Relationship between the condyle and adjacent structures in double temporomandibular joint view using panorama

측두하악관절의 panoramic double TMJ 방사선사진상에서 하악과두와 인접구조의 관계

Purpose: To investigate the ability of double TMJ view by multifunctional panorama to view the bony components and the space of the temporomandibular joint. Materials and Methods: Ten dry skulls fitted with resin shims over the articular surface of the condyle were used to reproduce the temporomandibular joint space. Fine metal wires were attached to the three portions of contours of the condylar head and the articular eminence. With 10 dry skulls and 20 cases having TMJ dysfunction, double TMJ views by multifunctional panorama (Planmeca 2002 Proline CC) and transcranial views were taken, analyzed from the anatomical view point, and compared statistically in view of the widths of the posterior joint space and the condylar head. Results: In double TMJ view, the supero-anterior part of the condyle represented the lateral 1/3, the most superior part represented center portion, and the posterior part medial l/3 of the condyle. In maximum mouth opening, no other structures were superimposed with the condyle in double TMJ view. In double TMJ view, petrous bone was moderately superimposed with the superior part of the condyle and the posterior increment of angle exposure made wider the images of the articular eminence and the condyle. The tendency of reduction in the posterior joint space appeared in the side of TMJ dysfunction compared with the normal side. The posterior joint spaces in double TMJ view were statistically wider (p<0.05) than those in transcranial view. The correlation coefficient was 0.5179 between the widths of the posterior joint spaces in two radiographic views. Conclusions: Double TMJ view can be substituted for transcranial view in evaluating the TMJ dysfunction.