Correlation between clinical variables and magnetic resonance imaging findings in symptomatic patients with chronic temporomandibular articular disc displacement with reduction: A retrospective analytical study

A Comparative Study of Temporomandibular Joints in Adults with Definite Sleep Bruxism on Magnetic Resonance Imaging and Cone-Beam Computer Tomography Images

Objective: The aim was to study the imaging characteristics of the temporomandibular joint (TMJ) of definite sleep bruxers through magnetic resonance imaging (MRI) and cone-beam computer tomography (CBCT). Methods: Nineteen definite sleep bruxers diagnosed by polysomnography and twenty asymptomatic non-bruxers matched by age, gender, and education level participated in this study. After obtaining MRI and CBCT images of all TMJs of the subjects, evaluation and measurement were conducted, respectively. The analyzed parameters included disc position, disc configuration, joint effusion (JE), joint space or condyle position, and condylar bony changes. Results: Of the 38 joints in the study group, disc deformity and disc displacement of TMJs were both 57.9% when the mouth was closed, and 76.3% showed condylar bony changes, while when the mouth was open, 82% of all TMJs showed physiological biconcave discs. Comparison of joint space revealed that the anterior space was larger in the study group. There was no significant difference between the mild and the moderate to severe sleep bruxism subgroups in the changes of TMJ. Conclusion: The results demonstrated that a higher prevalence of disc deformity, disc displacement, JE, and condylar bony changes occurred in temporomandibular joints of sleep bruxers. These changes were not related to the severity of sleep bruxism.

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

OBJECTIVE

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).

MATERIALS AND METHODS

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 18 years 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.

RESULTS

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.

CONCLUSION

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.

CLINICAL RELEVANCE

This study identified the most prevalent imaging signs of JIA to provide an early and correct diagnosis of the disease.

Assessment of mandibular kinematics values and its relevance for the diagnosis of temporomandibular joint disorders

Background/purpose

Temporomandibular disorders (TMD) are common conditions that involve the temporomandibular joints (TMJs), jaw muscles, or both, and can cause alteration in the mandibular kinematics. The aim of this study was to assess the relationship between mandibular kinematics and temporomandibular joint disorders (TMJD) as a clinical tool for evaluation and diagnosis of these patients.

Materials and methods

A retrospective study based on the analysis of the clinical findings from patients’ charts was carried out, with a sample size of 476 patients. Statistical analysis was made with chi-square test for qualitative variables and student t-test for quantitative variables. Then, odds ratio with its confidence interval were calculated. A p value < 0.05 was considered statistically significant.

Results

Most patients were female (80.7%) and between 16 and 25 years old. Disc displacement with reduction (DDwR) and subluxation were associated with increased kinematic parameters, while disc displacement without reduction (DDwoR) and retrodiscitis were associated with decreased kinematic values. A soft end feel was related to osteoarthritis (OA). Structural incompatibility was most prevalent in older patients.

Conclusion

Mandibular kinematic values are associated with specific temporomandibular joint disorders and could be considered as a useful clinical tool to perform the right diagnosis of TMJD.