Correlation between direction and severity of temporomandibular joint disc displacement and reduction ability during mouth opening

J Oral Rehabil. 2017 Dec;44(12):957-963. doi: 10.1111/joor.12576. Epub 2017 Oct 6.

Abstract

The most common temporomandibular joint (TMJ) internal derangement is an abnormal relationship of the disc with respect to the mandibular condyle, articular eminence and glenoid fossa-disc displacement. The aim of our study was to analyse the correlation between partial/complete disc displacement in the intercuspal position (IP) and its reduction in the open-mouth position (OMP) in both oblique sagittal and coronal planes on magnetic resonance imaging (MRI) in patients with temporomandibular disorders. Multisection MRI analysis of 382 TMJs was conducted in 191 patients with disc displacement according to the RDC/TMD criteria (148 women, 43 men; aged 14-60 years). The disc position was evaluated on all oblique sagittal and coronal images in the IP and the OMP. Univariate logistic regression analysis showed that the severity of disc displacement in the sagittal plane is a statistically significant predictor of reduction ability during mouth opening (B = 3.118; P < .001). Moreover, the severity of disc displacement in both planes is also a significant predictor of disc reduction in OMP (B = 2.200; P < .05). In conclusion, reduction ability during mouth opening is associated with the severity of disc displacement in IP, in both sagittal and coronal planes. Multisection analysis of all MR images allows distinguishing the correct disc position from disc displacement and can improve the ability to distinguish between various stages of TMJ internal derangement.

Keywords: magnetic resonance imaging; temporomandibular joint disc; temporomandibular joint disorders; temporomandibular joint dysfunction syndrome.

MeSH terms

  • Adolescent
  • Adult
  • Facial Pain
  • Female
  • Humans
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / physiopathology*
  • Magnetic Resonance Imaging
  • Male
  • Mandibular Condyle / anatomy & histology
  • Mandibular Condyle / diagnostic imaging
  • Mandibular Condyle / physiopathology*
  • Middle Aged
  • Range of Motion, Articular / physiology*
  • Reproducibility of Results
  • Severity of Illness Index
  • Temporomandibular Joint Disc / diagnostic imaging
  • Temporomandibular Joint Disc / physiopathology*
  • Temporomandibular Joint Disorders / diagnostic imaging
  • Temporomandibular Joint Disorders / physiopathology*
  • Young Adult