[Imaging of the temporomandibular joint]

Abstract

A large number of imaging techniques are available nowadays to visualise the temporomandibular joint and surrounding structures. It is important that osseous structures as well as soft tissue can be shown. Transcranial images, conventional tomography, panoramic radiography and computed tomography (CT) are more suitable for viewing the osseous structures. The best techniques to evaluate the soft tissues are arthrography and especially magnetic resonance imaging (MR). The panoramic radiography is the technique of choice in the general practice and provides adequate screening images of the temporomandibular joints, mandible, maxilla, teeth and surrounding tissues. When the joint is suspected of developmental anomalies, neoplastic conditions or a condylar trauma, CT-images are necessary to depict the bony abnormalities. CT has a poor reliability in imaging the disk. For this reason, disk displacements of the temporomandibular joint are best shown with MR, although the clinician should be very restrictive in using MR-images. They are very expensive and are only useful to confirm an uncertain diagnosis, or if disc surgery is the treatment of choice. The anamnesis and the clinical investigation are still the most important elements in diagnosing craniomandibular dysfunction.