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Failed temporomandibular joint prostheses: MR imaging.

J B Kneeland, D E Ryan, G F Carrera

    Radiology
    |October 1, 1987
    PubMed
    Summary
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    Magnetic resonance (MR) imaging accurately detects temporomandibular joint disk prosthesis fractures. This study determined the sensitivity and specificity of MR imaging for diagnosing these fractures, aiding in patient management.

    Area of Science:

    • Orthopedics
    • Radiology
    • Biomedical Engineering

    Background:

    • Temporomandibular joint (TMJ) disk prostheses are used to treat TMJ disorders.
    • Post-implantation pain and dysfunction can occur, potentially due to prosthesis fracture.
    • Accurate diagnosis of prosthesis integrity is crucial for effective treatment.

    Purpose of the Study:

    • To evaluate the diagnostic performance of magnetic resonance (MR) imaging in detecting fractures of temporomandibular joint disk prostheses.
    • To determine the sensitivity and specificity of MR imaging for identifying TMJ disk prosthesis fractures.

    Main Methods:

    • MR imaging with surface coils was performed on 43 TMJs with disk prostheses in 28 patients experiencing pain or dysfunction.
    • Prospective diagnosis of prosthesis fracture was based on MR findings of discontinuity.

    Related Experiment Videos

  • Surgical exploration served as the gold standard for final diagnosis.

    • Main Results:

    • MR imaging demonstrated a sensitivity of 0.81 and a specificity of 0.91 for diagnosing TMJ disk prosthesis fractures.
    • Other observed MR findings included soft tissue abnormalities, disk thinning, osteophytes, and condylar erosion.
    • A frequent, unexplained artifact obscured prostheses in false-negative cases, and prosthesis thinning caused a false-positive finding.

    Conclusions:

    • MR imaging is a valuable tool for diagnosing fractures in temporomandibular joint disk prostheses.
    • The study highlights the diagnostic accuracy of MR imaging, with high sensitivity and specificity.
    • Understanding potential artifacts and imaging limitations is important for accurate interpretation.