Infrared Thermography in the Assessment of Temporomandibular Joint Dysorder

Nahm, Francis Sahngun; Koo, Mi Suk; Kim, Yang Hyun; Suh, Jeong Hun; Shin, Hwa Yong; Choi, Yong Min; Kim, Yong Chul; Lee, Sang Chul; Lee, Pyung Bok

Abstract

BACKGROUND: Temporomandibular joint disorder (TMD) is a group of musculoskeletal conditions characterized by pain in the pre-auricular area, limitation of jaw movement and palpable muscle tenderness. Thermography is a nonionizing, noninvasive diagnostic alternative for the evaluation of TMD. This study was conducted to evaluate the usefulness of thermography in the assessment of TMD.
METHODS
Thermography was conducted on the 61 patients who had been diagnosed with TMD, and on the 34 normal symptom-free volunteers. The temperature differences between opposite sides of the temporomandibular joint (DeltaTTMJ) and the masseter muscle (DeltaTMST) were calculated. The sensitivity and specificity of thermography was calculated at the cut off values of 0.2, 0.3, and 0.4 degrees C.
RESULTS
In the patient group, the DeltaTTMJ was 0.42 +/- 0.38 degrees C and the DeltaTMST was 0.38 +/- 0.33 degrees C, whereas in the control group the DeltaTTMJ was 0.10 +/- 0.07 degrees C and the DeltaTMST 0.15 +/- 0.10 degrees C. In addition, the patient group demonstrated a significantly lower level of thermal symmetry than the control group (P < 0.001) in both the temporomandibular joints and the masseter muscles. The sensitivity of thermography at the cut off values of 0.2, 0.3 and 0.4 degrees C was 67.2, 49.2, and 42.6% in the temporomandibular joint (TMJ) and 60.7, 49.2 and 37.7% in the masseter muscle, respectively. The specificity of thermography at the cut off values of 0.2, 0.3 and 0.4 degrees C was 88.2, 100, and 100% in the TMJ and 61.8, 91.2 and 100% in the masseter muscles, respectively. The accuracy of thermography at the cut off values of 0.2, 0.3 and 0.4 degrees C was 74.7, 67.4, and 63.2% in TMJ and 61.1, 64.2 and 60.0% in the masseter muscles, respectively.
CONCLUSIONS
Temperature differences exist between the opposite sides of the TMD and masseter muscles in patients with TMD. Although the sensitivity of thermography in the diagnosis of TMD is low, it has high specificity in the evaluation of TMD, and is therefore applicable to patients with TMD.