Imaging modalities for temporomandibular joint disorders: an update

Area of Science:

• Radiology
• Dentistry
• Orthodontics

Background:

• Temporomandibular disorders (TMD) diagnosis and management necessitate clinical and imaging assessments of the temporomandibular joint (TMJ).
• The TMJ's complex anatomy presents challenges for accurate imaging.
• Selecting the appropriate imaging modality is crucial for effective TMD evaluation.

Purpose of the Study:

• To review and outline the indications for frequently used imaging techniques in diagnosing TMD.
• To provide guidance on choosing the optimal imaging method for TMJ assessment.

Main Methods:

• Review of current literature on TMJ imaging modalities.
• Discussion of the applications and limitations of conventional radiography, CT, cone beam CT, MRI, and ultrasonography in TMD diagnosis.

Main Results:

• Conventional radiography has limited utility for TMJ pathology due to the need for 3D imaging.
• CT and cone beam CT excel at visualizing osseous changes, with cone beam CT offering high-resolution, low-dose, multiplanar views.
• MRI is the gold standard for soft tissue evaluation, assessing the articular disc, early TMD signs, and joint effusion.
• High-resolution ultrasonography is a useful, noninvasive tool for diagnosing TMJ disc displacements, though its effectiveness depends on operator skill and equipment.

Conclusions:

• The choice of imaging technique for TMD depends on the specific diagnostic need, balancing visualization of hard and soft tissues.
• Cone beam CT and MRI are highly valuable for detailed TMJ assessment, while ultrasonography offers a dynamic option for disc displacement evaluation.