Digital Applications in Diagnosing Temporomandibular Joint Disorders

When examining osseous structures such as the long axis of the mandibular condyle, researchers recommend computer tomography (CT) or cone-beam computed tomography (CBCT). At the workstation digital images can be temporarily manipulated using DICOM-viewing software when examining sagittal oblique and coronal oblique planes. With soft tissues Tamimi et al recommends magnetic resonance imaging (MRI), as this type of imaging can ensure the images capture the correct spatial relationship of the disc to the condyle and fossa. MRI also provides a more accurate diagnoses with the direction of displacement (rotational or sideways).19 As with intraoral digital imaging, extraoral digital imaging requires less radiation to the patient, compared with medical computed tomography (CT). Scanning time is approximately 8-10 seconds. This is also helpful for cancer patients who have been exposed to medical therapy radiation (Figures 31-33).

Figure 31. 3D Imaging for Diagnoses.
Photograph showing 3D Imaging for Diagnoses.
Image Source: Sordex, Kavo Kerr Group Powai, Mumbai.
Figure 32. 3D Imaging for Diagnoses.
Photograph showing 3D Imaging for Diagnoses.
Image Source: Sordex, Kavo Kerr Group Powai, Mumbai.
Figure 33. 3D Dental Implant Treatment Planning.
Photograph showing 3D Dental Implant Treatment Planning.
Image Source: Sordex, Kavo Kerr Group Powai, Mumbai.

With 3D digital imaging, the results are detailed and can be enhanced with digital imaging software for region-of-interest (ROI) magnification and equalization. Dental practices that place dental implants will also have access to an extensive implant library from manufacturers. Some disadvantages with CBCT include the cost of the equipment, lack of training in interpreting structures outside what dental providers were taught with two-dimensional digital imaging, and mistakes with dental providers not including a field of view (FOV) wide enough to diagnose diseases and conditions.2,5,9