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. 2021 Jan;25(1):159-168.
doi: 10.1007/s00784-020-03347-9. Epub 2020 Jun 17.

The importance of multisection sagittal and coronal magnetic resonance imaging evaluation in the assessment of temporomandibular joint disc position

Monika Litko-Rola  1 , Jacek Szkutnik  1 , Ingrid Różyło-Kalinowska  2
Affiliations

The importance of multisection sagittal and coronal magnetic resonance imaging evaluation in the assessment of temporomandibular joint disc position

Monika Litko-Rola et al. Clin Oral Investig. 2021 Jan.

Abstract

Objectives: The aim of this study was to evaluate diagnoses of temporomandibular (TMJ) disc displacement by comparing evaluations done on the basis of central sagittal scans only, the most often used in temporomandibular disorder (TMD) patients, with a multisection evaluation done with both sagittal and coronal scans.

Materials and methods: Multisection MRI analysis of 382 TMJs was conducted in 191 patients with disc displacement according to RDC/TMD criteria. Disc position in the intercuspal position (IP) was assessed two times using two different methods. The first method involved a TMJ disc position evaluation on the central slide in the oblique sagittal plane only. In the second method, the TMJ disc position was assessed on all oblique sagittal and coronal images. McNemar's χ2 test was used to evaluate the differences between the sensitivities of two methods.

Results: The first method (central oblique sagittal scans assessment) identified 148 TMJs (38.7%) with normal disc position compared with 89 TMJs (23.3%) with normal disc position found by the second method (all oblique sagittal and coronal scans assessment). The sensitivity of analysis in both planes was significantly higher than in the sagittal plane only (p < 0.001).

Conclusions: The multisection analysis in the sagittal and coronal plane allows to distinguish the correct disc position from disc displacement and thus improve evaluation of TMJ internal derangement.

Clinical relevance: The multisection sagittal and coronal images should be recommended as a standard in MRI of the TMJ disc displacement in patients with TMD to avoid false-negative diagnoses.

Keywords: Magnetic resonance imaging; Temporomandibular joint disc; Temporomandibular joint disorders; Temporomandibular joint dysfunction syndrome.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Oblique sagittal slices
Fig. 2
Fig. 2
Oblique coronal slices
Fig. 3
Fig. 3
Schemes of TMJ disc position according to multisection sagittal and coronal MRI evaluation: a normal superior, b complete anterior, c partial anterior in the lateral part, d partial anterior in the medial part, e partial anterolateral, f partial anteromedial, g complete anterolateral, h complete anteromedial, i lateral, j medial
Fig. 4
Fig. 4
MRI of TMJ with partial anterior disc displacement in the lateral part. a–e Oblique sagittal slices in intercuspal position. f–j Oblique coronal slices in intercuspal position
Fig. 5
Fig. 5
MRI of TMJ with lateral disc displacement. a–e Oblique sagittal slices in intercuspal position. f–j Oblique coronal slices in intercuspal position
See this image and copyright information in PMC

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