The evolving role of MRI in dentomaxillofacial diagnostics: a comprehensive review

Abstract

Magnetic Resonance Imaging (MRI) has emerged as a pivotal diagnostic tool in dentomaxillofacial radiology, surpassing conventional imaging techniques by offering superior contrast resolution for soft tissue lesions without the use of ionizing radiation. This comprehensive review explores the expanding applications of MRI in dentistry, highlighting its integration into routine diagnostic protocols and its significance in the evaluation of oral and maxillofacial structures. The article delves into the physics of MRI, detailing the various sequences such as Spin Echo (SE), Gradient Echo (GRE), and Short-Tau Inversion Recovery (STIR), each tailored for specific diagnostic needs. Advanced techniques like Dynamic Contrast-Enhanced MRI and Diffusion-Weighted Imaging (DWI) are discussed for their roles in assessing tissue perfusion and differentiating between benign and malignant lesions. The review emphasizes the necessity of appropriate coil selection and parameter optimization to enhance image quality, particularly in dental applications where artifacts from restorative and prosthetic materials can pose challenges. Furthermore, the article addresses the utility of MRI in visualizing dental hard tissues, the temporomandibular joint, and neurovascular structures, providing a comprehensive overview of its diagnostic capabilities. The integration of MRI into global health systems and the role of Personal Electronic Health Records in reducing redundant imaging are also examined. Conclusively, the review underscores the transformative impact of MRI on dentomaxillofacial diagnostics, advocating for its broader adoption in clinical practice to facilitate accurate diagnosis and effective treatment planning.

Keywords: Dental imaging; dentomaxillofacial diagnostics; magnetic resonance imaging; radiology.

Figure 1.

Coronal sections in T2W MRI showing Spin Echo (a) and STIR (b) sequences. Hyperintense appearance observed in maxillary sinus mucosal thickening and nasal cavity in the STIR image due to fat signal suppression.

Figure 2.

Computed tomography (a) and MRI (b) axial sections showing significant signal loss in the anterior region due to the removable prosthetics in the maxilla.

Figure 3.

T2W SE MRI sagittal section showing dental structures. Mote that peripheral area of the impacted 3rd molar is hyperintense compared to the normal bone and the impacted tooth is in close relation with inferior alveolar nerve.

Figure 4.

Coronal SE T2W images of submental muscle group. Note the geniohyoid muscle, mylohyoid muscle and anterior bellies of digastric muscle.

Figure 5.

Axial T2W SE images showing masticatory muscles in axial plane. *: Mandibular foramen.

Figure 6.

A and B: T2-weighted images in open (A) and closed (B) mouth positions, depicting normal disc position and lateral pterygoid muscle (LPM) C: Proton Density Turbo Spin Echo (PD TSE) image showing lateral disc displacement. D and E: T2-weighted images in open (D) and closed (E) mouth positions displaying anterior disc displacement. F: T2-weighted Spin Echo (SE) with Short Tau Inversion Recovery (STIR) sequence demonstrating the normal position of the disk in the coronal plane.