• P-ISSN 2277-3525 E-ISSN 2582-7901

Journal of Multidisciplinary
Dental Research

Article

Journal of Multidisciplinary Dental Research

DOI: 10.38138/JMDR/v8i1.21.13

Volume: 8, Issue: 1, Pages: 20-25

Original Article

Correlation between Clinical Pain in Temporomandibular Disorders and Signal Intensity of the Retrodiscal Tissue Using Fluid Attenuation Inversion Recovery MRI – A Cross Sectional Study

R Meera​ ✉ 1 , A Kannan 2 , C L Krithika 2 , K Yesoda Aniyan 3

1 Post Graduate, Department of Oral Medicine and Radiology, SRM Dental College, Ramapuram, Chennai, Tamilnadu, 600089
2 Reader, Department of Oral Medicine and Radiology, SRM Dental College, Ramapuram, Chennai, Tamilnadu, 600089
3 Senior lecturer, Department of Oral Medicine and Radiology, SRM Dental College, Chennai, Tamilnadu, 600089
 
Corresponding author ✉ [email protected]
 

Received Date:09 October 2021, Accepted Date:25 January 2022, Published Date:08 July 2022

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Temporomandibular disorders (TMD) is a broad term referring to pain and dysfunction of temporomandibular joint (TMJ), nmasticatory muscles and its associated structures. TMD is the most common orofacial pain condition with prominent feature like regional pain in the face and preauricular area during static and dynamic movements. Methods of assessing clinical pain were subjective and not affirmative. There still remains element of drafting the clinical pain evaluation in TMD patients. This study correlated the pain range in TMD patients with the levels of signal intensity (SI) in FLAIR MRI (Fluid Attenuation Inversion Recovery magnetic resonance imaging) to devise an objective pain assessing system based on the SI values. Settings and design: The present study is institution based, observational cross sectional study. A 32 temporomandibular joints were evaluated in the study. Before imaging, subjective pain score were recorded using Visual Analog Scale (VAS). In FLAIR MRI, both grey matter and retro discal tissue were included in the Region of Interest and the SIRs were calculated. SIRs in painful temporomandibular joints were correlated with Visual Analog Scale score. Unpaired t test was used to compare the mean values recorded for SIR. P-value <0.05 is considered to be statistically significant. Study results shows that SIRs of retrodiscal tissue were significantly increased in patient with higher VAS score (p<0.05). Retrodiscal tissue in painful proteinous elements.

 

Keywords: Temporomandibular disorders, Signal intensity, FLAIR MRI, Retrodiscal tissue

References

  1. Sharma S, Gupta DS, Pal US, Jurel SK. Etiological factors of temporomandibular joint disorders. National journal of maxillofacial surgery. 2011;2(2):116. Available from: https://doi.org/10.4103/0975-5950.94463
  2. Greene CS. “The Ball on the Hill”: A new perspective on TMJ functional anatomy. Orthodontics & Craniofacial Research. 2018;21(4):170–174. Available from: https://doi.org/10.1111/ocr.12245
  3. Jivnani HM, Tripathi S, Shanker R, Singh BP, Agrawal KK, Singhal R. A Study to Determine the Prevalence of Temporomandibular Disorders in a Young Adult Population and its Association with Psychological and Functional Occlusal Parameters. J Prosthodont. 2017;28(1):29135060. Available from: https://doi.org/10.1111/jopr.12704
  4. Guarda-Nardini L, Piccotti F, Mogno G, Favero L, Manfredini D. Age-Related Differences in Temporomandibular Disorder Diagnoses. CRANIO®. 2012;30(2):103–109. Available from: https://doi.org/10.1179/crn.2012.015
  5. Casanova-Rosado JF, Medina-Solís CE, Vallejos-Sánchez AA, Casanova-Rosado AJ, Hernández-Prado B, Ávila-Burgos L. Prevalence and associated factors for temporomandibular disorders in a group of Mexican adolescents and youth adults. Clinical Oral Investigations. 2006;10(1):42–49. Available from: https://doi.org/10.1007/s00784-005-0021-4
  6. Mcnamara JJA. Orthodontic treatment and temporomandibular disorders. . Oral Surg Oral Med Oral Path Oral Rad Endod. 1997;83:107–117. Available from: https://doi.org/10.1016/s1079-2104(97)90100-1
  7. Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015;91(6):25822556. Available from: https://pubmed.ncbi.nlm.nih.gov/25822556/
  8. Kakimoto N, Shimamoto H, Kitisubkanchana J, Tsujimoto T, Senda Y, Iwamoto Y, et al. T2 relaxation times of the retrodiscal tissue in patients with temporomandibular joint disorders and in healthy volunteers: a comparative study. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2019;128(3):311–318. Available from: https://doi.org/10.1016/j.oooo.2019.02.005
  9. Lubosch W. U¨ ber den Meniskus im Kiefergelenk des Menschen. Anat Anz. 1906;29:417–448.
  10. Rees LA. The structure and function of the mandibular joint. Br Dent J. 1954;96:125–158.
  11. Shapiro HH, Rogers WM. The anatomy of the temporomandibular joint. Oral Surgery, Oral Medicine, Oral Pathology. 1950;3(12):1521–1539.
  12. Zenker W. Das retroarticul�re plastische Polster des Kiefergelenkes und seine mechanische Bedeutung. Zeitschrift f�r Anatomie und Entwicklungsgeschichte. 1956;119(5):375–388.
  13. Griffin CJ, Sharpe CJ. The structure of the adult human temporomandibular meniscus. Australian Dental Journal. 1960;5(4):190–195. Available from: https://doi.org/10.1111/j.1834-7819.1960.tb01935.x
  14. Choukas NC, Sicher H. The structure of the temporomandibular joint. Oral Surg Oral Med Oral Pathol. 1960;13:1203–1216.
  15. Ishibashi T. Microanatomic studies on the structure of the temporomandibular joint. Japanese Journal of Oral Biology. 1972;14(2):201–222.
  16. Lee SH, Yoon HJ. The relationship between MRI findings and the relative signal intensity of retrodiscal tissue in patients with temporomandibular joint disorders. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2009;107:113–118. Available from: https://doi.org/10.1016/j.tripleo.2008.02.027
  17. Holmlund AB, Gynther GW, Reinholt FP. Disk derangement and inflammatory changes in the posterior disk attachment of the temporomandibular joint. Oral Surgery, Oral Medicine, Oral Pathology. 1992;73(1):9–12. Available from: https://doi.org/10.1016/0030-4220(92)90145-g
  18. Suenaga S, Sonoda S, Oku T, Abeyama K, Noikura T. MRI of the Temporomandibular Joint Disk and Posterior Disk Attachment Before and After Nonsurgical Treatment. Journal of Computer Assisted Tomography. 1997;21(6):892–896. Available from: https://doi.org/10.1097/00004728-199711000-00008
  19. Suenaga S, Hamamoto S, Kawano K, Higashida Y, Noikura T. Dynamic MR imaging of the temporomandibular joint in patients with arthrosis: relationship between contrast enhancement of the posterior disk attachment and joint pain. American Journal of Roentgenology. 1996;166(6):1475–1481. Available from: https://doi.org/10.2214/ajr.166.6.8633468
  20. Pereira FJ, Lundh H, Westesson PLL. Age-related changes of the retrodiscal tissues in the temporomandibular joint. Journal of Oral and Maxillofacial Surgery. 1996;54(1):55–61. Available from: https://doi.org/10.1016/s0278-2391(96)90305-5
  21. Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Engl J Med. 2008;18(25).
  22. Lamot U, Strojan P, Popovič KŠ. Magnetic resonance imaging of temporomandibular joint dysfunction-correlation with clinical symptoms, age, and gender. Oral surgery, oral medicine, oral pathology and oral radiology. 2013;116:258–263. Available from: https://doi.org/10.1016/j.oooo.2013.04.019
  23. Kircos LT, Ortendahl DA, Mark AS, Arakawa M. Magnetic resonance imaging of the TMJ disc in asymptomatic volunteers. Journal of Oral and Maxillofacial Surgery. 1987;45(10):852–854.
  27. John MT, Dworkin SF, Mancl LA. Reliability of clinical temporomandibular disorder diagnoses. Pain. 2005;118(1):61–69.
  28. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JPP, 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†. Journal of Oral & Facial Pain and Headache. 2014;28(1):6–27.
  29. Imoto K, Otonari-Yamamoto M, Nishikawa K, Sano T, Yamamoto A. 2011.
  30. Hanyuda H, Otonari-Yamamoto M, Imoto K, Sakamoto J, Kodama S, Kamio T, et al. Analysis of elements in a minimal amount of temporomandibular joint fluid on fluid-attenuated inversion recovery magnetic resonance images. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2013;115(1):114–120.
  32. Otonari-Yamamoto M, Imoto K. 2018.
  33. Kurita K, Westesson PL, Sternby NH, Eriksson L, Carlsson LEE, Lundh H, et al. Histologic features of the temporomandibular joint disk and posterior disk attachment: Comparison of symptom-free persons with normally positioned disks and patients with internal derangement. Oral Surgery, Oral Medicine, Oral Pathology. 1989;67(6):635–643.

COPYRIGHT

© 2022 Published by International Dental Educationists’ Association (IDEA). This is an open-access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/)

  • 08 July 2022
  • VIEWS 1126
  • PDF 131
Article Metrics


More articles

DON'T MISS OUT!

Subscribe now for latest articles, news.