Regarding clinical implications of magnetic resonance imaging in temporomandibular disorder patients presenting ear fullness

The utilization of decision trees on orthopantomographic and lateral panoramic graphs for the diagnosis of unilateral anterior disc displacement of the temporomandibular joint

BACKGROUND

Investigation is to utilize decision trees in conjunction with orthopantomography (OPT) and lateral panoramic graphy (LPG) to diagnose unilateral anterior disc displacement (ADD) of the temporomandibular joint.

METHODS

In this study, 161 patients with images obtained through all three imaging methods, MRI, OPT, and LPG, were selected from the archives. The participants were categorized into two groups: the study group, comprising 89 patients with unilateral anterior disc displacement, and the control group, consisting of 72 healthy individuals. Measurements, including 2 angles (antero-posterior angle and superior-inferior angle) and 3 distance parameters (anterior joint space distance, superior joint space distance, and posterior joint space distance), were conducted on each imaging modality dataset. To assess the obtained measurement data within each patient, the differences from each measurement were calculated. Statistical analysis of the measurement differences between the control and study groups was carried out with independent t test, and decision trees were generated using the SPSS 25 decision tree module 5.0.

RESULTS

In ADD patients, it was statistically significantly found that the APA increased while the SIA decreased for angle measurements. But for linear measurements, AS increased while the SS and PS decreased in MRI, OPT, and LPG.

CONCLUSION

ADD can be diagnosed in OPT and LPG. The identification of the specific type of ADD that occurs in the temporomandibular joint is not feasible.

Accuracy of Panoramic Radiography for Degenerative Changes of the Temporomandibular Joint

Background:

Temporomandibular joint (TMJ) morphologies are complex, and changes in joint components have been studied extensively. TMJ conditions have many different etiologies, appearances, and relevant clinical significance.

Objective:

The objective of this study was to evaluate the concordance of the diagnosis of degenerative changes in the TMJ in panoramic radiographs.

Materials and Methods:

Cone beam computed tomography (CBCT) was used as a reference standard. Images of 84 patients (168 TMJs), 61 females (72.6%) and 23 males (27.4%) with an average age of 47.4 years, were evaluated by three radiologists who established the presence or absence of degenerative changes in the jaw heads. The data were collected and organized in a spreadsheet. Concordance between evaluators was analyzed using agreement percentages, statistical κ, and confidence intervals. In the analysis of compliance with CBCT, sensitivity, specificity, predictive positive and negative values, and probabilities of false positives and negatives were also calculated. All inferential tests were performed with a 5% significance level.

Results:

The percentage of agreement among raters in panoramic radiographs ranged from 66.7% to 82.9%, considered mild to moderate. Correlation between radiographic and tomographic images ranged from 45.5% to 64.9% in the inter-evaluator reviews, representing a very mild agreement. Sensitivity ranged from 28.6% to 58.7% and specificity from 66.7% to 100.0%. Positive predictive value ranged from 77.1% to 100.0%; the negative predictive value was lower, ranging from 32.2% to 54.8%. The probability of false negatives was higher than that of false positives, ranging from 45.2% to 67.8%.

Conclusion:

The rater did not reach acceptable diagnosis levels.