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International Poster Journal of Dentistry and Oral Medicine
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Int Poster J Dent Oral Med 2 (2000), No. 2     15. June 2000

Int Poster J Dent Oral Med 2000, Vol 2 No 2, Poster 37

Evaluation of the temporomandibular joint by magnetic resonance imaging using a standardized evaluation form

Language: English

Authors: Peter Ottl1, Andreas Hohmann2, Hans-Christoph Lauer1, Friedhelm Zanella2, Frank Hardenacke1
1Department of  Prosthodontics, School of Dentistry, ZZMK (Carolinum)
2Institute for Neuroradiology, J.W. Goethe University at Frankfurt am Main, Germany

Date/Event/Venue: 
26.11.99-27.11.99
32. Jahrestagung der Arbeitsgemeinschaft für Funktionslehre in der Deutschen Gesellschaft für Zahn-, Mund- und Kieferheilkunde
Bad Homburg


Posterpreis der Tagung

Objectives

  • Systematic diagnostic evaluation of MRI images of the temporomandibular joint
  • Documentation of primary/secondary findings

 
  Fig. 1a: TMJ right, closed, "sagittal": NPF
(Patient M.M.)
Fig. 1b: TMJ right, closed, coronal: NPF
(Patient M.M.)


  Fig. 2: TMJ right, open, "sagittal": NPF (arrow: disco-temporal ligament) Fig. 3: TMJ left, closed, "sagittal", T2-weighted: Joint effusion

Examination form

The following parameters are evaluated:

  • Condylar morphology (compacta, spongiosa)
  • Fossa and tubercular morphology
  • Disc morphology
  • Condyle/fossa relationship (closed/open mouth)
  • Disc position in two planes (closed/open mouth)
  • Signal areas, T2–weighted (condyle, joint space, bilaminar zone)

Condylar morphology

R   L
 

No pathological findings/Convex

 
 

Gable-shaped/Pointed angle

 
 

Depression

 
 

Concavity

 
 

Hypoplasia

 
 

Deformation

 
 

Fracture

 
 
  Compacta: No pathological findings  
    Erosion  
    Osteophyte formation  
 
  Spongiosa: No pathological findings  
    Degeneration  
    Inflammation/Tumor  

Fossa morphology

R   L
 

No pathological findings

 
 

Erosion

 
 

"Irregular joint surface"
(cartilaginous formations, exostoses)

 

Disc morphology

R   L
 

No evaluation possible

 
 

Biconcave

 
 

Biplanar

 
 

Overall thickening

 
 

Overall or central thinning

 
 

Thickening in the marginal area

 
 

Depression in the marginal area

 
 

Deformed

 
 

Plicated

 
 

Spherical

 
 

Perforated

 
 

Destroyed/Fragmented

 

Fig. 4: TMJ right, closed, "sagittal": Partial anterior disc displacement Fig. 5: TMJ right, open, "sagittal": Total anterior disc displacement without reduction


Fig. 6a: TMJ right, closed, coronal: Partial anterior disc displacement
(Patient T.K.)
Fig. 6b: TMJ left, closed, coronal : Osteochondrosis dissecans
(Patient T.K.)

Condyle/fossa relationship
(closed mouth)

R   L
 

Centric condylar position

 
 

Anterior orientation

 
 

Posterior orientation

 
 
 

Cranial orientation

 
 

Caudal orientation

 

Condyle/fossa relationship
(open mouth)

R    L
 

Translation movement: Yes

 
 

Translation movement: Hypermobile

 
 

Translation movement: Reduced

 
 

Translation movement: No

 

Disc position "sagittal"
(closed mouth)

R   L
 

No evaluation possible

 
 

Regular

 
 

Partial anterior disc displacement

 
 

Total anterior disc displacement

 
 

Posterior disc displacement

 

Disc position "sagittal"
(open mouth)

R   L
 

No evaluation possible

 
 

Regular

 
 

Anterior displacement

 
 

Posterior displacement

 
 
 

Disc repositioned: Yes

 
 

Disc repositioned: No

 
 
 

Disc adhesion

 

Disc position coronal
(closed mouth)

R   L
 

No evaluation possible

 
 

Coping-shaped

 
 

Lateral displacement

 
 

Medial displacement

 

Fig. 7a: TMJ right, closed, "sagittal": Disc position regular?
(Patient T.B.)
Fig. 7b: TMJ right, closed, coronal: Lateral disc displacement (Patient T.B.)

T2 weighting
(condyle, joint space, bilaminar zone)

R   L
 

No high-signal areas

 
 

High-signal areas

 

Retrospective study

Fig.8
Fig. 8: The relevance of the examination form for MRI evaluation is exemplified by the results for "Disc position sagittal".
(DD = Disc displacement)

This Poster was submitted on 12.05.00 by OA Dr. Peter Ottl

Correspondence address:
Herrn OA Dr. Peter Ottl
Poliklinik für Zahnärztliche Prothetik der J.W. Goethe-Universtität,
Uniklinikum Frankfurt/Main. 
Theodor-Stern-Kai 7
D - 60590 Frankfurt/M.