Role of panoramic radiographis in differential diagnosis of patients with temporomandibular dysfunction.

We reviewed the records for 4 patients with temporomandibular disorders (TMD), in all of whom temporomandibular joint (TMJ) arthrosis was initially suspected because of the clinical symptoms such as limited mouth opening and pain at the TMJ region. However, careful observation of the panoramic radiographs disclosed abnormalities other than TMJ arthrosis, including, obliteration of the posterior maxillary sinus wall (caused by squamous cell carcinoma of the maxillary sinus), resorption around the condylar neck (caused by hemangioma), and radiopaque foci at the anterior area of the right TMJ (synovial chondromatosis). Some of these abnormalities were not observed on the oblique lateral transcranial projection and the transorbital projection. Although panoramic imaging provides rather blurred images of the TMJ region it produces a broad image of the maxillofacial region which is helpful in the detection of neoplasms and other disorders. Its careful interpretation should be emphasized especially in the differential diagnosis of TMD. [ABSTRACT FROM AUTHOR]