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MRI evaluation of the classification, frequency, and disc morphology of temporomandibular joint disc displacements: a multicenter retrospective study in a Turkish population

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Abstract

Objectives

Magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) and temporomandibular disorders (TMDs) have been discussed in detail for various populations. As no such study has examined the Turkish population, we determined the frequency of TMDs in the Turkish population through a multicentric investigation using MRI.

Methods

This retrospective study examined 504 TMJs of 252 symptomatic patients who had undergone bilateral MRI investigation in four different dental schools. The image analysis included the assessment of disc position and morphology, and recaptured the coronal and sagittal planes in the closed and open mouth positions. The TMJ disorders were classified using the Clinical Diagnostic Criteria for Temporomandibular Disorders (CDC/TMD). The correlations among the groups of TMJs and disc morphologies were analyzed statistically using the chi-square test (P ≤ 0.05).

Results

Disc displacement and abnormal disc morphology were detected in 69.5% of the symptomatic TMJ patients. Of the joints examined using MRI, 154 were normal, 135 had anterior disc displacement with reduction (ADDwR), 145 had anterior disc displacement without reduction (ADDwoR), 30 had partial anterior disc displacement, and 18 had sideways disc displacements. Regarding disc morphology, enlargement in the posterior band was the most commonly encountered type and was observed in 152 TMJs. Overall, the average time for referral for treatment, which was defined as the time from symptom onset until the time of referral, was 1.5 years.

Conclusions

The most common type of disc displacement found in the Turkish population studied was ADDwoR. In addition, patients did not perceive the symptoms of TMDs as a disease and did not seek help until the TMJ derangement caused a major complaint.

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References

  1. Heffez L, Jordan S. A classification of temporomandibular joint disc morphology. Oral Surg Oral Med Oral Pathol. 1989;67:11–9.

    Article  PubMed  Google Scholar 

  2. Jensen U, Ruf S. Longitudinal changes in temporomandibular disorders in young adults: indication for systematic temporomandibular joint screening. J Orofac Orthop. 2007;68:501–9.

    Article  PubMed  Google Scholar 

  3. Abou-Atme YS, Zawawi KH, Melis M. Prevalence, intensity, and correlation of different TMJ symptoms in Lebanese and Italian subpopulations. J Contemp Dent Pract. 2006;7:71–8.

    PubMed  Google Scholar 

  4. Hussain AM, Packota G, Major PW, Flores-Mir C. Role of different imaging modalities in assessment of temporomandibular joint erosions and osteophytes: a systematic review. Dentomaxillofac Radiol. 2008;37:63–71.

    Article  PubMed  Google Scholar 

  5. Shahidi S, Haghnegahdar A, Falamaki FN, Khojastehpoor L. Clinical evaluation of internal joint derangement using sonography. Oral Radiol. 2008;24:34–8.

    Article  Google Scholar 

  6. Kurita K, Westesson PL, Tasaki M, Liedberg J. Temporomandibular joint: diagnosis of medial and lateral disc displacement with anteroposterior arthrography—correlation with cryosections. Oral Surg Oral Med Oral Pathol. 1992;73:364–8.

    Article  PubMed  Google Scholar 

  7. Orhan K, Nishiyama H, Tadashi S, Murakami S, Furukawa S. Comparison of altered signal intensity, position, and morphology of the TMJ disc in MR images corrected for variations in surface coil sensitivity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:515–22.

    Article  PubMed  Google Scholar 

  8. Tasaki MM, Westesson PL, Isberg AM, Ren YF, Tallents RH. Classification and prevalence of temporomandibular joint disc displacement in patients and symptom-free volunteers. Am J Orthod Dentofac Orthop. 1996;109:249–62.

    Article  Google Scholar 

  9. Kobayashi K. Efficacy of image diagnosis on temporomandibular joint disorders. Oral Radiol. 2003;19:70–1.

    Article  Google Scholar 

  10. Ma X. Imaging diagnosis and pathological basis of temporomandibular disorders. Oral Radiol. 2001;17:26–30.

    Article  Google Scholar 

  11. Dijkgraaf LC, De Bont LGM, Boering G. Three-dimensional visualisation of the temporomandibular joint: a computerised multisectional autopsy study of disc position and configuration. J Oral Maxillofac Surg. 1992;50:2–10.

    Article  PubMed  Google Scholar 

  12. Emshoff R, Brandlmaier I, Bertram S, Rudisch A. Relative odds of temporomandibular joint pain as a function of magnetic resonance imaging findings of internal derangement, osteoarthrosis, effusion, and bone marrow edema. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:437–45.

    Article  PubMed  Google Scholar 

  13. Jagger RG, Woolley SM, Savio L. Signs and symptoms of temporomandibular disorders in Ecuadorian Indians. J Oral Rehabil. 2004;31:293–7.

    Article  PubMed  Google Scholar 

  14. Fabian FM, Mumghamba EG. Risk factors for signs and symptoms of TMD in a rural southeast Tanzanian population. Cranio. 2008;26:44–9.

    PubMed  Google Scholar 

  15. Truelove EL, Sommers EE, LeResche L, Dworkin SF, Von Korff M. Clinical diagnostic criteria for TMD. New classification permits multiple diagnoses. J Am Dent Assoc. 1992;123:47–54.

    PubMed  Google Scholar 

  16. Katzberg RW, Westesson PL. Diagnosis of the temporomandibular joint. Philadelphia: W.B. Saunders; 1993. p. 35–8, 42–3.

  17. Foucart JM, Carpentier P, Pajoni D, Marguelles-Bonnet R, Pharaboz C. MR of 732 TMJs: anterior, rotational, partial and sideways disc displacements. EJR. 1998;28:86–94.

    Article  Google Scholar 

  18. Rutkiewicz T, Könönen M, Suominen-Taipale L, Nordblad A, Alanen P. Occurrence of clinical signs of temporomandibular disorders in adult Finns. J Orofac Pain. 2006;20:208–17.

    PubMed  Google Scholar 

  19. Milano V, Desiate A, Bellino R, Garofalo T. Magnetic resonance imaging of temporomandibular disorders: classification, prevalence and interpretation of disc displacement and deformation. Dentomaxillofac Radiol. 2000;29:352–61.

    Article  PubMed  Google Scholar 

  20. Duan X, Junzheng WU, Mao Y, Wang H, Wang M. A retrospective study on the relationship between aging and tomographic findings in 174 patients with TMD. Oral Radiol. 1999;15:9–17.

    Article  Google Scholar 

  21. Kursoglu P, Capa N. Elongated mandibular coronoid process as a cause of mandibular hypomobility. Cranio. 2006;24:213–6.

    PubMed  Google Scholar 

  22. Emshoff R, Rudisch A, Innerhofer K, Brandlmaier I, Moschen I, Bertram S. Magnetic resonance imaging findings of internal derangement in temporomandibular joints without a clinical diagnosis of temporomandibular disorder. J Oral Rehabil. 2002;29:516–22.

    Article  PubMed  Google Scholar 

  23. Ogura I. Magnetic resonance imaging characteristics of temporomandibular joint pain during opening and biting in patients with disc displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:669–72.

    Article  PubMed  Google Scholar 

  24. Kobs G, Bernhardt O, Kocher T, Meyer G. Critical assessment of temporomandibular joint clicking in diagnosing anterior disc displacement. Stomatologija. 2005;7:28–30.

    PubMed  Google Scholar 

  25. Müller-Leisse C, Augthun M, Bauer W, Roth A, Günther R. Anterior disc displacement without reduction in the temporomandibular joint: MRI and associated clinical findings. J Magn Reson Imaging. 1996;6:769–74.

    Article  PubMed  Google Scholar 

  26. Rao VM, Liem MD, Farole A, Razek AA. Elusive ‘stuck’ disc in the temporomandibular joint: diagnosis with MR imaging. Radiology. 1993;189:823–7.

    PubMed  Google Scholar 

  27. Pow EH, Leung KC, McMillan AS. Prevalence of symptoms associated with temporomandibular disorders in Hong Kong Chinese. J Orofac Pain. 2001;15:228–34.

    PubMed  Google Scholar 

  28. Larheim TA. Current trends in temporomandibular joint imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80:555–76.

    Article  PubMed  Google Scholar 

  29. Sato S, Sakamoto M, Kawamura H, Motegi K. Long-term changes in clinical signs and symptoms and disc position and morphology in patients with nonreducing disc displacement in the temporomandibular joint. J Oral Maxillofac Surg. 1999;57:23–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was presented at the 10th European Association of Dentomaxillofacial Radiology Congress (EADMFR) in Leuven, Belgium, 31 May–3 June 2006.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University, Bagdat Cad No:238, Goztepe, Istanbul, Turkey

    Ahmet Arslan

  2. Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ankara University, Besevler, 06500, Ankara, Turkey

    Kaan Orhan & Candan Semra Paksoy

  3. Department of Oral Diagnosis and Radiology, Gulhane Medical Military Academy, Ankara, Turkey

    Ozlem Ucok

  4. Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Hacettepe University, Sıhhiye, 06100, Ankara, Turkey

    Murat Ozbek, Sema Dural & Aydan Kanli

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  1. Ahmet Arslan
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  2. Kaan Orhan
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  3. Candan Semra Paksoy
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  4. Ozlem Ucok
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  5. Murat Ozbek
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  6. Sema Dural
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  7. Aydan Kanli
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Correspondence to Ahmet Arslan.

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Arslan, A., Orhan, K., Paksoy, C.S. et al. MRI evaluation of the classification, frequency, and disc morphology of temporomandibular joint disc displacements: a multicenter retrospective study in a Turkish population. Oral Radiol 25, 14–21 (2009). https://doi.org/10.1007/s11282-009-0001-5

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  • DOI: https://doi.org/10.1007/s11282-009-0001-5

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