 277 pairs of PD- and T2-WI sagittal TMJ images were used. Transfer learning of the pix2pix GAN model was utilized to generate T2-WI from PD-WI. Model performance was evaluated with the structural similarity index map (SSIM) and peak signal-to-noise ratio (PSNR) indices for 31 predicted T2-WI (pT2). The disc position was clinically diagnosed as anterior disc displacement with or without reduction, and joint effusion as present or absent. The true T2-WI-based diagnosis was regarded as the gold standard, to which pT2-based diagnoses were compared using Cohen's ĸ coefficient. The mean SSIM and PSNR values were 0.4781(±0.0522) and 21.30(±1.51) dB, respectively. The pT2 protocol showed almost perfect agreement (ĸ=0.81) with the gold standard for disc position. The number of discordant cases was higher for normal disc position (17%) than for anterior displacement with reduction (2%) or without reduction (10%). The effusion diagnosis also showed almost perfect agreement (ĸ=0.88), with higher concordance for the presence (85%) than for the absence (77%) of effusion. The application of pT2 images for a TMJ MRI protocol useful for diagnosis, although the image quality of pT2 was not fully satisfactory. Further research is expected to enhance pT2 quality.

Magnetic Resonance Imaging Evaluation of Closed-Mouth TMJ Disc-Condyle Relationship in a Population of Patients Seeking for Temporomandibular Disorders Advice

Objective To characterize the closed-mouth temporomandibular joint (TMJ) disc-condyle relationship in a population of individuals who sought hospital services for temporomandibular disorders (TMD). Methods Two hundred and twenty-four TMJ magnetic resonance images (MRIs) of 112 patients were assessed in all spatial planes to classify disc position with respect to the condyle in a closed-mouth position. Results Disc displacement (DD) was present in 62.1% and superior disc position in 29.9% of the patients. Position could not be determined in 8% of the cases. Among DD, pure anteriorized position was the most common condition (34.4%), with different combined translational and rotational displacements in all the other joints (27.7%). Conclusion There is a wide biological variability in disc position in closed mouth among patients seeking for TMD advice. Getting deeper into the correlation with clinical symptoms is recommended to refine the potential relevance of any diagnostic and management strategies based on the imaging evaluation of TMJ disc position.

Diagnostic significance of magnetic resonance imaging in distinguishing temporomandibular disorders: a retrospective chart review

BackgroundThis study was to evaluate the diagnostic significance of Magnetic Resonance Imaging (MRI) in distinguishing temporomandibular disorders (TMD).MethodsA total of 684 patients with TMD were included in the study. Diagnosis for TMD was conducted according to the international criteria. Two professional radiologists were selected for professional training, and the Kappa values were compared for the diagnosis results to determine the consistency of the diagnosis. Then MRI images of these 684 patients were analyzed and the diagnosis results were obtained.ResultsMRI can be used for the diagnosis of TMD. There were significantly more females (518 cases) than males (166 cases) with TMD; Disc displacement with/without reduction is more common in the youth group, with the majority aged 20–30 years. The highest incidence of temporomandibular joint osteoarthrosis is in the 60-year-old age group, followed by the 70-year-old age group.ConclusionsBilateral temporomandibular joint MRI can clearly show their changes; there are significantly more female with TMD than male; osteoarthritis has a significant correlation with age.

Analysis of Earlier Temporomandibular Joint Disorders in JIA Patients: A Clinical Report.

The aim of this study was to analyse the structural characteristics of the temporo-mandibular joint (TMJ) and the dysfunctional consequences induced by disease in subjects with juvenile idiopathic arthritis (JIA). The study was conducted in 25 patients with JIA (median age (IQR), 13.9 (10.9–15.3)) and 26 healthy controls (median age (IQR), 14.3 (11.6–17.2)) years. All enrolled patients were subjected to anamnestic evaluation, laboratory parameters, JIA subclass, and type of therapy for the disease. A clinical-gnathological evaluation, anamnestic and dysfunctional index (Ai and Di), and magnetic resonance imaging of TMJs were performed in all patients. The test group showed a significant reduction (p < 0.001) regarding the clinical findings such as maximal mouth opening, left and rightward laterotrusion and protrusion, and a significant difference in the reported symptoms (TMJ sounds, reduced mouth opening and pain), and Ai and Di (p < 0.001) compared to healthy patients. Correlation analysis showed a significant correlation between the median duration of disease and the maximum mouth opening and between visual analogue scale (VAS) score and maximum mouth opening, leftward laterotrusion, rightward laterotrusion, and protrusion. The results obtained in this study suggest that patients with JIA presented a cohort of symptoms in TMJs in comparison with healthy controls. Moreover, a careful TMJs evaluation and an early diagnosis of TMJs dysfunction and regular follow-ups are recommended in order to prevent and reduce functional and chewing problems in patients with JIA.

A magnetic resonance imaging study on the temporomandibular joint disc–condyle relationship in young asymptomatic adults

The aim of this study was to assess the temporomandibular joint (TMJ) disc–condyle relationship in asymptomatic young adults. Ninety-three volunteers aged 19–23 years without temporomandibular disorder (TMD) symptoms underwent TMJ magnetic resonance imaging (MRI). The condylar centre and apex methods were used to measure and analyse the position of the disc in the oblique sagittal plane, and the reliability of the two methods was compared by calculating the intra-class correlation coefficient (ICC). Furthermore, 18 of the volunteers were randomly selected for three-dimensional (3D) reconstruction of the TMJ structure and the disc–condyle relationship. The 3D TMJ structure was established by semi-automatic segmentation of the condyle and articular disc in ITK-SNAP software; the condylar apex method was then performed. It was found that only 33.3% of the posterior edge of the articular discs were located in the normal 12 o’clock position with respect to the condyle. Moreover, this study suggests that the condylar centre method lacks accuracy when compared to the condylar apex method in regard to the measurement of the TMJ disc–condyle relationship (0 < ICCcen < ICCapex < 1). The position of the articular disc (left and right) was more forward in young women when compared to young men. However, there was no significant difference in the TMJ disc–condyle position between the left and right sides in the same individual, although the two joint discs in the same individual were not completely symmetrical.

Association between Condylar Bone Density and Disk Displacement in the Temporomandibular Joint

Measuring bone density (BD) is a common method of determining bone quality; however, the relationship between condylar BD and the occurrence of temporomandibular joint (TMJ) disorders has not been investigated. To address this knowledge gap, we aimed to investigate condylar BD in terms of TMJ disk displacement (TMJ DD) using computed tomography (CT) and magnetic resonance imaging (MRI). We classified TMJ MRI results according to the position of the disk: normal disk position (Normal), anterior disk displacement with reduction (ADDR), and anterior disk displacement without reduction (ADDNR). After retrospectively evaluating 86 female condyles, we determined the total, cortical, and trabecular BD in the upper-joint portion of the condyle and the whole condyle using CT data. To standardize condylar BD, we calculated the BD ratios by dividing the condylar BD by the cervical axis BD. The Kruskal-Wallis test analyzed the differences in BD measurements in the TMJ DD patient groups and showed significant between-group differences in condylar BD. The total and trabecular BD was significantly higher in ADDNR condyles than in Normal or ADDR condyles (Normal = ADDR < ADDNR). However, there was no significant difference in the cortical BD among the three TMJ DD groups. The BD ratios showed a similar tendency with condylar BD. These results suggest that increased condylar BD – specifically total and trabecular BD – may be significantly associated with ADDNR condyles. Our findings will help clinicians determine the course of treatment for patients with disk-related TMJ disorders.

Assessing Evaluating and Correlating the Clinical Findings of Temporomandibular Joint Pathology with Orthopantomogram and Magnetic Resonance Imaging – A Cross-Sectional Study

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 multi-ethnic groups, selected from amongst those attending our dental c. Fifty subjects reporting to the Department of Oral Medicine and Radiology with TMJ pathologies were selected. Radiological bone changes were evaluated for flattening (flat bony contour deviating from normal convex form) and erosion (area of decreased density of cortical bone and adjacent subcortical bone) by OPG. After that, MRI of TMJ been taken and changes in the disk position was recorded with the help of radiologist. Statistical Analysis: Statistical presentation and analysis of the present study were done using the p value and Chi-square test by SPSSV20. Results: Result obtained from our study showed that pain was present in 28 (56%) patients and only 44% patients having chief complain other than pain such as noise in front of ear while mastication or restricted mouth opening [Table 1] Out of 28 patients with a chief complain of pain, 22 patients (78.57%) were having abnormal/flattened condylar head surface but out of 22 patients with a chief complain other than pain 18 patients (81.82%) were having abnormal/flattened condylar head surface [Table 2]. Out of 28 patients with a chief complain of pain, 18 patients (64.28%) were with an shortened condylar neck and also out of 22 patients with a chief complain other than pain 16 patients (72.72%) were having shortened condylar neck. The result showed statistically non-significant (P &gt; O.05) [Table 3]. Results also showed that 40% patients with Anterior Disc Displacement With Reduction (ADDR) and 50% with Anterior disc displacement without reduction (ADDWR) had abnormal condylar head surface [Table 4]. About 47.05% patients with ADDR and 41.17% with ADDWR had abnormal condylar neck [Table 5]. Even though there was a positive correlation between the OPG and MRI findings of the TMJ pathologies with the clinical findings of TMJ pathologies, result was not statistically significant which might be due to the reduced sample size. Conclusion: Based on the observation, it can be concluded that OPG and MRI provide valuable information regarding the temporomandibular disorders (TMD) and can play a key role in arriving at accurate clinical diagnosis of complex TMJ pathologies. It also makes the clinical diagnosis easy by correlating the clinical findings of the TMD with this imaging modality and helps clinician to arrive at the proper diagnosis and treatment plan at the earliest. This type of studies should be done on large scale in future based on specific parameters for early diagnosis and treatment planning for patients suffering with TMD to provide quality treatment to the patients at initial stage.

Effects of bruxism on temporomandibular joint internal derangement in patients with unilateral temporomandibular joint pain: The role of magnetic resonance imaging diagnostics

ABSTRACT Objective This study compared temporomandibular joint (TMJ) magnetic resonance imaging (MRI) findings between bruxism and control groups with unilateral TMJ pain as well as the TMJ MRI findings for the painful and non-painful sides of individuals in the two groups. Methods Clinical and MRI findings of patients seen at Uşak University, Dentistry Faculty, Department of Oral and Maxillofacial Surgery for unilateral TMJ pain between 2017 and 2020 were analyzed. Bruxism was diagnosed based on clinical findings and patient history. The MRI variables were disc/condyle relationship (normal, disc displacement with reduction, or disc displacement without reduction), disc structure (normal and abnormal), condyle degeneration type (normal, moderate, or severe), and joint effusion (absent or present). Pain was recorded based on a visual analog scale (VAS) numbered between 0 and 10. Statistical analyses were performed using IBM SPSS. The data were distributed non-normally according to the results of Kolmogorov–Smirnov tests. The Mann–Whitney U test was used to compare age and VAS. Chi-square tests were used to compare categorical variables. Statistical significance was defined as p < 0.05 Results This study assessed the MRI records of 558 cases of TMJ pain. No significant differences in disc/condyle relation, disc structure, condyle structure, or effusion were observed between the control and bruxism groups (p > 0.05). However, a significant difference in TMJ MRI findings was observed between the painful and non-painful sides of each individual in the control and bruxism groups (p = 0.001, p < 0.001 and p = 0.004, p < 0.001, respectively). Conclusion The results of this study established a relationship between the painful side for each patient and TMJ MRI findings. In particular, individuals with bruxism had a higher rate of TMJ internal derangement and effusion on the painful side.