Developing a reference MRI database for temporomandibular joints in healthy children and adolescents
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Recognition of normal temporomandibular joints (TMJs) is essential to assess arthropathic changes. Few, if any, prior studies have evaluated the morphological appearance of growing TMJs by magnetic resonance (MR) examinations in the pediatric population.
This study aimed to determine normative osseous appearance of growing TMJs according to age and gender, both qualitatively and quantitatively, concerning structural and bone marrow changes.
Materials and methods
From 1,036 MR scans screened, one joint was included from each of 157 patients (76% female; 2–18 years) presenting with at least one normal-appearing TMJ was included. Quantitatively, mandibular condyle was characterized by measuring the following: (i) head-neck angle, (ii) anteversion angle, (iii) condylar dimensions (mediolateral, craniocaudal and anteroposterior [AP]) and (iv) condylar volume. Furthermore, qualitative categorization of condylar shape, into one of three types, and condylar bone marrow type was performed.
The head-neck angle significantly correlated with age (bivariable regression β =0.60, P<0.001), indicating an increase of 1.6 degrees per year. Except for AP diameter of condyles, all other mandibular dimensions and condylar volume increased with age (β =0.20–0.59, P≤0.001–0.004). Significant age difference was observed among the different condylar shapes (P<0.001), indicating a change from rounded head without anterior tilt to rectangular head with anterior tilt. Lastly, mandibular condylar size, measured by volume and by AP and mediolateral dimensions, appeared larger in males.
The morphology of the mandibular condyles changes with age. During development, the shape of the condyles changes from round to rectangular in contour with the development of the anterior condylar tilt, as measured by the head-neck angle.
KeywordsChildren Mandible Magnetic resonance imaging Morphology Normal Qualitative assessment Quantitative assessment Temporomandibular joint
This work was presented at the 60th Annual Meeting and Categorical Course of the Society for Pediatric Radiology in Vancouver, BC, Canada, on May 18, 2017.
We would like to thank Dr. Lynn Spiegel, Rheumatology Department, The Hospital for Sick Children, for providing relevant clinical information.
Compliance with ethical standards
Conflicts of interest
- 1.Ringold S, Cron RQ (2009) The temporomandibular joint in juvenile idiopathic arthritis: frequently used and frequently arthritic. Pediatr Rheumatol Online J 7:11Google Scholar
- 5.Fjeld MG, Arvidsson LZ, Smith HJ et al (2010) Relationship between disease course in the temporomandibular joints and mandibular growth rotation in patients with juvenile idiopathic arthritis followed from childhood to adulthood. Pediatr Rheumatol Online J 8:13Google Scholar
- 9.Roth C, Ward RJ, Tsai S et al (2005) MR imaging of the TMJ: a pictorial essay. Apply Radiol 34:9–16Google Scholar
- 22.Tecco S, Saccucci M, Nucera R et al (2010) Condylar volume and surface in Caucasian young adult subjects. BMC Med Imaging 10:28Google Scholar
- 23.Saccucci M, D’Attilio M, Rodolfino D et al (2012) Condylar volume and condylar area in class I, class II and class III young adult subjects. Head Face Med 8:34Google Scholar
- 24.Al-koshab M, Nambiar P, John J (2015) Assessment of condyle and glenoidfossa morphology using CBCT in south-east Asians. PLoS One 10: e0121682Google Scholar
- 28.Ma GMY, Amirabadi A, Inarejos E et al (2015) MRI thresholds for discrimination between normal and mild temporomandibular joint involvement in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 13:53Google Scholar