Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제41권3호
  • /
  • Pages.125-132
  • /
  • 2015
  • /
  • 2234-7550(pISSN)
  • /
  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지
DOI QR코드

DOI QR Code

Correlation between clinical symptoms and magnetic resonance imaging findings in patients with temporomandibular joint internal derangement

  • Jung, Young-Wook (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine) ;
  • Park, Sung-Hoon (Department of Radiology, Ajou University School of Medicine) ;
  • On, Sung-Woon (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine) ;
  • Song, Seung-Il (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine)
  • 투고 : 2015.03.02
  • 심사 : 2015.04.08
  • 발행 : 2015.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: The purpose of this study was to clarify which findings in magnetic resonance imaging (MRI) are good predicators of pain and mouth opening limitation in patients with temporomandibular joint (TMJ) internal derangement (ID). Materials and Methods: Clinical examinations for pain and mouth opening limitation were conducted for suspected TMJ ID. MRI scans were taken within a week of clinical examinations. On the oblique-sagittal plane image, readings were obtained in terms of the functional aspect of disc position, degree of displacement, disc deformity, joint effusion, and osteoarthrosis. Multiple logistic regression analyses were conducted to identify the predictors of pain and mouth opening limitation. Results: A total of 48 patients (96 TMJs) were studied, including 39 female patients and 9 male patients whose ages ranged from 10 to 65 years. The resultant data showed significant correlations between pain and the MR imaging of the degree of disc displacement (P<0.05). The probability of there being pain in moderate to significant cases was 9.69 times higher than in normal cases. No significant correlation was found between mouth opening limitation and MRI findings. Conclusion: We identified a significant correlation between clinical symptoms and MRI findings of ID. The degree of anterior disc displacement may be useful for predicting pain in patients with TMJ ID.

키워드

참고문헌

  1. Barclay P, Hollender LG, Maravilla KR, Truelove EL. Comparison of clinical and magnetic resonance imaging diagnosis in patients with disk displacement in the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:37-43. https://doi.org/10.1016/S1079-2104(99)70191-5
  2. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al; International RDC/TMD Consortium Network, International Association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014;28:6-27. https://doi.org/10.11607/jop.1151
  3. 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. https://doi.org/10.1067/moe.2003.95
  4. Paesani D, Westesson PL, Hatala M, Tallents RH, Kurita K. Prevalence of temporomandibular joint internal derangement in patients with craniomandibular disorders. Am J Orthod Dentofacial Orthop 1992;101:41-7. https://doi.org/10.1016/0889-5406(92)70080-T
  5. Tasaki MM, Westesson PL. Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging. Radiology 1993;186:723-9. https://doi.org/10.1148/radiology.186.3.8430181
  6. Emshoff R, Innerhofer K, Rudisch A, Bertram S. Relationship between temporomandibular joint pain and magnetic resonance imaging findings of internal derangement. Int J Oral Maxillofac Surg 2001;30:118-22. https://doi.org/10.1054/ijom.2000.0028
  7. Westesson PL, Brooks SL. Temporomandibular joint: relationship between MR evidence of effusion and the presence of pain and disk displacement. Am J Roentgenol 1992;159:559-63. https://doi.org/10.2214/ajr.159.3.1503025
  8. Incesu L, Taskaya-Yilmaz N, Ogutcen-Toller M, Uzun E. Relationship of condylar position to disc position and morphology. Eur J Radiol 2004;51:269-73. https://doi.org/10.1016/S0720-048X(03)00218-3
  9. Roh HS, Kim W, Kim YK, Lee JY. Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings. J Craniomaxillofac Surg 2012;40:283-6. https://doi.org/10.1016/j.jcms.2011.04.006
  10. Farina D, Bodin C, Gandolfi S, De Gasperi W, Borghesi A, Maroldi R. TMJ disorders and pain: assessment by contrast-enhanced MRI. Eur J Radiol 2009;70:25-30. https://doi.org/10.1016/j.ejrad.2008.01.014
  11. Taskaya-Yilmaz N, Ogutcen-Toller M. Magnetic resonance imaging evaluation of temporomandibular joint disc deformities in relation to type of disc displacement. J Oral Maxillofac Surg 2001;59:860-5. https://doi.org/10.1053/joms.2001.25015
  12. Segami N, Nishimura M, Kaneyama K, Miyamaru M, Sato J, Murakami KI. Does joint effusion on T2 magnetic resonance images reflect synovitis? Comparison of arthroscopic findings in internal derangements of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:341-5. https://doi.org/10.1067/moe.2001.117808
  13. Segami N, Miyamaru M, Nishimura M, Suzuki T, Kaneyama K, Murakami K. Does joint effusion on T2 magnetic resonance images reflect synovitis? Part 2. Comparison of concentration levels of proinflammatory cytokines and total protein in synovial fluid of the temporomandibular joint with internal derangements and osteoarthrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:515-21. https://doi.org/10.1067/moe.2002.126697
  14. Segami N, Suzuki T, Sato J, Miyamaru M, Nishimura M, Yoshimura H. Does joint effusion on T2 magnetic resonance images reflect synovitis? Part 3. Comparison of histologic findings of arthroscopically obtained synovium in internal derangements of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:761-6. https://doi.org/10.1067/moe.2003.243
  15. Takahashi T, Nagai H, Seki H, Fukuda M. Relationship between joint effusion, joint pain, and protein levels in joint lavage fluid of patients with internal derangement and osteoarthritis of the temporomandibular joint. J Oral Maxillofac Surg 1999;57:1187-93. https://doi.org/10.1016/S0278-2391(99)90483-4
  16. Guler N, Uckan S, Imirzalioglu P, Acikgozoglu S. Temporomandibular joint internal derangement: relationship between joint pain and MR grading of effusion and total protein concentration in the joint fluid. Dentomaxillofac Radiol 2005;34:175-81. https://doi.org/10.1259/dmfr/49181266
  17. Santos KC, Dutra ME, Warmling LV, Oliveira JX. Correlation among the changes observed in temporomandibular joint internal derangements assessed by magnetic resonance in symptomatic patients. J Oral Maxillofac Surg 2013;71:1504-12. https://doi.org/10.1016/j.joms.2013.04.033
  18. Murakami S, Takahashi A, Nishiyama H, Fujishita M, Fuchihata H. Magnetic resonance evaluation of the temporomandibular joint disc position and configuration. Dentomaxillofac Radiol 1993;22:205-7. https://doi.org/10.1259/dmfr.22.4.8181648
  19. Brooks SL, Westesson PL, Eriksson L, Hansson LG, Barsotti JB. Prevalence of osseous changes in the temporomandibular joint of asymptomatic persons without internal derangement. Oral Surg Oral Med Oral Pathol 1992;73:118-22. https://doi.org/10.1016/0030-4220(92)90168-P
  20. Taskaya-Yýlmaz N, Ogutcen-Toller M. Clinical correlation of MRI findings of internal derangements of the temporomandibular joints. Br J Oral Maxillofac Surg 2002;40:317-21. https://doi.org/10.1016/S0266-4356(02)00140-7
  21. Cortes D, Exss E, Marholz C, Millas R, Moncada G. Association between disk position and degenerative bone changes of the temporomandibular joints: an imaging study in subjects with TMD. Cranio 2011;29:117-26. https://doi.org/10.1179/crn.2011.020
  22. Moncada G, Cortes D, Millas R, Marholz C. Relationship between disk position and degenerative bone changes in temporomandibular joints of young subjects with TMD. An MRI study. J Clin Pediatr Dent 2014;38:269-76. https://doi.org/10.17796/jcpd.38.3.w43m8474433n7ur2
  23. Campos MI, Campos PS, Cangussu MC, Guimaraes RC, Line SR. Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle. Int J Oral Maxillofac Surg 2008;37:529-34. https://doi.org/10.1016/j.ijom.2008.02.011
  24. Ogutcen-Toller M, Taskaya-Yilmaz N, Yilmaz F. The evaluation of temporomandibular joint disc position in TMJ disorders using MRI. Int J Oral Maxillofac Surg 2002;31:603-7. https://doi.org/10.1054/ijom.2002.0321
  25. Emshoff R, Brandlmaier I, Gerhard S, Strobl H, Bertram S, Rudisch A. Magnetic resonance imaging predictors of temporomandibular joint pain. J Am Dent Assoc 2003;134:705-14. https://doi.org/10.14219/jada.archive.2003.0256

피인용 문헌

  1. Retrospective magnetic resonance imaging study of risk factors associated with sideways disk displacement of the temporomandibular joint vol.58, pp.1, 2015, https://doi.org/10.2334/josnusd.58.29
  2. Reliability of discoraphy as a treatment modality for internal derangement of the temporomandibular joint : vol.8, pp.1, 2015, https://doi.org/10.1097/01.omx.0000511206.98615.ba
  3. Clinical study of the patients with intractable temporomandibular disorders intervened with psychologic problems vol.42, pp.3, 2018, https://doi.org/10.21851/obr.42.03.201809.140
  4. Comparison of the effectiveness of high resolution ultrasound with MRI in patients with temporomandibular joint dısorders vol.48, pp.5, 2015, https://doi.org/10.1259/dmfr.20180349
  5. Diagnostic value of dynamic magnetic resonance imaging of temporomandibular joint dysfunction vol.8, pp.None, 2015, https://doi.org/10.1016/j.ejro.2021.100390