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| Author(s): |
André Luiz Ferreira Costa
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas |
| Defense date: | 2008-02-26 |
| Examining board members: |
Fernando Cendes;
Roberto José Maria Covolan;
Alexandre Xavier Falcão;
Karina Lopes Devito;
Andréa de Castro Domingos
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| Advisor: | Fernando Cendes |
| Abstract | |
The aim of the present work was to evaluate a 3D reconstruction method of the temporomandibular joint by magnetic resonance imaging. The sample comprised of 42 individuals, 21 diagnosed with unilateral temporomandibular joint internal derangement (TMJ ID) and headache, 21 diagnosed with unilateral TMJ ID without headache. Eigtheen individuals without signs or symptoms of temporomandibular disorders or headache (control group) were included. The subjects with headache were evaluated by a neurologist, who performed a neurological examination by International Headache Society. All subjects were submitted TMJ magnetic resonance imaging (MRI). Three dimensional imaging reconstructions of temporomandibular joint were generated by segmentation software, allowing visualization of the components of temporomandibular joint (articular disc, condyle and temporal bone) on arbitrary planes. The diagnosis of disc position was equivalent in RM and in the three-dimensional reconstruction, disclosing an acceptable agreement for diagnostic accuracy (p = 0.9) between MRI findings and 3D reconstruction in control group and patients group. We found a significant decrease of TMJ disc volumes in the group of patients with TMD compared to the control group (p < 0.001). In addition, disc volumes were significantly smaller in joints from patients with effusion versus those without it (p< 0.001); as well as in patients with bruxism behavior compared those without it (p< 0.001); disc volumes of TMJ affected side when compared with any controls¿s side (p< 0.001). With regard to clinical and visual analyses, bruxing behavior was most frequently reported by patients with headaches (p< 0.012). A significant association between headache and temporomandibular joint effusion (p<0.012) was noted. Patients with more severe disc displacement also had a higher frequency of effusion (p<0.001). Thus, we concluded that 3D reconstruction is a useful and accurate method for the assessment of the ID TMJ and there is reduction of TMJ disc volume in patients with TMJ ID with joint effusion and/or bruxism (AU) | |