Correlation of MRT imaging with real-time axiography of TMJ clicks

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Correlation of MRT imaging with real-time axiography of TMJ clicks
Annals of Anatomy - Anatomischer Anzeiger
Volume 189, Issue 4, 11 July 2007, Pages 356-361
Special Issue:Anatomische Gesellschaft - 102nd Annual Meeting in Giessen, Germany, March 30 - April 2, 2007 - Interdisciplinary Symposium "Morphology, function and clinic of the temporomandibular joint"

Olga Tymofiyeva, a, Peter Proff, b, Ernst-J?rgen Richter, a, Peter Jakob, c, Jochen Fanghānel, d, Tomas Gedrange, b and Kurt Rottner, a
a - Poliklinik f?r Zahnārztliche Prothetik, Bayerische Julius-Maximilians-Universitāt W?rzburg, Pleicherwall 2, D-97070 W?rzburg, Germany
b - Poliklinik f?r Kieferorthopādie, Prāventive Zahnmedizin und Kinderzahnheilkunde, Ernst-Moritz-Arndt-Universitāt Greifswald, Rotgerberstra?e 8, D-17487 Greifswald, Germany
c - Institut f?r Experimentelle Physik V, Am Hubland, D-97074 WuĘrzburg, Germany
d - Abteilung f?r Oralanatomie im Zentrum f?r Zahn-, Mund- und Kieferheilkunde der Ernst-Moritz-Arndt-Universitāt Greifswald, Rotgerberstra?e 8, D-17487 Greifswald, Germany

Received 21 December 2006; accepted 20 February 2007. Available online 3 May 2007.

Summary
There is a series of tools useful for gathering diagnostic information on patients with temporomandibular joint disorders. Tracings of the joint movement (axiography) provide useful information about the motion of the joints. Since the availability of electronic axiographic tracers, the movement of the condyles can be resolved with high resolution both in space and in time. In order to obtain information about the anatomical relation of the joint surfaces and the disc, magnetic resonance tomography imaging (MRI) is routinely carried out. It is common practice to take MR images of the joints with the mouth closed and fully open. In order to correlate the MR images with the axiographic tracings, a series of images can provide much more information. In this study we examined patients with distinct temporomandibular joint (TMJ) clicks. In one case, the click occurs once a day, while in the other case the click happens every time the mouth is opened.

In order to obtain information about both motion and anatomical relation of the TMJ at and around the position where the clicks occur, we recorded a series of MRI scans with the mouth gradually opened and before and after joint clicks. Real-time axiographic tracings during the click were taken with an optimized system where the polar moments were reduced as much as possible to follow the movement during the click. These tracings were correlated with the MRI scans to determine the exact internal conditions of the TMJ and the changes during the click. In particular cases, the additional information provided by this procedure can be useful in deciding whether and which therapeutic intervention is advisable.

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