Study of the temporomandibular disorders (TMD) with Magnetic resonance
imaging (MRI) with active and passive mouth opening.
Ch. Papadeli1 , C. Kouskouras2 , G. Venetis3 , Adamantia Filippou4 1,3,4
1,3,4 Aristotle University of Thessaloniki, Faculty of Health Sciences, School of Dentistry, Greece,
2 Aristotle University of Thessaloniki, Faculty of Health Sciences, School of Medicine, Gree
DOI: DOI:https://dx.doi.org/10.54936/haoms2412535
SUMMARY: Objectives: TMD evaluation heavily relies on magnetic resonance imaging (MRI). In several investigations, the MRI examination results do not support the clinical diagnosis. The clinical examination’s diagnostic precision varies, falling between 54 and 90 percent. Our working theory holds that the method used to acquire the MRI is what allows for the acquisition of objective diagnostic findings. Materials and Method: The RDC-TMD diagnostic technique identified 30 patients as having “anterior displacement with reduction as the subjects. The results of the MRI test performed with the mouth closed supported the clinical diagnosis. The distance between the center of the condyle head and the apex of the articular eminence for each joint, as well as the range of motion of the condyle by passive mouth opening (biting a 60ml syringe plunger) and by active maximal mouth opening, without the use of an intraoral appliance, were calculated for each patient in the closed mouth position. Results: The condyle has a wider range of motion with the active opening typically, but the passive opening typically hides subluxation due to hypermobility.Conclusion: Our data underwent statistical analysis, which
demonstrated that active and passive opening are two distinct techniques that provide access to various imaging findings.
KEY WORDS: Magnetic resonance imaging (MRI), temporomandibular disorders (TMD), subluxation
REFERENCES:
1. Papadeli Ch. Study of the temporomandibular disorders (TMD) using magnetic resonance imaging (MRI) with active and passive mouth opening,2017, Doctoral dissertation, ΑUΤΗ, Τhessaloniki
2. Aoyama S, Kino K, Amagasa T, et al. Clinical and Magnetic resonance imaging study of unilateral sideways disc displacements of Temporomandibular joint. J Med Dent Sci 2002; 49: 89-94.
3. Larheim TA, Westesson PL, Sano T. Temporomandibular Joint Disc Displacement. Comparison in asymptomatic volunteers and patients. Radiology 2001; 218: 428-432.
4. Kannan A, Sathasivasubramanian S. Comparative study of clinical and Magnetic resonance imaging diagnosis in patients with internal derangement of temporomandibular joint. J Indian Acad Oral Med Radiol 2011; 23: 569-575.
5. Benbelaid R, Fleiter B. Sensitivity and specificity of a new MRI method evaluating temporomandibula joint disc condyle relationship- in vivo study. Surg Radiol Anat 2006; 28: 71-75.
6. Manfredini D, Guarda-Nardini L. 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 2008; 37: 612-616.
7. Orhan K, Nishiyama H, Tadashi S, Murakami S, Furukawa S. 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 2006; 101: 515-522.
8. Marguelles-Bonnet RE, Carpentier P, Yung JP, et al. Clinical diagnosis compared with findings of magnetic resonance imaging in 242 patients with internal derangement of the TMJ. J Orofac Pain 1995;
9: 244-253. 9. Orsini MG, Kuboki T, Terada S, Matsuka Y, Yamashita A, Clark GT. Diagnostic value of 4 criteria to interpret temporomandibular joint normal disk position on magnetic resonance images. Oral Surg Oral Med 1998; 86: 489-97
10. Manfredini D, Guarda-Nardini L, Winocur E, et al. Research diagnostic criteria for temporomandibular disorders: A systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112: 453-462
11. Barclay P, Hollender LG, Maravilla KR, Truelove EL. Comparison of clinical and magnetic resonance imaging diagnosis in patients with disk displacement in the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 37-43.
12. Usumez S, Oz F, Guray E. Comparison of clinical and magnetic resonance imaging diagnoses in patient with TMD history. J Oral Rehabil 2004; 31: 52-56. 13. Limchaichana N, Nilsson H, Ekberg EC, Nilner M, Petersson A. Clinical diagnoses and MRI findings in patients with TMD pain. J Oral Rehabil 2007; 34: 237-245.
14. Schmitter M, Kress B, Rammelsberg P. Temporomandibular joint pathosis in patients with myofascial pain: A comparative analysis of magnetic resonance imaging and a clinical examination based on a specific set of criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97: 318-324.
15. Tasaki MM, Westesson PL, Isberg AM. Classification and prevalence of temporomandibular joint disc displacement in patients and symptom-free volunteers. Am J Orthod Dentofacial Orthop. 1996; 109: 249-262.
16. Helms CA, Kaplan P. Diagnostic imaging of the temporomandibular joint: Recommendations for use of the various techniques. AJR Am J Roentgenol. 1990; 154: 319-322.
17. Rammelsberg P, Pospiech PR, Jäger L, Duc JMP, Böhm AO, Gernet W. “Variability of disk position in asymptomatic volunteers and patients with internal derangements of the TMJ”, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 1997; 83 (3) : 393-399.
18. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med. 1997; 8: 291-305. 19. Schiffman E. et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. Journal of Oral & Facial Pain and Headache 2014; 28: 6-27.
20. Takatsuka S, Yoshida K, Ueki K, et al. Disc and condyle translation in patients with temporomandibular disorder. Oral Surg Oral Med Oral Path 2005; 99: 614-621
21. Beer A, Kolk A, Neff A, et al. Cine MRI of the temporomandibular joint in comparison to static MRI and axiography [in German]. Rofo 2004; 176: 506-512. 22. Chang TH, Yuh DY, Wu YT, Cheng WC, Lin FG, Shieh YS, Fu E, Huang RY. The association between temporomandibular disorders and joint hypermobility syndrome: a nationwide population-based study. Clin Oral Investig 2015; 19(8): 2123- 32.
23. Tomas X. Berenguer J, Quinto L, Nicolaou C, Mercader J-M, Castro V. MR Imaging of Temporomandibular Joint Dysfunction: A Pictorial Review RadioGraphics 2006; 26: 765-781.
1,3,4 Aristotle University of Thessaloniki, Faculty of Health Sciences, School of Dentistry, Greece,
2 Aristotle University of Thessaloniki, Faculty of Health Sciences, School of Medicine, Gree
DOI: DOI:https://dx.doi.org/10.54936/haoms2412535
SUMMARY: Objectives: TMD evaluation heavily relies on magnetic resonance imaging (MRI). In several investigations, the MRI examination results do not support the clinical diagnosis. The clinical examination’s diagnostic precision varies, falling between 54 and 90 percent. Our working theory holds that the method used to acquire the MRI is what allows for the acquisition of objective diagnostic findings. Materials and Method: The RDC-TMD diagnostic technique identified 30 patients as having “anterior displacement with reduction as the subjects. The results of the MRI test performed with the mouth closed supported the clinical diagnosis. The distance between the center of the condyle head and the apex of the articular eminence for each joint, as well as the range of motion of the condyle by passive mouth opening (biting a 60ml syringe plunger) and by active maximal mouth opening, without the use of an intraoral appliance, were calculated for each patient in the closed mouth position. Results: The condyle has a wider range of motion with the active opening typically, but the passive opening typically hides subluxation due to hypermobility.Conclusion: Our data underwent statistical analysis, which
demonstrated that active and passive opening are two distinct techniques that provide access to various imaging findings.
KEY WORDS: Magnetic resonance imaging (MRI), temporomandibular disorders (TMD), subluxation
REFERENCES:
1. Papadeli Ch. Study of the temporomandibular disorders (TMD) using magnetic resonance imaging (MRI) with active and passive mouth opening,2017, Doctoral dissertation, ΑUΤΗ, Τhessaloniki
2. Aoyama S, Kino K, Amagasa T, et al. Clinical and Magnetic resonance imaging study of unilateral sideways disc displacements of Temporomandibular joint. J Med Dent Sci 2002; 49: 89-94.
3. Larheim TA, Westesson PL, Sano T. Temporomandibular Joint Disc Displacement. Comparison in asymptomatic volunteers and patients. Radiology 2001; 218: 428-432.
4. Kannan A, Sathasivasubramanian S. Comparative study of clinical and Magnetic resonance imaging diagnosis in patients with internal derangement of temporomandibular joint. J Indian Acad Oral Med Radiol 2011; 23: 569-575.
5. Benbelaid R, Fleiter B. Sensitivity and specificity of a new MRI method evaluating temporomandibula joint disc condyle relationship- in vivo study. Surg Radiol Anat 2006; 28: 71-75.
6. Manfredini D, Guarda-Nardini L. 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 2008; 37: 612-616.
7. Orhan K, Nishiyama H, Tadashi S, Murakami S, Furukawa S. 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 2006; 101: 515-522.
8. Marguelles-Bonnet RE, Carpentier P, Yung JP, et al. Clinical diagnosis compared with findings of magnetic resonance imaging in 242 patients with internal derangement of the TMJ. J Orofac Pain 1995;
9: 244-253. 9. Orsini MG, Kuboki T, Terada S, Matsuka Y, Yamashita A, Clark GT. Diagnostic value of 4 criteria to interpret temporomandibular joint normal disk position on magnetic resonance images. Oral Surg Oral Med 1998; 86: 489-97
10. Manfredini D, Guarda-Nardini L, Winocur E, et al. Research diagnostic criteria for temporomandibular disorders: A systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112: 453-462
11. Barclay P, Hollender LG, Maravilla KR, Truelove EL. Comparison of clinical and magnetic resonance imaging diagnosis in patients with disk displacement in the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 37-43.
12. Usumez S, Oz F, Guray E. Comparison of clinical and magnetic resonance imaging diagnoses in patient with TMD history. J Oral Rehabil 2004; 31: 52-56. 13. Limchaichana N, Nilsson H, Ekberg EC, Nilner M, Petersson A. Clinical diagnoses and MRI findings in patients with TMD pain. J Oral Rehabil 2007; 34: 237-245.
14. Schmitter M, Kress B, Rammelsberg P. Temporomandibular joint pathosis in patients with myofascial pain: A comparative analysis of magnetic resonance imaging and a clinical examination based on a specific set of criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97: 318-324.
15. Tasaki MM, Westesson PL, Isberg AM. Classification and prevalence of temporomandibular joint disc displacement in patients and symptom-free volunteers. Am J Orthod Dentofacial Orthop. 1996; 109: 249-262.
16. Helms CA, Kaplan P. Diagnostic imaging of the temporomandibular joint: Recommendations for use of the various techniques. AJR Am J Roentgenol. 1990; 154: 319-322.
17. Rammelsberg P, Pospiech PR, Jäger L, Duc JMP, Böhm AO, Gernet W. “Variability of disk position in asymptomatic volunteers and patients with internal derangements of the TMJ”, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 1997; 83 (3) : 393-399.
18. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med. 1997; 8: 291-305. 19. Schiffman E. et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. Journal of Oral & Facial Pain and Headache 2014; 28: 6-27.
20. Takatsuka S, Yoshida K, Ueki K, et al. Disc and condyle translation in patients with temporomandibular disorder. Oral Surg Oral Med Oral Path 2005; 99: 614-621
21. Beer A, Kolk A, Neff A, et al. Cine MRI of the temporomandibular joint in comparison to static MRI and axiography [in German]. Rofo 2004; 176: 506-512. 22. Chang TH, Yuh DY, Wu YT, Cheng WC, Lin FG, Shieh YS, Fu E, Huang RY. The association between temporomandibular disorders and joint hypermobility syndrome: a nationwide population-based study. Clin Oral Investig 2015; 19(8): 2123- 32.
23. Tomas X. Berenguer J, Quinto L, Nicolaou C, Mercader J-M, Castro V. MR Imaging of Temporomandibular Joint Dysfunction: A Pictorial Review RadioGraphics 2006; 26: 765-781.
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