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Dentomaxillofacial Radiology (2008) 37, 63-71
© 2008 British Institute of Radiology
doi: 10.1259/dmfr/16932758

SYSTEMATIC REVIEW

Role of different imaging modalities in assessment of temporomandibular joint erosions and osteophytes: a systematic review

AM Hussain1, G Packota2, PW Major3,4 and C Flores-Mir*,3,4

1 Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada, 2 College of Dentistry, University of Saskatchewan, Saskatoon, Canada, 3 Orthodontic Graduate Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada, 4 Craniofacial and Oral-health Evidence-based Practice Group (COEPG), Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

*Correspondence to: Dr Carlos Flores-Mir, Director of the Craniofacial and Oral-health Evidence-based Practice Group (COEPG), 4051 Dentistry/Pharmacy Centre, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada T6G 2N8. E-mail: carlosflores{at}ualberta.ca

Received 12 December 2006; revised 8 March 2007; accepted 18 March 2007

Objectives: To evaluate the ability of different diagnostic imaging techniques for diagnosing the presence of erosions and osteophytes in the temporomandibular joint (TMJ).

Methods: A systematic search of PubMed, Medline, all Evidence Based Medicine (EBM) reviews, Embase, Web of Sciences and Lilacs identified nine articles that met the selection criteria: some type of TMJ diagnostic imaging, data from autopsy or dry skull TMJs as gold standard, absence of diagnosed systemic arthritis and evaluation of the presence of erosions and/or osteophytes. A hand search of the references of the selected articles was also performed.

Results: Selected studies evaluated panoramic imaging (unenhanced and colour-enhanced digital subtraction panoramic imaging), axially corrected sagittal tomography, axially corrected frontal tomography, sagittal MRI, CT, high-resolution ultrasound and cone beam CT (CBCT).

Conclusions: Axially corrected sagittal tomography is currently the imaging modality of choice for diagnosing erosions and osteophytes in the TMJ. CT does not seem to add any significant information to what is obtained from axially corrected sagittal tomography. CBCT might prove to be a cost- and radiation dose-effective alternative to axially corrected sagittal tomography. Combining different radiographic techniques is likely to be more accurate in diagnosing erosions and osteophytes in the TMJ than using a single imaging modality. Diagnostic studies that simultaneously evaluate all of the available TMJ imaging technologies are needed.

Keywords: temporomandibular joint; radiography, panoramic; computed tomography; X-ray tomography; comparison






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