Bidirectional analysis of clinical and MRI correlations in temporomandibular disorders using regression models

In the course of a standard diagnostic procedure for temporomandibular joint disorder (TMD), there is often uncertainty regarding the necessity of magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). This study aims to clarify the relationship between clinical TMD symptoms and MRI findings using logistic regression models, to better define the role of MRI in diagnostics.

In this retrospective study, the authors analysed a sample of 80 temporomandibular joints (TMJs). Forty patients with TMD symptoms were selected for the study, all of which had previously undergone examination in accordance with the diagnostic criteria for temporomandibular disorders (DC/TMD), as well as having undergone TMJ MRI. Descriptive statistics and regression analyses were used to explore any correlation between clinical symptoms and MRI findings.

MRI-based explanation of clinical symptoms revealed thirteen significant regression models with the following dependent variables: palpation pain at the lateral TMJ pole, TMJ crepitation, condylar hypermobility, uncorrected mandibular deviation, and palpation pain in the medial and lateral pterygoid muscles, as well as in the masseter and temporalis muscles. In contrast, the clinical symptom-based inference of MRI diagnoses yielded eleven significant models, with MRI findings as dependent variables: effusion, degenerative joint disease, anterior disc displacement without reduction, medial disc displacement, thickening at the insertion of the lateral pterygoid muscle, subluxation of the mandibular condyle, reduced glenoid fossa height, and abnormal disc morphology. Among all models, only anterior disc displacement without reduction with condylar hypermobility and with the pain in the masseter muscle demonstrated acceptable predictive accuracy. (AUC = 0.651, AUC = 0.637).

This study confirms that clinical examination alone may be insufficient for accurately diagnosing specific TMJ pathologies. Although some clinical signs show strong associations with MRI findings, only two regression models demonstrated acceptable predictive value.