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DC/TMD에 기반한 턱관절 장애의 영상 진단

Imaging diagnosis of temporomandibular disorders based on DC/TMD

대한치과의사협회지 2021년 59권 10호 p.580 ~ 591
이연희,
소속 상세정보
이연희 ( Lee Yeon-Hee ) - Kyung Hee University School of Dentistry Department of Orofacial Pain and Oral Medicine

Abstract


Proper diagnosis and management of temporomandibular disorder (TMD) is essential. For this purpose, clinical examination as well as imaging examination of the temporomandibular joint (TMJ), surrounding structures, and masticatory muscles are required. Confirmation of diagnosis by imaging prevents delay in diagnosis and prevents chronic progression of TMD signs and symptoms. TMJ can be imaged using a variety of modalities, including conventional radiography represented by panoramic radiography, magnetic resonance imaging (MRI), computed tomography (CT), cone-beam CT (CBCT), and bone scans. The present study briefly explains the characteristics and indications of the imaging modalities used in the diagnosis of TMD according to the diagnostic criteria for temporomandibular disorders (DC/TMD), and presents representative images. However, imaging of TMJ can be challenging due to the anatomical complexity of the TMJ area. The use of panoramic radiography for pathological changes in the TMJ area is not enough due to overlapping of anatomical structures. With CT and CBCT, bony changes can be better identified. A three-dimensional image view is required for an accurate imaging diagnosis of TMJ. CBCT provides a high-resolution multiplanar reconstruction of the TMJ with low radiation dose without overlap of bone structures. Furthermore, MRI is a non-invasive dynamic imaging modality that is considered the gold standard for imaging the soft tissue components of the TMJ. MRI can be useful in evaluating the position and shape of the articular disc, and diagnosing TMJ disc displacement. It can also determine the early signs of TMD and the presence of joint effusion. Bone scans show whether bone changes and inflammatory reactions observed on other imaging modalities are active. The diagnostic value of imaging depends to a large extent on the equipment used and the experience of the examiner. It is recommended that the results of imaging examination be interpreted in conjunction with those of clinical examination. The information presented here is of great help to clinicians and researchers who are treating and studying TMD.

키워드

?temporomandibular disorders; temporomandibular joint; cone-beam computed tomography; magnetic resonance imaging; panoramic radiography; bone scan

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