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Abnormalities of the Temporomandibular Joint in Adults with Rheumatic Disease. A Comparison of Panoramic, Transcranial and Transpharyngeal Radiography with Tomography

1988; Oxford University Press; Volume: 17; Issue: 2 Linguagem: Inglês

10.1259/dmfr.1988.0014

1476-542X

Tore A. Larheim, S Johannessen, Lars Tveito,

Rheumatoid Arthritis Research and Therapies

The validity of panoramic, transcranial and transpharyngeal examinations for determining temporomandibular joint (TMJ) abnormalities was investigated in 58 adults (mean age 46 years) with rheumatic disease, mostly rheumatoid arthritis, who also had TMJ symptoms. Hypocycloidal lateral tomography was used as the reference examination. The film series were reviewed at different occasions and TMJs with destructive changes were recorded as abnormal (arthritic). Fifty-five abnormal joints in 32 patients were found with tomography. Panoramic, transcranial and transpharyngeal examinations, compared with the reference examination, had sensitivities of 81%, 79% and 81% respectively. Overestimation was minimal. Tomography is recommended in adults with rheumatic disease TMJ symptoms but negative panoramic, transcranial or transpharyngeal examinations. The substantial proportion of patients (45%) with no TMJ abnormalities suggests that either the amount of bone destruction is so small that it cannot be detected by present radiographic methods or the rheumatic process has not yet involved bone. However, the possibility of other TMJ disorders, such as disk displacement or myalgia, should also be considered in patients with rheumatic disease.