Assessment of Articular Disc Position in Normal and Pathologic Temporomandibular Joints Using MRI

Abstract

ABSTRACT Aim The aim of this study was to determine the TMJ disc position in asymptomatic, normal TMJs and in joints with TMD (Temporomandibular disorders) using MRI. Material and Methods The study was performed on forty TMJs of 20 symptomatic patients and twenty TMJs of 10 asymptomatic volunteers. Intermediate Zone (IZ) Criterion is used to interpret disc position. The readers of MRI images were blinded to each other's MRI analysis and clinical diagnosis. Data analyses included Kappa statistics for inter observer reliability correlation. Results Scan results of 20 asymptomatic joints revealed ADDWR in one joint. Out of 26 joints clinically diagnosed as internal derangement (ID), 4 joints showed ADDWOR and 8 joints confirmed ADDWR. One joint showed ADDWR in patient with MPDS and two joints of fibrous ankylosis demonstrated ADDWOR. Conclusion From our study, we could conclude that in most of the asymptomatic normal TMJs, disc will be in normal position with few exceptions. Joint tenderness was the most common clinical symptom and among displaced discs, ADDWR is the most frequent MRI diagnosis in patients with ID.