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中华口腔医学研究杂志(电子版) ›› 2024, Vol. 18 ›› Issue (06) : 406 -411. doi: 10.3877/cma.j.issn.1674-1366.2024.06.010

综述

医学影像学检查方法在颞下颌关节紊乱病中临床应用研究进展
唐金侨1, 叶宇佳1, 王港1, 赵彬1, 马艳宁1,()   
  1. 1.山西医科大学口腔医学院,口腔疾病防治与新材料山西省重点实验室,太原 030001
  • 收稿日期:2024-08-01 出版日期:2024-12-01
  • 通信作者: 马艳宁
  • 基金资助:
    山西省教育厅高校科技创新计划(2021L242)山西省高等学校教学改革创新项目(J20220405)

Clinical application and research progress of medical imaging methods in temporomandibular disorders

Jinqiao Tang1, Yujia Ye1, Gang Wang1, Bin Zhao1, Yanning Ma1,()   

  1. 1.Shanxi Medical University School and Hospital of Stomatology,Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials,Taiyuan 030001,China
  • Received:2024-08-01 Published:2024-12-01
  • Corresponding author: Yanning Ma
引用本文:

唐金侨, 叶宇佳, 王港, 赵彬, 马艳宁. 医学影像学检查方法在颞下颌关节紊乱病中临床应用研究进展[J]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 406-411.

Jinqiao Tang, Yujia Ye, Gang Wang, Bin Zhao, Yanning Ma. Clinical application and research progress of medical imaging methods in temporomandibular disorders[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2024, 18(06): 406-411.

颞下颌关节紊乱病(TMD)因其高患病率,且与多学科密切相关而受到学者的广泛关注。TMD 具有早期难发现、难诊断、难治愈和影像学检查多样性等特点,需要合理地选择检查方法,为TMD 诊断和防治提供依据。常用的影像检查方法包括X 线检查、锥形束CT(CBCT)、磁共振成像(MRI)和超声检查等。随着影像学诊断技术的发展,TMD诊断越来越精准,影像学评估内容也逐渐丰富。当获取影像学资料后,临床工作者需要快速、准确地评估检查内容。本文对TMD 医学影像学检查方法及临床评估内容作系统性综述,为临床工作者合理应用检查方法,结合影像学评估内容进行综合分析,确保准确、有效地制定TMD诊断和防治方案。

Temporomandibular disorders(TMD)have garnered significant attention from scholars due to their high prevalence and multidisciplinary relevance. Given the challenging nature of early detection,diagnosis,and treatment of TMD,as well as the wide array of imaging modalities available, it is imperative to judiciously select imaging techniques to establish a solid foundation for TMD diagnosis and prevention. Commonly utilized imaging modalities encompass X-ray film examination,cone beam CT(CBCT),magnetic resonance imaging(MRI),ultrasonography,among others. With advancements in diagnostic imaging technology,the accuracy of TMD diagnosis has markedly improved,and the scope of imaging evaluation has expanded. Nevertheless,it is essential for clinical practitioners to swiftly and accurately interpret imaging findings. This article presents a systematic review of medical imaging modalities and imaging clinical assessment of TMD,aiming to guide clinical practitioners in the rational application of imaging techniques tailored to the specific characteristics and requirements of the disease. By conducting a comprehensive analysis of imaging assessment content,clinicians can ensure the precision and efficacy of TMD diagnosis,prevention,and treatment strategies.

[1]
Borges REA,Mendonça LDRA,Dos Santos Calderon P.Diagnostic and screening inventories for temporomandibular disorders:A systematic review[J]. Cranio,2024,42(3):341-347. DOI:10.1080/08869634.2021.1954376.
[2]
Ferreira LA,Grossmann E,Januzzi E,et al. Diagnosis of temporomandibular joint disorders:Indication of imaging exams[J]. Braz J Otorhinolaryngol,2016,82(3):341-352. DOI:10.1016/j.bjorl.2015.06.010.
[3]
Omnell KA,Petersson A. Radiography of the temporomandibular joint utilizing oblique lateral transcranial projections. Comparison of information obtained with standardized technique and individualized technique[J].Odontol Revy,1976,27(2):77-92.
[4]
Meng X,Liu S,Wu Z,et al.Application of panoramic radiographs in the diagnosis of temporomandibular disorders[J]. Medicine(Baltimore),2024,103(5):e36469.DOI:10.1097/MD.0000000 000036469.
[5]
Yang W,Wang F. Multislice spiral computed tomography postprocessing technology in the imaging diagnosis of extremities and joints[J].Comput Math Methods Med,2021:9533573.DOI:10.1155/2021/9533573.
[6]
叶泽林,刘媛媛,王虎,等.口腔颌面锥形束CT 的临床指南分析[J]. 中华口腔医学杂志,2023,58(9):964-970. DOI:10.3760/cma.j.cn112144-20230403-00133.
[7]
Almashraqi AA,Barngkgei I,Halboub ES,et al. Cone beam computed tomography findings in the temporomandibular joints of chronic qat chewers:Radiographic bone density and trabecular microstructural analyses[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2021,132(4):465-474. DOI:10.1016/j.oooo.2020.12.017.
[8]
Scariot R,Gonsar B,Gill N,et al. Mandibular condylar dimensions:Correlation between 3D tomography and dried skull measurements[J].Cranio,2019,37(3):153-158.DOI:10.1080/08869634.2017.1409169.
[9]
陈志晔,胡敏.颞下颌关节紊乱病的MRI评估[J].中华口腔医学杂志,2020,55(2):139-144. DOI:10.3760/cma.j.issn.1002-0098.2020.02.014.
[10]
傅开元,胡敏,余强,等.颞下颌关节常规MRI检查规范及关节盘移位诊断标准的专家共识[J].中华口腔医学杂志,2020,55(9):608-612.DOI:10.3760/cma.j.cn112144-20200514-00268.
[11]
Xiong X,Ye Z,Tang H,et al. MRI of temporomandibular joint disorders:Recent advances and future directions[J]. J Magn Reson Imaging,2021,54(4):1039-1052. DOI:10.1002/jmri.27338.
[12]
Vogl TJ,Günther D,Weigl P,et al.Diagnostic value of dynamic magnetic resonance imaging of temporomandibular joint dysfunction[J]. Eur J Radiol Open,2021,8:100390. DOI:10.1016/j.ejro.2021.100390.
[13]
Zhao Z,Ge H,Xiang W,et al. Exploration of MRI T2 mapping image application in articular disc displacement of the temporomandibular joint in adolescents[J]. Int J Gen Med,2021,14:6077-6084.DOI:10.2147/IJGM.S330116.
[14]
Li Z,Wang H,Lu Y,et al. Diagnostic value of T1ρ and T2 mapping sequences of 3D fat-suppressed spoiled gradient(FS SPGR-3D)3.0-T magnetic resonance imaging for osteoarthritis[J].Medicine(Baltimore),2019,98(1):e13834.DOI:10.1097/MD.0000000000013834.
[15]
Shigeno K,Sasaki Y,Otonari-Yamamoto M,et al. Evaluating the mandibular condyles of patients with osteoarthritis for bone marrow abnormalities using magnetic resonance T2 mapping[J].Oral Radiol,2019,35(3):272-279. DOI:10.1007/s11282-018-0357-5.
[16]
Díaz DZR,Müller CEE,Gaviüo MBD. Ultrasonographic study of the temporomandibular joint in individuals with and without temporomandibular disorder[J]. J Oral Sci,2019,61(4):539-543.DOI:10.2334/josnusd.18-0278.
[17]
Talmaceanu D,Lenghel LM,Bolog N,et al. High-resolution ultrasonography in assessing temporomandibular joint disc position[J]. Med Ultrason,2018,1(1):64. DOI:10.11152/mu-1025.
[18]
Elbarbary M,Goldberg M,Tenenbaum HC,et al.Assessment of concordance between chairside ultrasonography and digital palpation in detecting myofascial trigger points in masticatory myofascial pain syndrome[J]. J Endod,2023,49(2):129-136.DOI:10.1016/j.joen.2022.11.013.
[19]
Talmaceanu D,Lenghel LM,Csutak C,et al. Diagnostic value of high-resolution ultrasound for the evaluation of capsular width in temporomandibular joint effusion[J]. Life,2022,12(4):477.DOI:10.3390/life12040477.
[20]
Lee YH,Hong IK,An JS. Anterior joint space narrowing in patients with temporomandibular disorder[J]. J Orofac Orthop,2019,80(3):116-127.DOI:10.1007/s00056-019-00172-y.
[21]
王瑞永,马绪臣,张万林,等.颞下颌关节盘前移位关节间隙改变的X线研究[J].华西口腔医学杂志,2010,28(3):303-305+310.DOI:10.3969/j.issn.1000-1182.2010.03.019.
[22]
Ayyıldız E,Orhan M,Bahşi İ,et al. Morphometric evaluation of the temporomandibular joint on cone-beam computed tomography[J].Surg Radiol Anatomy,2021,43(6):975-996.DOI:10.1007/s00276-020-02617-1.
[23]
王瑞永,马绪臣,张万林,等.健康成年人颞下颌关节间隙锥形束计算机体层摄影术测量分析[J].北京大学学报(医学版),2007,39(5):503-506. DOI:10.3321/j.issn:1671-167x.2007.05.013.
[24]
马绪臣.颞下颌关节紊乱病医学影像学诊断的重要性和局限性[J]. 中华口腔医学杂志,2020,55(9):603-607. DOI:10.3760/cma.j.cn112144-20200701-00389.
[25]
Zhu J,Gong Y,Zheng F,et al.Relationships between functional temporomandibular joint space and disc morphology,position,and condylar osseous condition in patients with temporomandibular disorder[J]. Clin Oral Investig,2024,28(3):193. DOI:10.1007/s00784-024-05579-5.
[26]
蒋峰,谷志远,张雄,等.76例颞下颌关节紊乱病患者许氏位片中髁突位置的分析[J].国际口腔医学杂志,2008,35(2):111-113.DOI:10.3969/j.issn.1673-5749.2008.02.003.
[27]
Ahmad M,Schiffman EL. Temporomandibular joint disorders and orofacial pain[J]. Dent Clin North Am,2016,60(1):105-124.DOI:10.1016/j.cden.2015.08.004.
[28]
Ferrazzo KL,Osório LB,Ferrazzo VA. CT images of a severe TMJ osteoarthritis and differential diagnosis with other joint disorders[J].Case Rep Dent,2013:242685.DOI:10.1155/2013/242685.
[29]
Shu J,Li A,Shao B,et al. Descriptions of the dynamic joint space of the temporomandibular joint[J]. Computer Methods Programs Biomed,2022,226:107149. DOI:10.1016/j.cmpb.2022.107149.
[30]
Tsai CM,Wu FY,Chai JW,et al. The advantage of cone-beam computerized tomography over panoramic radiography and temporomandibular joint quadruple radiography in assessing temporomandibular joint osseous degenerative changes[J]. J Dent Sci,2020,15(2):153-162. DOI:10.1016/j.jds.2020.03.004.
[31]
Wu M,Almeida F,Friesen R. A systematic review on the association between clinical symptoms and CBCT findings in symptomatic TMJ degenerative joint disease[J]. J Oral Facial Pain Headache,2021,35(4):332-345. DOI:10.11607/ofph.2953.
[32]
Sawada K,Amemiya T,Hirai S,et al. Diagnostic reliability of 3.0-T MRI for detecting osseous abnormalities of the temporomandibular joint[J]. J Oral Sci,2018,60(1):137-141. DOI:10.2334/josnusd.16-0838.
[33]
Liu S,Xu L,Lu S,et al. Diagnostic performance of magnetic resonance imaging for degenerative temporomandibular joint disease[J]. J Oral Rehabil,2023,50(1):24-30. DOI:10.1111/joor.13386.
[34]
Tasaki MM,Westesson PL,Isberg AM,et al. Classification and prevalence of temporomandibular joint disk displacement in patients and symptom-free volunteers[J]. Am J Orthod Dentofac Orthop,1996,109(3):249-262.DOI:10.1016/s0889-5406(96)70148-8.
[35]
Azlağ Pekince K,Čağlayan F,Pekince A. The efficacy and limitations of USI for diagnosing TMJ internal derangements[J].Oral Radiol,2020,36(1):32-39. DOI:10.1007/s11282-019-00376-3.
[36]
张祖燕.口腔颌面医学影像诊断学[M].7 版.北京:人民卫生出版社,2020:187-198.
[37]
Koh KJ,Park HN,Kim KA. Relationship between anterior disc displacement with/without reduction and effusion in temporomandibular disorder patients using magnetic resonance imaging[J]. Imaging Sci Dent,2013,43(4):245-251. DOI:10.5624/isd.2013.43.4.245.
[38]
陈志晔,胡敏,王燕一.颞下颌关节骨关节炎的MRI 成像诊断[J].中华口腔医学杂志,2022,57(6):660-664.DOI:10.3760/cma.j.cn112144-20220113-00016.
[39]
Bas B,Yılmaz N,Gökce E,et al. Ultrasound assessment of increased capsular width in temporomandibular joint internal derangements: Relationship with joint pain and magnetic resonance grading of joint effusion[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2011,112(1):112-117. DOI:10.1016/j.tripleo.2011.02.020.
[40]
Larheim TA, Westesson PL, Sano T. MR grading of temporomandibular joint fluid:Association with disk displacement categories,condyle marrow abnormalities and pain[J]. Int J Oral Maxillofac Surg,2001,30(2):104-112. DOI:10.1054/ijom.2000.0017.
[41]
Khawaja SN,Crow H,Mahmoud RF,et al. Is there an association between temporomandibular joint effusion and arthralgia?[J]. J Oral Maxillofac Surg,2017,75(2):268-275.DOI:10.1016/j.joms.2016.08.027.
[42]
Takahara N,Nakagawa S,Sumikura K,et al. Association of temporomandibular joint pain according to magnetic resonance imaging findings in temporomandibular disorder patients[J]. J Oral Maxillofac Surg,2017,75(9):1848-1855. DOI:10.1016/j.joms.2017.03.026.
[43]
Díaz Reverand S,Muñoz Guerra M,Rodríguez Campo J,et al.Correlation between joint effusion and clinical symptoms,magnetic resonance imaging and arthroscopic findings in patients with temporomandibular joint disease[J]. J Craniomaxillofac Surg,2020,48(12):1146-1151. DOI:10.1016/j.jcms.2020.10.003.
[44]
Mizuhashi F,Ogura I,Mizuhashi R,et al.Examination for the factors involving to joint effusion in patients with temporomandibular disorders using magnetic resonance imaging[J]. J Imaging,2023,9(5):101.DOI:10.3390/jimaging9050101.
[45]
Hosgor H. The relationship between temporomandibular joint effusion and pain in patients with internal derangement[J]. J Craniomaxillofac Surg,2019,47(6):940-944. DOI:10.1016/j.jcms.2019.03.010.
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