Comparison of three radiographic methods for detection of morphological temporomandibular joint changes: panoramic, scanographic and tomographic examination. 2009

H Hintze, and M Wiese, and A Wenzel
Department of Oral Radiology, School of Dentistry, Faculty of Health Sciences, University of Aarhus, Vennelyst Boulevard 9, DK-8000 Aarhus C, Denmark. hhintze@odont.au.dk

OBJECTIVE To compare the diagnostic accuracy of panoramic, scano- and tomographic examination for the detection of morphological temporomandibular joint (TMJ) changes. METHODS TMJs in 80 dry human skulls were radiographed using digital panoramic examination, 4x sagittal (lateral) scanography, and sagittal cross-sectional tomography. All images were examined by three independent observers for the presence or absence of flattening, defects and osteophytes in the various joint components. The true presence of the morphological changes was unanimously decided by consensus of three independent observers using naked-eye inspection. The accuracy for detection of the specific changes in each joint component was expressed as sensitivity and specificity values, whereas the accuracy for detection of morphological changes in general in the condyle and in the TMJ in toto was expressed as the number of matching radiographic and "gold standard" scores. RESULTS Up to 23% and 9% of the three joint components were recorded as non-accessible to examination with panoramic examination and sagittal (lateral) scanography, respectively, whereas all components were accessible to examination with sagittal cross-sectional tomography. The difference was significant between panoramic examination and sagittal cross-sectional tomography (P = 0.018). No significant differences between the three methods for detection of specific morphological changes in the condyles and defects in the articular tubercles and changes in the TMJ in toto were found. CONCLUSIONS No differences in accuracies between the methods were found for the detection of morphological TMJ changes. However, with panoramic examination and sagittal (lateral) scanography markedly more joint components were non-accessible to examination than with sagittal cross-sectional tomography, with which all components were accessible.

UI MeSH Term Description Entries
D008335 Mandibular Condyle The posterior process on the ramus of the mandible composed of two parts: a superior part, the articular portion, and an inferior part, the condylar neck. Condyle, Mandibular,Condyles, Mandibular,Mandibular Condyles
D011862 Radiography, Panoramic Extraoral body-section radiography depicting an entire maxilla, or both maxilla and mandible, on a single film. Orthopantomography,Panoramic Radiography,Pantomography,Orthopantomographies,Panoramic Radiographies,Pantomographies,Radiographies, Panoramic
D003766 Dental Occlusion The relationship of all the components of the masticatory system in normal function. It has special reference to the position and contact of the maxillary and mandibular teeth for the highest efficiency during the excursive movements of the jaw that are essential for mastication. (From Jablonski, Dictionary of Dentistry, 1992, p556, p472) Canine Guidance,Occlusal Guidance,Occlusal Plane,Occlusion, Dental,Dental Occlusions,Guidance, Canine,Guidance, Occlusal,Occlusal Guidances,Occlusal Planes,Occlusions, Dental,Plane, Occlusal,Planes, Occlusal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D013704 Temporomandibular Joint An articulation between the condyle of the mandible and the articular tubercle of the temporal bone. TMJ,Joint, Temporomandibular,Joints, Temporomandibular,Temporomandibular Joints
D013705 Temporomandibular Joint Disorders A variety of conditions affecting the anatomic and functional characteristics of the temporomandibular joint. Factors contributing to the complexity of temporomandibular diseases are its relation to dentition and mastication and the symptomatic effects in other areas which account for referred pain to the joint and the difficulties in applying traditional diagnostic procedures to temporomandibular joint pathology where tissue is rarely obtained and x-rays are often inadequate or nonspecific. Common diseases are developmental abnormalities, trauma, subluxation, luxation, arthritis, and neoplasia. (From Thoma's Oral Pathology, 6th ed, pp577-600) TMJ Disorders,TMJ Diseases,Temporomandibular Disorders,Temporomandibular Joint Diseases,Disease, TMJ,Disease, Temporomandibular Joint,Diseases, TMJ,Diseases, Temporomandibular Joint,Disorder, TMJ,Disorder, Temporomandibular,Disorder, Temporomandibular Joint,Disorders, TMJ,Disorders, Temporomandibular,Disorders, Temporomandibular Joint,Joint Disease, Temporomandibular,Joint Diseases, Temporomandibular,Joint Disorder, Temporomandibular,Joint Disorders, Temporomandibular,TMJ Disease,TMJ Disorder,Temporomandibular Disorder,Temporomandibular Joint Disease,Temporomandibular Joint Disorder
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face
D015588 Observer Variation The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material). Bias, Observer,Interobserver Variation,Intraobserver Variation,Observer Bias,Inter-Observer Variability,Inter-Observer Variation,Interobserver Variability,Intra-Observer Variability,Intra-Observer Variation,Intraobserver Variability,Inter Observer Variability,Inter Observer Variation,Inter-Observer Variabilities,Inter-Observer Variations,Interobserver Variabilities,Interobserver Variations,Intra Observer Variability,Intra Observer Variation,Intra-Observer Variabilities,Intra-Observer Variations,Intraobserver Variabilities,Intraobserver Variations,Observer Variations,Variabilities, Inter-Observer,Variabilities, Interobserver,Variabilities, Intra-Observer,Variabilities, Intraobserver,Variability, Inter-Observer,Variability, Interobserver,Variability, Intra-Observer,Variability, Intraobserver,Variation, Inter-Observer,Variation, Interobserver,Variation, Intra-Observer,Variation, Intraobserver,Variation, Observer,Variations, Inter-Observer,Variations, Interobserver,Variations, Intra-Observer,Variations, Intraobserver,Variations, Observer
D016059 Range of Motion, Articular The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES. Passive Range of Motion,Joint Flexibility,Joint Range of Motion,Range of Motion,Flexibility, Joint

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