Transcranial Radiographs Research Articles

Significance of condylar positions in patients with temporomandibular disorders

Radiographs of closed condylar positions in subjects with symptoms of temporomandibular joint disorders are compared with those in subjects without symptoms. Of the condyles in asymptomatic subjects, 30% had anterior or posterior deviations of more than 1 mm in either direction. Of the condyles in symptomatic subjects, 27% had anterior or posterior deviations of more than 1 mm. As the findings are almost the same for both groups, it appears that condylar position in the fossa, as determined by transcranial radiographs, is of questionable significance as it relates to the symptoms of temporomandibular disorders.

Treatment of mandibular asymmetries during growth. A longitudinal study.

The purpose of this work was to investigate whether some mandibular asymmetries are adaptive to mandibular displacement during growth and can consequently be treated by orthopaedic means. Eleven growing subjects with mandibular asymmetry and a lateral chin deviation were selected: they all showed a malocclusion consistent with an ipsilateral mandibular displacement at an earlier age. Posteroanterior and lateral cephalometric radiographs and TMJ oblique lateral transcranial radiographs (TRs) were taken in intercuspal position. On the posteroanterior radiographs 7 points were selected to define three areas (mandibular, upper cranial and craniomandibular) bilaterally. The position of the highest condylar point inside the glenoid fossa was also digitized and assessed. A ‘position of symmetry’ was determined on the posteroanterior radiographs and repositioning splints were constructed to permanently hold the mandible of the subjects in this position. Orthodontic treatment followed so that the intercuspal position would finally coincide with the position of symmetry. Radiographic data were collected and processed again after splint insertion and at the end of a mean observation period of 37.6 months (s.d. 8.89). Further radiographs were taken at intervals of 6–12 months. After the observation period a consistent improvement in mandibular symmetry had occurred in 9 out of 11 patients. This was due to compensatory mandibular and condylar growth on the side where these had been hampered as a consequence of mandibular displacement.

Absorbed radiation doses in transcranial temporomandibular joint radiography

Lateral transcranial radiographs are commonly used to evaluate TMJ morphology and function. This study evaluated the use of four TMJ positioners in controlling the amount of radiation absorbed at predetermined sites on a phantom head. Use of positioners and collimators can reduce the amount of radiation exposure.

Assessment of mandibular condyle position: A comparison of transcranial radiographs and linear tomograms

Transcranial radiographs are frequently used to assess condyle-fossa relationships. However, their validity in representing condyle position has been questioned. Intermethod comparisons were performed between methods assessing condyle position by subjective evaluation and by linear and area measurement of the interarticular space. Linear measurement of the subjective closest anterior and posterior interarticular space and subjective evaluation were the mutually preferred methods in both transcranial radiographs and tomograms. Statistically significant correlations were shown ( p < 0.05) for condyle position between pairs of clinical transcranial radiographs and linear tomograms of the same temporomandibular joints. However there was a qualitative concordance in assessed posterior concentric and anterior positions in only 80% of the pairs, and a full concordance in the degree of condylar displacement was found in only 60% of the cases. Although still clinically helpful, the use of transcranial radiographs to monitor small changes in condylar position relative to the tomogram was questioned.

Comparison of the multiphasic dysfunction profile with lateral transcranial radiographs

Lateral transcranial radiographs of 926 patients were analyzed for condylar position, TMJ space, and obvious condylar morphologic changes. Differences in condylar position and joint space variations were noted between men and women. An increase in nonconcentric condylar position, joint space variations, and condylar morphologic changes were found with advancing age. There was a significant correlation of condylar position, joint space variations, and condylar morphology with mandibular dysfunction profile scores. Mandibular dysfunction is manifested by a wide range of signs and symptoms, none of which is always present with the disorder. Although TRs are limited in their total diagnostic value, their use in discerning major TMJ changes serves as an important adjunct in the examination and diagnosis of mandibular dysfunction.

Consistency of performance of a new craniostat for oblique lateral transcranial radiographs of the temporomandibular joint

A new craniostat for use with OLTP radiography of the TMJ is described. In a clinical study of 20 patients the craniostat demonstrated a satisfactory consistency of radiographic reproduction.

Orthodontic/orthopedic treatment of craniomandibular pain dysfunction. Part 1: diagnosis with transcranial radiographs.

AbstractCraniomandibular dysfunction is a phenomenon with multiple causes. The most commonly cited of these factors are occlusal problems, stress, and condylar displacements. Craniomandibular dysfunction problems are more common than most practitioners have thought, and every orthodontic practice will come in contact with a significant number of these disorders.Since every orthodontic treatment is in reality a “full-mouth reconstruction” or orthopedic case when the craniomandibular relationship is taken into consideration, it is important that orthodontists recognize the extent of the craniomandibular dysfunction and correct it as best as possible with orthodontic/orthopedic treatment. Particular attention should be paid to the final placement of the condyles and the functional articulation (assuming that goals for skeletal and soft tissue harmony have been met). Transcranial radiographs should be made of each patient as treatment nears completion, and he or she should be carefully examined for posterior ...

Practical evaluation of the lateral temporomandibular joint radiograph

The reevaluation of the lateral transcranial radiograph is needed because of the confusion that surrounds the diagnosis and treatment of TMJ dysfunction-pain. The lack of universal acceptance of the validity of the lateral TMJ radiograph contributes to the lack of progress of TMJ dysfunction-pain treatment and improved methods for the treatment of prosthodontic patients. The lateral transcranial TMJ radiograph was reevaluated for its duplicability (+/- 0.2 mm). The image was found to be a cross section of the lateral third of the condyle rather than a composite view of the condyle made at an angle. The condylar position in the fossa can be correctly evaluated in transcranial radiographs, because the relative condylar position in the fossa is similar in all sagittal views and the image is always of the same sagittal plane (lateral third). Soft tissue within or lining the fossa does not affect the evaluation of condylar position. Chronic osteoarthritic TMJ pathology can exist without subjective pain; therefore, routine use of initial TMJ radiographs with subsequent radiographs at 5-year intervals is suggested for all patients. Because condylar repositioning may be indicated before subjective pain symptoms appear, condylar repositioning should be contemplated whenever extensive prosthodontic treatment is needed. In addition, if chronic osteoarthritic lesions are observed initially, radiographs are indicated at more frequent intervals and anti-inflammatory agents should be considered for routine use depending on the rate and extent of the pathologic development. The existence of osteoarthritic lesions was confirmed by serial radiographs over 5 to 10 years. If an osteoarthritis is present, condylar repositioning (when condylar displacement is present) or changes in occlusion should be considered. There is some clinical evidence that condylar displacement is associated with pathologic remodeling and/or osteoarthritic lesions of the condyle and that condyle repositioning arrests the pathologic process. The principle of condylar concentricity , previously established for the treatment of TMJ dysfunction-pain syndrome and for functional centric relation in prosthodontics, was formulated by associating condylar position in the fossa with TMJ dysfunction-pain in many patients. This article suggests the value of the lateral TMJ radiograph as an important practical aid in the diagnosis and treatment of TMJ dysfunction pain and in the establishment of functional centric relation in prosthodontics.

Transcranial radiography: correlation between actual and radiographic joint spaces.

The purpose of this article is to report on the ability of the transcranial radiograph to view the temporomandibular joint space and the position of the condyle within the fossa. This was studied by placing six shims of known thickness one by one on a condyle and then radiographing the joint. The shims gave known minimum distances between the condyle and the fossa, and the transcranial films were studied with this in mind. The radiographs produced provided the examiner with clear and accurate views of a direct correlation between the known minimum joint space and the space seen on the radiograph.

Definitive prosthodontic therapy for TMJ patients. Part II: Posterior and superior condylar displacement

Examples of anterior condylar repositioning were given for fixed and removable partial denture prostheses without changes in the vertical dimension of occlusion. A superior condylar displacement was treated with a temporary acrylic resin inferior repositioning prosthesis, followed by a gold onlay for over a year. Subsequent final porcelain-fused-to-gold restorations preserved the therapeutic inferior condylar repositioning. The treatment procedures are the same in principle for all patients, that is, the diagnosis and the fabrication of the provisional treatment prosthesis and the final prosthesis are carried out with the specific guidance of lateral transcranial TMJ radiographs. The patient must be comfortable in the planned treatment position for at least 3 months before final restorative procedures are initiated. The repositioned condyles in the fossae are reproduced in the final prosthesis and documented at each step of the procedure radiographically. The TMJ lateral transcranial radiograph, then, is a direct guide to the diagnosis, treatment prosthesis, and final prosthodontic restoration.

Transcranial radiography: contours of the condyle and fossa of the TMJ.

AbstractThe purpose of this article is to present transcranial radiography as a means of visualizing the various anatomic components of the temporomandibular joint. For the study described here, radiopaque wires and markers were first placed on two condyles. These condyles were then radiographed and the resulting films were studied. Wires were next placed on the articulating surface of the condyle and on various other points of importance, and the procedure was repeated. The radiographs thus produced provided the examiner with clear and accurate views of the contours and structures of the joint.

The importance of radiography in the diagnosis of TMJ dysfunctions: A comparative evaluation of transcranial radiographs and serial tomography

Eight men and 22 women with TMJ pain-dysfunction syndrome were selected. After clinical examination, TR and serial tomography were performed in 5 to 7 different planes. In 27 patients, TR showed a condylar displacement. This was confirmed by serial tomography, which also showed that the apparent position may vary from the medial to the lateral aspects due to rotation in some patients. Changes in shape were a common feature and did not necessarily occur in the same manner on each side or in the different sections of the same condyle. In these patients, the TR shape was generally more similar to that of the middle and lateral tomographic planes. The relationship between remodeling pattern and condylar position was confirmed. Degenerative lesions were present in some patients but could only be clearly detected by serial tomography. This study confirms the important role of the TMJ in dysfunctions and the validity of radiography in diagnosis.

Condylar remodeling after occlusal therapy

Seven men and 15 women with TMJ pain dysfunction syndrome were selected. After clinical examination, polytomography of the TMJ was performed in centric occlusion in different planes. Open-mouth projections were also made in three patients, frontal tomography in one patient, and transcranial radiographs in 16 patients. Occlusal analysis was performed on the articulator. Twenty patients showed various patterns of condylar displacement with flattening of the anterior, superior, or posterior condylar walls in 11 patients, including three with arthritic lesions. Therapy included occlusal splints (21 patients), selective grinding (seven patients), prosthodontic rehabilitation (10 patients), and orthodontic treatment (two patients). After therapy, tomographic examination was repeated at intervals of 9 to 44 months. A distinct reshaping of the condyle was seen in seven patients. The new shape tended to be rounded. The three patients with degenerative changes before treatment showed regression of the lesions. No change was seen in condyles which were rounded before therapy.

Comparative Study on the Form of Mandibular Fossa by Means of Standardized Transcranial Radiography - Comparison between Normal Young Adults and Older Adults Wearing Complete Denture -.

International AbstractsComparative Study on the Form of Mandibular Fossa by Means of Standardized Transcranial Radiography — Comparison between Normal Young Adults and Older Adults Wearing Complete Denture —M. TamogamiM. TamogamiSearch for more papers by this authorPublished Online:23 Jan 2015https://doi.org/10.1259/dmfr.1975.0070SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail About"Comparative Study on the Form of Mandibular Fossa by Means of Standardized Transcranial Radiography — Comparison between Normal Young Adults and Older Adults Wearing Complete Denture —." Dentomaxillofacial Radiology, 4(2), p. 114 Previous article Next article FiguresReferencesRelatedDetails Volume 4, Issue 2June 1975Pages: 76-136 © 1975 The Authors. Published by the British Institute of Radiology History Published onlineJanuary 23,2015 Metrics Download PDF