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[Three-dimensional imaging with computerized tomography. Etiologic considerations and methods for studying
R Ciccarelli1, F Di Salle, G Guidi
1Dipartimento di Scienze Biomorfologiche e Funzionali, Facoltà di Medicina e Chirurgia, Università degli Studi Federico II, Napoli.
La Radiologia Medica
|August 4, 1998
Summary
Three-dimensional computed tomography (3D CT) offers an accurate and repeatable method for assessing temporomandibular joint (TMJ) disorders. This advanced imaging technique provides valuable functional insights, supporting clinical findings in TMJ diagnostics.
Area of Science:
- Radiology
- Medical Imaging
- Orthodontics
Background:
- Temporomandibular joint (TMJ) disorders have traditionally been evaluated using conventional tomography and MRI.
- Computed Tomography (CT) traditionally offered limited visualization of periarticular soft tissues.
- Recent advancements in 3D CT reconstructions provide enhanced visualization of TMJ morphology and function.
Purpose of the Study:
- To evaluate the efficacy of 3D CT reconstructions in assessing functional changes in the temporomandibular joint (TMJ).
- To introduce a simple and accurate measurement system for TMJ morphologic and functional parameters using 3D CT.
- To establish 3D CT as a potential gold standard for functional TMJ studies.
Main Methods:
- 347 patients with TMJ disorders underwent CT scans with mouth closed and maximally open.
- Two different 3rd generation CT units were utilized.
- Dedicated software generated 3D reconstructions for measuring zygomatic tubercle height, condylar inclination, TMJ movement range, and condylar angle changes.
Main Results:
- 3D CT successfully visualized the complex morphology and function of the TMJ.
- The examination and reconstruction process was efficient, taking approximately 20-25 minutes.
- Artifacts such as pseudoforamina and pseudocalcifications were noted but did not impede overall assessment.
- The measurement system proved easy to perform, repeatable, and comparable across different CT units.
- Functional results from 3D CT correlated well with clinical findings.
Conclusions:
- 3D CT with dedicated software is a valuable tool for evaluating TMJ disorders.
- This technique allows for easy and accurate measurements of both TMJ sides simultaneously.
- While MRI provides joint disk visualization, 3D CT is considered the gold standard for functional TMJ assessment, supporting clinical diagnoses.