Top

Clinical Oral Investigations

Published in:

01-05-2013 | Original Article

Disk and joint morphology variations on coronal and sagittal MRI in temporomandibular joint disorders

Authors: Oana C. Almăşan, Mihaela Hedeşiu, Grigore Băciuţ, Daniel C. Leucuţa, Mihaela Băciuţ

Published in: Clinical Oral Investigations | Issue 4/2013

Abstract

Objectives

This study aims to assess the disk morphology and the condyle position in subjects with temporomandibular (TMJ) disk displacements on sagittal and coronal magnetic resonance imaging (MRI).

Materials and methods

Seventy-four TMJs (from 37 patients) with positive clinical TMD symptoms according to the RDC/TMD axis I protocol were evaluated by 1.5 T MRI. Disk position, disk morphology, sagittal and coronal condyle position, joint effusion, joint space, and coronal condyle angulation were evaluated. Multivariate logistic regression was used to explore the relationship between disk displacement and MRI variables.

Results

Disk displacement with reduction (DDR) was found in 36.48 % and without reduction (DDwR), in 21.62 % of the joints. Disk displacement was anterior in 35.1 %, anterior-medial in 13.5 %, and anterior-lateral in 9.45 % of cases. The thickened posterior band (94.48 OR, p = 0.001) and the posterior condyle position (4.57 OR, p = 0.03) were more likely found on sagittal MRI in disk displacements. On coronal slices, the disk displacement was significantly associated with the distance from the most medial condyle point to the midplane (p < 0.05).

Conclusions

Disk displacement is associated with changes of disk shape, disk dimension, and condyle position on sagittal MRI. A significant variation of the distance from the most medial condyle point to the midplane in disk displacement was found on coronal MRI.

Clinical relevance

Our study highlights the existence of changes on coronal MRI in TMD patients which should be assessed for better understanding of the clinical evolution of temporomandibular disorders.

Gahleitner A, Watzek G, Imhof H (2003) Dental CT: imaging technique, anatomy, and pathologic conditions of the jaws. Eur Radiol 13:366–410PubMed

Tasaki MM, Westesson PL (1993) Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging. Radiology 186:723–729PubMed

Boeddinghaus R, Whyte A (2008) Current concepts in maxillofacial imaging. Eur J Radiol 66:396–418PubMedCrossRef

Guler N, Yatmaz PI, Ataoglu H, Emlik D, Uckan S (2003) Temporomandibular internal derangement: correlation of MRI findings with clinical symptoms of pain and joint sounds in patients with bruxing behaviour. Dentomaxillofac Radiol 32:304–310PubMedCrossRef

Abolmaali ND, Schmitt J, Schwarz W, Toll DE, Hinterwimmer S, Vogl TJ (2004) Visualization of the articular disk of the temporomandibular joint in near-real-time MRI: feasibility study. Eur Radiol 14:1889–1894PubMed

Tasali N, Cubuk R, Aricak M, Ozarar M, Saydam B, Nur H, Tuncbilek N (2012) Temporomandibular joint (TMJ) pain revisited with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Eur J Radiol 81:603–608PubMedCrossRef

Farina D, Bodin C, Gandolfi S, De Gasperi W, Borghesi A, Maroldi R (2009) TMJ disorders and pain: assessment by contrast-enhanced MRI. Eur J Radiol 70:25–30PubMedCrossRef

Park JW, Song HH, Roh HS, Kim YK, Lee JY (2012) Correlation between clinical diagnosis based on RDC/TMD and MRI findings of TMJ internal derangement. Int J Oral Maxillofac Surg 41:103–108PubMedCrossRef

Larheim TA, Westesson P, Sano T (2001) Temporomandibular joint disk displacement: comparison in asymptomatic volunteers and patients. Radiology 218:428–432PubMed

10.

Schmitter M, Kress B, Ludwig C, Koob A, Gabbert O, Rammelsberg P (2005) Temporomandibular joint disk position assessed at coronal MR imaging in asymptomatic volunteers. Radiology 236(2):559–564PubMedCrossRef

11.

Brooks S, Westesson PL (1993) Temporomandibular joint: value of coronal MR images. Radiology 188:317–321PubMed

12.

Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 6:301–355PubMed

13.

Manfredini D, Guarda-Nardini L (2008) Agreement between Research Diagnostic Criteria for Temporomandibular Disorders and magnetic resonance diagnoses of temporomandibular disk displacement in a patient population. Int J Oral Maxillofac Surg 37:612–616PubMedCrossRef

14.

Orhan K, Nishiyama H, Tadashi S, Murakami S, Furukawa S (2006) Comparison of altered signal intensity, position, and morphology of the TMJ disk in MR images corrected for variations in surface coil sensitivity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:515–522PubMedCrossRef

15.

Robinson de Senna B, Marques LS, França JP, Ramos-Jorge ML, Pereira LJ (2009) Condyle-disk-fossa position and relationship to clinical signs and symptoms of temporomandibular disorders in women. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:e117–124PubMed

16.

Kundel HL, Polansky M (2003) Measurement of observer agreement. Radiology 228:303–308PubMedCrossRef

17.

R Development Core Team. R (2004) A language and environment for statistical computing, 4th edn. R Foundation for Statistical Computing, Vienna, http://www.R-project.org

18.

Sxener S, Akgunlu F (2004) MRI characteristics of anterior disk displacement with and without reduction. Dentomaxillofac Radiol 33:245–252CrossRef

19.

Incesu L, Taskaya-Yilmaz N, Ogutcen-Toller M, Uzun E (2004) Relationship of condylar position to disk position and morphology. Eur J Radiol 51:269–273PubMedCrossRef

20.

Heffez L, Jordan S (1989) A classification of temporomandibular joint disk morphology. Oral Surg Oral Med Oral Pathol 67:11–19PubMedCrossRef

21.

Miller TL, Katzberg RW, Tallents RH, Bessette RW, Hayakawa K (1985) Temporomandibular joint clicking with nonreducing anterior displacement of the meniscus. Radiology 154:121–124PubMed

22.

Taşkaya-Yýlmaz N, Oğütcen-Toller M (2002) Clinical correlation of MRI findings of internal derangements of the temporomandibular joints. Br J Oral Maxillofac Surg 40:317–321PubMedCrossRef

23.

Wang M, Cao H, Ge Y, Widmalm SE (2009) Magnetic resonance imaging on TMJ disk thickness in TMD patients: a pilot study. J Prosthet Dent 102:89–93PubMedCrossRef

24.

Rammelsberg P, Jäger L, Duc JM (2000) Magnetic resonance imaging-based joint space measurements in temporomandibular joints with disk displacements and in controls. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:240–248PubMedCrossRef

25.

Pereira LJ, Gavião M, Bonjardim LR, Castelo PM (2007) Ultrasound and tomographic evaluation of temporomandibular joints in adolescents with and without signs and symptoms of temporomandibular disorders: a pilot study. Dentomaxillofac Radiol 36:402–408PubMedCrossRef

26.

Roh HS, Kim W, Kim YK, Lee JY (2012) Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings. J Craniomaxillofac Surg 40:283–286PubMedCrossRef

27.

Manfredini D, Basso D, Arboretti R, Guarda-Nardini L (2009) Association between magnetic resonance signs of temporomandibular joint effusion and disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:266–271PubMedCrossRef

28.

Larheim TA, Westesson PL, Sano T (2001) MR grading of temporomandibular joint fluid: association with disk displacement categories, condyle marrow abnormalities and pain. Int J Oral Maxillofac Surg 30:104–112PubMedCrossRef

29.

Huh JK, Kim HG, Ko JY (2003) Magnetic resonance imaging of temporomandibular joint synovial fluid collection and disk morphology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 95:665–671PubMedCrossRef

Title: Disk and joint morphology variations on coronal and sagittal MRI in temporomandibular joint disorders
Authors: Oana C. Almăşan
Mihaela Hedeşiu
Grigore Băciuţ
Daniel C. Leucuţa
Mihaela Băciuţ
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Clinical Oral Investigations / Issue 4/2013
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-012-0803-4

At a glance: The STEP trials

Springer Medicine

Disk and joint morphology variations on coronal and sagittal MRI in temporomandibular joint disorders

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 4/2013

Changes in mastication after an immediate loading implantation with complete fixed rehabilitation

Oral mucosa produces cytokines and factors influencing osteoclast activity and endothelial cell proliferation, in patients with osteonecrosis of jaw after treatment with zoledronic acid

In vivo hemostatic efficacy of polyurethane foam compared to collagen and gelatin

Mapping cavitation activity around dental ultrasonic tips

Accuracy of digital models obtained by direct and indirect data capturing

Non-surgical periodontal therapy influences salivary melatonin levels