Imaging Sci Dent.  2017 Dec;47(4):219-226. 10.5624/isd.2017.47.4.219.

Internal derangement as a predictor of provoked pain on mouth opening: A magnetic resonance imaging study

• Koh KJ
• Park HN
• Kim KA

• KMID: 2397835
• DOI: http://doi.org/10.5624/isd.2017.47.4.219

Abstract

PURPOSE
This study investigated the relationship between pain and internal derangement in temporomandibular disorder (TMD) patients using magnetic resonance imaging (MRI).
MATERIALS AND METHODS
This study analyzed 356 TMD patients (712 temporomandibular joints [TMJs]). The inclusion criteria were the presence of spontaneous or provoked pain on one or both TMJs and having undergone MRI. The patients with provoked pain were divided into 3 groups: pain on palpation, pain on mouth opening, and pain on mastication. MRI was performed using a 1.5-T scanner. T1- and T2-weighted parasagittal and paracoronal images were obtained. According to the findings on the T1-weighted images, another 3 groups were created based on internal derangement: normal, disc displacement with reduction, and disc displacement without reduction. The MRI findings were independently interpreted by 2 experienced oral and maxillofacial radiologists at 2 different times. Statistical analysis was performed by the chi-square test using SPSS (version 12.0; SPSS Inc., Chicago, IL, USA).
RESULTS
Provoked pain on mouth opening was found to be correlated with internal derangement in TMD patients (P < .05). However, spontaneous pain and provoked pain on palpation or mastication were not associated with internal derangement (P>.05).
CONCLUSION
These results suggest that internal derangement was a significant predictor of provoked pain on mouth opening.

Keyword

Magnetic Resonance Imaging; Temporomandibular Joint; Pain

MeSH Terms

Humans
Magnetic Resonance Imaging*
Mastication
Mouth*
Palpation
Temporomandibular Joint
Temporomandibular Joint Disorders

Figure

• 

  Fig. 1 Normal disc position, with the posterior band of the disc located superiorly to the condyle. The disc shows a biconcave configuration, with the thin intermediate zone in the 10 o'clock position.

• 

  Fig. 2 A and B. Disc displacement with reduction. A T1-weighted image in the closed mouth position shows mild anterior disc displacement and a T2-weighted image in the open mouth position demonstrates a recaptured disc.

• 

  Fig. 3 A and B. Disc displacement without reduction. A T1-weighted image in the closed mouth position showing anterior disc displacement and a T2-weighted image in the open mouth position showing anterior disc displacement relative to the condyle.

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