The aim of this functional magnetic resonance imaging (fMRI) study was to investigate the correlation between the severity of malocclusion and brain activation. The fMRI was used to measure blood-oxygenation- level-dependent (BOLD) signals of twelve healthy human subjects while they clenched in two different ways to simulate two types of malocclusion. In each malocclusion model, a custom-made splint forced the mandible to each of two retrusive positions (0.5 mm, 0.7 mm). A no-modification splint provided the control. We compared the BOLD signals measured at each clenching position with those measured during the corresponding resting conditions. The BOLD signals were significantly stronger in the amygdala and the prefrontal area (PFA) when subjects clenched in the two retrusive positions compared during clenching in the control position. In addition, the BOLD signal in the PFA increased as the simulated malocclusion became more severe. These results indicate that we may be able to objectively assess the severity of malocclusion via focus on the brain activity.

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MRI has a measurable impact on the therapeutic approach to the internal derangement of the TMJ. The position of the disk and condyle can be reproducibly judged, while the signal intensity of the disk and bilaminar zone and the osseous changes are subject to wide observer variations.