Temporomandibular joint disk position assessed at coronal MR imaging in asymptomatic volunteers. 2005

Marc Schmitter, and Bodo Kress, and Christina Ludwig, and Andreas Koob, and Olaf Gabbert, and Peter Rammelsberg
Department of Prosthodontics and Neuroradiology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Marc_Schmitter@med.uni-heidelberg.de

OBJECTIVE To assess the normal position of the temporomandibular joint (TMJ) disk relative to the condyle by using coronal magnetic resonance (MR) imaging in asymptomatic volunteers. METHODS This study was approved by the review committee for human research, and all subjects signed an informed consent form. Thirty symptom-free volunteers without histories of TMJ disorders underwent standardized clinical examinations. Afterward, bilateral sagittal oblique and coronal oblique MR images were acquired with the patient's mouth opened and closed. The coronal oblique opened- and closed-mouth images were analyzed by using computer software. The medial and lateral edges of both the TMJ disk and the condyle were marked for these imaging examinations by using the section through the posterior 3 mm of the disk. To eliminate the effect of different magnifications and/or distortions, the distance between these points was measured automatically and divided by the largest mediolateral dimensions of the condyle. To assess the reliability of the measurements, four observers evaluated the position of the disk in the coronal plane. To assess the changes in position of the posterior 3 mm of the disk in the coronal plane in the closed- and opened-mouth positions, the Wilcoxon signed rank test for matched pairs was used. Interobserver measurement reliability was evaluated by using interclass correlation coefficients (ICCs). RESULTS Analysis of the coronal closed-mouth disk position revealed a medial position of the TMJ disk relative to the condyle in 11 (21%) of 52 analyzed joints. In the opened-mouth position, the medial location of the disk was more frequent: 29 (85%) of 34 analyzed joints exhibited a medial position of the disk relative to the condyle in this plane. This increasingly medial position of the disk was statistically significant (P < or = .001). Measurement reliability assessment revealed sufficient results (ICC > or = 0.7). CONCLUSIONS At both closed- and opened-mouth MR imaging, a medially located TMJ disk seems to be within the normal range of variation. The disk seems to shift even more medially when the mouth is opened.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010865 Pilot Projects Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. Pilot Studies,Pilot Study,Pilot Project,Project, Pilot,Projects, Pilot,Studies, Pilot,Study, Pilot
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D019224 Temporomandibular Joint Disc A plate of fibrous tissue that divides the temporomandibular joint into an upper and lower cavity. The disc is attached to the articular capsule and moves forward with the condyle in free opening and protrusion. (Boucher's Clinical Dental Terminology, 4th ed, p92) Articular Disk, Temporomandibular,Disk, Temporomandibular Joint,Temporomandibular Joint Disk,Articular Disc, Temporomandibular,Articular Discs, Temporomandibular,Articular Disks, Temporomandibular,Disc, Temporomandibular Articular,Disc, Temporomandibular Joint,Discs, Temporomandibular Articular,Discs, Temporomandibular Joint,Disk, Temporomandibular Articular,Disks, Temporomandibular Articular,Disks, Temporomandibular Joint,Joint Disc, Temporomandibular,Joint Discs, Temporomandibular,Joint Disk, Temporomandibular,Joint Disks, Temporomandibular,Temporomandibular Articular Disc,Temporomandibular Articular Discs,Temporomandibular Articular Disk,Temporomandibular Articular Disks,Temporomandibular Joint Discs,Temporomandibular Joint Disks

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