Comparative Evaluation of Clinical Findings in Temporomandibular Joint Pathology with Magnetic Resonance Imaging – A Cross-sectional Study

Abstract

Background: Temporomandibular disorders (TMDs) are broad group of clinical problems involving the masticatory musculature, the temporomandibular joint (TMJ), and the surrounding hard and soft-tissue components or combination of these problems. It can also be secondary to muscle hyperfunction or parafunction, traumatic injuries, hormonal influences, and articular changes within the joint. Magnetic resonance imaging (MRI) is currently considered as the preferred method for imaging the soft-tissue structures of the TMJ and has been pointed out as the best imaging modality in diagnosing disc displacements. Aim: The aim of this study is to comparatively evaluate the clinical findings of temporomandibular pathology with the MRI. Methodology: This is a cross-sectional observational study with comprised multiethnic group. A total of 50 patients reporting to the dental OPD with TMJ pathology were selected. These subjects underwent thorough clinical examination of TMJ and MRI of the TMJ was taken for all the individuals and parameters such as change in disk position, condylar surface, and effusion were recorded with the help of the radiologist. Statistical Data Analysis: Statistical presentation and analysis of the present study were done using the P value and Chi-square test by SPSSV20. Results: The results obtained in this study showed that out of 50 individuals, pain was present only in 28, that is, 56% of population other complaints of jaw deviation, clicking sound, and restricted mouth opening. Disc displacement was found only in 57.14% of symptomatic individual and 72.72% of asymptomatic individuals. MRI revealed pain and effusion was present only in 28% of symptomatic patients. About 76% of the subjects had jaw deviation while mouth opening out of which 68.42% showed disc displacement in MRI. About 56% of the subjects had positive history of trauma out of which 50% showed disc displacement in MRI. About 56% of the subjects reported with the clicking sound out of which 64.28% showed disc displacement in MRI. Conclusion: TMJ is one of the complex joints in the entire body. Because of this complexity of the TMJ, the pathologies as well as normal anatomical patterns must be known before any diagnosis. The selection of the proper radiological technique for TMJ, as well as of the patient, must be carefully made by the practitioner, in correlation with the clinical signs and symptoms. MRI is the diagnostic study of choice for evaluation of disk position and internal derangement of the joint. Although already many studies had been done on MRI, such type of studies should be conducted on large scale in future based on specific parameters for early diagnosis and treatment planning for patients suffering with TMD to provide quality treatment to the patients at initial stage.