Magnetic Resonance Imaging (MRI) Evaluation for Anterior Disc Displacement of the Temporomandibular Joint

Yang, Zhiyuan; Wang, Mingguo; Ma, Yingwei; Lai, Qingguo; Tong, D. M.; Zhang, Fenghe; Dong, Lili

doi:10.12659/msm.899230

Cited by 38 publications

(33 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On univariate regression, bilateral joint effusions and disc displacement were correlated with bilateral invasive treatment while bilateral condyle arthritis trended towards significance. Joint effusion and condyle arthritis both had odds ratio trends (OR) > 2, consistent with findings in the literature regarding the importance of these variables [ 7 , 12 , 17 , 19 , 20 ]. On multivariate regression, only disc recapture failed to trend towards statistical significance in both the six and twelve component regressions; however, it trended towards significance in predicting the need for any invasive treatment (p = 0.088) in the twelve component analysis.…”

Section: Discussionsupporting

confidence: 89%

“…Suenaga associated pain syndromes with internal derangement, joint effusion, osteoarthritis, and bone marrow edema [15] , whereas others have focused on disc displacement and arthralgia [16] . An emphasis has also been placed on the disc-condyle relationship [17] , even irrespective of disc displacement or arthritis [18] . Especially after mandibular condyle fracture, joint effusion has been used as a marker of TMJ disease severity [19] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Temporomandibular Joint Internal Derangement Score (TIDS): novel magnetic resonance imaging assessment score and its relation to invasive treatment in patients with clinical temporomandibular joint pathology

Kowalchuk

Kaplan-List

et al. 2018

Heliyon

View full text Add to dashboard Cite

PurposeA new magnetic resonance imaging (MRI) based scoring system for temporomandibular joint (TMJ) internal derangement was developed to predict disease severity and the likelihood of invasive treatment.Patients and methodsReports and images from bilateral TMJ MRI studies of 100 consecutive patients with TMJ pain were retrospectively reviewed. A Temporomandibular Joint Internal Derangement Score (TIDS) score was composed of 6 MRI characteristics: joint effusion, disc displacement, disc nonrecapture, disc degenerative changes, abnormal condyle translation, and condyle arthritis. The primary endpoint was whether disease severity merited invasive treatment (arthrocentesis, arthroscopy, arthroplasty, or discectomy). Primary analyses were conducted as univariate regression, with the level of significance set at p < .05. Multivariate regression was also used to assess the impacts of each variable upon the need for invasive treatment.ResultsInvasive treatment was performed in 29 patients and planned in an additional 9 patients. Patients with clinical bilateral pathology were no more likely to undergo invasive treatment than those with unilateral clinical pathology. Statistically significant correlations were found between bilateral invasive treatment and the presence of bilateral joint effusions (p = 0.0037) and disc displacement (p = 0.014), as well as with increasing values of right TIDS (p = 0.0015) and bilateral TIDS (p = 0.0090). Bilateral TIDS of greater than 6 was correlated with both bilateral invasive treatment (p = 0.0033) and with invasive treatment of any kind (p = 0.041). In each instance of TIDS > 6, the patient demonstrated multiple signs of bilateral TMJ pathology. On multivariate regression, only disc recapture failed to trend towards statistical significance in both the six and twelve component regressions, which trended towards significance only in the twelve component analysis.ConclusionA TIDS score was developed to serve as an adjunct to the clinical assessment of TMJ pathology. Bilateral TIDS score greater than 6 was statistically significantly correlated with the severity of TMJ pathology.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Temporomandibular Joint Internal Derangement Score (TIDS): novel magnetic resonance imaging assessment score and its relation to invasive treatment in patients with clinical temporomandibular joint pathology

Kowalchuk

Kaplan-List

et al. 2018

Heliyon

View full text Add to dashboard Cite

show abstract

“…Lack of disc reduction during opening may limit the range of this movement by mechanically blocking or even completely preventing translational movement in the affected joint [11]. In our study the smallest (only 18 mm) range of mandibular opening was found in the group of patients with bilateral lack of disc reduction ( Table 1).…”

Section: Discussionmentioning

confidence: 44%

Range and pattern of mandibular opening in patients with anterior displacement of temporomandibular disc without reduction

Litko¹,

Szkutnik²,

Berger³

et al. 2018

J Pre Clin Clin Res.

View full text Add to dashboard Cite

Introduction. Impairment of mandible mobility model is one of the criteria for clinical diagnosis of temporomandibular joint (TMJ) disc displacement. Objectives. Analysis of the range and pattern of the mandibular opening in patients with anterior disc displacement without reduction. Materials and method. According to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) the range and pattern of mandibular opening were analyzed in 49 patients (45 women and 4 men) with uni-and bilateral anterior disc displacement without reduction on MR imagines. Results. The average range of opening in patients with unilateral lack of disc reduction was 33.74 mm, and 28.93 mm in patients with bilateral lack of reduction. The difference between the average range of opening in both groups was statistically significant (p<0.05). Uncorrected mandibular deviation was the most frequent opening pattern in patients with unilateral lack of reduction (19 out of 35 cases). In 11 out of 14 cases with bilateral lack of reduction the straight opening pattern was found. Conclusions. TMJ disc displacement with bilateral lack of reduction during opening can cause greater opening limitation than unilateral lack of reduction. Anterior disc displacement without reduction in the MR images can clinically present with limitation of mandibular opening as well as correct range of this movement, which can cause difficulties in the clinical diagnosis of these problems.

show abstract

“…This may be explained by the gradual traction done via guiding elastics during FT, had helped in the reduction of the displaced condylar segment with subsequent disc retraction and it was sufficient to reduce the disc in 2 cases, (26) but in GI, the reduction was abruptly performed, so prevented the disc chance for re-catching the condyle, in agree with many studies. (24,27) The key findings of this study are that closed treatment of CFs is a reliable method with high successful rate and low cost. Also, FT provided a shortened period of distress, when compared to rigid IMF.…”

Section: Discussionmentioning

confidence: 87%

“…The MRI results revealed that the trauma caused anterior disc displacement in 50% of the patients, limited anterior translation of the disc/condyle assembly in 83.3% of the patients mirror these functional disruptions, (13) but was not ascertained in other study. (24) The anterior disc displacement may occurred due to the tear of the retrodiscal tissues. (25) The MRI results at 6 months FU revealed that GII was superior to GI in regaining the normal relationship.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Functional Therapy Vs Intermaxillary Fixation in Condylar Fracture Treatment

et al. 2018

View full text Add to dashboard Cite

Purpose: To compare the outcomes after rigid intermaxillary fixation (IMF) versus functional therapy (FT) in patients with mandibular condylar fractures (CFs). Patients and Methods: A prospective comparative study with 3 follow-ups (FU) at 1, 3 and 6 months was undertaken in 2 groups, which exclusively privileged either surgical or conservative treatment due to different therapeutic agendas. Patients from Group1 (GI) received IMF for 10 days, followed by physiotherapy, whereas those in Group2 (GII) had undergone FT for 21 days via guiding elastics. In both groups, all concomitant fractures (if present) were treated by open reduction and internal fixation (ORIF). Patients with unilateral CFs, with or without concomitant mandibular fractures showing one or more of the following conditions were included: adult patients (>18 years of age) indicated for closed treatment, and sufficient dentition for arch bars application. Previous history of tempromandibular joint (TMJ) dysfunction, severe pre-traumatic skeletal dysgnathia, and mid face fractures was excluded. Results: 12 patients (6 in GI and 6 in GII) were included. The clinical TMJ Dysfunction Index of Helkimo (CTDI-H) was equal in both groups at 1 month FU, it became worse in GI than in the GII at 3 month FU, corresponding to better function on the short-term. At the 6 month FU, there were better values in the GII. The Magnetic Resonance Imaging (MRI) scans revealed that the trauma caused disc displacement for 33.3% of GI and 66.7 % of GII. At 6 months FU, 33.3% of GI had improvement in the degree of the disc displacement, but they still had internal derangement with reduction. In GII, 2 out of 4 retained the normal position of the disc and the others had improvement in the disc displacement degree only. Conclusion: Both treatment options may yield acceptable results, however, FT seems to be the appropriate treatment for rapid recovery of range of mandibular motion (ROMM), relief of pain during palpation of masticatory muscles, and recovery of disc position during FU. Its success depends on the passive maneuver of physiotherapy if there is no restricted maximum interincisal opening (MIO) and it should be in a forcible manner in case of restricted MIO.

show abstract

Magnetic Resonance Imaging (MRI) Evaluation for Anterior Disc Displacement of the Temporomandibular Joint

Cited by 38 publications

References 20 publications

Temporomandibular Joint Internal Derangement Score (TIDS): novel magnetic resonance imaging assessment score and its relation to invasive treatment in patients with clinical temporomandibular joint pathology

Temporomandibular Joint Internal Derangement Score (TIDS): novel magnetic resonance imaging assessment score and its relation to invasive treatment in patients with clinical temporomandibular joint pathology

Range and pattern of mandibular opening in patients with anterior displacement of temporomandibular disc without reduction

Evaluation of Functional Therapy Vs Intermaxillary Fixation in Condylar Fracture Treatment

Contact Info

Product

Resources

About