Comparison of Pre- and Posttreatment Airway Volume in Patients with Temporomandibular Joint Disorders Treated with Ultra-Low Frequency Transcutaneous Electrical Nerve Stimulation Using Cone Beam Computed Tomography

Introduction  Temporomandibular joint disorders (TMD) present with a multitude of symptoms that can range from headaches to shoulder pain. Patients frequently present with pain in the ear, dizziness, and vertigo. It is noted that some patients who report TMDs also have a history of sleep disturbances, which is noted in cone beam computed tomography (CBCT) as a reduction in the oropharyngeal airway volume. Objective  To evaluate the airway volume in pre- and posttreatment of TMD with the use of neuromuscular orthotics made with ultra-low frequency transcutaneous electrical nerve stimulation (ULF-TENS). Methods  A total of 15 patients were evaluated for TMDs using the related criteria. Those included were treated with ULF-TENS with evaluation of the airway volume both pre- and posttreatment using CBCT and the Dolphin 3D volume analysis software. Results  While the symptoms were shown to be significantly reduced in patients who were treated with this particular modality, the airway volume varied in those who reported a reduction after a period of 3 months and those that reported after a period of 6 months. Conclusion  Posttreatment evaluation of the airway should be done after a period of 6 months for a more objective evaluation. A multidisciplinary evaluation of the patient is required in such cases.

Classifying Temporomandibular Disorder with Artificial Intelligent Architecture Using Magnetic Resonance Imaging

This study proposes a new diagnostic tool for automatically extracting discriminative features and detecting temporomandibular joint disc displacement (TMJDD) accurately with artificial intelligence. We analyzed the structural magnetic resonance imaging (MRI) images of 52 patients with TMJDD and 32 healthy controls. The data were split into training and test sets, and only the training sets were used for model construction. U-net was trained with 100 sagittal MRI images of the TMJ to detect the joint cavity between the temporal bone and the mandibular condyle, which was used as the region of interest, and classify the images into binary categories using four convolutional neural networks: InceptionResNetV2, InceptionV3, DenseNet169, and VGG16. The best models were InceptionV3 and DenseNet169; the results of InceptionV3 for recall, precision, accuracy, and F1 score were 1, 0.81, 0.85, and 0.9, respectively, and the corresponding results of DenseNet169 were 0.92, 0.86, 0.85, and 0.89, respectively. Automated detection of TMJDD from sagittal MRI images is a promising technique that involves using deep learning neural networks. It can be used to support clinicians in diagnosing patients as having TMJDD.

Cone Beam Computed Tomography

In the last several decades, the need for 3D images in dentistry have developed. Computerized tomography was first introduced mainly with the advent of implantology, but its use remained limited to a small number of specialists, due to its indications, access and dose radiation. In the late 90's, a new technology using a cone-shaped beam and a reciprocating detector, which rotates around the patient 360 degrees and acquires projected data in a single rotation, namely the cone beam computerized tomography (CBCT), invaded dentistry, making the perception of 3D easily acceptable to dentists and their patients.

Magnetic resonance and sonographic imagings of masticatory muscle myalgia in temporomandibular disorder patients

This article reviews recently published studies investigating the MRI and sonographic diagnosis of masticatory muscle myalgia in temporomandibular disorder patients. The MRI and sonographic features of muscle after treatment are also discussed. Literature published within the last 15 years was obtained from the PubMed database using the following Mesh terms: magnetic resonance imaging (MRI) or sonography, masticatory muscle pain, and treatment. MRI and sonography enable accurate visualization and evaluation of the masticatory muscles, thereby increasing our understanding of pathology and cause of pain associated with these muscles. Although therapeutic efficacy is often evaluated based on clinical findings, MR and sonographic imaging studies may also be valuable.

Condyle Excursion Angle, Articular Eminence Inclination, and Temporomandibular Joint Morphologic Relations With Disc Displacement

PURPOSE

The aim of this study was to evaluate the relations of the condyle excursion angle (CEA) and the morphology and morphometry of the articular eminence to disc displacement (DD) using magnetic resonance imaging (MRI) of symptomatic patients.

MATERIALS AND METHODS

MRIs of 199 temporomandibular joints (TMJs) were evaluated. Qualitative and quantitative morphologic analyses were performed with tools available in PACS 11.0 (Carestream Health, Inc, Rochester, NY). The articular eminence inclination (AEI), eminence height (EH), CEA, and articular eminence morphologic shape were evaluated. Statistical analyses were used to evaluate any possible association of the variables with DD in the closed- and open-mouth positions, age, and gender. The significance level was set at .05.

RESULTS

Elderly women (>60 yr) presented higher prevalence values (43.26%). There was no statistical correlation between DD and gender (P = .4290). Higher mean values of the AEI and EH were associated with box-shaped eminences. The EH, AEI, and CEA were not related to the presence or absence of DD and the different types of DD. The AEI (P = .002) and CEA (P < .001) values were higher for TMJs with disc reduction in the open-mouth position.

CONCLUSION

Disc position in the closed- and open-mouth positions is not influenced by articular eminence morphology; however, the AEI and CEA have an influence on disc reduction.

Quantitative measurements of the articular areas of mandibular condyles with temporomandibular joint disorders using magnetic resonance imaging

OBJECTIVE

The authors sought to clarify the variation in the condylar anterior functional surface (AFS) of patients with temporomandibular joint (TMJ) disorders using quantitative measurements by magnetic resonance imaging (MRI).

METHODS

MR images of 68 joints (2 males, 32 females) were used. The subjects were classified into three groups: with/without defects of cortical bone groups and a combination group without defects. The AFS was measured as the length between the protrusive point and the apex of the condyle on MRI (4-mm-thick slices), and the quad value of the length was defined as the area on the slice. The summed quad values of all slices were used as the AFS area. Differences in the areas among the three groups were compared by one-way analysis of variance (ANOVA).

RESULTS

The non-defect group had significantly larger AFS areas than the defect group.

CONCLUSIONS

Quantitative measurement on MR images clarified the changes in the condylar sagittal appearance.