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Analysis of three-dimensional imaging findings and clinical symptoms in patients with temporomandibular joint disorders

Authors
 Kug Jin Jeon  ;  Chena Lee  ;  Yoon Joo Choi  ;  Sang-Sun Han 
Citation
 QUANTITATIVE IMAGING IN MEDICINE AND SURGERY, Vol.11(5) : 1921-1931, 2021-05 
Journal Title
QUANTITATIVE IMAGING IN MEDICINE AND SURGERY
ISSN
 2223-4292 
Issue Date
2021-05
Keywords
Cone-beam computed tomography (CBCT) ; magnetic resonance imaging (MRI) ; temporomandibular joint ; temporomandibular joint disorders (TMD) ; three-dimensional image
Abstract
Background: The purpose of this study was to analyze cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) findings in temporomandibular joint disorder (TMD) patients and to comprehensively assess the relationships between these imaging findings and clinical symptoms.

Methods: A total of 754 temporomandibular joints (TMJs) in 377 patients with clinical symptoms of TMD who underwent both CBCT and MRI examinations were retrospectively reviewed. Clinical symptoms included TMJ pain, TMJ sound, and limitation of mouth opening. Oral radiologists evaluated osseous changes of the condylar head on CBCT, as well as the disc configuration, internal derangement, and joint effusion on MRI. The frequency of CBCT and MRI findings and the mean and standard deviation of age were analyzed. Logistic regression analysis was used to identify associations between these imaging findings and clinical symptoms using SPSS version 25.0 for Windows (IBM Corp., Armonk, NY, USA). The model fit was evaluated using the Hosmer and Lemeshow test.

Results: TMD patients consisted of 294 females and 83 males, and the age group of 20-39 accounted for 47.2% of the patients. Normal findings regarding osseous changes of the condylar head on CBCT were found in 65.1% of the patients. On MRI, a change in disc configuration was found in 54.9% of the patients, internal derangement in 62.6%, and joint effusion in 46.0%. TMJ pain was significantly associated with sclerosis [odds ratio (OR): 3.81], disc displacement without reduction (DDWOR) (OR: 3.22), grade 2 joint effusion (OR: 2.33), and grade 3 joint effusion (OR: 5.54). TMJ sound was significantly associated with disc displacement with reduction (DDWR) (OR: 3.04), DDWOR (OR: 2.50), grade 2 joint effusion (OR: 2.37), and grade 3 joint effusion (OR: 3.23). Limitation of mouth opening was significantly associated with flattened disc configuration (OR: 2.08), folded disc configuration (OR: 2.30), and grade 3 joint effusion (OR: 2.85).

Conclusions: CBCT findings had little to do with clinical symptoms. In contrast, MRI findings, including disc configuration, internal derangement, and joint effusion, were associated with clinical symptoms. These results suggest that MRI should be recommended over CBCT for the proper diagnosis of TMD patients.
Files in This Item:
T202100997.pdf Download
DOI
10.21037/qims-20-857
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Radiology (영상치의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Chena(이채나) ORCID logo https://orcid.org/0000-0002-8943-4192
Jeon, Kug Jin(전국진) ORCID logo https://orcid.org/0000-0002-5862-2975
Choi, Yoon Joo(최윤주) ORCID logo https://orcid.org/0000-0001-9225-3889
Han, Sang Sun(한상선) ORCID logo https://orcid.org/0000-0003-1775-7862
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182819
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