1
|
Gonzalez LV, López JP, Orjuela MP, de la Sen O, Díaz-Báez D, Martin-Granizo R. Could temporomandibular joint arthroscopic discopexy with resorbable pins or disc mobilisation influence mandibular condyle marrow? Br J Oral Maxillofac Surg 2025; 63:39-46. [PMID: 39592295 DOI: 10.1016/j.bjoms.2024.10.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 08/15/2024] [Accepted: 10/04/2024] [Indexed: 11/28/2024]
Abstract
The aim of this study was to evaluate the relationship between arthroscopic discopexy with resorbable pins or disc mobilisation and its effect on the bone marrow of the mandibular condyle. An observational analytical retrospective cohort study was conducted. The inclusion criteria comprised adult patients with Wilkes IV and V with MRI in T2 sequence undergoing TMJ arthroscopy. The first group included subjects who received discopexy with pins (Level III Arthroscopy), and the second included subjects who underwent disc mobilisation without any fixation (Level IIb Arthroscopy). Variables studied were maximum interincisal opening (MIO), pain, and Signal Intensity Ratio (SIR) index. Data were analysed using the chi-squared test, Fisher's exact test, the Mann Whitney U test, and the Shapiro-Wilk test. To establish the relationship between the variables and SIR ≥ 2, a multivariate analysis was performed using unconditional logistic regression. A total of 50 joints were divided in two groups. In the multivariate logistic regression analysis, discopexy surgery with pins (Odds Ratio OR = 0.03, 95% [CI] 0.02 to 0.69, p = 0.027) was identified as an independent predictor for the non-development of a high SIR score (≥2.0) after adjusting preoperative covariates. This study shows changes in the medullary signal in patients undergoing discopexy with resorbable pins. However, more studies are required that correlate quantitative measures.
Collapse
Affiliation(s)
- Luis Vicente Gonzalez
- Hospital Universitario La Samaritana, Bogotá, Colombia; Institución Universitaria Colegios de Colombia, Bogotá, Colombia
| | - Juan Pablo López
- Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, DC, Colombia; Universidad El Bosque, Unidad de Investigación en Epidemiología Clínica Oral UNIECLO, Bogotá, Colombia.
| | - María Paula Orjuela
- Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, DC, Colombia; Oral and Maxillofacial Surgery Program, Universidad El Bosque, Bogotá, Colombia
| | - Oscar de la Sen
- Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain
| | - David Díaz-Báez
- Unit of Basic Oral Investigation (UIBO), Facultad de odontología, Universidad El Bosque, Bogotá, Colombia
| | - Rafael Martin-Granizo
- Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain
| |
Collapse
|
2
|
Tesch RDS, Calcia TBB, DE Nordenflycht D. Unveiling MRI-based structural phenotypes in temporomandibular joint osteoarthritis: implications for clinical practice and research. Dental Press J Orthod 2024; 29:e24spe4. [PMID: 39230116 PMCID: PMC11368237 DOI: 10.1590/2177-6709.29.4.e24spe4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 06/16/2024] [Indexed: 09/05/2024] Open
Abstract
INTRODUCTION Osteoarthritis (OA) is a progressive degenerative disease characterized by the gradual degradation of cartilage, remodeling of subchondral bone, synovitis, and chronic pain. This condition impacts various large and small joints, including the temporomandibular joint (TMJ). However, addressing OA, particularly in impeding or reducing disease progression, is challenging due to its clinical and imaging heterogeneity. Authors are increasingly suggesting that this heterogeneity involves different phenotypes or subpopulations, discernible by variations in the disease's pathophysiology and structural manifestations. Even within the TMJ, these phenotypes may display distinct clinical features, laboratory parameters, biochemical markers, and imaging criteria. Recent research has proposed MRI as a reference standard for TMJ OA, highlighting its substantial agreement with histopathological changes. MRI-based phenotypes offer a promising avenue for understanding disease progression and treatment response, potentially providing valuable insights for prognosis and treatment planning. OBJECTIVE This article introduces the ROAMES-TMJ (Rapid OsteoArthritis MRI Eligibility Score for TMJ) to assess the structural eligibility of individuals for inclusion in TMJ OA clinical trials.
Collapse
Affiliation(s)
- Ricardo de Souza Tesch
- Centro Universitário Arthur Sá Earp Neto/Faculdade de Medicina de Petrópolis (UNIFASE/FMP)
| | | | | |
Collapse
|
3
|
Sang S, Ameli N, Almeida FT, Friesen R. Association between clinical symptoms and MRI image findings in symptomatic temporomandibular joint (TMJ) disease: A systematic review. J Craniomaxillofac Surg 2024; 52:835-842. [PMID: 38724287 DOI: 10.1016/j.jcms.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 01/16/2024] [Accepted: 04/11/2024] [Indexed: 07/23/2024] Open
Abstract
To evaluate the association between clinical signs and symptoms of temporomandibular joint (TMJ) and magnetic resonance image (MRI) findings in patients with temporomandibular disorders (TMD). Relevant articles on humans over 18 years of age were obtained from five databases (Ovid MEDLINE, PubMed, Scopus, Web of Science, and Google Scholar) up to August 2022. Risk of bias assessment was completed using the Joanna Briggs Institute critical appraisal tools. The GRADEpro (Grading of Recommendations, Assessment, Development, and Evaluation) instrument was applied to assess the level of evidence across studies in a GRADE Summary of Findings table. In total, 22 studies were included in this systematic review. Of these, 11 studies highlighted that joint pain was positively associated with particular MRI findings: joint effusion, bone marrow edema, disk displacement with/without reduction, and condylar erosion. Masticatory muscle pain was found to have a strong positive correlation with disk displacement in four studies. Five studies found no significant association between MRI findings and masticatory muscle pain. Range of motion and MRI findings were examined in six studies. Limited mouth opening was found to be correlated with disk displacement in five studies. Of the 11 studies evaluating the correlation between joint noise and MRI findings, eight reported a significant association between disk displacement and TMJ noise. The results suggested that patients with joint pain and limited range of motion may benefit from MRI. Patients exhibiting primarily muscle pain are unlikely to benefit clinically from MRI. Future studies with improved quality are warranted.
Collapse
Affiliation(s)
- Sara Sang
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Nazila Ameli
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Fabiana T Almeida
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Reid Friesen
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| |
Collapse
|
4
|
Higuchi K, Chiba M, Sai Y, Yamaguchi Y, Nogami S, Yamauchi K, Takahashi T. Relationship between temporomandibular joint pain and magnetic resonance imaging findings in patients with temporomandibular joint disorders. Int J Oral Maxillofac Surg 2020; 49:230-236. [DOI: 10.1016/j.ijom.2019.06.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/23/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
|
5
|
Matsubara R, Yanagi Y, Oki K, Hisatomi M, Santos KC, Bamgbose BO, Fujita M, Okada S, Minagi S, Asaumi J. Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders. Dentomaxillofac Radiol 2018; 47:20170412. [PMID: 29451403 DOI: 10.1259/dmfr.20170412] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate the correlations among various temporomandibular joint (TMJ) findings on MRI and the relationships between MRI findings and symptoms. METHODS 425 patients (850 TMJs) with temporomandibular joint disorders (TMDs) who underwent MRI were enrolled. Oblique sagittal proton density-weighted and T2 weighted images in open- and closed-mouth positions were evaluated. MRI findings included disc configuration, disc position, condylar morphology, bone marrow pattern, and joint effusion. Symptoms included TMJ pain, TMJ noise, and limitation of mouth opening. For statistical analyses, Spearman's rank correlation coefficient and logistic regression analysis were applied. RESULTS Folded disc, disc displacement without reduction (DDWOR), and osteophytes had significant negative correlations with other normal MRI findings (p < 0.01). DDWOR and marrow edema were associated with TMJ pain. Conversely, osteophytes [odds ratio (OR): 0.52; 95% CI (0.30-0.90)] and combination-type condylar degeneration [OR: 0.45; 95% CI (0.24-0.83)] were associated with decreased risk of TMJ pain. Condylar flattening was positively associated with TMJ noise [OR: 5.25; 95% CI (1.44-19.07)] and negatively associated with limitation of mouth opening [OR: 0.34; 95% CI (0.11-0.99)]. High-grade joint effusion was significantly associated with TMJ pain and noise. CONCLUSIONS DDWOR and high-grade joint effusion (an indicator of inflammation in the articular cavity) were associated with TMD symptoms. This finding suggests that treatment strategy for DDWOR and decreasing inflammation might lessen clinical TMD symptoms. Condylar degeneration was not associated with indicators of inflammation or TMJ symptoms. These results suggest that patients with TMD symptoms should undergo initial MRI to allow rapid selection of appropriate therapies.
Collapse
Affiliation(s)
- Risa Matsubara
- 1 Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan
| | - Yoshinobu Yanagi
- 2 Department of Dental Informatics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan
| | - Kazuhiro Oki
- 3 Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan
| | - Miki Hisatomi
- 4 Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital , Okayama , Japan
| | - Karina Cp Santos
- 5 Department of Stomatology, School of Dentistry, University of Sao Paulo , Sao Paulo , Brazil
| | - Babatunde O Bamgbose
- 1 Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan.,6 Oral Diagnostic Sciences, Faculty of Dentistry, Bayero University , kano , Nigeria
| | - Mariko Fujita
- 7 Preliminary Examination Room, Okayama University Hospital , Okayama , Japan
| | - Shunsuke Okada
- 4 Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital , Okayama , Japan
| | - Shogo Minagi
- 3 Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan.,8 Department of Occlusal and Oral Funtional Rehabilitation, Okayama University Hospital , Okayama , Japan
| | - Junichi Asaumi
- 1 Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan.,4 Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital , Okayama , Japan.,7 Preliminary Examination Room, Okayama University Hospital , Okayama , Japan
| |
Collapse
|
6
|
Evaluation of lateral pterygoid muscles in painful temporomandibular joints by signal intensity on fluid-attenuated inversion recovery images. Oral Radiol 2017; 34:17-23. [PMID: 30484089 DOI: 10.1007/s11282-017-0272-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/11/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Pathological changes of the lateral pterygoid muscle (LPM) have been investigated using various modalities, including magnetic resonance (MR) imaging and electromyography. Fluid-attenuated inversion recovery (FLAIR) is an MR sequence that we hypothesized can be used to evaluate abnormalities of the LPM. The purpose of this study was to analyze the FLAIR signal intensity of the LPM in painful temporomandibular joints (TMJs) and investigate the pathological changes of the muscle. METHODS The study was based on 149 TMJs of 77 patients who were referred for MR imaging of the TMJ. Patients rated their degree of pain during chewing and mouth opening using a visual analog scale (VAS). Regions of interest were placed over the superior and inferior heads of the LPM and gray matter on FLAIR sagittal images. Using the signal intensity of gray matter as a reference, the signal intensity ratio (SIR) of the LPM was calculated. Spearman's rank-correlation coefficient was used to analyze the correlation between the SIR and the VAS score (p < 0.05). RESULTS A significant correlation was present between the SIR on FLAIR images and the VAS score. CONCLUSIONS These results suggest that the FLAIR signal intensity of the superior and inferior heads of the LPM significantly increases as TMJ pain becomes more severe. Thus, FLAIR could be useful in assessing the relationship between the MR signals of the LPM and clinical symptoms.
Collapse
|
7
|
Suenaga S, Nagayama K, Nagasawa T, Indo H, Majima HJ. The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders. JAPANESE DENTAL SCIENCE REVIEW 2016; 52:93-106. [PMID: 28408961 PMCID: PMC5390340 DOI: 10.1016/j.jdsr.2016.04.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 04/14/2016] [Accepted: 04/26/2016] [Indexed: 12/30/2022] Open
Abstract
The causes of pain symptoms in the temporomandibular joint (TMJ) and masticatory muscle (MM) regions may not be determined by clinical examination alone. In this review, we document that pain symptoms of the TMJ and MM regions in patients with temporomandibular disorders (TMDs) are associated with computed tomography and magnetic resonance (MR) findings of internal derangement, joint effusion, osteoarthritis, and bone marrow edema. However, it is emphasized that these imaging findings must not be regarded as the unique and dominant factors in defining TMJ pain. High signal intensity and prominent enhancement of the posterior disk attachment on fat saturation T2-weighted imaging and dynamic MR imaging with contrast material are closely correlated with the severity of TMJ pain. Magnetic transfer contrast, MR spectroscopy, diffusion tensor imaging, and ultrasonography findings have helped identify intramuscular edema and contracture as one of the causes of MM pain and fatigue. Recently, changes in brain as detected by functional MR neuroimaging have been associated with changes in the TMJ and MM regions. The thalamus, the primary somatosensory cortex, the insula, and the anterior and mid-cinglate cortices are most frequently associated with TMD pain.
Collapse
Affiliation(s)
- Shigeaki Suenaga
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Kunihiro Nagayama
- Department of Orthodontics and Dentofacial Orthopedics, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Taisuke Nagasawa
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hiroko Indo
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hideyuki J. Majima
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| |
Collapse
|
8
|
Wahaj A, Hafeez K, Zafar MS. Association of bone marrow edema with temporomandibular joint (TMJ) osteoarthritis and internal derangements. Cranio 2016; 35:4-9. [PMID: 27077262 DOI: 10.1080/08869634.2016.1156282] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This study reviewed the dental literature in order to determine the association of bone marrow edema with osteoarthritis and temporomandibular joint (TMJ) internal derangement disorders. METHODS A literature search was performed using electronic databases PubMed/Medline (National Library of Medicine, Bethesda, Maryland) and Cochrane for articles published during the last 15 years (January 2000-December 2014). A predetermined inclusion and exclusion criteria were used for filtering the scientific papers. Research articles fulfilling the basic inclusion criteria were included in the review. RESULTS The reviewed studies showed that bone marrow edema is found in painful joints with osteoarthritis in a majority of cases. A few cases with no pain or significant degenerative changes are reported to have a bone marrow edema pattern as well. CONCLUSIONS Bone marrow edema, increased fluid level, and pain are associated with osteoarthritis in the majority of patients reporting TMJ arthritis. Degenerative and disc displacement conditions are multifactorial and require further investigations. Magnetic resonance imaging can be employed to detect bone marrow edema even in the absence of pain and clinical symptoms in the patients of internal derangements.
Collapse
Affiliation(s)
- Aiyesha Wahaj
- a Department of Orthodontics , Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University , Karachi , Pakistan
| | - Kashif Hafeez
- b Oxford Deanery, Broadshires Dental Practice , Carterton , Oxon, OX18 1JA , UK
| | | |
Collapse
|
9
|
Gomes LR, Gomes M, Jung B, Paniagua B, Ruellas AC, Gonçalves JR, Styner MA, Wolford L, Cevidanes L. Diagnostic index of three-dimensional osteoarthritic changes in temporomandibular joint condylar morphology. J Med Imaging (Bellingham) 2015; 2:034501. [PMID: 26158119 PMCID: PMC4495313 DOI: 10.1117/1.jmi.2.3.034501] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 06/09/2015] [Indexed: 11/14/2022] Open
Abstract
This study aimed to investigate imaging statistical approaches for classifying three-dimensional (3-D) osteoarthritic morphological variations among 169 temporomandibular joint (TMJ) condyles. Cone-beam computed tomography scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA), 15 subjects at initial diagnosis of OA, and 7 healthy controls. Three-dimensional surface models of the condyles were constructed and SPHARM-PDM established correspondent points on each model. Multivariate analysis of covariance and direction-projection-permutation (DiProPerm) were used for testing statistical significance of the differences between the groups determined by clinical and radiographic diagnoses. Unsupervised classification using hierarchical agglomerative clustering was then conducted. Compared with healthy controls, OA average condyle was significantly smaller in all dimensions except its anterior surface. Significant flattening of the lateral pole was noticed at initial diagnosis. We observed areas of 3.88-mm bone resorption at the superior surface and 3.10-mm bone apposition at the anterior aspect of the long-term OA average model. DiProPerm supported a significant difference between the healthy control and OA group ([Formula: see text]). Clinically meaningful unsupervised classification of TMJ condylar morphology determined a preliminary diagnostic index of 3-D osteoarthritic changes, which may be the first step towards a more targeted diagnosis of this condition.
Collapse
Affiliation(s)
- Liliane R. Gomes
- University of Michigan, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, 1011 North University Avenue, Ann Arbor, Michigan 48109, United States
- UNESP Univ Estadual Paulista, Faculdade de Odontologia de Araraquara, Department of Orthodontics and Pediatric Dentistry, 1680 Humaita Street, Centro, Araraquara, São Paulo 14801-903, Brazil
| | - Marcelo Gomes
- University of Michigan, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, 1011 North University Avenue, Ann Arbor, Michigan 48109, United States
- Private practice, Salvador, Bahia 41940-455, Brazil
| | - Bryan Jung
- University of North Carolina, School of Medicine, Department of Psychiatry, 101 Manning Drive, Chapel Hill, North Carolina 27599, United States
| | - Beatriz Paniagua
- University of North Carolina, School of Medicine, Department of Psychiatry, 101 Manning Drive, Chapel Hill, North Carolina 27599, United States
| | - Antonio C. Ruellas
- University of Michigan, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, 1011 North University Avenue, Ann Arbor, Michigan 48109, United States
- University of North Carolina, School of Medicine, Department of Psychiatry, 101 Manning Drive, Chapel Hill, North Carolina 27599, United States
| | - João Roberto Gonçalves
- UNESP Univ Estadual Paulista, Faculdade de Odontologia de Araraquara, Department of Orthodontics and Pediatric Dentistry, 1680 Humaita Street, Centro, Araraquara, São Paulo 14801-903, Brazil
| | - Martin A. Styner
- University of North Carolina, School of Medicine, Department of Psychiatry, 101 Manning Drive, Chapel Hill, North Carolina 27599, United States
| | - Larry Wolford
- Federal University of Rio de Janeiro, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Carlos Chagas Filho Avenue, Cidade Universitária, Rio de Janeiro 21941-902, Brazil
| | - Lucia Cevidanes
- University of Michigan, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, 1011 North University Avenue, Ann Arbor, Michigan 48109, United States
| |
Collapse
|
10
|
Suenaga S, Nagayama K, Nagasawa T, Kawabata Y, Indo H, Majima HJ. Evaluation of the relationships between contrast-enhanced magnetic resonance characteristics and joint pain in patients with temporomandibular disorders. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0213-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Kodama S, Otonari-Yamamoto M, Sano T, Sakamoto J, Imoto K, Wakoh M. Signal intensity on fluid-attenuated inversion recovery images of condylar marrow changes correspond with slight pain in patients with temporomandibular joint disorders. Oral Radiol 2014; 30:212-218. [PMID: 25177105 PMCID: PMC4145205 DOI: 10.1007/s11282-014-0165-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 12/23/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Edema and necrosis of the temporomandibular joint (TMJ) have been described in terms of bone marrow signal abnormalities in magnetic resonance imaging (MRI). However, painful joints often show no such signaling abnormalities, making the diagnosis of TMJ disorders difficult in the clinical setting. An association has been suggested between TMJ bone marrow change and TMJ pain, but even when such change results in slight pain, it may be too slight to be visually apparent on MR images. We hypothesized that fluid-attenuated inversion recovery (FLAIR) can be used to detect such minimal changes. The purpose of this study was to determine whether there is an association between signal intensity on FLAIR images and pain in the TMJ. METHODS The study included 85 TMJs in 45 patients referred to our department for MRI. The signal intensity on FLAIR images was measured. Pain was evaluated based on the visual analog scale. An unpaired t test and Pearson's product-moment correlation coefficient were used for the statistical analysis. A p value of <0.05 was considered statistically significant. RESULTS Signal intensity on the FLAIR images was significantly higher in painful than in nonpainful TMJs, although a significant correlation was not observed between the signal intensity and the pain score. CONCLUSIONS The results of this study suggest an association between abnormalities in the marrow of the mandibular condyle and pain. They also indicate that FLAIR imaging is a useful tool in the clinical diagnosis of painful TMJs.
Collapse
Affiliation(s)
- Sayaka Kodama
- Department of Physiology, Tokyo Dental College, Misakichyo 2-1-14, Chiyoda-ku, Tokyo, 101-0061 Japan
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, Tokyo, Japan
| | | | - Tsukasa Sano
- Division of Radiology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, Tokyo, Japan
| | - Junichirou Sakamoto
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Imoto
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, Tokyo, Japan
| | - Mamoru Wakoh
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, Tokyo, Japan
| |
Collapse
|
12
|
Hanyuda H, Otonari-Yamamoto M, Imoto K, Sakamoto J, Kodama S, Kamio T, Sano T. Analysis of elements in a minimal amount of temporomandibular joint fluid on fluid-attenuated inversion recovery magnetic resonance images. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:114-20. [DOI: 10.1016/j.oooo.2012.09.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 09/13/2012] [Accepted: 09/21/2012] [Indexed: 11/30/2022]
|
13
|
Larheim TA, Sano T, Yotsui Y. Clinical Significance of Changes in the Bone Marrow and Intra-Articular Soft Tissues of the Temporomandibular Joint. Semin Orthod 2012. [DOI: 10.1053/j.sodo.2011.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
14
|
Imoto K, Otonari-Yamamoto M, Nishikawa K, Sano T, Yamamoto A. Potential of fluid-attenuated inversion recovery (FLAIR) in identification of temporomandibular joint effusion compared with T2-weighted images. ACTA ACUST UNITED AC 2011; 112:243-8. [DOI: 10.1016/j.tripleo.2011.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 03/02/2011] [Accepted: 03/04/2011] [Indexed: 12/24/2022]
|
15
|
Sano T, Yajima A, Otonari-Yamamoto M, Wakoh M, Katakura A. Interpretation of images and discrepancy between osteoarthritic findings and symptomatology in temporomandibular joint. JAPANESE DENTAL SCIENCE REVIEW 2008. [DOI: 10.1016/j.jdsr.2008.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
|