Imaging diagnosis of the temporomandibular joint: critical review of indications and new perspectives

Abstract

In recent decades, there have been important developments in temporomandibular joint (TMJ) imaging. New techniques complement preexisting methods, and each modality is indicated for specific conditions in accordance with the clinical diagnosis. The aim of this review is to give an overview of conventional and new techniques in TMJ imaging. The literature review includes studies published between 1976 and 2009 that appear in the Medline database. Magnetic resonance imaging remains the “gold standard” modality for TMJ analysis. It allows structures to be visualized without radiation whether or not they are mineralized; however, it is costly and complex. Ultrasonography, an alternative method with increasing importance in TMJ analysis, is a simple, noninvasive, and low-cost technique that allows for the visualization of the position of the disk; however, it does not detect condylar abnormalities. Reconstructions in three-dimensions can be obtained with computed tomography, magnetic resonance imaging, and ultrasonography and can be used to obtain rapid prototyping biomodels. Health professionals performing TMJ imaging exams should consider clinical history and findings, exam cost, radiation exposure, results of previous exams, and whether the current result will influence diagnosis and treatment planning.