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Objectives: The purpose of this study was to propose a machine learning model and assess its ability to classify temporomandibular joint (TMJ) disc displacements on MR T1-weighted and proton density-weighted images., Methods: This retrospective cohort study included 180 TMJs from 90 patients with TMJ signs and symptoms. A radiomics platform was used to extract imaging features of disc displacements. Thereafter, different machine learning algorithms and logistic regression were implemented on radiomics features for feature selection, classification, and prediction. The radiomics features included first-order statistics, size- and shape-based features, and texture features. Six classifiers, including logistic regression, random forest, decision tree, k-nearest neighbours (KNN), XGBoost, and support vector machine were used for a model building which could predict the TMJ disc displacements. The performance of models was evaluated by sensitivity, specificity, and ROC curve., Results: KNN classifier was found to be the most optimal machine learning model for prediction of TMJ disc displacements. The AUC, sensitivity, and specificity for the training set were 0.944, 0.771, 0.918 for normal, anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) while testing set were 0.913, 0.716, and 1 for normal, ADDwR, and ADDwoR. For TMJ disc displacements, skewness, root mean squared, kurtosis, minimum, large area low grey level emphasis, grey level non-uniformity, and long-run high grey level emphasis, were selected as optimal features., Conclusions: This study has proposed a machine learning model by KNN analysis on TMJ MR images, which can be used for TMJ disc displacements., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Institute of Radiology and the International Association of Dentomaxillofacial Radiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Whether pain, jaw function and quality of life are correlated with disc positions is controversial, and similar studies evaluating disc positions by magnetic resonance imaging (MRI) are very limited., Objective: This study evaluated the pain, mandibular function and quality of life of the temporomandibular disorders (TMDs) patients with different disc positions according to MRI, and the relationship among them., Methods: Three hundred and thirty-five participants were included. Patients completed questionnaires included the Numeric Rating Scale (NRS), Jaw Functional Limitation Scale 8-item (JFLS-8), the Generalised Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire 9-item (PHQ-9) and Oral Health Impact Profile for TMD (OHIP-TMD). MRI was conducted to evaluate these diagnoses, resulting in the identification of three distinct categories: normal positioning (NP), disc displacement with reduction (DDwR) and disc displacement without reduction (DDwoR)., Results: Participants had the mean age of 28.55 ± 11.10 years (80.90% women). DDwR and DDwoR had a higher percentage of females compared with NP. Significant differences existed among patients in all questionnaires. The DDwoR group had significantly the highest pain, functional limitation and the worst quality of life. Moreover, they experienced the most difficulties in chewing tough foods, yawning, experiencing pain and psychological discomfort. Moreover, the multivariate regression showed that age, female gender, diagnosis as DDwoR, GAD-7 and PHQ-9 were significantly linked to higher functional limitation. Worse quality of life was associated with age, diagnosis as DDwoR, GAD-7 and PHQ-9., Conclusions: Among patients with different disc positions, DDwoR showed the highest pain, functional limitation and the worst quality of life. Also, NP showed a proportion of chronic pain. Physical pain, psychological discomfort and chewing tough food were regarded as the most impaired. Women who experience anxiety and depression tended to have a higher propotion of dysfunction and a lower quality of life., (© 2024 John Wiley & Sons Ltd.)

Background and Objectives: Fibrillinopathies have different phenotypic expression: Marfan-like skeleton features, MLSF; mitral valve prolapse syndrome, MVPS; MASS phenotype, M = mitral valve prolapse, MVP, A = aortic root dilation, S = skeletal features, and the second S = (cutaneous) striae; Marfan Syndrome, MS. The study had the following main objectives: the correlation between disc displacement, DD (a major sign for temporomandibular joint dysfunction, TMDs) on magnetic resonance imaging, MRI, and aortic Z score (a major sign for aortic root dilation) on echocardiography; the predictive value of DD towards aortic Z score. DD had 2 types of severity: DD with reduction (the mild type, DDwR), and DD without reduction (the severe type, DDwoR). Materials and Methods: The type of fibrillinopathy was precised by clinical exam (systemic score), ophthalmic exam (for ectopia lentis), and echocardiography (aortic Z score, MVP). Medical treatment consisted of betablockers, BB (for patients with tachycardia), or angiotensin II receptor blockers, ARB. Surgical treatment was addressed to aortic root aneurysm, and severe mitral regurgitation, MR. DD benefited from dental conservatory treatment or surgical restoration. Results: DD-Z score had a powerful correlation in MASS (Rho = 0.787, p < 0.01), and in MS patients (Rho = 0.819, p < 0.01). For the entire sample, both DDwR-Z score and DDwoR-Z score had a moderate correlation (Rho = 0.469, and respectively 0.669). Furthermore, DD was an important predictor for Z score. DDwoR had a double power of prediction for the Z score compared with DDwR (B coefficient = 1.661 for DDwR and 3.281 for DDwoR). Conclusions: TMDs had a powerful correlation with aortic root dilation in MASS and MS patients from the sample. Likewise, TMDs was a major predictor for aortic root dilation, in the entire sample. In clinical practice, we can utilize an extracardiac finding, TMDs, obtained by a non-invasive technique, MRI, for cardiac severity stratification of fibrillinopathies.

Objective: To evaluate the inter-examiner reliability of the Chinese version of the Axis I diagnoses of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and to compare the consistency between clinical diagnoses and magnetic resonance imaging (MRI)., Methods: Sixty-seven individuals were evaluated by three TMD specialists, and 49 underwent MRI examination. Cohen's Kappa coefficient (κ) was used to evaluate the inter-examiner reliability and the consistency between clinical diagnoses and MRI manifestations., Results: Diagnostic agreement was good to excellent for pain and disc displacement with or without reduction (κ = 0.659-1.000). Agreement between clinical diagnoses and MRI findings was fair to good (κ = 0.400)., Conclusion: Inter-examiner diagnostic reliability using the Chinese version of the DC/TMD Axis I instruments was excellent, especially for arthrogenic TMDs.

Background and Objectives: This research was aimed at constructing a complete automated temporomandibular joint disc position identification system that could assist with magnetic resonance imaging disc displacement diagnosis on oblique sagittal and oblique coronal images. Materials and Methods: The study included fifty subjects with magnetic resonance imaging scans of the temporomandibular joint. Oblique sagittal and coronal sections of the magnetic resonance imaging scans were analyzed. Investigations were performed on the right and left coronal images with a closed mouth, as well as right and left sagittal images with closed and open mouths. Three hundred sagittal and coronal images were employed to train the artificial intelligence algorithm. Results: The accuracy ratio of the completely computerized articular disc identification method was 81%. Conclusions: An automated and accurate evaluation of temporomandibular joint disc position was developed by using both oblique sagittal and oblique coronal magnetic resonance imaging images.

Objective: The objective of the study was to investigate the relationship between types of disc displacement (DD) diagnosed by magnetic resonance imaging (MRI), and the risk (presence or absence) and severity of condylar erosion (CE) graded using cone-beam computed tomography (CBCT) in adult Temporomandibular disorders (TMD) patients., Methods: A total of 353 TMD patients (283 females, 70 males) underwent MRI scans to categorise DD as normal (NA), anterior displacement with reduction (ADDR), or anterior displacement without reduction (ADDNR). CE severity was graded on a scale of 0-3 (absence, mild, moderate or severe) using CBCT. To establish the plausibility and cut-off points for CE diagnosis, the severity of CE was then further divided into three classifications: Grade 0 versus 1 + 2 + 3; Grades 0 + 1 versus 2 + 3; Grades 0 + 1 + 2 versus 3. Logistic regression analysis was performed, adjusting for age, gender and joint correlation., Results: ADDNR significantly increased the risk of CE compared with NA (OR = 10.04, 95% CI: [6.41, 15.73]) and showed a significant increase in CE severity across all classifications (ORs = 10.04-18.95). The effects of ADDNR were significant in both genders (p < .001) and had a greater impact in females. ADDR was predominantly associated with mild CE., Conclusions: ADDNR significantly increased the risk and severity of CE independent of gender when compared to NA, whereas ADDR was mainly associated with mild CE. Slight cortical discontinuity may represent a subclinical diagnosis requiring further investigation., (© 2024 John Wiley & Sons Ltd.)

Introduction: Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The aim of this study was to investigate the characteristics of the patients with TMJ osteoarthrosis on MR imaging., Methods: The MR images of 206 TMJs of 103 patients with temporomandibular disorders (TMD) were evaluated retrospectively in this study. The relationship between osteoarthrosis and age, gender, TMJ pain and MR imaging findings, such as disc displacement with or without reduction and TMJ effusion, was analysed., Results: The patients with TMJ osteoarthrosis (mean: 51.6 years) were significantly older than those without osteoarthrosis (mean: 44.8 years, P = 0.027). The incidence of the patients with TMJ osteoarthrosis was significantly different between with (10.0 %) and without reduction (57.0 %, P < 0.001). Logistic multivariate regression analysis demonstrated that disc displacement without reduction was significant in patients with TMJ osteoarthrosis (odds ratio = 12.285, P < 0.001)., Conclusions: This study suggests that characteristics of the patients with TMJ osteoarthrosis on MR imaging include older and disc displacement without reduction., (© 2020 The Royal Australian and New Zealand College of Radiologists.)

Purpose: The purpose of this study is to explore the diagnostic accuracy and clinical utility of an examination by a physical therapist using a clinical patient population for diagnosing a specific sub-type of disc displacement (DDWoR wLO) compared to the imaged disc position., Methods: Data from 46 patients with a clinical diagnosis of DDWoR wLO (92 clinical examinations and MRI records) were collected. Clinical diagnosis was made based on predefined diagnostic criteria, and the MRI diagnosis was made based on the MRI radiology report obtained from the dental provider. A McNemar test was used to determine whether the outcomes of the clinical and MRI diagnoses differed significantly, and sensitivity, specificity, likelihood ratios, predicative values, 95% confidence intervals, and the overall diagnostic accuracy were computed., Results: There was high sensitivity (85%), moderate but unacceptable specificity (73%), and acceptable overall diagnostic accuracy (80%) for using predefined criteria in the diagnosis of DDWoR wLO. The likelihood ratios and predictive values supported the clinical utility of the criteria used for diagnosing DDWoR wLO., Conclusion: This is the first study to characterize diagnostic accuracy by a physical therapist of a specific sub-type of TMD in a clinical patient population rather than a research based population. The results suggest that while sensitivity and the overall diagnostic accuracy were acceptable, specificity was lower than acceptable and these findings are discussed in relation to clinical utility of using diagnostic criteria in a clinical setting against a gold standard of MRI.

The aim was to study the characteristics of lateral mandibular horizontal deviations during opening-closing movements and their association with TMJ sounds of the clicking type. Subjects were 28 healthy volunteers and 38 patients diagnosed with MRI imaging as having TMJ disc dysfunction, 22 with disc displacement without (DD) and 16 as having disc displacement with reduction (DDR). TMJ sounds were recorded with miniature microphones placed in the ear canals, and jaw movements were documented with a kinesiograph. A sign, unbalanced lateral deviation (ubd) was defined as a rapid, short duration, change in jaw movement direction from, and back to, a smooth deviation path in the horizontal plane. The hypotheses were that degrees of maximal deviations, proportions of unbalanced deviation (ubd) and such deviation associated with TMJ sounds (ubdS), differ between healthy subjects and patients with DD or DDR. Comparisons between groups were made using one-way anova and chi-square analysis, as appropriate. No differences were found between groups regarding degree of lateral deviation per se. The proportions of ubd and ubdS were significantly higher in patients with DDR than in healthy subjects and than in patients with DD (P < 0·001), but no such differences were found between healthy subjects and patients with DD. For prediction of DDR, the sensitivity and specificity of the sign ubdS were found to be 68·8% and 89·3%, respectively. For the sign ubd, they were 100·0% and 64·3%. This indicates that the sign ubdS has diagnostic value in screening for DDR., (© 2016 John Wiley & Sons Ltd.)

Background: The influence of complete denture occlusion on temporomandibular disorder (TMD) is controversial. Some studies found that defective occlusion contributes to the development of TMD, while others found no correlation., Objective: This prospective controlled study evaluated the relationship between renewal of old defective complete dentures and TMD as evidenced both by clinical examination and magnetic resonance imaging (MRI) findings., Materials and Methods: The study included 25 complete denture patients with signs and symptoms of TMD and 21 asymptomatic controls. Clicking was a common finding in all symptomatic joints. All selected participants needed complete denture renewal. MRI and clinical assessment following research diagnostic criteria for TMD guidelines (RDC/TMD) were carried out at baseline and 2 years after new complete denture insertion. Temporomandibular joint (TMJ) pain, muscle pain, clicking and movement limitation were the assessed signs and symptoms. MRIs were conducted to evaluate the TMJs for disc displacement, disc morphology and joint effusion., Results: Complete denture renewal significantly improved the signs and symptoms of TMD in symptomatic group (p < 0.01). Only in the symptomatic group, treatment resulted in a significant increase in joints displaying superior (normal) disc position (symptomatic p < 0.001; asymptomatic p = 0.157). New dentures did not affect disc morphology in both groups (p = 0.5 for both groups) but significantly reduced joint effusion in the symptomatic group (symptomatic p < 0.001; asymptomatic p = 0.5). Relationship between clinical and MRI findings was not one to one., Conclusions: New complete dentures had a positive impact on TMD signs and symptoms, disc position and joint effusion but not on disc morphology., (© 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.)

Objective: Repositioning of the jaw in orthognathic surgery must produce precise and stable long-term results; an effective and practical method of intraoperative condyle positioning is required to achieve this. Most traditional methods, such as manual positioning or positioning plates do not permit intraoperative monitoring of the temporomandibular joint (TMJ) position. This study evaluates the results of intraoperative, sonographically-monitored joint positioning, comparing preoperative and postoperative MRI scans., Patients and Methods: Of the 97 patients who were originally assessed (53 female, average age 29 ± 10.93; and 44 male, average age 28 ± 9.25), 21 had incomplete data sets and were excluded, leaving 76 evaluable patients. MRIs were performed preoperatively between 2 days and 100 weeks (median 30.5 days), and postoperatively between 12 and 96 weeks (median 150 days). Condyle positioning, intercondylar distance, and disc degeneration and dislocation were compared in preoperative and postoperative MRIs, and differentiated by Angle class on horizontal, axial and sagittal scans. Condyle to fossa distances were measured on parasagittal images from 0° (the vertical sagittal plane), 45° anteriorly and 45° posteriorly. The intercondylar distances between the condylar head midpoints were measured on axial sections. Two-sided t-tests (α < 0.05) were used for comparisons within classes; the interclass correlation was performed using univariate ANOVA and linear correlation for paired sample correlation settings., Results: In 27 Angle class II cases, the anterior distance of both condyles increased on average 0.3 ± 1.0 mm, the posterior position decreased 0.1 ± 1.2 mm, and the vertical position decreased 0.2 ± 1.1 mm postoperatively. In 47 Angle class III cases the anterior distance of both condyles increased on average 0.3 ± 0.8 mm, the posterior 0.1 ± 0.8 mm and the vertical distance 0.1 ± 0.8 mm postoperatively. All alterations of the condyle-fossa relation were non-significant except for the anterior distance in Angle class ІІІ (p = 0.02). Alterations of the disc position and disc degeneration were non-significant in class II. In class ІІІ, the disc degeneration deteriorated slightly on the left side (p = 0.02). Intercondylar distance increased 1 ± 5.5 mm in class ІІ and decreased by 1 ± 5.5 mm in class ІІІ postoperatively, alterations were non-significant., Conclusion: Sonography is a non-invasive, comfortable, fast, economical and effective intraoperative method of condyle positioning. The results of the present study support this statement because the degree of disc degeneration and luxation remained unaltered and the condyle position did not change significantly. Prospective randomized comparison to manual positioning is in preparation and will be conducted in the near future., (Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Purpose: There has been no study on the prevalence of disc displacement (DD) of different levels in children and adolescents with adequate sample size using magnetic resonance images (MRIs). This retrospective cross-sectional study was designed to investigate the relationship between increasing age and the prevalence of DD of various severities in a young preorthodontic population., Materials and Methods: Of 199 preorthodontic patients aged 6 to 15 years visiting a private orthodontic office for initial examination, 153 patients with signs and symptoms of temporomandibular joint (TMJ) disorders had MRIs of their TMJs taken for further evaluation. Of those, 302 TMJs from 151 patients' MRIs of diagnostic quality were divided into three age groups (I: 6 to 9, II: 10 to 12, and III: 13 to 15 years). DD of each patient was categorized based on its severity from stage 0 (normal) to stage 4 (total DD without reduction). The distribution of DD stages in each age group was plotted on a line graph and statistically analyzed for intergroup comparison., Results: A graphical representation of the results clearly demonstrated a trend for higher occurrence of more advanced DD with an increase in age. No gender difference was observed. Statistical analysis showed that DD was significantly more advanced in group II than group I (p < 0.01) and group III than group I (p < 0.01)., Conclusions: The study revealed a high prevalence of DD in the young preorthodontic population and significant increase in the proportion of patients with more advanced stages of DD in older patients., (© 2014 by the American College of Prosthodontists.)

Temporomandibular joint (TMJ) disc displacement is a common disorder in patients with internal derangement. Certain anatomic features of TMJ may make the patient prone to this condition, namely lateral pterygoid muscle (LPM) insertion variations. The aim of this study was to investigate LPM attachments and their relationships with disc displacement and subsequent pathologic changes. A total of 26 patients with clinical temporomandibular disorders (TMDs) and a control group of 14 unaffected individuals were studied. Magnetic resonance images (MRIs) were taken to evaluate LPM insertion patterns, superior LPM head pathologic changes, and relative disc to condyle position. Data registration and analysis were done using SPSS v. 16.0. The most common variation (type I) was shown to be the superior head with two bundles, one attached to the disc and another to the condyle. No significant relationship between LPM insertion type and disc displacement or pathologic changes of the muscle was found. However, a link between disc displacement and muscle pathologic changes was established (P=0.001)., (Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

A Temporomandibular joint (TMJ) effusion is an accumulation of fluid components in the articular space. It represents an inflammatory process which can be associated with trauma, arthritis or internal derangement of TMJ such as disc displacement. In this study, we present the case of a 48-year-old patient presented with TMJ effusion, diagnosed as resulting from disc displacement without reduction and osteoarthrosis. The case report details the diagnostic and therapeutic strategies employed.

Objective: To evaluate the inter-examiner reliability of the Chinese version of the Axis I diagnoses of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and to compare the consistency between clinical diagnoses and magnetic resonance imaging (MRI). Methods: Sixty-seven individuals were evaluated by three TMD specialists, and 49 underwent MRI examination. Cohen's Kappa coefficient (κ) was used to evaluate the inter-examiner reliability and the consistency between clinical diagnoses and MRI manifestations. Results: Diagnostic agreement was good to excellent for pain and disc displacement with or without reduction (κ = 0.659–1.000). Agreement between clinical diagnoses and MRI findings was fair to good (κ = 0.400). Conclusion: Inter-examiner diagnostic reliability using the Chinese version of the DC/TMD Axis I instruments was excellent, especially for arthrogenic TMDs. [ABSTRACT FROM AUTHOR]

This study aims to determine if a large anterior and reduced posterior/superior joint space is highly predictable for disc displacement. From patients with temporomandibular disorders symptoms, fifty-two experimental joints and fourteen control joints were included. The cone beam computed tomography (CBCT) images were used to calculate posterior-to-anterior (P-A) and superior-to-anterior (S-A) joint space ratios, while disc position was determined using magnetic resonance imaging (MRI). One-way analysis of covariance test and receiver operating characteristics analysis were carried out. The results showed that among the 52 experimental joints, 45 were diagnosed as disc displacement and 7 as normal disc positions (N). All 14 control joints showed normal disc positions. The P-A ratio was 1.46 ± 0.21, 0.99 ± 0.23, and 0.86 ± 0.30 in the control, N, and DD groups, respectively (p < 0.001). The S-A ratio was 1.80 ± 0.27, 1.44 ± 0.33, and 1.08 ± 0.35 in the control, N, and DD groups, respectively (p < 0.001). When an altered P-A ratio and/or S-A ratio are observed on the CBCT, the diagnosis of disc displacement is quite predictable with high sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Background: Anterior repositioning splint (ARS) is used to treat temporomandibular joint (TMJ) disc displacement with reduction (DDwR). However, high recurrence rate remains a problem especially in patients with unstable occlusions. Objective: This study optimised standard ARS therapy and proposed a step‐back ARS retraction (SAR) method in adult patients with DDwR. Methods: Dental examinations and magnetic resonance imaging of TMJ were obtained before treatment (T0), 1 to 3 months (T1), 3 to 6 months (T2) and 6 to 12 months (T3) during treatment in 48 adults (average age 27.1 ± 5.7 years). After 3 months of basic ARS wearing, personalised treatment for patients with normal disc–condyle relationship was prescribed depending on bilaminar zone adaptations and severity of molar openbite. SAR which required sequential ARS wearing was designed for patients with deep overbite/overjet until retrodiscal tissue adaptations and stable occlusions were achieved. Results: The maximum interincisal opening was increased from 44.3 ± 6.9 to 45.3 ± 6.3 mm (p <.01), and joint pain was alleviated after ARS treatment. The overall success rate of ARS wearing was 92.1% (58/63) featured by a recaptured disc. Fifteen patients who underwent SAR therapy all showed bilaminar zone adaptations in the end, and one patient had positive condylar bone remodelling. Conclusions: ARS treatment could improve mouth opening and joint symptoms in adult DDwR patients. SAR method was suitable for treating DDwR patients with deep overbite and overjet and improved retrodiscal tissue adaptations and condylar bone remodelling. [ABSTRACT FROM AUTHOR]

Background: The temporomandibular joint (TMJ) is considered a complex joint. Temporomandibular disorders (TMDs) are a common cause of musculoskeletal pain. At least one TMD symptom is seen in 33% of the population and 3.6% to 7.0% of the population shows significant severity warranting treatment. Magnetic resonance imaging (MRI) is better for the evaluation of disc and adjacent soft-tissue structures compared to cone beam computed tomography. MRI allows articular disc assessment in open and closed mouth positions. MRI has 95% accuracy in the assessment of disc disorders and 93% accuracy for osseous changes. Materials and Methods: A cross-sectional study was performed with a sample size of 21 patients as per inclusion and exclusion criteria. MRI findings were noted and compared with clinical findings. Results: As per our study, the most common age group is between 20 and 35 years. Of 42 TMJ, 41 joints show disc displacement changes and one TMJ was normal. Disc displacement with reduction is less than disc displacement without reduction. Left TMJ is more affected as disc displacement without reduction, as compared to the right side. Two TMJ were with posterior DD. Four TMJ shows anteromedial and 4 TMJ shows anterolateral DD. Six joints have a subluxation. Conclusion: In our study, we found that MRI in TMDs is more reliable and accurate for the diagnosis of DD.

Purpose: This observational study aimed to elucidate the pathophysiology of subchondral cysts (SC) in the temporomandibular joint (TMJ) and examine the results of conservative therapy administered to patients with SCs in the TMJ. Methods: The study included 41 patients with SCs, extracted from 684 consecutive patients who underwent magnetic resonance imaging (MRI). The anatomical features of SCs and positional abnormalities of the articular disc were initially evaluated using MRI. A second MRI examination was performed for 28/41 patients at 40-107 months (mean, 66 months) after the first MRI. The joint space, anteroposterior width of the condylar head (WiC), articular eminence angle (AEA), and visual analog scale of jaw pain (VAS) were assessed alongside the MRI examinations. Results: Most SCs were present in the anterosuperior and central condyle. Disc displacement was observed in 100% of 42 TMJs with SCs. Of the 29 joints in 28 patients, SCs in 19 joints resolved with time, whereas SCs in 10 joints persisted. A significant increase in the WiC and a significant decrease in AEA and VAS scores were observed on the second MRI scan. Conclusions: SCs tended to form in the anterosuperior and central parts of the condyle, where mechanical loading was likely to be applied. SCs are strongly associated with articular disc displacement. Two-thirds of SCs resolved over time, accompanied by resorption and osteophytic deformation of the condyle. SC might not be an indicator for the start of surgical treatment, and nonsurgical treatment could improve the clinical symptoms of patients with SCs. [ABSTRACT FROM AUTHOR]

This study assessed the relationship between clinical symptoms and magnetic resonance imaging (MRI) findings in temporomandibular disorders (TMD). A total of 324 temporomandibular joints (TMJs) from 162 patients were included. The TMJs were divided into three groups based on disc positions on MRI: normal disc position, anterior disc displacement with reduction (ADDwR), and anterior disc displacement without reduction (ADDwoR). Clinical findings included TMJ pain, TMJ noise, and maximum mouth opening (MMO). The disc configuration, disc positions, condylar morphology, and joint effusion were evaluated in proton density-weighted and T2-weighted open and closed-mouth sagittal sections. Patients comprised 135 females and 27 males, with a mean age of 37.63 ± 13.86 years. The VAS score was significantly higher in ADDwoR than in ADDwR (p = 0.007). Condylar sclerosis (β coefficient: 1.449, 95% confidence interval (CI): 0.505-2.393, p = 0.003) and condylar flattening (β coefficient: 1.024, 95% CI: 0.209-1.840, p = 0.014) had higher VAS scores than the other MRI findings in multiple regression analyses. Limited mouth opening (MO) was independently associated with ADDwoR. ADDwoR had a higher risk of having limited MO than normal disc position (odds ratio: 5.268), while there were no associations between limited MO and other MRI findings. None of the MRI findings showed significant performance in predicting TMJ noise. The convex and folded disc configuration percentages, the frequencies of osteophyte formation, and grade 3 effusion were significantly higher in the ADDwoR group. More severe clinical symptoms and a higher degree of disc deformity, osteophyte formation, and high-grade effusion were shown to be associated with ADDwoR. [ABSTRACT FROM AUTHOR]

Abstract Background Magnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) in temporomandibular disorder (TMD) patients of different ages are still unclear. The aim of this study was to analyze and compare the characteristics of MRI features of TMJs in different age groups. Methods A total of 1760 TMJs from 880 patients were included in the study and divided into three groups: ≤ 18Y (n = 195, 14.89 ± 2.35Y); 19-30Y (n = 475, 24.09 ± 3.23Y); and > 30Y (n = 210, 41.73 ± 10.45Y). T2-weighted image (T2WI) of MRI was obtained to evaluate the relationship between age and disc morphology, the degree of disc displacement, joint effusion, joint movement and changes of condylar bone morphology. Data were analyzed by Pearson Chi square test and Spearman correlation coefficient. Results There was no statistical difference between left and right sides in all age groups. Except condylar morphology (χ2 = 0.943, P = 0.624), there were significant differences in the distribution of disc morphology, disc position, joint effusion and joint motion among different age groups (χ2 = 24.450, χ2 = 24.829, χ2 = 19.855, χ2 = 39.259, respectively). There were significant differences in the distribution of the degree of anterior disc displacement, condyle morphology and joint effusion in different types of disc morphology among the different age groups (except for joint effusion in > 30Y), among which the first two were significantly correlated with the disc morphology. Conclusions The morphology and position of the articular disc changed significantly with age, but the proportion of abnormal condylar bone remained about 50%. The greater the degree of disc folding, the more prone to bone abnormalities. Trial registration This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014).

Disc displacement (DD) appears in the majority of temporomandibular disorder (TMD) patients. The correlation between craniofacial morphology and different disc positions has been underlined, while the craniofacial morphological differences based on sex and sagittal skeletal pattern stratification have been insufficiently studied. In this study, 304 patients with TMD complaints were included and classified into normal position, disc displacement with reduction (DDwR) and disc displacement without reduction (DDwoR) groups according to magnetic resonance imaging. A total of 24 cephalometric measurements, covering the cranial base, vertical relationship, sagittal relationship, mandible position and morphology, and dental relationship, were assessed using lateral cephalograms. A stratified analysis was performed based on the sex and sagittal skeletal pattern. Overall, DD patients had distinctive craniofacial morphological features. The posterior cranial base length and mandibular arc angle were statistically different only in females, while the Y-axis angle, occlusal plane angle and sella nasion point A angle (SNA) might be unique features in males. Skeletal class II had the most statistically different measurements compared to the others. Differences in the Frankfort mandibular incisor angle (FMIA) and saddle angle were especially displayed in skeletal class III patients. The sex and skeletal sagittal pattern could affect the morphological differences in TMD patients with different disc positions. [ABSTRACT FROM AUTHOR]

Objectives: To predict temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDWR) from condylar shape, position, and dimensions obtained from CBCT images. Methods: This cross-sectional study was performed on 17 patients suffering from temporomandibular disorders diagnosed by history taking according to the chart of the American Association of orthodontists, clinical examination according to the Helkimo index and MRI. CBCT and MRI examinations were performed within one-week interval. Disc position, diagnosed by MRI was used as the gold standard. TMJs with posterior disc displacement or anterior disc displacement without reduction were excluded. Qualitative and quantitative analyses were performed on CBCT images to find the correlation between condylar variables and ADDWR. A logistic regression model was created to estimate ADDWR from condylar dimensions (height, width and depth). Results: Condylar shape and condylar position in the glenoid fossa were significantly correlated with ADDWR (P < 0.05). Condylar width, height and depth were significantly smaller in condyles with ADDWR compared to condylar dimensions in normal disc position. Logistic regression analysis could be used to predict the probability of anterior disc displacement with reduction from condylar dimensions. Conclusion: Condylar shape, position, and dimensions assessed by CBCT are significantly correlated with ADDWR of the TMJ. Substituting the values of condylar width, height and depth in the equation suggests the probability of ADDWR. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) in temporomandibular disorder (TMD) patients of different ages are still unclear. The aim of this study was to analyze and compare the characteristics of MRI features of TMJs in different age groups. Methods: A total of 1760 TMJs from 880 patients were included in the study and divided into three groups: ≤ 18Y (n = 195, 14.89 ± 2.35Y); 19-30Y (n = 475, 24.09 ± 3.23Y); and > 30Y (n = 210, 41.73 ± 10.45Y). T2-weighted image (T2WI) of MRI was obtained to evaluate the relationship between age and disc morphology, the degree of disc displacement, joint effusion, joint movement and changes of condylar bone morphology. Data were analyzed by Pearson Chi square test and Spearman correlation coefficient. Results: There was no statistical difference between left and right sides in all age groups. Except condylar morphology (χ2 = 0.943, P = 0.624), there were significant differences in the distribution of disc morphology, disc position, joint effusion and joint motion among different age groups (χ2 = 24.450, χ2 = 24.829, χ2 = 19.855, χ2 = 39.259, respectively). There were significant differences in the distribution of the degree of anterior disc displacement, condyle morphology and joint effusion in different types of disc morphology among the different age groups (except for joint effusion in > 30Y), among which the first two were significantly correlated with the disc morphology. Conclusions: The morphology and position of the articular disc changed significantly with age, but the proportion of abnormal condylar bone remained about 50%. The greater the degree of disc folding, the more prone to bone abnormalities. Trial registration This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014). [ABSTRACT FROM AUTHOR]

The aim of this research was to assess possible relationships between petrotympanic fissure (PTF) characteristics, malleus position, and temporomandibular joint disorders (TMD). A retrospective study was performed, including patients with TMD. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) examination were used to evaluate temporomandibular joint (TMJ) disc position and condylar bone changes. Fifty-eight TMJs from twenty-nine patients (23:6 females: males) were assessed. Erosive changes (DDR-disc displacement with a reduction of 6 (24%), DDwR-disc displacement without a reduction of 8 (61.5%) vs. normal disc position 3 (15%), p = 0.012) and condyle osteophytes production (DDR 6 (24%), DDwR 9 (69.2%) vs. normal condyle 7 (35%), p = 0.012) were more frequent in subjects with disc displacement compared to normal disc position; malleus was closer to PTF in cases with erosive changes (median 2.15 interquartile range: (1.85–2.75) vs. 2.75 (2.25–3.15), p = 0.029) as well as those with condylar osteophytosis (2.25 (1.91–2.75) vs. 2.75 (2.33–3.32), p = 0.015); the PTF length was higher in cases with condylar osteophytosis compared to those without (4.45 (3.50–4.77) vs. 3.67 (3.34–4.28), p = 0.039). The disc position and disc shape were not related to PTF or malleus position. Malleus position and PTF dimensions were not associated with the PTF type. In cases with erosive changes and condylar osteophytosis, malleus was closer to PTF. [ABSTRACT FROM AUTHOR]

Background/aim: To investigate morphological features of the mandibular condyle and its association with anterior temporomandibular disc displacement on sagittal oblique MRI plane. Materials and methods: One hundred and twenty patients with temporomandibular MRI examination were retrospectively involved in the study. Patients aged less than 18 years and those with severe osteoarthritis, posterior disk displacement, tumor, abscess, history of a rheumatic disease, facial trauma, and motion artifacts on images were excluded. Three radiologists evaluated all images in consensus. Temporomandibular disc locations were classified as normal, anteriorly displaced with reduction (ADr), and anteriorly displaced without reduction (ADwr) on sagittal oblique T1-weighted images. Condylar shapes were classified as flat, rounded, and angled, and condyle anteroposterior width (c-APW) was measured on these images in closed-mouth position. Results: Ninety six discs were in normal position (40%), 70 discs were ADr (29%), and 74 discs were ADwr (31%). Eighty-four condyles were flat (35%), 100 condyles were rounded (42%), and 56 condyles were angled (23%). Mean c-APW was 7 mm in normal joints, 5.9 mm in ADr, and 5.8 mm in ADwr joints, and it was smaller in joints with anterior disc displacement (p < 0.001). In normal joints, flat and rounded type condylar shape was more common and almost equally prevalent (44% and 43%); however, rounded type was more common among ADr (%47) and angled type was more common among ADwr joints (36%) (p = 0.008). Patients with anterior disc displacement were significantly younger from normal cases and anterior disc displacement was more common among female sex. Conclusion: Mandibular condyle shape alterations and condyle size on sagittal oblique MRI plane are associated with anterior disc displacement. Angled shape was more common among ADwr joints. Joints with anterior disc displacement had smaller c-APW than normal joints. [ABSTRACT FROM AUTHOR]

Modic changes (MCs) are known to be associated with low back pain (LBP). Literature contains conflicting reports about the prevalence of MCs and other spinal phenotypes among different populations with LBP patients. We aimed to evaluate the prevalence of MCs in the lumbar spine and associated features in Eastern Anatolian chronic LBP patients. The study sample comprised of 786 consecutive patients [(490 female, 296 male), (mean age 39.7; range 20–78)] with a history of low back pain for at least 3 months. Data about MCs involvement, Schmorl's nodes (SN), disc degeneration (DD), disc displacement, disc height and osteophytes were obtained via MRI. Patients' demographic characteristics, Oswestry disability index (ODI) and visual analog scale (VAS) scores were assessed using a questionnaire. MCs were present in 67.2% (528/786) of the patients. Of all evaluated lumbar-level changes, 86 (6.2%) were Type I, 991 (76.8%) were Type II, 11 (0.8%) were Type III, 47 (6.5%) were Type II/III, 89 (8.5%) were Type I/II, and 29 (1.2%) were Type I/II/III MCs. MCs were significantly associated with severe DD (p < 0.001), disc displacement (p < 0.001), SN (p < 0.001), and osteophytes (p < 0.001). In the multivariate regression analysis, BMI (for both ODI and VAS) and age (only for ODI) were the only independent predictors of clinical severity. The present study is the largest cross-sectional study of adult members of the Eastern Anatolian population with chronic LBP. Modic changes were detected in 67.2% of patients with chronic LBP and the prevalence of other phenotypic features differed significantly between MCs and non-MCs disc levels. Nevertheless, the results of the current study do not support a causal relationship of MCs or any MRI changes with clinical symptom severity. [ABSTRACT FROM AUTHOR]

Introduction: Magnetic resonance imaging (MRI) is undoubtedly the gold standard for diagnosing lumbar disc prolapse. Unfortunately, this is closely related to random finds. In this study, we sought to determine to what extent 1.5 Tesla MRI correlates with clinical features and intraoperative results in cases of lumbar disc prolapse. Methods: During a 2-year period, 50 consecutive patients with a herniated lumbar disc who required a discectomy were examined. The MRI results that we observed included the level of prolapse, type, position, migration, high-intensity zones, lateral depression and anterior wall stenosis. To determine the significance of various MRI results, a logistic regression analysis was performed. Finally, the results of MRI studies were confirmed by intraoperative data and conclusions were made. Study design: A single-center prospective study. Results: The sensitivity and specificity of MRI scans for determining surgically significant levels were 100% and 94.94%, respectively. The test for raising a straight leg (Lasega’s symptom) was positive in 74% of patients, with 85%, 43% and 75% for paramedian, medial and foraminal localization, respectively. Foraminal compression was the only MRI parameter that had a significant association with neurological deficits. In patients with highintensity zones, a significant increase in back pain was observed on MRI, and 63% had identifiable ring tears during surgery. The results of intraoperative anatomy were significantly correlated with the results of MRI. Conclusions: The results of MRI strongly correlate with intraoperative features and can serve as a useful tool in the planning of surgery due to the accurate description of morphometric features. However, the decision on surgery should be made only when detailed clinical data in combination with MRI results allow us to accurately identify the fragment of the disc that is the culprit and the pain generator. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) is widely used in the region of temporomandibular joint (TMJ), particularly to examine disc position and configuration, posterior disc attachment, and mandibular marrow status and to assess the presence of TMJ effusion. Aims: The aim of this study is to investigate the characteristics of the patients with TMJ effusion on MRI. Materials and Methods: MR images of 98 TMJs of 49 patients with temporomandibular disorders were evaluated in this study. The patients with TMJ effusion were concerning age, gender, TMJ pain, disc displacement with or without reduction, and osteoarthrosis. Results: The incidence of the patients with TMJ effusion was significantly different between male (19.2%) and female (51.4%, P = 0.005) and between TMJ pain present (53.7%) and absent (29.5%, P = 0.024), respectively. Logistic multivariate regression analysis demonstrated that gender (odds ratio = 4.188, P = 0.012) and TMJ pain (odds ratio = 2.704, P = 0.027) were significant in patients with TMJ effusion. Conclusions: This study suggests that characteristics of the patients with TMJ effusion include female and TMJ pain.

Aim: The purpose of this study is to investigate the relationship between TMJ disc displacement and chondylar degenerative changes. Material and Methods: The MRIs of 182 TMJs belonging to 91 patients with TMD were evaluated. TMJs were distributed into three groups according to the disc positions as normal disc position (Group 1, n=39), disc displacement with reduction (Group 2, n=49) and disc displacement without reduction (Group 3, n=94). Condylar degenerative change is diagnosed according to presence or absence of erosion, sclerosis, flattening and osteophyte encountered in MRI. When more than one type of degenerative change was observed, the joint was determined to have degenerative changes. Results: The results of MRI evaluation of 182 TMJs revealed Group 1, Group 2 and Group 3 in 39 (21.4%), 49 (26.9%) and 94 (51.6%) joints, respectively. No degenerative condyle was found in 107 (58.8%) joints whereas degenerative condylar changes were encountered in 75 (41.2%) of 182 TMJs by the MRI evaluation. Condyle degeneration was detected in 2 (5.1%) of the joints with normal disc position whereas 6 (12.2%) and 67 (71.3%) of the joints with reducing and non-reducing disc displacement revealed condyle degeneration, respectively. Conclusion: A statistically significantly higher rate of condyle degeneration was encountered in the joints with disc displacement without reduction than the joints with disc displacement with reduction and normal disc position. Advancing disc displacement causes condylar degenerative changes. [ABSTRACT FROM AUTHOR]

Background and Aims :The most frequent cause of TMJ dysfunction is internal derangement which that largely involves the function of the articular disc. Anterior disc displacement (ADD) is one of the major findings in TMJ internal derangement. Since the importance of knowledge of its etiology and also the role of all structural indicators association with TMD was not evaluated, in this research was investigated Correlation between TMJ structure and disc displacement. Materials and Methods: This study was done based on case-control method. 31 Joints with TMJ internal derangements and 57 normal joint Were examined. The two groups of clients were matched in age, sex , Economic and social situation. MRI finding was Disk position in Open and closed mouth and condyle morphology coronal and axial view.MRI findings were Disk position in Open and closed mouth and condyle morphology coronal and axial view. The data were analyzed using Chi-square test and Fisher's test. Results: Patients with TMJ internal derangement (ID), In all three groups inchiding disk displacement with reduction(DDWR), disk displacement without reduction(DDWOR), anterior disc displacement(ADD), was encountered more frequently in Anterior, Anterior-inferior disk position in closed mouth,A statistically significant correlation was found( P <0.001 ). Also no significant difference was found in measurements between the three groups, for condyle morphology in coronal and axial view. ( P > 0.4) Conclusion: It seems , Anterior disc displacement (ADD) is correlated Anterior, Anterior-inferior disk position in closed mouth But There is no correlation between Anterior disc displacement (ADD) And condyle morphology in coronal and axial view. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the relationship between temporomandibular joint (TMJ) effusion and joint pain in patients with internal derangement based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). A total of 240 TMJs from 120 patients with unilateral painful joints (103 females and 17 males, mean age 29.9 ± 12 years) were evaluated. Clinical assessments were carried out according to the DC/TMD guidelines. Magnetic resonance imaging (MRI) was used to evaluate the degree of effusion in each joint. The radiological and clinical findings were analysed for statistically significant correlations. Although the results indicated a statistically significant association between moderate joint effusion and disc displacement (p < 0,05), there was no statistically significant association between moderate effusion and joint pain (p > 0,05). There were, however, statistically significant associations between marked effusion and both disc displacement and joint pain (p < 0,05). TMJ effusion is associated with both disc displacement and joint pain: the effusion increased in direct proportion to the severity of pain and disc displacement. The possibility that there are various aetiologies for the condition should also be considered. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the relationship between effusion and disc displacement that were detected in MRIs of temporomandibular joint disorder (TMD) patients. Material and Methods: MRIs of 60 patients who had pain and/or dysfunction in the TMJ region were evaluated for the presence of effusion. TMC disc positions of 60 MRI results were divided into three groups: normal disc position (control group, n: 20), disc displacement with reduction (R group, n: 20) and disc displacement without reduction (NR group, n: 20). When evaluating the presence of effusion, hyperintense thin lines or absence of effusion was evaluated as no effusion; while signal intensity of more than 2 mm at the anterior-posterior length or superior-inferior height at the joint space was evaluated as the presence of effusion. Results: According to MRI findings, effusion was observed in 2 of the 20 joints (10%) in the control group, 8 of the 20 joints (40%) in the R group and 17 of the 20 joints (85%) in the NR group. When the groups were compared with each other, there was a statistically significant difference between the groups (p<0.05). Conclusion: In TMD, where normal disc position deteriorates to disc displacement, the prevalence of effusion also increases. It is thought that changes in effusion levels can be used as a marker for evaluating the prognosis of TMD. [ABSTRACT FROM AUTHOR]

Magnetic resonance imaging (MRI) has been used for a long time as an ancillary diagnostic tool to treat temporomandibular disorders (TMDs). In the case of disc displacement, several researchers have used it in many clinical studies. It has also been adopted in clinical practice as a common diagnostic tool. However, the data in the literature is contrasting, specially concerning measuring protocols, interpretation of the results and clinic correlations. This review aims to put in context the use of sagittal MRI to asses disc position. To evaluate changes in condylar, fossa and articular eminence dimensions associated with TMJ disc position, both computer tomography (CT) and MRI should be used respectively, but also the reliability of the interpretation of MRIs and CT gives rise to concern. Moreover, the lack of correlation between imaging and symptoms make us see that more precise diagnostic tools are necessary. We do believe that all of the aforementioned needs to be taken in consideration when evaluating pre and post treatment disc position, specially those treatments that are targeted to reposition or change TMJ disc position. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to determine the diagnostic value of high-resolution ultrasonography (US) in temporomandibular joint (TMJ) disc displacements.Materials and Methods: A number of 74 patients (148 TMJs) with signs and symptoms of TMJ disorders, according to the Research Diagnostic Criteria for Temporomandibular Disorders, were included in this study. All patients received US and magnetic resonance imaging (MRI) of both TMJs 1 to 5 days after the clinical examination. MRI examinations were performed using 1.5 T MRI equipment (Siemens Avanto, Siemens, Erlangen). Ultrasonographic examination was performed on a Hitachi EUB 8500 (Hitachi Medical Corp., Tokyo, Japan) scanner with L 54 M6.5-13 MHz linear transducer.Results: MRI depicted 68 (45.95%) normal joints, 47 (31.76%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 34 (22.97%) with degenerative changes. US detected 78 (52.7%) normal joints, 37 (25%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 21 (14.19%) with degenerative changes. Compared to MRI, US showed a sensitivity of 93.1%, specificity of 87.88%, accuracy of 90.32%, a positive predictive value of 87.1% and a negative predictive value of 93.55% for overall diagnosis of disc displacement. The Youden index was 0.81.Conclusions: Based on our results, high-resolution ultrasonography showed high sensitivity, specificity and accuracy in the diagnosis of TMJ disc displacement. It could be a valuable imaging technique in assessing TMJ disc position. The diagnostic value of high-resolution ultrasonography depends strictly on the examiner's skills and on the equipment used. [ABSTRACT FROM AUTHOR]

• This study proposed for the first time the method of artificial intelligent assisted diagnosis of Temporomandibular joint disc displacement based on deep learning network, which also laid the theoretical and technical foundation for its future large-scale clinical application. • A Multimodal Stepped Attention Net (MSANet), combining multimodal technology and attention mechanism, was built in this study. Each set was composed of 8 consecutive images, where continuity and cohesion were valued. • A total of 1200 TMJ MRI image sets was used to train this model, and it was proved to be helpful to the diagnostic accuracy and efficiency of physicians in TMJ, Orthodontic and General Dentistry through diagnostic study. Temporomandibular joint (TMJ) disc displacement is a common condition that required magnetic resonance imaging (MRI) for diagnosis. However, it has occasionally been challenging for doctors to make a firm diagnosis based on TMJ MRI due to imaging concerns and the significant requirement for clinical competence. As a result, a Multimodal Stepped Attention Net (MSANet) was built in this study, and a deep learning network was used to train the assisted diagnosis AI model (TMJ MRI-Net). A total of 600 patients were recruited, including 1200 lateral joint MRI sequences, which are made up of eight consecutive images for each lateral joint. 11 sides of cases with poor image quality were excluded. MSANet combining multimodal technology and attention mechanism was proposed and designed for this study, which mainly included Area Detection Module and Feature Network. The whole experiment was designed according to stard standard. There is statistically significant difference between the least square mean of diagnosis time for the physicians (from TMJ, Orthodontics and General Dentistry) with AI (TMJ MRI-Net) assistance group (16.15, 95% CI:10.88–21.41) and the physician only group (21.01, 95%CI: 15.74–26.28). The AUC, sensitivity and specificity of patients whether is disc displacement and patients whether the disc displacement is with/without reduction for the physicians' diagnoses were all statistically improved by the assistance of AI. In addition, AUC and specificity were improved for three different specialties with the AI assistance. Meanwhile, AI can help to save reading time for physicians from all three departments, and the increment was statistically significant. To conclude, the AI-assisted strategy significantly improved the diagnostic accuracy of physicians (especially in General Dentistry) on anterior disc displacement in TMJ MRI and improve diagnostic efficiency. [ABSTRACT FROM AUTHOR]