• The korean journal of orthodontics
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• v.36 no.2 s.115
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• pp.136-144
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• 2006

The purpose of this study was to determine whether association exists between temporomandibular joint (TMJ) characteristics in transcranial radiographs and TMJ internal derangement and to evaluate the validity of transcranial radiographs in diagnosis of internal derangement. Transcranial radiographs and magnetic resonance imaging (MRI) of 113 TMJs from 76 subjects were used for this study and all TMJs were classified into 3 groups according to the results of MRI: normal disk position, disk displacement with reduction, and disk displacement without reduction. Transcranial analysis included linear measurement of joint spaces and condylar head angle measurement. To determine any relationship between transcranial measurements according to disk displacement, one-way ANOVA was used. The results showed that condyle-fossa relationship in standard transcranial radiographs had no relationships with disk displacement. And, as disk displacement progressed, condylar angle between head and neck increased significantly. This result can be interpreted that condylar head angle reflects structural hard tissue change according to internal derangement progress. But this is insufficient in the determination of internal derangement. Therefore, although still clinically helpful, the validity of standard transcranial radiographs to diagnose TMJ internal derangement was questioned.

• Imaging Science in Dentistry
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• v.31 no.4
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• pp.185-192
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• 2001

Purpose: To evaluate the condylar movement at maximal mouth opening on MRI in patients with internal derangement. Materials and Methods: MR images and transcranial views for 102 TMJ s in 51 patients were taken in closed and maximal opening positions, and the amount of condylar movement was analyzed quantitatively and qualitatively. Results: For MR images, the mean condylar movements were 9.4 mm horizontally, 4.6 mm vertically and 10.9 mm totally, while those for transcranial views were 12.5 mm, 4.6 mm, and 13.7 mm respectively. The condyle moved forward beyond the summit of the articular eminence in 41 TMJs (40.2%) for MR images and 56 TMJs (54.9%) for transcranial views. Conclusion: The horizontal and total condylar movements were smaller in MR images than in transcranial views.

• Journal of Oral Medicine and Pain
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• v.36 no.1
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• pp.39-51
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• 2011

The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.163-173
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• 2013

When the mandible performs opening movement, the condyle-disk complex conducts sliding movement along the articular eminence. Thus, anatomic configuration of articular eminence is very important to normal movement of TMJ. The purpose of this study was to measure the posterior slope of the articular eminence and evaluate the effect of a pathologic bone change in the condylar head on the stiffness of articular eminence, and compare the differences of the articular eminence slope by gender and age using dental cone-beam CT. As using i-CAT Cone-Beam Computed Tomography, the CT images of 204 TMJs of 102 patients(43 men and 59 women, mean age: 37.7 years) who were diagnosed at Wonkwang University Sanbon Dental Hospital were evaluated. All images were converted into a TMJ analysis mode to observe the continuous sagittal section images and coronal section images of the joints. To observe and assess bone changes in the condyle, three dentists measured the stiffness of the articular eminence on the same images, and when two of the three dentists agreed on their reading, these results were adopted and recorded. The articular eminence slope, considering the condylar anatomic configuration, was measured in three regions, namely, lateral part, central part, and medial part of the condyle. In the cases of a normal condyle(NCBC) and a condyle(CBC) with bone change, the articular eminence slopes were $57.0^{\circ}$(NCBC) and $51.8^{\circ}$(CBC) at the medial part, $57.9^{\circ}$(NCBC) and $52.4^{\circ}$(CBC) at the central part, and $55.1^{\circ}$(NCBC) and $49.5^{\circ}$(CBC) at the lateral part of the condyle. And the articular eminence slope of the condyle with bone change demonstrated less steepness than that of normal condyle (p<0.05). The articular eminence slope showed mediolaterally that it was the steepest at the central, followed by at the medial, and at the lateral (p<0.05). There were no significant differences by the gender and the age (p.0.05).