DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20172117

Evaluation of temporomandibular joint disorders using cone beam computed tomography

Sonam Kohli, Rahul Krishan Sharma, Anchal Goel, M. K. Sunil

Abstract


Background: The aim of this study was to evaluate efficacy of segmental cone beam computed tomography (CBCT) in detecting bony changes in condyle and thickness of roof of glenoid fossa in temporomandibular joint (TMJ) disorders.

Methods: The study group comprised of 10 temporomandibular disorders (TMD) patients of either sex between the age group of 20-60 years diagnosed as TMDs by clinical evaluation using the research diagnostic criteria was considered. After the clinical examination, radiographic investigations were carried out which included digital OPG, transcranial radiograph and CBCT scan. TMJ Evaluation included: (a) bony changes of the condyle (flattening, erosion, sclerosis, osteophytes, resorption); (b) joint space (normal, increased, reduced, bony contact between the condyle and the mandibular fossa); and (c) bony changes of mandibular fossa (normal, sclerosis, erosion, resorption). The radiographic findings were statistically analysed.

Results: Significant difference between OPG, transcranial and CBCT were found for the presence of erosion (P =0.000), thickness of roof of glenoid fossa (P =0.000), deformed contour (P =0.001), joint space (P =0.011), subchondral sclerosis (P =0.011), irregularity of articular surface and eminence (P =0.000), flattening (P =0.050).

Conclusions: Using CBCT as imaging technique in our study to detect osseous changes in the TMJ was proved to be effective as compared to the conventional radiographic techniques, the results achieved with CBCT was 100%.The results obtained in our study prove to be a full proof one and it seems to promise to go one step closer to detect progression and severity of the osseous changes in the condylar head and mandibular fossa in patients with TMDs.


Keywords


Temporomandibular joint, Cone beam computed tomography, Transcranial, Glenoid fossa, Sclerosis, Osteophytes

Full Text:

PDF

References


Dworkin SF. Epidemology of signs & symptoms in TMDS: clinical signs in case & control. JADA. 1990;120:273-81.

Tomislav B, Miljenko M, Josipa K, Mirko L. A quantitative analysis of splint therapy of displaced temporomandibular joint disc. Ann Anat. 2009;191(3):280-7.

Buescher JJ. TMJ Disorders. Am Fam Physician. 2007;76(10):1477-82.

Fricton JR, Chung SC. Contributing factors: A key to chronic pain. In: Fricton JR, Kroening RJ, Hathaway KM, editors. TMJ and Craniofacial Pain: Diagnosis and Management. MO: Ishiyaku EuroAmerica: St Louis; 1988.

Alexiou KE. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofacial Radiol. 2009;38:141–7.

White S, Pharoah M. Textbook of Oral Radiology. Principles & Interpretations. 6th Edition. Elsevier; 2008.

Jin JY. Combining scatter reduction and correction to improve image quality in cone beam computed tomography. Med Phys. 2010;37:5634.

Schulze D. Radiation exposure during midfacial imaging using 4 and 16 slice computed tomography, cone beam computed tomography systems and conventional radiography. Dentomaxillofac Radiol. 2004;33:83-6.

Honda K. Relationship between patient characteristics, mandibular head morphology and thickness of the roof of the glenoid fossa in symptomatic temporomandibular joints. Dentomaxillofac Radiol. 2007;36(5):277-81.

Scarfe WC, Farman AG. Cone Beam Computed Tomography: A paradigm shift for clinical dentistry. J Australian Dental Pract. 2007:92-100.

Martinez-Blanco M. Osteoarthrosis of the temporomandibular joint. A clinical and radiological study of 16 patients. Med Oral. 2004;9:106–15.

Tyndall DA. Cone-beam CT diagnostic applications: Caries, periodontal bone assessment, and endodontic applications. Dent Clin North Am. 2008;52(4):825-41.

Honda K. Evaluation of the usefulness of the limited cone-beam CT (3DX) in the assessment of the thickness of the roof of the glenoid fossa of the temporomandibular joint. Dentomaxillofacial Radiol. 2004;33:391-5.

Benson BW. Disorders of the temporomandibular joint. Dent Clin North Am. 1994;38:167–85.

Tsiklakis K. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofacial Radiol. 2004;33:196-201.

Meng JH. Diagnostic evaluation of the temporomandibular joint osteoarthritis using cone beam computed tomography compared with conventional radiographic technology. Beijing Da Xue Xue Bao. 2007;39(1):26-9.

dos Anjos Pontual ML, Freire JSL, Barbosa JMN, Frazão MAG, dos Anjos Pontual A, Fonseca da Silveira MM. Evaluation of bone changes in the TMJ using CBCT. DMFR. 2012;41:24-9.

Gynther GW. Comparison of arthroscopy and radiography in patients with temporomandibular joint symptoms and generalized arthritis. Dentomaxillofac Radiol. 1998;27:107–12.

Campos MI. Analysis of Magnetic resonance imaging characteristics and pain in the TMJ with and without degenerative changes of condyle. Int J Oral Maxillofac Surg. 2008;37:529-34.

Hintze H. Cone beam CT and conventional tomography for the detection of morphological temporomandibular joint changes. Dentomaxillofacial Radiol. 2007;36:192-7.

Dworkin SF, LeResche L, DeRouen T. Assessing clinical signs of temporomandibular disorders: Realibility of clinical examiners. J Prosthetic Dentistry. 1990;63(9):574-9.