Imaging of the temporomandibular joint - contemporary clinical and radiological implications

Jeremić-Knežević, Milica; Boban, Jasmina; Djurovic-Koprivica, Daniela; Krstic, V. D.; Marković, Vladimir; Knežević, Aleksandar

doi:10.2298/sarh190515099j

Cited by 2 publications

(2 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The agreement between the clinical and radiological findings for osteoarthritis was even lower (with very low sensitivity), owing partly to the fact that MRI is not a method of choice for depicting osseous changes [ 48 ]. More importantly, MRI demonstrates the degenerative changes years before they clinically manifest [ 49 ]. Finally, osteoarthritic changes are followed by transient pain, present only in the active phase of the disease [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females

et al. 2023

Self Cite

View full text Add to dashboard Cite

(1) Background: The aim of this study was to investigate the agreement between a clinical diagnosis based on research diagnostic criteria/temporomandibular disorders (RDC/TMD) and high-field magnetic resonance imaging (MRI) findings of temporomandibular joints (TMJs) in asymptomatic females. (2) Methods: A prospective study on 100 females (200 TMJs) was performed, using clinical examinations (RDC/TMD) and same-day MRIs of TMJs on a 3T MR unit. The inclusion criteria were as follows: females, age > 18, the presence of upper and lower incisors, and an understanding of the Serbian language. Descriptive statistics (means and standard deviations) and ANOVA with a post hoc Tukey test for differences among the patient subgroups was performed. The agreement between the clinical and MRI findings was determined using Cohen’s kappa coefficient (k < 0.21 slight, 0.21–0.4 fair, 0.41–0.6 moderate, 0.61–0.8 substantial, and 0.81–1 almost perfect). The statistical significance was set at p ≤ 0.05. (3) Results: Normal findings were observed in 86.7%, disc dislocation (DD) was observed in 9.2%, and arthralgia/osteoarthritis/osteoarthrosis was observed in 2.6% of TMJs using RDC/TMD. On the MRI, normal findings were observed in 50.5%, disc dislocation was observed in 16.3%, and arthralgia/osteoarthritis/osteoarthrosis was observed in 23.5% of TMJs. The anterior DD with reduction showed fair agreement of the clinical and MRI findings (k = 0.240, p < 0.001) compared with the DD without reduction (k = 0.355, p < 0.001). Both showed high specificity (94.9% and 99.4%) but low sensitivity (24.2% and 25.0%). The sensitivity in osteoarthritic changes was low (4.8%), but the specificity remained high (96.2%). (4) Conclusions: The sensitivity of the clinical examination remains low compared with 3T MRI, especially in osteoarthritic changes and anterior DD with reduction. However, the number of false positive diagnoses using RDC/TMD is low in asymptomatic patients. RDC/TMD remains a sensible method for establishing a clinical diagnosis and avoiding the overtreatment of asymptomatic patients.

show abstract

Section: Discussionmentioning

confidence: 99%

High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Contemporary imaging modalities, if used properly and according to adequate clinical implications and criteria, are able to depict different pathological processes and play a crucial role in establishing the right diagnosis and monitoring therapeutic effect. The key to the right diagnosis, however, still lies in thorough familiarity with the TMJ developmental and functional anatomy, as well as with the TMJ dysfunction related to the jaws, teeth, and cranial base [42].…”

Section: Discussionmentioning

confidence: 99%

A New Mechanical Mouth Opener for Dynamic Magnetic Resonance Imaging of the Temporomandibular Joint

Knezevic,

Boban

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

(1) Background: During the magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ), it is necessary to scan the joints in the closed- and open-jaw position, as well as in the maximally open-jaw position. In order to examine both joints in these positions, an MRI compatible mouth opener is required, which allows the articular surfaces to maintain their position stably. (2) Methods: In this study, we included 200 patients aged 18 to 65, with various levels of clinical severity. The mouth opener is made of polymethyl methacrylate and used for dynamic imaging of TMJ. It is in the form of an arrow, with incisures on upper and lower surfaces 1 mm apart and these match possible variations in jaw opening. All the patients were scanned with mouth opener and, immediately after this scanning, with syringe (20 ccm) as a standard device used for mouth opening in clinical setting. (3) Results: A total of 200 MR examinations of TMJs were performed and the mechanical mouth opener was successfully applied without artifacts in all patients. The mouth opener device proved to be adequate in case of MRI of the TMJ for different ranges of mouth opening with the proper protocol for provoked imaging, because the incisures are located at a distance of 1 mm and no objective artifacts were observed in any examination that degraded the diagnostic quality of the examination. (4) Conclusions: The design of the acrylate mouth opener is precisely defined, and it has a purpose in the MRI diagnosis of TMJ disorders.

show abstract

Imaging of the temporomandibular joint - contemporary clinical and radiological implications

Cited by 2 publications

References 38 publications

High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females

High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females

A New Mechanical Mouth Opener for Dynamic Magnetic Resonance Imaging of the Temporomandibular Joint

Contact Info

Product

Resources

About