Skip to main content
Erschienen in: Oral Radiology 1/2023

07.05.2022 | Original Article

Introducing a novice-friendly classification system for magnetic resonance imaging of the temporomandibular joint disc morphology

verfasst von: Qinlanhui Zhang, Xin Xiong, Yanji Gong, Fang Liu, Yang Liu

Erschienen in: Oral Radiology | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Objective

To introduce a new classification, aiming to correspond TMJ disc configuration with diagnosis, meanwhile reduce difficulty and subjectivity in TMJ MRI evaluation and training of TMD diagnosis for dental students.

Methods

90 patients sought for TMD treatment were enrolled in the study, whose MRIs were used to establish the new classification. A total of 180 discs were evaluated using MRI for position (normal, DDWR or DDWoR) and classified by morphology according to previous (Murakami’s classification) and new classification respectively. 60 discs were selected and judged by two groups (2 TMJ specialists and 30 dental students) to assess the reliability and validity of the new classification. Questionnaires were acquired for all observers to assess the attitude toward two classification systems. Descriptive statistics, Spearman’s rank correlation coefficient, and intraclass correlation coefficient were performed. P < 0.05 was considered statistically significant.

Results

In the new classification, Class 1 disc was significantly correlated with DDWR and Class 3 disc was significantly correlated with DDWoR. Interobserver reliability/consistency for observers between TMJ specialists was 0.867 when Murakami’s classification was applied and 0.948 when the new classification was applied. Interobserver ICC value for dental students was 0.656 when using Murakami’s classification, and 0.831 when using the new classification. The difference in attitude toward different classification systems was statistically significant.

Conclusion

A new classification of TMJ disc configuration is presented. The correlation between disc morphology and position revealed helps diagnosis and management. The new classification improves TMJ MRI interpreting accuracy and provides a better learning and using experience.
Literatur
1.
Zurück zum Zitat Westesson PL, Rohlin M. Internal derangement related to osteoarthrosis in temporomandibular joint autopsy specimens. Oral Surg Oral Med Oral Pathol. 1984;57(1):17–22.CrossRef Westesson PL, Rohlin M. Internal derangement related to osteoarthrosis in temporomandibular joint autopsy specimens. Oral Surg Oral Med Oral Pathol. 1984;57(1):17–22.CrossRef
2.
Zurück zum Zitat Arayasantiparb R, Tsuchimochi M, Mitrirattanakul S. Transformation of temporomandibular joint disc configuration in internal derangement patients using magnetic resonance imaging. Oral Sci Int. 2012;9:43–8.CrossRef Arayasantiparb R, Tsuchimochi M, Mitrirattanakul S. Transformation of temporomandibular joint disc configuration in internal derangement patients using magnetic resonance imaging. Oral Sci Int. 2012;9:43–8.CrossRef
3.
Zurück zum Zitat Vogl TJ, Lauer HC, Lehnert T, et al. The value of MRI in patients with temporomandibular joint dysfunction: correlation of MRI and clinical findings. Eur J Radiol. 2016;85(4):714–9.CrossRef Vogl TJ, Lauer HC, Lehnert T, et al. The value of MRI in patients with temporomandibular joint dysfunction: correlation of MRI and clinical findings. Eur J Radiol. 2016;85(4):714–9.CrossRef
4.
Zurück zum Zitat Yoshida H, Hirohata H, Onizawa K, et al. Flexure deformation of the temporomandibular joint disk in pseudodynamic magnetic resonance images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(1):104–11.CrossRef Yoshida H, Hirohata H, Onizawa K, et al. Flexure deformation of the temporomandibular joint disk in pseudodynamic magnetic resonance images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(1):104–11.CrossRef
5.
Zurück zum Zitat Taşkaya-Yilmaz N, Oğütcen-Toller M. Magnetic resonance imaging evaluation of temporomandibular joint disc deformities in relation to type of disc displacement. J Oral Maxillofac Surg. 2001;59(8):860–5.CrossRef Taşkaya-Yilmaz N, Oğütcen-Toller M. Magnetic resonance imaging evaluation of temporomandibular joint disc deformities in relation to type of disc displacement. J Oral Maxillofac Surg. 2001;59(8):860–5.CrossRef
6.
Zurück zum Zitat Matsubara R, Yanagi Y, Oki K, et al. Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders. Dentomaxillofac Radiol. 2018;47(4):20170412.CrossRef Matsubara R, Yanagi Y, Oki K, et al. Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders. Dentomaxillofac Radiol. 2018;47(4):20170412.CrossRef
7.
Zurück zum Zitat Pinto GNS, Grossmann E, Iwaki FL, et al. Correlation between joint effusion and morphology of the articular disc within the temporomandibular joint as viewed in the sagittal plane in patients with chronic disc displacement with reduction: a retrospective analytical study from magnetic resonance imaging. Cranio. 2021;39(2):119–24.CrossRef Pinto GNS, Grossmann E, Iwaki FL, et al. Correlation between joint effusion and morphology of the articular disc within the temporomandibular joint as viewed in the sagittal plane in patients with chronic disc displacement with reduction: a retrospective analytical study from magnetic resonance imaging. Cranio. 2021;39(2):119–24.CrossRef
8.
Zurück zum Zitat Koh KJ, Park HN, Kim KA. Relationship between anterior disc displacement with/without reduction and effusion in temporomandibular disorder patients using magnetic resonance imaging. Imaging Sci Dent. 2013;43(4):245–51.CrossRef Koh KJ, Park HN, Kim KA. Relationship between anterior disc displacement with/without reduction and effusion in temporomandibular disorder patients using magnetic resonance imaging. Imaging Sci Dent. 2013;43(4):245–51.CrossRef
9.
Zurück zum Zitat Dias IM, Cordeiro PC, Devito KL, et al. Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis. Int J Oral Maxillofac Surg. 2016;45(3):313–7.CrossRef Dias IM, Cordeiro PC, Devito KL, et al. Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis. Int J Oral Maxillofac Surg. 2016;45(3):313–7.CrossRef
10.
Zurück zum Zitat Roh HS, Kim W, Kim YK, et al. Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings. J Craniomaxillofac Surg. 2012;40(3):283–6.CrossRef Roh HS, Kim W, Kim YK, et al. Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings. J Craniomaxillofac Surg. 2012;40(3):283–6.CrossRef
11.
Zurück zum Zitat Rudisch A, Innerhofer K, Bertram S, et al. Magnetic resonance imaging findings of internal derangement and effusion in patients with unilateral temporomandibular joint pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(5):566–71.CrossRef Rudisch A, Innerhofer K, Bertram S, et al. Magnetic resonance imaging findings of internal derangement and effusion in patients with unilateral temporomandibular joint pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(5):566–71.CrossRef
12.
Zurück zum Zitat Ottl P, Hohmann A, Piwowarczyk A, et al. Retrospective study on the evaluation of the TMJ by MRI using a newly developed standardized evaluation form. Cranio. 2008;26(1):33–43.CrossRef Ottl P, Hohmann A, Piwowarczyk A, et al. Retrospective study on the evaluation of the TMJ by MRI using a newly developed standardized evaluation form. Cranio. 2008;26(1):33–43.CrossRef
13.
Zurück zum Zitat Murakami S, Takahashi A, Nishiyama H, et al. Magnetic resonance evaluation of the temporomandibular joint disc position and configuration. Dentomaxillofac Radiol. 1993;22(4):205–7.CrossRef Murakami S, Takahashi A, Nishiyama H, et al. Magnetic resonance evaluation of the temporomandibular joint disc position and configuration. Dentomaxillofac Radiol. 1993;22(4):205–7.CrossRef
14.
Zurück zum Zitat Ottl P, Hohmann A, Piwowarczyk A, et al. Assessment of the temporomandibular joint using MRI and a new standardised evaluation form. Aktuelle Rheumatol. 2007;32(2):86–91.CrossRef Ottl P, Hohmann A, Piwowarczyk A, et al. Assessment of the temporomandibular joint using MRI and a new standardised evaluation form. Aktuelle Rheumatol. 2007;32(2):86–91.CrossRef
15.
Zurück zum Zitat Schmitter M, Kress B, Hähnel S, et al. The effect of quality of temporomandibular joint MR images on interrater agreement. Dentomaxillofac Radiol. 2004;33(4):253–8.CrossRef Schmitter M, Kress B, Hähnel S, et al. The effect of quality of temporomandibular joint MR images on interrater agreement. Dentomaxillofac Radiol. 2004;33(4):253–8.CrossRef
16.
Zurück zum Zitat Widmalm SE, Brooks SL, Sano T, et al. Limitation of the diagnostic value of MR images for diagnosing temporomandibular joint disorders. Dentomaxillofac Radiol. 2006;35(5):334–8.CrossRef Widmalm SE, Brooks SL, Sano T, et al. Limitation of the diagnostic value of MR images for diagnosing temporomandibular joint disorders. Dentomaxillofac Radiol. 2006;35(5):334–8.CrossRef
17.
Zurück zum Zitat Hirata FH, Guimarães AS, Oliveira JX, et al. Evaluation of TMJ articular eminence morphology and disc patterns in patients with disc displacement in MRI. Braz Oral Res. 2007;21(3):265–71.CrossRef Hirata FH, Guimarães AS, Oliveira JX, et al. Evaluation of TMJ articular eminence morphology and disc patterns in patients with disc displacement in MRI. Braz Oral Res. 2007;21(3):265–71.CrossRef
18.
Zurück zum Zitat De Farias JF, Melo SL, Bento PM, et al. Correlation between temporomandibular joint morphology and disc displacement by MRI. Dentomaxillofac Radiol. 2015;44(7):20150023.CrossRef De Farias JF, Melo SL, Bento PM, et al. Correlation between temporomandibular joint morphology and disc displacement by MRI. Dentomaxillofac Radiol. 2015;44(7):20150023.CrossRef
19.
Zurück zum Zitat Serindere G, Aktuna BC. MRI investigation of TMJ disc and articular eminence morphology in patients with disc displacement. J Stomatol Oral Maxillofac Surg. 2021;122(1):3–6.CrossRef Serindere G, Aktuna BC. MRI investigation of TMJ disc and articular eminence morphology in patients with disc displacement. J Stomatol Oral Maxillofac Surg. 2021;122(1):3–6.CrossRef
20.
Zurück zum Zitat Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network* and orofacial pain special interest group†. J Oral Fac Pain Headache. 2014;28(1):6–27.CrossRef Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network* and orofacial pain special interest group†. J Oral Fac Pain Headache. 2014;28(1):6–27.CrossRef
21.
Zurück zum Zitat Kumar R, Pallagatti S, Sheikh S, et al. Correlation between clinical findings of temporomandibular disorders and MRI characteristics of disc displacement. Open Dent J. 2015;9:273–81.CrossRef Kumar R, Pallagatti S, Sheikh S, et al. Correlation between clinical findings of temporomandibular disorders and MRI characteristics of disc displacement. Open Dent J. 2015;9:273–81.CrossRef
22.
Zurück zum Zitat Orhan K, Nishiyama H, Tadashi S, et al. Comparison of altered signal intensity, position, and morphology of the TMJ disc in MR images corrected for variations in surface coil sensitivity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(4):515–22.CrossRef Orhan K, Nishiyama H, Tadashi S, et al. Comparison of altered signal intensity, position, and morphology of the TMJ disc in MR images corrected for variations in surface coil sensitivity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(4):515–22.CrossRef
23.
Zurück zum Zitat Koca CG, Gümrükçü Z, Bilgir E. Does clinical findings correlate with magnetic resonance imaging (MRI) findings in patients with temporomandibular joint (TMJ) pain? A cross sectional study. Med Oral Patol Oral Cir Bucal. 2020;25(4):e495–501.CrossRef Koca CG, Gümrükçü Z, Bilgir E. Does clinical findings correlate with magnetic resonance imaging (MRI) findings in patients with temporomandibular joint (TMJ) pain? A cross sectional study. Med Oral Patol Oral Cir Bucal. 2020;25(4):e495–501.CrossRef
24.
Zurück zum Zitat Almăşan OC, Hedeşiu M, Băciuţ G, et al. Disk and joint morphology variations on coronal and sagittal MRI in temporomandibular joint disorders. Clin Oral Investig. 2013;17(4):1243–50.CrossRef Almăşan OC, Hedeşiu M, Băciuţ G, et al. Disk and joint morphology variations on coronal and sagittal MRI in temporomandibular joint disorders. Clin Oral Investig. 2013;17(4):1243–50.CrossRef
25.
Zurück zum Zitat Emshoff R, Bertram A, Hupp L, et al. Condylar erosion is predictive of painful closed lock of the temporomandibular joint: a magnetic resonance imaging study. Head Face Med. 2021;17(1):40.CrossRef Emshoff R, Bertram A, Hupp L, et al. Condylar erosion is predictive of painful closed lock of the temporomandibular joint: a magnetic resonance imaging study. Head Face Med. 2021;17(1):40.CrossRef
26.
Zurück zum Zitat Emshoff R, Bertram A, Hupp L, et al. A logistic analysis prediction model of TMJ condylar erosion in patients with TMJ arthralgia. BMC Oral Health. 2021;21(1):374.CrossRef Emshoff R, Bertram A, Hupp L, et al. A logistic analysis prediction model of TMJ condylar erosion in patients with TMJ arthralgia. BMC Oral Health. 2021;21(1):374.CrossRef
27.
Zurück zum Zitat Hegab AF, Al Hameed HI, Karam KS. Classification of temporomandibular joint internal derangement based on magnetic resonance imaging and clinical findings of 435 patients contributing to a nonsurgical treatment protocol. Sci Rep. 2021;11(1):20917.CrossRef Hegab AF, Al Hameed HI, Karam KS. Classification of temporomandibular joint internal derangement based on magnetic resonance imaging and clinical findings of 435 patients contributing to a nonsurgical treatment protocol. Sci Rep. 2021;11(1):20917.CrossRef
29.
Zurück zum Zitat Hegab AF, Youssef AH, Hameed H, et al. MRI-based determination of occlusal splint thickness for temporomandibular joint disk derangement: a randomized controlled clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(1):74–87.CrossRef Hegab AF, Youssef AH, Hameed H, et al. MRI-based determination of occlusal splint thickness for temporomandibular joint disk derangement: a randomized controlled clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(1):74–87.CrossRef
30.
Zurück zum Zitat Polat ME, Yanik S. Efficiency of arthrocentesis treatment for different temporomandibular joint disorders. Int J Oral Maxillofac Surg. 2020;49(5):621–7.CrossRef Polat ME, Yanik S. Efficiency of arthrocentesis treatment for different temporomandibular joint disorders. Int J Oral Maxillofac Surg. 2020;49(5):621–7.CrossRef
31.
Zurück zum Zitat Xiong X, Yin X, Liu F, et al. Magnetic resonance imaging-guided disc-condyle relationship adjustment via articulation: a technical note and case series. J Int Med Res. 2020;48(8):300060520951052.CrossRef Xiong X, Yin X, Liu F, et al. Magnetic resonance imaging-guided disc-condyle relationship adjustment via articulation: a technical note and case series. J Int Med Res. 2020;48(8):300060520951052.CrossRef
Metadaten
Titel
Introducing a novice-friendly classification system for magnetic resonance imaging of the temporomandibular joint disc morphology
verfasst von
Qinlanhui Zhang
Xin Xiong
Yanji Gong
Fang Liu
Yang Liu
Publikationsdatum
07.05.2022
Verlag
Springer Nature Singapore
Erschienen in
Oral Radiology / Ausgabe 1/2023
Print ISSN: 0911-6028
Elektronische ISSN: 1613-9674
DOI
https://doi.org/10.1007/s11282-022-00615-0

Weitere Artikel der Ausgabe 1/2023

Oral Radiology 1/2023 Zur Ausgabe

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Zahnmedizin

Bestellen Sie unseren kostenlosen Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.