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The use of magnetic resonance to visualize posterior occlusion in temporomandibular joint
International Congress Series 1256 (2003) 1408
The use of magnetic resonance to visualize posterior occlusion in temporomandibular joint S. Sztuk a, A. Urbanik a, R. Chrzana,*, M. Szafirska a, K. Kleinrok a, M. Dyras b,1 a
Radiology Department, Collegium Medicum, Jagiellonian University, Kopernika 19, 31-501 Cracow, Poland Orthodonthics Department, Collegium Medicum, Jagiellonian University, Montelupich 4, 31-155 Cracow, Poland
b
Received 25 February 2003; received in revised form 25 February 2003; accepted 4 March 2003 Keywords: MR; Temporomandibular joint
1. Introduction According to some authors, the frequency of temporomandibular joint (TMJ) dysfunction in population of 15 years and older is 43% to 83%. The aim of the study was to access the most frequent TMJ’s articular disc mobility dysfunctions and to assess the pathological changes in bony structures in patients suffering from posterior occlusion. 2. Material and methods Thirty-seven patients: 24 women and 13 men were examined using 1.5T Signa Horizon MRI system (GEMS) equipped with 8.75-cm diameter surface coil. Each joint was tested separately both in closed and opened position. Images were collected every 3-mm plane perpendicular and every 2-mm plane parallel to condylar process of the mandible. The location of the disc at rest and at maximum opening of the jaws in plains, its shape in opened position and its replacement were assessed. Most of the examinations were done only in PD sequences that resulted in best images. In some individuals where bony lesions were found or fluid in the joint was suspected, T1- and T2-weighted images with paramagnetic contrast administration were obtained. 3. Results Multiple function and bone structure TMJ defects were detected in examined patients. The largest group of malformations consisted of various articular disc deformations (especially in fully opened position), asymmetric location of the disc and subluxation. Degeneration of bone structure was observed in patients above 30 years. Patients were referred for further diagnosis following unsuccessful treatment of misdiagnosed trigeminal nerve neuralgia or migraine. TMJ malfunctions were found in 80% of these cases in forms of: subluxation, articular disc deformation, disc mobility impairment with unilateral disc rupture, with total disc destruction and its fixation in front of articular tuberculum in mouth opening (2 woman, 16 and 20 years old). 4. Conclusions Magnetic resonance proved to be the best method of TMJ imaging because it allows simultaneous visualisation of cartilage and bone structure without exposing patients to X-rays. Pathology of articular disc is seen even in very young patients and up to now only invasive methods (arthroscopy, arthrography) were used for diagnosing those cases. * Corresponding author. Tel.: +48-12-4213661; fax: +48-12-4110446. E-mail address: [email protected] (R. Chrzan). 1 Tel.: +48-12-6322401. 0531-5131/03 D 2003 Elsevier Science B.V. and CARS. All rights reserved. doi:10.1016/S0531-5131(03)00210-3
The use of magnetic resonance to visualize posterior occlusion in temporomandibular joint S. Sztuk a, A. Urbanik a, R. Chrzana,*, M. Szafirska a, K. Kleinrok a, M. Dyras b,1 a
Radiology Department, Collegium Medicum, Jagiellonian University, Kopernika 19, 31-501 Cracow, Poland Orthodonthics Department, Collegium Medicum, Jagiellonian University, Montelupich 4, 31-155 Cracow, Poland
b
Received 25 February 2003; received in revised form 25 February 2003; accepted 4 March 2003 Keywords: MR; Temporomandibular joint
1. Introduction According to some authors, the frequency of temporomandibular joint (TMJ) dysfunction in population of 15 years and older is 43% to 83%. The aim of the study was to access the most frequent TMJ’s articular disc mobility dysfunctions and to assess the pathological changes in bony structures in patients suffering from posterior occlusion. 2. Material and methods Thirty-seven patients: 24 women and 13 men were examined using 1.5T Signa Horizon MRI system (GEMS) equipped with 8.75-cm diameter surface coil. Each joint was tested separately both in closed and opened position. Images were collected every 3-mm plane perpendicular and every 2-mm plane parallel to condylar process of the mandible. The location of the disc at rest and at maximum opening of the jaws in plains, its shape in opened position and its replacement were assessed. Most of the examinations were done only in PD sequences that resulted in best images. In some individuals where bony lesions were found or fluid in the joint was suspected, T1- and T2-weighted images with paramagnetic contrast administration were obtained. 3. Results Multiple function and bone structure TMJ defects were detected in examined patients. The largest group of malformations consisted of various articular disc deformations (especially in fully opened position), asymmetric location of the disc and subluxation. Degeneration of bone structure was observed in patients above 30 years. Patients were referred for further diagnosis following unsuccessful treatment of misdiagnosed trigeminal nerve neuralgia or migraine. TMJ malfunctions were found in 80% of these cases in forms of: subluxation, articular disc deformation, disc mobility impairment with unilateral disc rupture, with total disc destruction and its fixation in front of articular tuberculum in mouth opening (2 woman, 16 and 20 years old). 4. Conclusions Magnetic resonance proved to be the best method of TMJ imaging because it allows simultaneous visualisation of cartilage and bone structure without exposing patients to X-rays. Pathology of articular disc is seen even in very young patients and up to now only invasive methods (arthroscopy, arthrography) were used for diagnosing those cases. * Corresponding author. Tel.: +48-12-4213661; fax: +48-12-4110446. E-mail address: [email protected] (R. Chrzan). 1 Tel.: +48-12-6322401. 0531-5131/03 D 2003 Elsevier Science B.V. and CARS. All rights reserved. doi:10.1016/S0531-5131(03)00210-3