Is magnetic resonance imaging or cone beam computed tomography alone adequate for the radiological diagnosis of symptomatic temporomandibular joint osteoarthritis? A retrospective study

This study was performed to compare the diagnostic accuracy of cone beam computed tomography (CBCT) alone and magnetic resonance imaging (MRI) alone in patients with clinical symptoms of temporomandibular joint osteoarthritis (TMJ-OA). Fifty-two patients (83 joints) with clinical signs of TMJ-OA were included in the study. Two examiners evaluated CBCT and MRI images. McNemar and kappa tests and Spearman's correlation analysis were applied. Radiological findings of TMJ-OA were detected in all 83 joints on CBCT or MRI . Seventy-four joints (89.2%) were positive for degenerative osseous changes on CBCT. MRI findings were positive in 50 joints (60.2%). Osseous changes were found in 22 joints, joint effusion in 30 joints, and disc perforation/degeneration in 11 joints on MRI. CBCT was more sensitive than MRI in detecting condylar erosion (P = 0.001), osteophyte (P = 0.001), and flattening (P = 0.002) and flattening of the articular eminence (P = 0.013) . Poor agreement (κ = -0.21) and weak correlations were found between CBCT and MRI. The study findings suggest that CBCT is superior to MRI in evaluating osseous changes of TMJ-OA, and that CBCT is more sensitive than MRI in detecting condylar erosion, condylar osteophyte, and flattening of the condyle and articular eminence.

Radiological examination of the articular eminence morphology using cone beam CT

OBJECTIVE

The purpose of the present study was to investigate the articular eminence inclination and height according to age and gender in patients with temporomandibular joint (TMJ) dysfunction and healthy controls using cone beam CT (CBCT).

METHODS

The measurements were performed on CBCT records of 52 TMJ dysfunction patients (11 males and 41 females) and 41 control patients (17 males and 24 females). The eminence inclination and height were measured on the CBCT images.

RESULTS

The eminence inclination and height values were higher in males than in females in both TMJ dysfunction patient and control groups; however, these differences were not statistically significant (p>0.05). While no statistically significant differences were found in the eminence inclination and height values between the age groups (p>0.05) in the TMJ dysfunction patient group, there were statistically significant differences in the control group. The eminence inclination was highest between the ages of 21 and 30 years and showed a decrease after the age of 30 years. Additionally, the eminence inclinations of the control patients were statistically higher than those of the TMJ dysfunction patients.

CONCLUSION

There were no statistically significant differences in eminence inclination and height according to gender. The eminence inclination reaches its highest value between the ages of 21 and 30 years and shows a decrease after the age of 31 years in healthy patients. The eminence inclination was steeper in healthy control patients than in patients with TMJ dysfunction.

The importance of cone beam CT in the radiological detection of osteomalacia

Although osteomalacia is one of the most common osteometabolic diseases among the elderly, there is no case in the literature that presents the effects of osteomalacia in detail using cone beam CT (CBCT). While thin and porous bones are the most common radiographic sign of the disease, the radiological hallmarks are pseudofractures (Looser's zone). We coincidentally detected osteomalacia in a 23-year-old female and we showed the pseudofracture on CBCT images. In the present case, we aim to present the images of osteomalacia that were detected by CBCT in detail. CBCT has an important value in screening for osteomalacia.