Open-Mouth Bone Scintigraphy Is Better than Closed-Mouth Bone Scintigraphy in the Diagnosis of Temporomandibular Osteoarthritis
- 217 Downloads
Closed-mouth bone scintigraphy (CM scan) and closed-mouth single-photon emission computed tomography (CM SPECT) are used for conventional evaluation of osteoarthritis of the temporomandibular joint (TMJ). However, the adequacy of open-mouth bone scintigraphy (OM scan) has not yet been evaluated. Therefore, the purpose of this study was to compare the diagnostic performance of CM scan, CM SPECT, and OM scan.
Thirty-six patients with suspicion of an abnormality of the TMJ and who underwent a 99mTc-HDP CM scan, CM SPECT, and an OM scan were enrolled. The scans were assessed visually for the presence of positive focal uptake in the TMJ. Osteoarthritis was defined as arthralgia plus crepitus or radiologic signs of arthrosis.
Of 72 TMJs, 21 (29.2 %) were diagnosed with osteoarthritis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90.5 %, 49.0 %, 42.2 %, 92.6 % and 61.1 % for the CM scan, 81.0 %, 58.8 %, 44.7 %, 88.2 % and 65.3 % for CM SPECT, and 81.0 %, 82.4 %, 65.4 %, 91.3 % and 81.9 % for the OM scan, respectively. The accuracy of the OM scan was higher than that of CM SPECT and the CM scans (p = 0.004 and p < 0.001, respectively).
The OM scan was more accurate than the conventional CM scan and even CM SPECT for diagnosing TMJ osteoarthritis.
KeywordsOpen mouth Temporomandibular joint Osteoarthritis Bone scintigraphy Bone scan
This work was supported by the Nuclear Safety Research Program through the Korea Foundation of Nuclear Safety (KOFONS) and the Nuclear Safety and Security Commission (NSSC), Republic of Korea (grant no. 1305033).
Compliance with Ethical Standards
Conflicts of interest
Ki Seong Park, Ho-Chun Song, Sang-Geon Cho, Sae-Ryung Kang, Jahae Kim, Haeng Man Jun, Minchul Song, Geum-Cheol Jeong, Hee Jeong Park, Seong Young Kwon, Jung-Joon Min and Henry Hee-Seung Bom declare that they have no conflicts of interest.
The study was approved by an institutional review board and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The institutional review board waived the need for informed consent.
- 21.Hayashi T, Ito J, Koyama J, Hinoki A, Kobayashi F, Torikai Y, et al. Detectability of anterior displacement of the articular disk in the temporomandibular joint on helical computed tomography: the value of open mouth position. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:106–11.CrossRefPubMedGoogle Scholar