Objective: To observe the different imaging manifestations of condylar sclerosis in temporomandibular joint osteoarthrosis and explore the imaging significance of condylar sclerosis. Methods: From January 2018 to December 2020, 50 patients with temporomandibular joint condylar sclerosis were examined by cone-beam CT (CBCT) and underwent spiral CT, MRI and radionuclide bone imaging at the Department of Oral and Maxillofacial Surgery in General Hospital of Chinese PLA. There were 15 males and 35 females aged from 16 to 65 years with age of (42.7±14.5) years. The imaging manifestations of CBCT, spiral CT, MRI and radionuclide bone imaging, joint disc displacement and abnormal bone metabolism of condylar sclerosis were analyzed. And the area of condylar sclerosis was graded according to the image of CBCT. Results: A total of 50 patients were included, including 38 unilateral condylar sclerosis, 12 patients with bilateral condylar sclerosis, the total condylar sclerosis were 66. There was no significant difference between the detection rate of further spiral CT (95.5%, 63/66) and CBCT (100.0%, 66/66) (corrected χ²=1.36,P=0.244). The area of condylar sclerosis was (35.5±4.5) mm², ranged from 1 to 100 mm². In addition, spiral CT showed more clearly condylar sclerosis than CBCT. Sclerosis can occur in all parts of condyle, mainly in the upper middle region (68.2%,45/66) in coronal position and in the upper front region (71.2%,47/66) in sagittal position. Fifty-seven condylar sclerosis were detected by MRI, including 4(4/19) condylar sclerosis less than 4 mm². There was significant difference in the displacement of temporomandibular joint disc between the sclerotic side and the non sclerotic side (χ²=10.09, P=0.006). MRI display the condylar sclerosis showed low signal (56/62), followed by high signal (5/62) and medium signal (1/62). Radionuclide bone imaging showed that 4 of the 38 patients with unilateral condyle sclerosis had symmetrical bone metabolism, 34 had abnormal bone metabolism, and 21 patients had concentrated on the non-sclerotic side. Radionuclide bone imaging showed that 4 of the 38 patients with unilateral condyle sclerosis had symmetrical bone metabolism and 34 had abnormal bone metabolism. Conclusions: Spiral CT is more accurate than CBCT in terms of condyle sclerosis through different imaging analysis, and the detection rate of both is higher than MRI. Most of condylar sclerosis showed different degrees of low signal on MRI. The condylar sclerosis side is usually manifested by abnormal bone metabolism.
Male ; Female ; Humans ; Mandibular Condyle/diagnostic imaging* ; Sclerosis/diagnostic imaging* ; Temporomandibular Joint/diagnostic imaging* ; Temporomandibular Joint Disorders/etiology* ; Temporomandibular Joint Disc/diagnostic imaging* ; Cone-Beam Computed Tomography ; Temporomandibular Joint Dysfunction Syndrome ; Osteoarthritis/etiology* ; Magnetic Resonance Imaging

Objective: To explore the correlation between the attachment type of lateral pterygoid muscle (LPM) and the position of temporomandibular joint (TMJ) disc in patients with temporomandibular disorders (TMD) by using wireless amplified magnetic resonance imaging detector (WAND) coupled with conventional head and neck joint coil for high resolution imaging of TMJ. Methods: Eighty-five patients with TMD diagnosed by oral and maxillofacial surgeons of Guizhou Provincial People's Hospital from October 2019 to January 2022 were collected. A total of 160 TMJ were included. There were 16 males and 69 females, aged (32.7±14.2) years. All patients were scanned with open, closed oblique sagittal and coronal WAND coupled head and neck coils with bilateral TMJ. Based on TMJ and LPM high resolution imaging, to explore the correlation between LPM attachment types and the position of TMJ disc in TMD patients, and to evaluate the potential clinical value of LPM attachment types in TMD patients. χ² test and Pearson correlation analysis were used to evaluate the correlation between LPM attachment type and TMJ disc location. Results: There were three types of LPM attachment: type Ⅰ in 51 cases [31.9% (51/160)], type Ⅱ in 77 cases [48.1% (77/160)] and type Ⅲ in 32 cases [20.0% (32/160)]. There was a significant correlation between the type of LPM attachment and the position of articular disc (χ²=28.20, P=0.002, r=0.776). There was no statistical significance between the type of LPM attachment and the reversible displacement of articular disc (χ²=0.24, P=0.887, r=0.825). Conclusions: There is a correlation between the attachment type of LPM and the position of the disc in TMD patients. WNAD coupled with conventional head and neck joint coil TMJ high resolution scan can provide reliable imaging evidence for TMD patients in evaluating the type of LPM attachment and the location of disc.
Male ; Female ; Humans ; Temporomandibular Joint Disc/pathology* ; Pterygoid Muscles/pathology* ; Joint Dislocations ; Temporomandibular Joint Disorders/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Temporomandibular Joint/pathology*

Objective To evaluate lateral pterygoid muscle(LPM)contraction in the patients with temporomandibular disorders(TMD)based on 3D-T2 weighted imaging(3D-T2WI).Multiplanar reconstruction(MPR)was employed to measure the length of LPM in the images taken in closed-and open-mouth positions. Methods Seventeen TMD patients [age of(29.82±10.70)years,males/females=8/9] and 13 normal volunteers [control,age of(23.54±3.31)years,males/females=6/7] received 3D-T2WI of the temporomandibular joints in closed-and open-mouth positions from November 2019 to April 2020 in Department of Radiology,Hainan Hospital of Chinese PLA General Hospital.According to the position of the discs,the subjects were classified into the following groups:TMD with disc displacement without reduction(TMD-DDwoR),TMD with disc displacement with reduction(TMD-DDwR),TMD without disc displacement(TMDwoDD),and normal control without disc displacement(NCwoDD).MPR was employed to measure the maximal length of the superior belly of LPM.One-way analysis of variance,receiver operating characteristic curve,and permutation test were employed for the statistical analyses. Results The contraction of LPM was significantly shorter in TMD-DDwoR group [(3.36±1.96)mm] than in TMDwoDD group [(7.90±3.95)mm],NCwoDD group [(8.77±3.13)mm](
Adult ; Female ; Humans ; Joint Dislocations ; Magnetic Resonance Imaging ; Male ; Muscle Contraction ; Pterygoid Muscles/diagnostic imaging* ; Temporomandibular Joint Disc ; Temporomandibular Joint Disorders/diagnostic imaging* ; Young Adult

Objective: To investigate the imaging features of condylar cystic degeneration of temporomandibular joint (TMJ) by cone-beam CT (CBCT), spiral CT, MRI and radionuclide bone imaging. Methods: From January 2018 to December 2020, thirty-two patients with cyst-like lesions of condylein temporomandibular joint were examined by CBCT, spiral CT, MRI and radionuclide bone imaging at the Department of Oral and Maxillofacial Surgery in General Hospital of Chinese PLA. There were 12 males and 20 females involved, aged from 16 to 65 years with an average age of (33.9±12.5) years. The characteristics of CBCT, spiral CT, MRI and radionuclide bone imaging were analyzed. Condylar cyst like lesions were classified as type A and type B based on the presence or absence of surface bone defects. Condylar cyst like lesions were classified as type Ⅰ(yes) and type Ⅱ(no) according to the accompanying bone marrow edema-like lesions of the condyles. The incidence of condylar bone marrow edema, disc displacement and abnormal bone metabolism were analyzed. Results: A total of 64 joint images of 32 patients were included, including 34 sides with TMJ cyst-like lesion and 6 sides with multiple cyst-like lesions,the total cyst-like lesions were 42. The largest diameter of cyst-like lesion ranged from 1.0 to 12.4 mm, with an average length of (3.7± 1.8) mm. There were 24 cases of type A TMJ cyst like lesion and 10 cases of type B cyst-like lesion. The detection rate of CBCT was 95.2% (40/42) and that of spiral CT was 100% (42/42), there was no significant difference (Calibration Chi-square=0.51, P=0.474). The detection rate of nuclear magnetic resonance was 80.1% (34/42), and the detection rate of cyst-like lesions less than 2 mm was 3/11. In the cyst like lesion side, there were 9 sides with anterior disc displacement with reduction, 20 sides with anterior disc displacement without reduction. In the non-cyst like lesion side, 10 sides with anterior disc displacement with reduction and 6 sides with anterior disc displacement without reduction. There was a significant difference in the displacement of the disc between cyst-like and non-cystic lesion side (χ²=7.80, P=0.005). MRI showed that 6 cases of cystic side[17.6% (6/34)] had bone marrow edema-like lesions (all type A), 1 case of non-cyst like lesions side [3.3% (1/30)] had bone marrow edema-like lesion, there was no significant difference between cystic and non-cystic lesions (Calibration Chi-square=2.04, P=0.153). There was a significant difference between type A and B cystic lesions (Fisher exact probability method, P=0.024). Radionuclide bone imaging showed abnormal bone metabolism in 26 patients in the cyst-like lesion side and 5 patients in the non-cyst like lesion side (χ²=22.82, P<0.001). Conclusions Multi-slice Spiral CT could detect the cyst-like lesion of TMJ condyle in the early stage, which is different from the large joint. And the formation mechanism may vary from the different classifications.
Adolescent ; Adult ; Aged ; Cysts ; Female ; Humans ; Joint Dislocations ; Magnetic Resonance Imaging ; Male ; Mandibular Condyle/diagnostic imaging* ; Middle Aged ; Multimodal Imaging ; Temporomandibular Joint/diagnostic imaging* ; Temporomandibular Joint Disc ; Temporomandibular Joint Disorders/diagnostic imaging* ; Young Adult

Arthritis, Juvenile ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging ; Orthodontics, Corrective ; methods ; Temporomandibular Joint Disc ; diagnostic imaging ; Temporomandibular Joint Disorders ; diagnosis ; diagnostic imaging ; therapy ; Tomography, X-Ray Computed

OBJECTIVETo retrospectively analyze the advantages and disadvantages of radiographic methods commonly used for diagnostic of condylar fractures.

METHODSFrom Jan 2002 to Nov 2013, 290 patients (405 condylars) in the temporomandibular joint (TMJ) division of Ninth People's Hospital Shanghai Jiao Tong University School of Medicine were diagnosed as condylar fractures. Panoramic films and CT were taken in all patients to check and count the amount of condylar fractures, including intracapsular condyle fracture (type A, B, C and M), condylar neck fracture and subcondylar fracture. MRI was also taken in 119 patients with 174 condylar fractures to check the position of TMJ disc. The data were analyzed and compared among the three examinations in the diagnosis of the condylar fractures.

RESULTSPanoramic films showed 79.8% (323/405) condylar fractures. Among condylar fractures, intracapsular condylar fractures, condylar neck fractures and subcondylar fractures accounted for 48.9% (198/405), 20.3% (82/405) and 10.6% (43/405) respectively. CT showed 64.0% (259/405) intracapsular condylar fractures, 24.0% (97/405) condylar neck fractures and 12.1% (49/405) subcondylar fractures. Among intracapsular condylar fractures, Type A fracture was the most common type of ICF, which accounted for 48.7% (126/259), followed by Type B fracture, which accounted for 30.9% (80/259) and Type M fracture, 12.4% (32/259). Type C fracture was the least type which accounted for 8.1% (21/259). According to the diagnostic criteria of CT, there were 10 condylar neck fractures misdiagnosed with intracapsular condylar fractures. MRI showed 94.9% (129/136) TMJ disc displacement in intracapsular condylar fractures, 53.6% (15/28) in condylar neck fractures and 60.0% (6/10) in subcondylar fractures. Among intracapsular condylar fractures, there were 95.3% (61/64) TMJ disc displacement in type A, 95.2% (40/42) in type B, 89.0% (8/9) in type C, and 95.2% (20/21) in type M. There was significant difference of TMJ disc displacement between intracapsular condylar fractures and condylar neck fractures or subcondylar fractures (P < 0.05), and no significant difference between condylar neck fractures and subcondylar fractures (P < 0.05). There was also no significant difference among various type of intracapsular condylar fractures.

CONCLUSIONSPanoramic films can initially diagnose condylar fractures but with the high misdiagnosis rate for intracapsular fractures, minor fractures and fractures without fragment displacement. CT, especially coronal CT, should be considered for positioning fracture lines and confirming the displacement angle of fragment. MRI should also be used to determine the position of TMJ disc in intracapsular condylar fractures.

China ; Humans ; Joint Capsule ; Joint Dislocations ; Magnetic Resonance Imaging ; Mandibular Condyle ; Mandibular Fractures ; diagnostic imaging ; Radiography, Panoramic ; Retrospective Studies ; Temporomandibular Joint ; Temporomandibular Joint Disc ; Temporomandibular Joint Disorders ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVETemporomandibular joint sideways and rotational disc displacement was assessed by arthrography with dental volumetric computerized tomography.

METHODSThe study was conducted retrospectively on 119 joints of 109 patients (87 females, 22 males, mean age 31.1 years), who had undergone arthrography with dental volumetric CT in the sagittal and coronal planes. The disc displacements were subdivided into 5 types; condylar abnormalities were subdivided into 4 types.

RESULTSComplete anterior disc displacement was the commonest (70.6%) and medial the rarest (0.8%); anterolateral and anteromedial displacements were 18.5% and 10.1% respectively. The types of disc displacements were not correlated with bone lesions. A higher prevalences of bone lesions were found in the lateral poles of condyles.

CONCLUSIONSArthrography using dental volume CT can be taken in the sagittal and coronal planes, so the sideways and rotational disc displacements, perforations and bone lesions can be evaluated. It's superior to conventional arthrography.

Adolescent ; Adult ; Aged ; Arthrography ; Female ; Humans ; Male ; Middle Aged ; Temporomandibular Joint Disc ; diagnostic imaging ; Temporomandibular Joint Disorders ; diagnostic imaging ; Tomography, X-Ray Computed

Objective: MRI images were used to study the efficacy of anterior repositioning splint (ARS) in the treatment of different types of disc displacement with reduction (DDWR) in temporomandibular joint. Methods: From September 2020 to December 2021, 26 patients with DDWR were enrolled in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Zhengzhou University. There were 5 males and 21 females with an average age of (20.8±5.8) years. ARS was used for 3-6 months. The changes of joint clicking, opening type and joint pain before and after treatment were compared. The changes of disc position, disc-condyle angle and condylar bone mass before and after treatment were compared by MRI. Paired t-test was performed on the disc-condyle angle before and after treatment, Fisher's exact test was performed on the change of disk position, and other count data were expressed as rate (%). Results: After ARS treatment, the effective rates of joint clicking,abnormal opening, joint pain and disc displacement were 97%(35/36), 14/18, 7/9 and 95%(36/38). MRI analysis found that there was a significant difference between the disc position before and after treatment (P<0.001), MRI analysis showed that the anterior disc displacement (48%, 25/52) and the anterolateral disc displacement (17%, 9/52) were the most common before treatment. In contrast, the normal superior disc (75%, 39/52) and the anterior disc displacement (17%, 9/52) were the most common after treatment, no significant changes were seen after treatment in the anteromedial disc displacement. The disc-condylar angle was (36.09±19.02) ° before ARS treatment and (3.94±10.12) ° after ARS treatment(t=9.23, P<0.001). After treatment, 46% (12/16) of the patients showed new bone formation, and the height of the condyle recovered. Conclusions: The clinical efficacy of ARS in the treatment of anterior disc displacement and anterolateral displacement of temporomandibular joint is remarkable, which can restore the disc-condylar relationship of most patients with indications.
Adolescent ; Adult ; Arthralgia ; Female ; Humans ; Joint Dislocations/therapy* ; Magnetic Resonance Imaging ; Male ; Splints ; Temporomandibular Joint ; Temporomandibular Joint Disc/diagnostic imaging* ; Young Adult

OBJECTIVETo investigate the relationship between fractured fragment and joint disc displacement after sagittal fracture of mandibular condyle (SFMC).

METHODSbased on CT examination, SFMC were classified into fissue, displacement and dislocation type. Based on oblique sagittal MRI examination, the displacement of joint disc was grouped into type A and type B. Abnormal superiorposterior attachment was classified into elongation and avulsion type.

RESULTSCT exmination were taken in 26 patients with 41 SFMC. There were 5 SFMC (12%) with fissue type, 18 SFMC (44%) with displacement type and 18 SFMC (44%) with dislocation type. Both CT and MRI examination were taken in 19 patients with 32 SFMC. There were 27 (84%) SFMC with disc displacement. Five SFMC with type fissue showed no signs of disc displacement. Among 15 SFMC with type displacement, there were 3 cases with type A disc displacement and 12 cases with type B disc displacement. All the dislocated SFMC (12 cases) were type B disc displacement. In term of superiorposterior attachment figures, 4 cases (4/5) of type fissue SFMC showed normal. 14 cases (14/15) of the displacement SFMC showed elongated and all cases with dislocated SFMC showed sign of avulsion. There were 20 cases (63%) showing superior joint effusion. There were 13 cases (13/15) with displaced SFMC and 6 cases with dislocated SFMC showing joint effusion. One case with fissue SFMC showed no sign of joint effusion.

CONCLUSIONSJoint effusion, disc displacement and abnormal superiorposterior attachment were related to the displacement of condyle which was involved with SFMC.

Adolescent ; Adult ; Child ; Female ; Humans ; Joint Dislocations ; etiology ; Magnetic Resonance Imaging ; Male ; Mandibular Condyle ; injuries ; Mandibular Fractures ; classification ; diagnosis ; diagnostic imaging ; Middle Aged ; Temporomandibular Joint Disc ; pathology ; Temporomandibular Joint Disorders ; diagnosis ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed ; Young Adult