Journal of Dental Medicine

Background and Aim: Digital subtraction Radiography (DSR) is a method of accurate assessing condylar head changes. several studies have been carried out in applying DSR in dentistry, however there is a few number of studies in efficacy of DSR method in assesment of condylar head changes, The aim of this study was to compare panoramic radiography and DSR detecting simulated lesions of the mandibular condyl.

Materials and Methods: this was a process reaserch study, in which two dry human skulls with no obvious temporomandibular joint pathology were used. Osteophytic lesions were simulated using three sizes of bone chips that were placed on the medial portion of anterior and superolateral aspects of the condyle. Osteolytic lesions were simulated making 1 and 2 mm holes using round burr in the central portion of anterior aspect and Lateral pole of the condyle. Panoramic radiographs were prepared with and without the lesions in place. These paired radiographs were digitized and digital- subtraction images of the original panoramic images were obtained. Eight observers evaluated 155 images of each modality for the presence or absence and the type of simulated lesions of the mandibular condyle. Sensitivity, specificity, reliability and measure of agreement were analyzed using kappa test and crossed tables and qualitative variables were assess by chi-square and fisher's Exact test.

Results: Specificity of panoramic and DSR methods were 15.4% and 66.7% respectively. Sensitivity of panoramic and DSR methods were 61.1% and 80.6% for osteophytic lesions and 37.5% and 83.3% for Osteolytic lesions. The percentage of correct decisions made in DSR method was significantly more than conventional panoramic method (82.6% vs 41.9%) (p<0.0001).

Conclusion: Based on the results of this study digital subtraction technique was significantly more accurate than the panoramic radiographs in detection of simulated lesions of the mandibular condyle.

Background and Aims: Disc displacement is the most common temporomandibular joint disorder and magnetic resonance imaging (MRI) is the gold standard in its diagnosis. This disorder can lead to changes in signal intensity of magnetic resonance (MR). The purpose of this study was evaluation of correlation between relative signal intensity of MR images of retrodiscal tissue, superior and inferior head of lateral ptrygoid muscle with type of anterior disk displacement and condylar head flattening in patients with temporomandibular disorder (TMD).

Materials and Methods: In this retrospective study, 31 MR images of patients who had anterior disc displacement were evaluated. After relative signal intensity measurement for retrodiscal tissue, superior and inferior head of lateral ptrygoid muscle, the correlation between relative signal intensity and type of anterior disc displacement was evaluated with repeated measure ANOVA test. In each of these 3 areas, t-test was used to compare the groups with and without condylar head flattening.

Results: The correlation between relative signal intensity of MR images and type of anterior disc displacement in retrodiscal tissue, superior and inferior head of lateral ptrygoid muscle was not significant. There was also no statistically significant correlation between relative signal intensity of MR images and flattening of condylar head in retrodiscal tissue, superior and inferior head of lateral ptrygoid muscle (P>0.05).

Conclusion: According to findings of this study, relative signal intensity of MR images in retrodiscal tissue, superior and inferior head of ptrygoid muscle is not a good predictor for type of anterior disc displacement and flattening of condylar head. It seems that this cannot be used as a diagnostic marker for TMD progression.