Craniomandibular disorders--comparative investigations with clinical examination and electronic axiography

An essential problem in the diagnosis of craniomandibular disorders is still the evaluation of the type and severity of the TMJ diseases. For a differential classification of TMJ diseases, we developed an electronic axiography system which facilitates a recording of lower jaw movements. It works 3-dimensionally and relates to the joints. The measuring system, which was internationally patented, is based on a linear resistive foil for the sagittal plane and an inductive gauge for the horizontal plane. The aim of this pilot study was to evaluate the usefulness of our electronic axiography system in obtaining a differential diagnosis of craniomandibular disorders. We examined 30 patients (60 joints) with complaints in the TMJ area (pain and TMJ sounds). Clinical examinations yielded only uncertain indications of TMJ disease. With the help of electronic axiography we could differentiate the TMJ diseases into microtrauma and macrotrauma. Both forms may show a loss of function and an audible TMJ clicking. 23 joints had a macrotrauma (disk displacement with reduction, 20 times; disk displacement without reduction, 3 times). In 8 joints, a microtrauma was found. 3 joints showed a subluxation. In 4 uncertain cases, the diagnosis was confirmed with the help of magnetic resonance imaging (MRI). All patients with a diagnosed arthrogenic disorder received adequate treatment with reposition splints. Our initial results show that 3-dimensional electronic axiography can be a good aid in further characterization of craniomandibular disorders and permits an effective therapy.