The validity of transcranial radiography in diagnosis of internal derangement / 대한치과교정학회지

The purpose of this study was to determine whether association exists between temporomandibular joint (TMJ) characteristics in transcranial radiographs and TMJ internal derangement and to evaluate the validity of transcranial radiographs in diagnosis of internal derangement. Transcranial radiographs and magnetic resonance imaging (MRI) of 113 TMJs from 76 subjects were used for this study and all TMJs were classified into 3 groups according to the results of MRI: normal disk position, disk displacement with reduction, and disk displacement without reduction. Transcranial analysis included linear measurement of joint spaces and condylar head angle measurement. To determine any relationship between transcranial measurements according to disk displacement, one-way ANOVA was used. The results showed that condyle-fossa relationship in standard transcranial radiographs had no relationships with disk displacement. And, as disk displacement progressed, condylar angle between head and neck increased significantly. This result can be interpreted that condylar head angle reflects structural hard tissue change according to internal derangement progress. But this is insufficient in the determination of internal derangement. Therefore, although still clinically helpful, the validity of standard transcranial radiographs to diagnose TMJ internal derangement was questioned.

Transcranial radiograph and magnetic resonance imaging in the evaluation of osseous changes of the temporomandibular joint / 대한구강악안면방사선학회지

PURPOSE: To evaluate the diagnostic accuracy of transcranial radiographs and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) in the assessment of osseous changes of the condylar head and articular eminence. MATERIALS AND METHODS: Osseous changes of the TMJ were evaluated in forty-three patients. Osseous changes of the condylar head and articular eminence were observed in 41 joints and 64 joints, respectively on transcranial radiographs, and 48 joints and 59 joints, respectively on MRI. RESULTS: The flattening, sclerosis, erosion, and osteophyte formation of the condylar heads were observed in 36.6%, 43.9%, 12.2%, and 7.3%, respectively on transcranial radiographs compared with 35.4%, 20.8%, 37.5%, and 6.3%, respectively on MRI. While, the flattening, sclerosis, and erosion of the articular eminences were observed in 26.6%, 67.2%, and 6.2%, respectively on transcranial radiographs compared with 32.2%, 59.3%, and 8.5%, respectively on MRI. CONCLUSION: There were no statistical differences between transcranial radiographs and MRI scans in the detection of osseous changes of the TMJ. However, MRI scans were superior to the transcranial radiographs in the detection of erosion of the condylar head (p<0.01).

Comparison of condylar position in transcranial radiography and polytomography from Polytome-U / 대한구강악안면방사선학회지

The authors examined the condylar position and shape of condylar process from the transcranial radiographs and polytomographs of the 130 temporomandibular joints of 65 patients who complained symptoms of temporomandibular disorder and the followings were obtained ; 1. The age and sex distribution of the 65 patients showed peak incidence in 2nd decade (27.7%) followed by 3rd (18.5%) and 4th decade (18.5%) and female predominance (87.7%). 2. In polytomography 64 joints (49.2%) showed consistent condylar position from lateral to medial and 39 joints (30.0%) of them showed agreement with those of transcranial radiographs. Among the 66 joints (50.8%) which showed changes in condylar position, 48 joints (36.9%) showed agreement with lateral and central tomographic and transcranial radiographic position. 41 joints (31.5%) showed disagreement in condylar position between the polytomographic and transcranial radiographic images. 3. When the condylar position was classified as anterior, central and posterior, the posterior position was the most frequent position, that is , 42.3% of the transcranial radiography and 42.3%, 49.2% and 38.5% of the lateral, central and medial polytomographic radiographs. 4. In polytomography 84 joints (64.6%) showed consistent condylar shape from lateral to medial and 74 joints (56.9%) of them showed agreement with those of transcranial radiographs. Among the 46 joints (35.4%) which showed changes in condylar shape, 40 joints (30.1%) showed agreement with lateral and central tomographic and transcranial radiographic shape. 41 joints (31.5%) showed disagreement in condylar shape between the polytomographic and transcranial radiographic images.

A comparative study on the standard and individually corrected radiographs in TMJ transcranial radiography / 대한치과교정학회지

Among the radiographs for temporomandibular joint, transcranial radiograph is widely used for screening and diagnosing temporomandibular disorder because it has sharp image and it is easy to take. This study was performed to compare condylar position and image sharpness in standard and individually corrected transcranial radiographs using Accurad-200 headholder. Submentovertex view, Reverse-Towne view, Standard and individually corrected transcranial radiographs of 45 university students who were randomly selected were traced, measured and analyzed. The results were as follows: 1. The means of condylar axes and lateral slopes were 16.8degrees and 22.5degrees respectively. There were no differences between male and female or right and left side. 2. Individually corrected radiographs showed smaller posterior joint space and larger anterior joint space than standard radiographs, but superior joint space did not show a statistical difference between standard and individually corrected radiographs. 3. While a large number(42.2%) of the standard radiographs showed concentric condylar position, lots of(57.8) condylar positions were retropositioned in the individually corrected radiographs. 4. The image sharpness was inferior in the individually corrected radiographs to that of the standard radiographs.