Incidence of temporomandibular joint changes after whiplash trauma: a prospective study using MR imaging.

Abstract

OBJECTIVE. Thepurpose of thisstudywastodescribe theincidence of temporomandibularjoint (TMJ) changes after a well-defined whiplash trauma. SUBJECTSAND METHODS. Sixtyconsecutively admitted patients withsymptoms inthe neck after rear-end traffic collisions underwent MR imaging of the TMJs within 3â€"14 days after the collisions. Fifty-three healthy volunteers constituted a control group. RESULTS.No statistically significant differences werefoundbetween the60 patients andthe 53 volunteers regarding frequency, stage, grade, or direction of TMJ disk displacement or joint effusion.MR imaging revealedthat 45% of the controlgroup and 53% of the patient group had a displaced disk in one or both TMJs (p = .393). Disk displacement was seen in 35% ofTMJs in the control group and 40% ofTMJs in the patient group. Effusion was seen in 8% of TMJs in the control group and 6% of TMJs in the patient group. No signs of bleeding or edemain the softtissueswere observed. In 15% of the patients,mild clinical symptomsin the TMJ or masticatory muscles developed in association with the trauma; in one third of these patients the symptoms were transient. CONCLUSION. Thisprospective studydoesnotshowanysignificantly increased mcidence of disk displacement, joint effusion, or any other injury to the TMJ after whiplash trauma that could be revealed by MR imaging.

MR Imaging Assessment of Temporomandibular Joint Soft Tissue Injuries in Dislocated and Nondislocated Mandibular Condylar Fractures

“…Previous MR imaging studies [1][2][3][4][5][6][7][8][9][10][11][12] indicated that the soft tissue changes included abnormal disk locations, disk shape, disk avulsion, retrodiskal tissues, joint spaces, and joint capsules. The current study demonstrated that the TMJ soft tissue changes were mainly with disk displacements, joint effusion, abnormal retrodiskal tissues, and joint capsules.…”

“…Oezmen et al 1 and Gerhard et al 8 found a low rate of disk displacement in patients with a condylar injury. Bergman et al 11 reported that there was no significantly increased incidence of disk displacement, joint effusion, or any other injury to the TMJ between patients with whiplash trauma and volunteers.…”

“…The anterior or anteromedial displacement of the disk after TMJ injury has been reported in previous literature [1][2][3][4][6][7][8]11 since Schellhas 6 described the sign in 1989. However, Westesson et al 7 depicted that the TMJ disk was located superiorly to the fragment of the condyle and was anteriorly and inferiorly displaced relative to the remaining condyle on sagittal MR images.…”

“…Investigators 5 believed that damage to the TMJ could be seen more clearly on MR imaging than on clinical and radiographic examinations. Recently, many studies [1][2][3][4][5][6][7][8][9][10][11][12] used MR imaging to evaluate soft tissue changes of TMJ traumatic injuries. Most of them found that MR imaging was helpful in the diagnosis of soft tissue changes after an acute condylar traumatic injury.…”

The relationship of whiplash injury and temporomandibular disorders: a narrative literature review

“…These findings are categorized into 2 groups for comparison purposes and are listed in reverse chronological order. The first 8 studies, including 4 prospective (Visscher et al, 12 Kasch et al, 13 Bergman et al, 14 Heise et al 1 ) and 4 retrospective studies (Carroll et al, 15 Ferrari et al, 2 Deboever et al, 16 Probert et al 17 ), indicate a low incidence or prevalence. A second group of 8 studies, including 4 prospective studies (Sale et al, 18 Haggman et al, 19 Garcia and Arrington, 20 Kronn 21 ) and 4 retrospective studies (Klobas et al, 22 Pullinger and Seligman 3 , Pullinger and Monteiro, 23 Weinberg and Lapoints 24 ), indicate a moderate to high incidence or prevalence.…”