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Review
. 2015;44(1):20140235.
doi: 10.1259/dmfr.20140235.

Temporomandibular Joint Diagnostics Using CBCT

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Free PMC article
Review

Temporomandibular Joint Diagnostics Using CBCT

T A Larheim et al. Dentomaxillofac Radiol. .
Free PMC article

Abstract

The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost- and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome.

Keywords: CBCT; TMJ; diagnostic imaging; review.

Figures

Figure 1
Figure 1
CBCT of normal temporomandibular joint with motion artefact simulating osteophyte and remodeling (double contour) (female, 75 years).
Figure 2
Figure 2
CBCT of beaking of anterior aspect of condyle—remodeling or small osteophyte? (female, 61 years).
Figure 3
Figure 3
CBCT of osteoarthritis: osteophyte, sclerosis, flat articular surfaces, erosion and possible subchondral cyst (female, 68 years).
Figure 4
Figure 4
CBCT of juvenile idiopathic arthritis (female, 13 years): deformed (remodelled) right joint: rather flat fossa/eminence and condyle, without cortical erosion (upper) and normal left joint for comparison (lower).
Figure 5
Figure 5
CBCT of juvenile osteoarthritis: deformed (remodelled) joint: osteophyte, sclerosis and cortical erosions (female, 13 years).
Figure 6
Figure 6
CBCT of normal temporomandibular joint (?): non-compact, non-homogeneous cortical surface of condyle (upper), making diagnostic assessment uncertain (female, 13 years). Normal compact and homogeneous cortical outline of condyle (lower) for comparison (female, 69 years).
Figure 7
Figure 7
CBCT of rheumatoid arthritis: punched-out destruction with sclerosis (female, 59 years).
Figure 8
Figure 8
CBCT of juvenile idiopathic arthritis: deformed (remodelled) joint with surface erosions: flattened condyle with enlarged anteroposterior dimension and double contour. Articular eminence also flattened (female, 16 years).
Figure 9
Figure 9
CBCT of intra-articular fractures. Reproduced from Larheim and Westesson with permission from Springer.
Figure 10
Figure 10
CBCT of developmental anomaly, probably hemifacial microsomia (male, 8 years). Abnormal condyle morphology and condyle location, lack of fossa/eminence development and enlarged coronoid process (upper, middle). For comparison, normal contralateral joint (lower).

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