From the Guidelines
The recommended initial imaging modality for Temporomandibular Joint (TMJ) dysfunction is MRI for ligament-capsule tissue disorders, and CBCT or CT scan for bone disease, as indicated by the national guidelines for dental diagnostic imaging 1. When evaluating TMJ dysfunction, it is crucial to consider the specific clinical presentation and suspected pathology to guide the choice of imaging modality.
- For cases where internal derangement of the TMJ disc is suspected, MRI is the preferred imaging modality due to its excellent soft tissue visualization, allowing for detailed assessment of the disc and surrounding ligament-capsule components 1.
- In contrast, for clinical cases suspected of condyle and glenoid cavity involvement based on medical history and clinical examination, CBCT or CT scan is recommended as these modalities provide superior visualization of bony structures 1. Key considerations in selecting an imaging modality for TMJ dysfunction include:
- The need for detailed visualization of soft tissues, such as the disc and ligaments, which favors MRI 1.
- The requirement for accurate assessment of bony structures, including the condyle and glenoid cavity, which is better achieved with CBCT or CT scan 1. It is essential to note that panoramic and other radiographic images may not supply sufficient information about the joint components and ligament-capsule components, and are therefore not recommended as the initial imaging modality for TMJ dysfunction 1.
From the Research
Recommended Imaging Modality for TMJ Dysfunction
The recommended initial imaging modality for Temporomandibular Joint (TMJ) dysfunction is:
Reasons for Choosing MRI
Some reasons why MRI is chosen as the initial imaging modality include:
- Non-invasive technique 4, 5
- Ability to evaluate the articular disc and its congruity as well as its location relative to the condyle in both closed- and open-mouth positions 3, 4, 6
- High contrast resolution, allowing for demonstration of joint effusion, bone edema and sclerosis, rupture of the retrodiscal layers and impairment of the lateral pterigoid muscle 4
- Ability to provide accurate information about disk position in a non-invasive manner 5
Other Imaging Modalities
Other imaging modalities that can be used to image the TMJ include:
- Computed Tomography (CT) 2
- Cone beam CT 2
- Ultrasonography 2
- Conventional radiography 2 However, these modalities have limitations, such as:
- Conventional radiography is of limited interest due to the need for three-dimensional imaging views 2
- CT and cone beam CT are better for visualizing osseous changes, but may not provide the same level of detail as MRI for soft tissue evaluation 2
- Ultrasonography is a non-invasive, dynamic, and inexpensive imaging technique, but its diagnostic value is strictly dependent on the examiner's skills and equipment used 2