Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지

The Usefulness of Cone Beam Computed Tomography in Diagnosis of Temporomandibular Joint Osteoarthritis

측두하악관절 골관절염 환자의 진단에서 Cone Beam 전산화 단층촬영의 유용성

  • Roh, Chang-Se (Department of Oral Medicine, College of Dentistry, Pusan National University) ;
  • Jung, Yun-Hoa (Department of Maxillofacial Radiology, College of Dentistry, Pusan National University) ;
  • Tae, Il-Ho (Department of Oral Medicine, College of Dentistry, Pusan National University) ;
  • Ko, Myung-Yun (Department of Oral Medicine, College of Dentistry, Pusan National University) ;
  • Ahn, Yong-Woo (Department of Oral Medicine, College of Dentistry, Pusan National University)
  • 노창세 (부산대학교 치의학전문대학원 구강내과학 교실) ;
  • 정연화 (부산대학교 치의학전문대학원 구강악안면방사선학교실) ;
  • 태일호 (부산대학교 치의학전문대학원 구강내과학 교실) ;
  • 고명연 (부산대학교 치의학전문대학원 구강내과학 교실) ;
  • 안용우 (부산대학교 치의학전문대학원 구강내과학 교실)
  • Published : 2009.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

This study is designed to assess Relationship between clinical diagnosis of Temporomandibular Joint Disorder and diagnostic finding of Cone Beam Computed Tomography(CBCT) The author performed clinical examination for TMD Patients who visited Orofacial pain clinic, Jin-ju ooo Dental office. CBCT(Cone beam computed tomography) was taken for 190 joints in 95 subjects. A Oral medicine and Oral radiologist evaluated CBCT each other. then we compared with that result, Condyle bony changes were classified by no bone change, flattening, erosion and osteophyte. The obtained results were as follow: 1. The Kappa index of the diagnosis between oral medicine and oral radiogist were high, the index of diagnosis by degenerative joint disease were more higher. 2. The Kappa index of panoramic view and CBCT was low, more condylar bone chages were observed by CBCT diagnosis 3. Condylar bone changes of the 54.2% of non-DJD group clinicaly was observed by CBCT diagnosis and no bone changes of the 15.3% of DJD group.was observed by CBCT 4. TMJ pain was associated with erosion of condyle bone change of TMJ. Crepitation and longest duration of TMD were associated with osteophytic bone change.

2005년부터 2007년까지 진주 OOO치과의원 턱관절/구강안면통증클리닉에 내원한 측두하악장애환자 95명, 190개의 관절을 대상으로 한 명의 검사자가 측두하악관절장애 분석검사와 파노라마영상검사를 엄격히 시행하고, CBCT영상을 촬영하여 구강내과 전문의와 치과방사선과 전문의가 각각 영상진단 하였으며, 임상적 진단과 CBCT영상의 결과를 비교하여 다음과 같은 결과를 얻었다. 1. 구강내과 전문의와 치과방사선과 전문의에 의한 CBCT의 영상진단의 일치도(Kappa: 0.681)가 높았다. 2. 파노라마영상과 CBCT의 영상진단과의 일치도(Kappa: 0.169)가 낮으며, 파노라마영상에서 골변화의 위음성이 높았다. 3. 임상적으로 비퇴행성골관절염으로 진단된 관절 중 CBCT의재진단시 54.2%에서 골변화가 관찰되었으며, 퇴행성골관절염으로 진단된 관절 중 CBCT의 재진단시 15.3%에서 골변화가 없는 것으로 관찰되었다. 4. 관절통은 침식성 골변화에서 높게 나타났으며, 골증식체의 골변화에서 염발음이 가장 많이 나타났으며 병력기간도 가장 길었다.

Keywords

References

  1. Chung SC, Kim YK et al. Orofacial pains and temporomandibular disorders. 2nd ed, Seoul, 2006, Shinhung Co., pp. 176-179
  2. K. Yamada, I. Saito, K. Hanada, T. Hayashi. Observation of three cases of temporomandibualr joint osteoarthritis and mandibular morphology during adolescence using helical CT. J Oral Rehabilitation 2004;30:298-305
  3. Kazuhiro Y, Kooji H, Takafumi H, Jusuke I. Condylar bony change, disk displacement, and signs and symptoms of TMJ disorders in orthognathic surgery patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:603-10 https://doi.org/10.1067/moe.2001.112153
  4. Kyung-A Kim, Kwang-Joon Koh. Radiographic study of bony changes of the mandibular consyle. Korean J Oral Maxillofac Radiol 2000;30(1):23-32
  5. Christiansen E.L., Thompson J.R., Kopp S.F.O., Hasso A.N., Hinshaw D.B. Radiographic sign of temporomandibular joint disease: An investigation utilizing X-ray computed tomography. Dentomaxillofac Radilo 1985;14:83-92 https://doi.org/10.1259/dmfr.1985.0011
  6. Suarez F.R. Bhussry B.R., Huang K.H., Vaughn D. A preliminary study of computerized tomography for evaluation of the temporomandibular joint. Compend contin Educ Dent 1980;1:217-222
  7. Avrahami E., Segal R., Solomon A. et al. Direct coronal high resolution computed tomography of the temporomandubular joint in patients with rheumatoid arthritis. J Rheumatol 1989;16:298-301
  8. Goupillie P., Fouquet B., Cotty P., Goga D., Valat J.P. Direct coronal computed tomography of the temporomandibular joint in patients with rheumatoid arthritis. Br J Radiol 1992;65:955-960 https://doi.org/10.1259/0007-1285-65-779-955
  9. Larheim T.A., Kolbenstved A. Osseous temporomandiblular joint abnormalities in rheumatic disease. Acta Radiol 1990;31:383-387 https://doi.org/10.1080/02841859009172012
  10. Christiansen E.L., Thompson J.R., Kopp S.F.O., Hasso A.N., Hinshaw D.B. Radiographic sign of temporomandibular joint disease: An investigation utilizing X-ray computed tomography. Dentomaxillofac Radilo 1985;14:83-92 https://doi.org/10.1259/dmfr.1985.0011
  11. Larheim T.A. Current trends in temporomandibualr joint imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endol 1995;80:555-576 https://doi.org/10.1016/S1079-2104(05)80154-4
  12. K Tsiklakis, K Syriopoulos, HC Stamatakis. Radiographic examination of the temporomandibualr joint using cone beam computed tomography. Dentomaxillofacial Radiology 2004;33:196-201 https://doi.org/10.1259/dmfr/27403192
  13. K Hona, TA Larheim, K Maruhashi, K Mastumoto, K Iwai. Osseous abnormalities of the mandibular condyle: diagnostic reliability of cone beam computed tomography compared with helical computed tomography based on an autopsy material. Dentomaxillofacial Radiology 2006;35:152-157 https://doi.org/10.1259/dmfr/15831361
  14. Oana Bida Honey, William Charles Scarfe, Michael J. Higers et al. Accuracy of cone-beam computed tomography imaging of the temporomandibular joint:Comparisions with panoramic radiology and linear tomography. Am J Orthod Dentofacial Orthop 2007;132:429-38 https://doi.org/10.1016/j.ajodo.2005.10.032
  15. AM Hussain, G Packota, PW Major, C Flores-Mir. Role of different imaging modalities in assessment of temporomandibular joint erosion and osteophytes: a systematic review. Dentomaxillofacial Radiology 2008;37:63-71 https://doi.org/10.1259/dmfr/16932758
  16. Dworkin SF., LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;6(4):301-55
  17. Pertes RA, Attanasio R. In: Kaplan AS, Aasael LA. Temporomandibular disorder: Diagnosis and Treatment. Philadelphia, 1991, W.B. Saunders Co., pp. 142-164
  18. McNeill C. Science and Practice of Occlusion. 1st ed., illinois, 1997, Quintessence Publishing Co., pp. 259-270
  19. Hatcher D., McEvoy S., Mah R., Faulkner G. In : McNeil C. Science and Practice of Occlusion. 1st ed., illinois, 1997, Quintessence Publishing Co., pp.259-270
  20. Rasmussen OC. Clinical findings during the course of temporomandibular arthropathy. Scand J Dent Res 1981;89:283-288 https://doi.org/10.1111/j.1600-0722.1981.tb01684.x
  21. Goupillie P., Fouquet B., Cotty P., Goga D., Valat J.P. Direct coronal computed tomography of the temporomandibular joint in patients with rheumatoid arthritis. Br J Radiol 1992;65:955-960 https://doi.org/10.1259/0007-1285-65-779-955
  22. Rohlin M., Akerman S., Kopp S. Tomography as an aid to detect macroscopic change of the temporomandibualr joint. An autopsy study of the aged. Acta Odontol Scand 1986;44(3):131-140 https://doi.org/10.3109/00016358609026565
  23. Epstein JB, Caldwell J, Black G. The utility of panoramic imaging of the temporomandibular joint in patients with temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:236-9 https://doi.org/10.1067/moe.2001.114158
  24. HC Crow, E Parks, JH Campbell, DS Stuck and Daggy. The utility of panoramic radiography in temporomandibualr joint assessment. Dentomaxillofacial Radiology 2005;34:91-95 https://doi.org/10.1259/dmfr/24863557
  25. Chul-Hee Ko, Yong-Woo Ahn, Myung-Yun Ko, June-Sang Park. Evaluation of condylar surface in temporomandibualr joint with lock sensation using computed tomography. Korean J Oral medicine 2004;29(1):69-77
  26. Muir C.B., Goss A.N. The radiologic morphology of asymptomatic temporo-mandibular joints. Oral Surg Oral Med Oral Pathol 1990;70:349-354 https://doi.org/10.1016/0030-4220(90)90154-K
  27. Ericksson L., Westesson P.L. Clinical and radiological study of patients with anterior disc displacement of the temporomandibular Joint. Swed Dent J 1983;7:55-64
  28. Roberts C.A., Tallents R.H., Espeland M.A., Handelman S.L Katxberg R.W. Mandibular range of motion versus arthrougraphic diadgnosis of temporomandibular joint. Oral Surg Oral Med Oral Pathol 1985;60:244-251 https://doi.org/10.1016/0030-4220(85)90305-6
  29. Krik W.S. Sagittal magnetic resonance image characteristics and surgical findings of mandibular condyle surface disease in staged internal derangement. J Oral Maxillofac Surg 1994;52:64-68 https://doi.org/10.1016/0278-2391(94)90017-5