CBCT and MRI of Temporomandibular Joint Disorders and Related Structures

  • Tammy L. BalatgekEmail author
  • G. Gary Demerjian
  • Anthony B. Sims
  • Mayoor Patel


Clinical assessment of patients presenting with temporomandibular joint (TMJ) symptoms includes radiographic examination. There are several imaging modalities available to visualize the TMJ, and this chapter will focus specifically on cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). CBCT has revolutionized oral and maxillofacial radiology and offers low-dose, high-spatial resolution characteristics of the bony structures. In addition to anatomy seen on traditional TMJ radiographs of transpharyngeal, transcranial, panoramic radiograph, or tomographic section of the TMJ, CBCT will offer additional detailed information about bony alterations. These bony alterations may include flattening, sclerosis, erosions, osteophytes, resorption of the condylar head, ankyloses, erosion of the mandibular fossa, and reduced joint space. CBCT is also useful to visualize fractures, infection, invasion by tumor, and congenital abnormalities [1].



Cone beam computed tomography


Magnetic resonance imaging


Temporomandibular joint disorder


Temporomandibular joint


  1. 1.
    Bag AK, Gaddikeri S, Singhal A, Hardin S, Tran BD, Medina JA, Cure JK. Imaging of the temporomandibular joint: an update. World J Radiol. 2014;6(8):567–82.CrossRefGoogle Scholar
  2. 2.
    Tsiklakis K, Syriopoulos K, Stamatakis HC. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofac Radiol. 2004;33(3):196–201.CrossRefGoogle Scholar
  3. 3.
    American Dental Association Council on Scientific Affairs. The use of cone-beam computed tomography in dentistry: an advisory statement from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2012;143(8):899–902.CrossRefGoogle Scholar
  4. 4.
    Okano T, Sur J. Radiation dose and protection in dentistry. Jpn Dent Sci Rev. 2010;46(2):112–21.CrossRefGoogle Scholar
  5. 5.
    Ide Y, Nakazawa K, Hongo T, Tateishi J. Anatomical atlas of the temporomandibular joint. Tokyo: Quintessence; 2001.Google Scholar
  6. 6.
    Blaschke DD, Blaschke TJ. Clinical science normal TMJ bony relationships in centric occlusion. J Dent Res. 1981;60(2):98–104.CrossRefGoogle Scholar
  7. 7.
    Dalili Z, Khaki N, Kia SJ, Salamat F. Assessing joint space and condylar position in the people with normal function of temporomandibular joint with cone-beam computed tomography. Dent Res J. 2012;9(5):607–12.CrossRefGoogle Scholar
  8. 8.
    Laskin DM. Temporomandibular joint disorders. In: Cummings CHW, Fredrickson JM, Harker LA, Krause CHJ, Shuller DE, editors. Otolaryngology: head and neck surgery, vol. 2. T2. Missouri: Mosby Year Book; 1993. p. 1443–50.Google Scholar
  9. 9.
    Gateno J, Anderson PB, Xia JJ, Horng JC, Teichgraeber JF, Liebschner MA. A comparative assessment of mandibular condylar position in patients with anterior disc displacement of the temporomandibular joint. J Oral Maxillofac Surg. 2004;62(1):39–43.CrossRefGoogle Scholar
  10. 10.
    Tomas X, Pomes J, Berenguer J, Quinto L, Nicolau C, Mercader JM, Castro V. MR imaging of temporomandibular joint dysfunction: a pictorial review 1. Radiographics. 2006;26(3):765–81.CrossRefGoogle Scholar
  11. 11.
    Singh GD. On the etiology and significance of palatal and mandibular tori. Cranio. 2010;28(4):213–5.CrossRefGoogle Scholar
  12. 12.
    Murtagh RD, Caracciolo JT, Fernandez G. CT findings associated with eagle syndrome. Am J Neuroradiol. 2001;22(7):1401–2.PubMedGoogle Scholar
  13. 13.
    Gerbino G, Bianchi S, Bernardi M, Berrone S. Hyperplasia of the mandibular coronoid process: long-term follow-up after coronoidotomy. J Cranio-Maxillofac Surg. 1997;25(3):169–73.CrossRefGoogle Scholar
  14. 14.
    Schwab RJ, Gupta KB, Gefter WB, Metzger LJ, Hoffman EA, Pack AI. Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med. 1995;152(5 Pt 1):1673–89.CrossRefGoogle Scholar
  15. 15.
    Friedlander AH, Freymiller EG. Detection of radiation-accelerated atherosclerosis of the carotid artery by panoramic radiography. A new opportunity for dentists. J Am Dent Assoc. 2003;134(10):1361–5.CrossRefGoogle Scholar
  16. 16.
    Guralnick W, Kaban LB, Merrill RG. Temporomandibular-joint afflictions. N Engl J Med. 1978;299(3):123–9.CrossRefGoogle Scholar
  17. 17.
  18. 18.
    Üşümez S, Öz F, Güray E. Comparison of clinical and magnetic resonance imaging diagnoses in patients with TMD history. J Oral Rehabil. 2004;31(1):52–6.CrossRefGoogle Scholar
  19. 19.
    Alomar X, Medrano J, Cabratosa J, Clavero J, Lorente M, Serra I, Monill J, Salvador A. Anatomy of the temporomandibular joint. In: Seminars in ultrasound, CT and MRI. Berlin: Elsevier; 2007. p. 170–83.Google Scholar
  20. 20.
    DaSilva AF, Shaefer J, Keith DA. The temporomandibular joint: clinical and surgical aspects. Neuroimaging Clin N Am. 2003;13(3):573–82.CrossRefGoogle Scholar
  21. 21.
    Pereira FJ, Lundh H, Westesson P-L. Morphologic changes in the temporomandibular joint in different age groups: an autopsy investigation. Oral Surg Oral Med Oral Pathol. 1994;78(3):279–87.CrossRefGoogle Scholar
  22. 22.
    Westesson P-L. Structural hard-tissue changes in temporomandibular joints with internal derangement. Oral Surg Oral Med Oral Pathol. 1985;59(2):220–4.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Tammy L. Balatgek
    • 1
    Email author
  • G. Gary Demerjian
    • 2
  • Anthony B. Sims
    • 3
  • Mayoor Patel
    • 4
  1. 1.Center for TMJ and Sleep DisordersReadingUSA
  2. 2.Center for TMJ & Sleep TherapyGlendoraUSA
  3. 3.Maryland Center for Craniofacial, TMJ and Dental Sleep DisordersColumbiaUSA
  4. 4.Craniofacial Pain and Dental Sleep Center of GeorgiaAtlantaUSA

Personalised recommendations