TMJ Studies

Individual or bilateral TMJ

 An important advantage of CBCT imaging of TMJ is that it allows accurate measurements of the volume and surface of the condyle. These measurements are extremely advantageous in clinical practice when treating patients with TMJ dysfunctions (TMD). This type of scan is particularly useful in identifying and visualising osseous detail of the TMJs, including evaluation of osseous ankylosis, neoplasms, heterotopic bone growth and other abnormalities in and around the joints which might be missed in a conventional CT scan. In addition to large volume CBCT, it is worth noting that TMJ scans do not need to cover the whole facial skeleton, hence minimising further radiation to the patient. We can provide dynamic studies of the joint and in some cases register the CBCT scan against the MRI of the same region. Your patient’s scan can be done at various mandibular positions, as with conventional tomography.

Advantages of CBCT over other imaging methods for TMJ

 The TMJ area is difficult to be imaged with 2D techniques due to factors like superimposition of adjacent structures and morphological variations. CBCT provides a definite advantage over these other techniques due to its low radiation dose to the patient and the ability to provide multiplanar reformation and 3D images. Indeed the complexity of the TMD demands a clear, precise and easily manipulable image of the region for effective management of the patient. When CBCT and MRI are compared, CBCT is better than MRI in detecting changes in shape (flattening, osteophyte formation or erosion) because of its superior spatial resolution and thinner slice thickness in clinical use.

Importance of diagnosing TMJ across all ages and injuries

 Osteoarthritis of the TMJ is an age-related degenerative disease seen in almost 40% of patients above the age of 40 years. It causes bone changes in the TMJ like flattening, sclerosis, formation of osteophytes, erosion, resorption of the condylar head, erosion of the mandibular fossa and reduced joint space. Flattening (59%) and osteophyte (29%) are the most prevalent degenerative changes seen on CBCT. The CBCT scans play an important role in diagnosing early stages of juvenile idiopathic arthritis (JIA) in children which, when undetected, can damage facial development and cause growth alterations. Clinicians will be looking at volumetrically quantifying the TMJ damage in these patients by measuring condylar and mandibular volumes. Condylar asymmetry is very common in children with JIA. CBCT shows a wide variety of condylar destruction patterns which could be small erosions within the cortex to almost complete deformation of the head of the condyle. The TMJ is often involved in patients with multiple maxillofacial fractures. CBCT enables us to meet the patient’s needs by providing adequate information regarding the nature of fracture, its extent and relative locations of important anatomic structures.

Right-left comparison of the temporomandibular joint space

The temporomandibular joint area is challenging for good diagnostic radiographs. TMJ Xrays are commonly used for a variety of different tasks such as diagnosing anatomic discrepancies, TMJ disorders, traumatic injuries, etc. The temporomandibular view allows for visualisation of the articular tubercle, mandibular condyle and fossa and is thus useful to identify structural changes and displaced fractures, as well as assess excursion and joint spaces.

TMJ Xrays usually occur in more traumatics situations. Clinical indications include trauma, the presence of joint noises, trismus and occlusal alterations. Your dentist may recommend a professional radiograph to you for a variety of orthodontic situations. TMJ Xrays are not quite as common as the other X-Rays we offer, but if there are abnormalities, or any other possible harmful situations we will immediately take a TMJ Xray.

Should your dentist recommend a TMJ Xray, it would be best to take the matter seriously as it is an advanced dental imaging device. The position for a TMJ Xray is a lot different than other Xrays. The patient is typically seated upright with the side of interest closest to the detector. This may cause discomfort based on what part of the mouth is receiving the TMJ Xray. The patient’s head is usually placed in a true lateral position, and depending on the projection, you may either be asked to have your mouth open or closed.

Titanium Dental Imaging is the #1 recommended Dental Imaging Practice for dentists to recommend their patients to. We understand that radiographs can be uncomfortable for some, and our staff is trained to make your experience as enjoyable as possible so you can have healthy teeth. If you are in need of advanced dental imaging, ask your dentist about Titanium Dental Imaging, or you can schedule an appointment with us today!