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Kurup S, Crow H, Gonzalez Y, Schiffman ES, Truelove ET, Ohrbach R. A cross-sectional study of temporomandibular joint coronal plane disk position: imaging reliability and clinical utility. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:161-168. [DOI: 10.1016/j.oooo.2020.04.817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/03/2020] [Accepted: 04/27/2020] [Indexed: 01/16/2023]
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Zhou J, Li DH, Zhu PF, Yi CY, Chang L, Zhang Y, Yang XH. Effect of mandibular advancement device on the stomatognathic system in patients with mild-to-moderate obstructive sleep apnoea-hypopnoea syndrome. J Oral Rehabil 2020; 47:889-901. [PMID: 32306424 PMCID: PMC7318685 DOI: 10.1111/joor.12982] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/13/2020] [Accepted: 04/06/2020] [Indexed: 11/30/2022]
Abstract
Objective This study was conducted to evaluate the changes of temporomandibular joints (TMJs) through magnetic resonance imaging (MRI) scanning and the electrical changes in mandibular movement and masticatory muscle surface of mild‐to‐moderate obstructive sleep apnoea‐hypopnoea syndrome (OSAHS) patients before and after treatment with mandibular advancement device (MAD). Methods This was a single‐centre, prospective study recruiting OSAHS patients undergoing treatment with MAD in Department of Stomatology, Yannan Hospital, Kunming, China. Patients were recruited from February 2015 to October 2015, and TMJ changes were observed in MRI scanning before and after 18 months of treatment with MAD in cohort 1. The second cohort of the patients were recruited from January 2014 to September 2015 and electrical changes in mandibular movement and masticatory muscle surface of patients before and after 6 months of treatment with MAD. Results In the cohort 1, TMJ changes analysed through MRI scanning, before and after 18‐month treatment with MAD, there was no significant deviation in the angle of joint disc position. A minor change in the position relationship between condylar process, articular disc and articular fossa but not significant was observed. There was no significant difference in the shape and magnitude of mandibular incision edge movement, percussion movement, masticatory movement and condylar central trajectory among the recruited OSAHS patients, before and after 6 months of MAD treatment as analysed through electromyography. Conclusion In this study, from the results it was evident that the effect of MAD on the stomatognathic system of OSAHS patients is minimal.
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Affiliation(s)
- Jing Zhou
- Department of Stomatology, Kunming Yan'an Hospital, Kunming City, China
| | - De-Hong Li
- Department of Stomatology, Kunming Yan'an Hospital, Kunming City, China
| | - Peng-Fei Zhu
- Department of Stomatology, Kunming Yan'an Hospital, Kunming City, China
| | - Chun-Yan Yi
- Department of Stomatology, Kunming Yan'an Hospital, Kunming City, China
| | - Lin Chang
- Department of Stomatology, Kunming Yan'an Hospital, Kunming City, China
| | - Yanan Zhang
- Department of Stomatology, Kunming Yan'an Hospital, Kunming City, China
| | - Xiang-Hong Yang
- Department of Stomatology, Kunming Yan'an Hospital, Kunming City, China
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Satoh K, Satoh K, Imaizumi-Ohashi Y, Yokoi-Hayakawa M, Fukada T, Seo Y. Rat mandibular condyle and fossa grew separately then unified as a single joint at 20 days old, which was the weaning age. J Oral Sci 2020; 62:197-201. [PMID: 32224572 DOI: 10.2334/josnusd.19-0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Magnetic resonance imaging (MRI) was used to observe growth of the mandibular condyle, mandibular fossa, and articular disc as a single unit. Changes in each component's relative position and size were observed using 7-tesla MRI. Mandibular condyle chondrocytes' growth was evaluated with immunohistochemistry, using the expression of zinc transporter ZIP13. Three-dimensional T1-weighted (T1w) MRI was used to obtain images of the TMJ of Sprague Dawley rats at 4-78 days old (P4-78) with a voxel resolution of 65 μm. Two-dimensional T1w MR images were acquired after a subcutaneous injection of the contrast reagent gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). The T1w MR images showed that the mandibular condyle was located posterior to the mandibular fossa until P20; however, it then moved to a location underneath the mandibular fossa. In the Gd-DTPA enhanced images, the articular disc was identified as a region with lower signal intensity from P20. The number of ZIP13-positive chondrocytes at P6 was larger than the number at P24. In conclusion, the mandibular condyle with cartilage and disc grows on the posterior side of the mandibular fossa until P20, which was the weaning age. Then, the condyle fit into the mandibular fossa and completed the functional unit.
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Affiliation(s)
- Keitaro Satoh
- Department of Regulatory Physiology, Dokkyo Medical University School of Medicine.,Department of Pharmacology, Asahi University School of Dentistry
| | - Kaori Satoh
- Department of Regulatory Physiology, Dokkyo Medical University School of Medicine
| | | | - Mika Yokoi-Hayakawa
- Department of Regulatory Physiology, Dokkyo Medical University School of Medicine
| | - Toshiyuki Fukada
- Faculty of Pharmaceutical Sciences, Tokushima Bunri University.,Division of Pathology, Department of Oral Diagnostic Sciences, School of Dentistry, Showa University.,Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences
| | - Yoshiteru Seo
- Department of Regulatory Physiology, Dokkyo Medical University School of Medicine
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Ertem SY, Konarılı FN, Ercan K. Does Incidence of Temporomandibular Disc Displacement With and Without Reduction Show Similarity According to MRI Results? J Maxillofac Oral Surg 2019; 19:603-608. [PMID: 33071510 DOI: 10.1007/s12663-019-01322-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022] Open
Abstract
Purpose The aim of this study is to assess MRI reports of the patients and to provide retrospective analysis by conducting detailed evaluation of temporomandibular disc position. Patients and Methods MRI images of 259 patients from 2008 to 2017 were reviewed retrospectively. Existence of disc displacement in joint with and without reduction, existence of effusion in joint gap, arthritis, degenerative changes in joints and limitation of movement of joint and anatomic characteristics were evaluated. Results One hundred and seventeen (45.2%) of the patients had healthy joint connection bilaterally. Anterior disc displacement was observed in 101 (38.9%) of the patients. The number of the patients having disc displacement with reduction was 50 (19.3%) and without reduction was 51 (19.6%) similarly. Conclusion The incidence of anterior disc displacement with or without reduction was similar; besides this, the majority of the patients diagnosed with anterior disc displacement were unilateral.
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Affiliation(s)
- Sinan Yasin Ertem
- Oral and Maxillofacial Surgery Department, Dentistry Faculty, Ankara Yildirim Beyazit University, Guclukaya Mah., Fatih Cad. Cagla Sok. No:2, 06280 Kecioren, Ankara Turkey
| | - Fatma Nur Konarılı
- Oral and Maxillofacial Surgery Department, Dentistry Faculty, Ankara Yildirim Beyazit University, Guclukaya Mah., Fatih Cad. Cagla Sok. No:2, 06280 Kecioren, Ankara Turkey
| | - Karabekir Ercan
- Department of Radiology, Ankara Ataturk Training and Research Hospital, Universiteler Mh., Bilkent Cad. No:1, Çankaya, Ankara Turkey
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Lazarin R, Previdelli I, Silva R, Iwaki L, Grossmann E, Filho L. Correlation of gender and age with magnetic resonance imaging findings in patients with arthrogenic temporomandibular disorders: a cross-sectional study. Int J Oral Maxillofac Surg 2016; 45:1222-8. [DOI: 10.1016/j.ijom.2016.04.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 02/29/2016] [Accepted: 04/25/2016] [Indexed: 11/27/2022]
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Khawaja SN, Crow H, Mahmoud RFG, Kartha K, Gonzalez Y. Is There an Association Between Temporomandibular Joint Effusion and Arthralgia? J Oral Maxillofac Surg 2016; 75:268-275. [PMID: 27663534 DOI: 10.1016/j.joms.2016.08.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 08/17/2016] [Accepted: 08/19/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE The literature on joint effusion (JE) and its association with clinical and radiologic variables in patients with temporomandibular disorders (TMDs) is inconsistent and is characterized by multiple methodologic limitations. The primary aim of this investigation was to evaluate the association between magnetic resonance imaging (MRI) identified JE and temporomandibular joint (TMJ) arthralgia. The secondary aim of this investigation was to determine the association between JE and other clinical and MRI-identified soft tissue characteristics. MATERIALS AND METHODS A retrospective cohort study was conducted. Clinical and soft tissue imaging assessments were carried out according to the Diagnostic Criteria for Temporomandibular Disorders guidelines. The dependent variable was JE and the primary independent variable was arthralgia. The secondary independent variables were TMJ pain-associated characteristics and MRI-identified variables. When applicable, Pearson χ2 or t test was used to determine the statistical associations between JE and clinical characteristics and between JE and MRI-identified variables. Furthermore, generalized estimating equation (GEE) modeling was conducted to determine which of the independent clinical and MRI-identified variables were associated with JE. RESULTS Data for 158 participants, representing 312 joints, were extracted. The mean age of the female sample (59.4%) was 31 ± 11.1 years and that of the male sample (40.6%) was 29.8 ± 9.7 years. No association was found between JE and arthralgia. However, statistically significant associations were found between JE and lateral disc rotation (P = .001) and between JE and disc position in the coronal and sagittal planes (P = .001). The GEE model suggested that disc displacement with reduction (odds ratio = 2.5) was a statistically relevant contributing factor for JE in the absence of degenerative joint disease. CONCLUSION Results associated JE with the position of the disc in the sagittal plane. No association was found between JE and arthralgia or TMJ pain-associated clinical characteristics in patients with TMDs.
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Affiliation(s)
- Shehryar N Khawaja
- Resident, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA; Postgraduate Fellow, Harvard School of Dental Medicine, Harvard University, Boston, MA; Former Teaching and Research Fellow, Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, Buffalo, NY.
| | - Heidi Crow
- Associate Professor and Chair, Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, Buffalo, NY
| | - Ruba F G Mahmoud
- Resident, Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, Buffalo, NY
| | - Krishnan Kartha
- Adjunct Assistant Professor, Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, NY
| | - Yoly Gonzalez
- Associate Professor, Department of Oral Diagnostic Sciences; Director, TMD and Orofacial Pain Program, University at Buffalo, Buffalo, NY
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Magnetic resonance imaging evaluation of temporo-mandibular joint disorders, criterial analysis and significance in comparison with arthroscopy. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Bernal-Mañas CM, González-Sequeros O, Moreno-Cascales M, Sarria-Cabrera R, Latorre-Reviriego RM. New anatomo-radiological findings of the lateral pterygoid muscle. Surg Radiol Anat 2016; 38:1033-1043. [DOI: 10.1007/s00276-016-1665-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 03/07/2016] [Indexed: 01/17/2023]
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Razek AAKA, Al Mahdy Al Belasy F, Ahmed WMS, Haggag MA. Assessment of articular disc displacement of temporomandibular joint with ultrasound. J Ultrasound 2014; 18:159-63. [PMID: 26191103 DOI: 10.1007/s40477-014-0133-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/20/2014] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess pattern of articular disc displacement in patients with internal derangement (ID) of temporomandibular joint (TMJ) with ultrasound. MATERIALS AND METHODS Prospective study was conducted upon 40 TMJ of 20 patients (3 male, 17 female with mean age of 26.1 years) with ID of TMJ. They underwent high-resolution ultrasound and MR imaging of TMJ. The MR images were used as the gold standard for calculating sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of ultrasound for diagnosis of anterior or sideway displacement of the disc. RESULTS The anterior displaced disc was seen in 26 joints at MR and 22 joints at ultrasound. The diagnostic efficacy of ultrasound for anterior displacement has sensitivity of 79.3 %, specificity of 72.7 %, accuracy of 77.5 %, PPV of 88.5 %, NPV of 57.1 %, PLR of 2.9 and NLR of 0.34. The sideway displacement of disc was seen in four joints at MR and three joints at ultrasound. The diagnostic efficacy of ultrasound for sideway displacement has a sensitivity of 75 %, specificity of 63.6 %, accuracy of 66.7 %, PPV of 42.8, NPV of 87.5 %, PLR of 2.06, and NLR of 0.39. CONCLUSION We concluded that ultrasound is a non-invasive imaging modality used for assessment of anterior and sideway displacement of the articular disc in patients with ID of TMJ.
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Affiliation(s)
| | | | - Wael Mohamed Said Ahmed
- Department of Oral and Maxillofacial Surgery, Mansoura Faculty of Dentistry, Mansoura, Egypt
| | - Mai Ahmed Haggag
- Department of Oral and Maxillofacial Surgery, Mansoura Faculty of Dentistry, Mansoura, Egypt
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Santos KCP, Dutra MEP, Warmling LV, Oliveira JX. Correlation among the changes observed in temporomandibular joint internal derangements assessed by magnetic resonance in symptomatic patients. J Oral Maxillofac Surg 2013; 71:1504-12. [PMID: 23948363 DOI: 10.1016/j.joms.2013.04.033] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 04/25/2013] [Accepted: 04/27/2013] [Indexed: 11/19/2022]
Abstract
PURPOSE The objective was to assess possible correlations among the anatomy and position of the articular disc, the morphology of the articular eminence and of the condyle, and the presence of joint effusion. MATERIALS AND METHODS Magnetic resonance images of 142 joints of symptomatic patients were assessed. The articular disc was classified as normal, elongated, or folded; displacement was classified as normal, anterior with reduction, anterior without reduction, or posterior, lateral, or medial; the condyle was classified as rounded, convex, flattened, or angulated; and the articular eminence was classified as box, sigmoid, flattened, or deformed. RESULTS The most frequent forms of the articular disc, articular eminence, and condyle were normal, box, and flattened, respectively. Associations were confirmed between the form of the articular disc and its anterior and lateral positions; between the form of the condyle and an anterior position of the disc; and between the form of the articular eminence and the form of the disc. The form of the articular eminence was the only variant that was not associated to the presence of joint effusion. CONCLUSIONS Magnetic resonance imaging allowed the clear observation of articular structures, without attributing a cause-and-effect relation. The prevalence of changes observed was associated with the diagnosis of internal derangement and was statistically proved.
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Affiliation(s)
- Karina Cecília Panelli Santos
- Discipline of Dental Radiology, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
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Eberhard L, Giannakopoulos NN, Rohde S, Schmitter M. Temporomandibular joint (TMJ) disc position in patients with TMJ pain assessed by coronal MRI. Dentomaxillofac Radiol 2013; 42:20120199. [PMID: 23503807 DOI: 10.1259/dmfr.20120199] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To assess the position of the temporomandibular joint (TMJ) disc in patients with TMJ pain and compare it with equivalent published data of asymptomatic volunteers. METHODS The oblique coronal closed- and open-jaw MR images from 66 patients with TMJ pain were evaluated. Clinical examination followed the research diagnostic criteria for temporomandibular disorders. In all coronal images, the transverse condylar axis and the medial and lateral edges of the disc were determined using special software. Inter-rater agreement was calculated [two raters; inter-rater correlation coefficient (ICC)]. The presence of osteoarthrosis (OA) was determined by two independent raters. The influence of OA was estimated in patients (generalized estimation equation model). The results were compared with those of healthy volunteers (t-test). Differences between closed and open jaw in patients were analysed with the Wilcoxon matched-pair test. RESULTS The ICC was good for the transverse condylar axis (0.987) and the medial edge of the disc (0.799) and fair for the lateral edge (0.355). On average, the disc projected 5.5% to the medial side; laterally, the condyle was partially uncovered by the disc (-16.6%). In the open-jaw position, both the medial and the lateral edges shifted medially (to 17.6% vs -23.6%, Wilcoxon matched-pair test, p < 0.001). OA had no significant influence (generalized estimation equation model, p = 0.952). The disc position differed significantly from asymptomatic individuals (t-test, p < 0.001) who showed a medial disc position and full coverage of the condyle. CONCLUSIONS In patients with TMJ pain, the disc seems to be smaller and located less medially than in healthy volunteers. The extent of the medial shift on opening was similar.
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Affiliation(s)
- L Eberhard
- Department of Prosthodontics, University of Heidelberg, Germany.
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Arencibia A, Hidalgo MR, Vázquez JM, Contreras S, Ramírez G, Orós J. Sectional anatomic and magnetic resonance imaging features of the head of juvenile loggerhead sea turtles (Caretta caretta). Am J Vet Res 2012; 73:1119-27. [PMID: 22849670 DOI: 10.2460/ajvr.73.8.1119] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare anatomic features of cross-sectional specimens with those of MRI images of the heads of loggerhead sea turtles (Caretta caretta). ANIMALS 5 cadavers of juvenile female loggerhead sea turtles. PROCEDURES Spin-echo T1-weighted and T2-weighted MRI scans were obtained in sagittal, transverse, and dorsal planes with a 0.2-T magnet and head coil. Head specimens were grossly dissected and photographed. Anatomic features of the MRI images were compared with those of gross anatomic sections of the heads from 4 of these turtles. RESULTS In the MRI images, anatomic details of the turtles' heads were identified by the characteristics of signal intensity of various tissues. Relevant anatomic structures were identified and labeled on the MRI images and corresponding anatomic sections. CONCLUSIONS AND CLINICAL RELEVANCE The MRI images obtained through this study provided valid information on anatomic characteristics of the head in juvenile loggerhead sea turtles and should be useful for guiding clinical evaluation of this anatomic region in this species.
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Affiliation(s)
- Alberto Arencibia
- Department of Morphology, University of Las Palmas de Gran Canaria, Las Palmas, Spain.
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Almăşan OC, Hedeşiu M, Băciuţ G, Leucuţa DC, Băciuţ M. Disk and joint morphology variations on coronal and sagittal MRI in temporomandibular joint disorders. Clin Oral Investig 2012; 17:1243-50. [PMID: 22868824 DOI: 10.1007/s00784-012-0803-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 07/19/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study aims to assess the disk morphology and the condyle position in subjects with temporomandibular (TMJ) disk displacements on sagittal and coronal magnetic resonance imaging (MRI). MATERIALS AND METHODS Seventy-four TMJs (from 37 patients) with positive clinical TMD symptoms according to the RDC/TMD axis I protocol were evaluated by 1.5 T MRI. Disk position, disk morphology, sagittal and coronal condyle position, joint effusion, joint space, and coronal condyle angulation were evaluated. Multivariate logistic regression was used to explore the relationship between disk displacement and MRI variables. RESULTS Disk displacement with reduction (DDR) was found in 36.48 % and without reduction (DDwR), in 21.62 % of the joints. Disk displacement was anterior in 35.1 %, anterior-medial in 13.5 %, and anterior-lateral in 9.45 % of cases. The thickened posterior band (94.48 OR, p = 0.001) and the posterior condyle position (4.57 OR, p = 0.03) were more likely found on sagittal MRI in disk displacements. On coronal slices, the disk displacement was significantly associated with the distance from the most medial condyle point to the midplane (p < 0.05). CONCLUSIONS Disk displacement is associated with changes of disk shape, disk dimension, and condyle position on sagittal MRI. A significant variation of the distance from the most medial condyle point to the midplane in disk displacement was found on coronal MRI. CLINICAL RELEVANCE Our study highlights the existence of changes on coronal MRI in TMD patients which should be assessed for better understanding of the clinical evolution of temporomandibular disorders.
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Affiliation(s)
- Oana C Almăşan
- Faculty of Dentistry, Department of Prosthetic Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, 32 Clinicilor Street, Romania
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Mello Junior CFD, Saito ODC, Guimarães Filho HA. Avaliação ultrassonográfica dos distúrbios intracapsulares temporomandibulares. Radiol Bras 2011. [DOI: 10.1590/s0100-39842011000600005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar a sensibilidade e a especificidade do exame ultrassonográfico de alta resolução para a avaliação dos distúrbios intracapsulares temporomandibulares. MATERIAIS E MÉTODOS: Estudamos 38 pacientes (76 articulações) com queixas de distúrbios temporomandibulares. Todos os pacientes realizaram exames de ultrassonografia e ressonância magnética (padrão ouro para a avaliação) e os resultados obtidos foram comparados. RESULTADOS: De 24 articulações evidenciando deslocamento discal com o paciente em repouso na ressonância magnética, 7 foram confirmados pela ultrassonografia, em 13 não foram visualizados os discos e 4 estavam tópicos na ultrassonografia. Em 48 articulações, o disco articular não foi visualizado na ultrassonografia com o paciente em repouso. Destes, 41 apresentavam posicionamento normal na ressonância magnética e 7 apresentavam deslocamento anterior. Alterações morfológicas do côndilo mandibular foram visualizadas pela ressonância magnética em 13 articulações, identificadas pela ultrassonografia em 2 delas. CONCLUSÃO: Podemos concluir, no estudo, que o exame de ultrassonografia apresenta alta sensibilidade e especificidade para o diagnóstico da localização do disco articular com o paciente em repouso, tanto para a análise de seu posicionamento anatômico como nos casos de deslocamentos, não apresentando resultados significativos para a análise dos discos com o paciente com a boca aberta e para a análise de alterações morfológicas discais e condilares.
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Magnetic resonance imaging of the temporomandibular joint in the rat compared with low-powered light microscopy. Arch Oral Biol 2011; 56:1382-9. [PMID: 21549351 DOI: 10.1016/j.archoralbio.2011.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 03/07/2011] [Accepted: 03/31/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE High magnetic field magnetic resonance imaging (MRI) was applied to the temporomandibular joint (TMJ) in the rat. The purpose of this study was the depiction of the internal structure of the TMJ, including the articular disc, articular cartilage, and the upper and lower joint cavities. We also proposed MRI settings and slices suitable for imaging the TMJ in the rat. METHODS Temporomandibular joints from one female and eight male Sprague Dawley rats (5-8 weeks old) and four male Wistar-Hamamatsu rats (7-8 weeks old) were used. Using scout images, the horizontal plane was defined as being parallel to the body of the basisphenoid bone underneath the base of the brain. The coronal plane was defined as a slice vertical to the horizontal plane and vertical to the longitudinal fissure of the cerebrum. The sagittal plane was defined as a slice vertical to the horizontal plane and parallel to the longitudinal fissure of the cerebrum. RESULTS T(1)-weighted MR images with a spatial resolution of 75 μm were obtained for 5 min. The temporal bone and mandibular condyle were depicted as lower signal intensity images and the articular disc was depicted as an intermediate signal intensity image. In accordance with Gd-DTPA-enhanced MR or T(2)-weighted MR images, the articular disc, articular cartilage, and the upper and lower joint cavities could be assigned clearly. CONCLUSION These MRI findings closely agreed with those observed with haematoxylin-eosin staining under light microscopy, suggesting that MRI is a useful method for analyzing the complex structure of the TMJ in the rat.
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RIBEIRO-ROTTA RF, MARQUES KDS, PACHECO MJ, LELES CR. Do computed tomography and magnetic resonance imaging add to temporomandibular joint disorder treatment? A systematic review of diagnostic efficacy. J Oral Rehabil 2010; 38:120-35. [DOI: 10.1111/j.1365-2842.2010.02133.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Butzke KW, Batista Chaves KD, Dias da Silveira HE, Dias da Silveira HL. Evaluation of the reproducibility in the interpretation of magnetic resonance images of the temporomandibular joint. Dentomaxillofac Radiol 2010; 39:157-61. [PMID: 20203277 DOI: 10.1259/dmfr/16076453] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The aim was to determine the intra- and interexaminer reproducibility in the interpretation of MRI of the temporomandibular joint among independent observers, with respect to six specific articular characteristics, and to discover which of these had greater and lesser agreement. METHODS 30 magnetic resonance examinations of temporomandibular joints of adults were independently interpreted by 9 experienced and trained observers at 2 different times. Observers were divided into three groups according to their specialties: surgeon dentists specialized in temporomandibular dysfunction and orofacial pain, surgeon dentists specialized in radiology and medical doctors specialized in radiology. The reproducibility analysis was carried out using Cohen's kappa coefficient. RESULTS The interexaminer reproducibility ranged from slight to fair. The intraexaminer reproducibility ranged from slight to no agreement. In the interexaminer evaluation, anterior disc displacement without reduction presented greater agreement, whereas change in condylar head shape showed the poorest agreement. In the intraexaminer evaluation, anterior disc displacement without reduction presented slight agreement, whereas, for the other characteristics, no agreement was observed. CONCLUSION Examiners do not demonstrate reproducibility in the interpretation of MRI of temporomandibular joints. Therefore, more efforts are necessary with respect to understanding the changes that may be detected in these images in terms of diagnosis and appropriate treatment approaches.
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Affiliation(s)
- K W Butzke
- Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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RODRÍGUEZ MJ, AGUT A, SOLER M, LÓPEZ-ALBORS O, ARREDONDO J, QUEROL M, LATORRE R. Magnetic resonance imaging of the equine temporomandibular joint anatomy. Equine Vet J 2010; 42:200-7. [DOI: 10.1111/j.2042-3306.2010.00030.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Arayasantiparb R, Tsuchimochi M. Quantification of disc displacement in internal derangement of the temporomandibular joint using magnetic resonance imaging. Odontology 2010; 98:73-81. [PMID: 20155511 DOI: 10.1007/s10266-009-0115-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Accepted: 11/15/2009] [Indexed: 01/20/2023]
Abstract
Many measures have been developed to determine the extent of disc displacement in internal derangements of the temporomandibular joint (TMJ) using magnetic resonance imaging. The purpose of this study was to develop a quantitative method of analyzing disc position and to evaluate the positions of the disc in internal derangements of the TMJ (group 1, with reduction; group 2, without reduction). Magnetic resonance images of 150 TMJs in 20 healthy volunteers and 55 patients with internal derangements were evaluated. The anatomical points of interest of the TMJ, including the anterior (DA) and posterior (DP) points of the disc, were marked on parasagittal magnetic resonance images of the TMJ disc taken in both the closed- and the open-mouth positions. All points were recorded using an x-y coordinate system, with reference to a referral line. In the closed-mouth position, the DP in patients in group 1 was situated in a more-anterior direction than the DP in volunteers. The DP in group 2 was located further anterior and inferior than the DP in group 1. However, the position of the DA did not differ between group 1 and group 2. In the open-mouth position, the DP was displaced anteroinferiorly to a greater extent in group 2 than in group 1 (one-way ANOVA, followed by Scheffe's test; P < 0.0001). The distance between the disc points in the closed- and open-mouth positions was also evaluated. Comparison of the disc point position in the closed- and open-mouth positions in symptomatic and asymptomatic displaced TMJ discs revealed no significant difference. In conclusion, most of our results quantitatively support previously reported findings in imaging, surgical, and histopathological studies of TMJ internal derangement. We suggest that our measure of disc position of the TMJ would be useful to assess the status and response to treatment of internal derangements of the TMJ.
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Affiliation(s)
- Raweewan Arayasantiparb
- Quantitative Diagnostic Imaging Program, Graduate School of Life Dentistry at Niigata, The Nippon Dental University, Nippon, Japan
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Schmitter M, Rammelsberg P, Hassel A, Schroeder J, Seneadza V, Balke Z, Essig M. Evaluation of disk position and prevalence of internal derangement, in a sample of the elderly, by gadolinium-enhanced magnetic resonance imaging. ACTA ACUST UNITED AC 2008; 106:872-8. [PMID: 18554938 DOI: 10.1016/j.tripleo.2008.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Revised: 01/30/2008] [Accepted: 01/30/2008] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess disk position and the prevalence of disk displacement (DD) in a sample of the elderly by use of contrast agent-enhanced magnetic resonance imaging (MRI). STUDY DESIGN Thirty subjects (73-75 years old) were drawn from a representative sample and examined clinically. The position and contours of the temporomandibular disk was assessed by using gadolinium-enhanced MR images which were evaluated by 2 independent raters. Statistical assessment was performed by using descriptive statistics and nonparametric tests. RESULTS Agreement between raters with respect to disk position was excellent. The MRI showed that 8 subjects (27%; 2 men, 6 women) had DD. CONCLUSION Gadolinum-enhanced MRI showed that DD is common in the elderly (27%) and that DD occurs more frequently in women than in men. In women without DD the disk is positioned more anteriorly than in men.
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Affiliation(s)
- Marc Schmitter
- Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
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Articular disc position in association with mandibular setback surgery. ACTA ACUST UNITED AC 2008; 105:e19-21. [DOI: 10.1016/j.tripleo.2007.07.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 07/10/2007] [Accepted: 07/23/2007] [Indexed: 11/19/2022]
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Stehling C, Vieth V, Bachmann R, Nassenstein I, Kugel H, Kooijman H, Heindel W, Fischbach R. High-Resolution Magnetic Resonance Imaging of the Temporomandibular Joint. Invest Radiol 2007; 42:428-34. [PMID: 17507815 DOI: 10.1097/01.rli.0000262081.23997.6b] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the image quality of a high-resolution imaging protocol for the temporomandibular joint (TMJ) at 3.0 T and to compare it with our standard 1.5 T protocol. MATERIALS AND METHODS Fifteen volunteers without history of TMJ dysfunction underwent bilateral magnetic resonance imaging (MRI) of the TMJ with the jaw in closed and open position. MRI was performed with using a 1.5 T (standard TMJ coil) and 3.0 T (purpose build phased array coil) MR system (Gyroscan Intera 1.5 T and 3.0 T; Philips Medical Systems, Best, the Netherlands). Imaging protocols consisted of a parasagittal PDw-TSE sequence and a coronal PDw-TSE sequence in closed mouth position and a sagittal PDw-TSE sequence in open mouth position. Acquisition parameters were adjusted for 3.0 T and voxel size was reduced from 0.29 x 0.29 x 3.0 mm (1.5 T) to 0.15 x 0.15 x 1.5 mm (3.0 T). Total examination time (15 minutes) was similar for both systems. Two observers assessed in consensus delineation, image quality, and artifacts of anatomic landmarks (disk, bilaminar zone, capsular attachment, cortical bone) and ranked them qualitatively on a 5-point scale from 1 (optimal) to 5 (nondiagnostic). Disk position and motility was noted. For CNR analysis, signal intensity from disk and retrodiscal tissue was measured. RESULTS Disk position and mobility was identical at both field strengths. All anatomic landmarks were visualized significantly better at 3.0 T. In particular, the capsular attachment was depicted in more detail. Overall image quality was ranked significantly higher at 3.0 T, whereas artifact score was similar. Quantitative evaluation showed significantly higher CNR for 3.0 T (10.23 vs. 8.08, P < 0.0001). CONCLUSION Depiction of the normal anatomy of the TMJ benefits significantly when investing the higher SNR at 3.0 T into better spatial resolution. We anticipate that this advantage of 3.0 T MRI will also permit a more detailed analysis of capsular and disk pathology.
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Affiliation(s)
- Christoph Stehling
- Department of Clinical Radiology, University of Muenster, Münster, Germany.
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Kress B, Schmitter M. [Temporomandibular joint: MRI diagnostics]. Radiologe 2005; 45:790, 792-6. [PMID: 16133403 DOI: 10.1007/s00117-005-1258-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
MRI of the temporomandibular joint (TMJ) requires 1.5 T. The radiologist must be familiar with the anatomy and pathology of the TMJ. This review gives a description of MRI protocols for the TMJ, and MRI anatomy and pathology of the TMJ (open and closed mouth) by means of MR images and drawings. Diagnosing of the TMJ related diseases depends on standardized clinical and MR examinations. Therefore close interdisciplinary cooperation between dentist and radiologist is necessary.
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Affiliation(s)
- B Kress
- Abteilung Neuroradiologie, Universitätsklinikum Heidelberg.
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