KONDİLLERDEKİ DEJENERATİF DEĞİŞİKLİKLERİN İNCELENMESİNDE PANORAMİK RADYOGRAFİ ETKİNLİĞİNİN KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİ İLE DEĞERLENDİRİLMESİ

Öz

Amaç: Bu çalışmanın amacı temporomandibular disfonkisyona sahip hastaların kondiler dejeneratif değişikliklerinin tespitinde panoramik radyografi (OPG) etkinliğinin araştırılmasıdır.
Gereç ve Yöntem: Temporomandibular eklem (TME) şikayetine yönelik konik ışınlı bilgisayarlı tomografi (KIBT) alınmış 40 hastaya ait OPG ve KIBT görüntüleri bu çalışmaya dahil edilmiş ve 5 olası kondiler dejeneratif değişiklik açısından değerlendirilmiştir.
Bulgular: Sık gözlenen değişiklikler arasında yer alan erozyon, düzleşme ve osteofit tespitinde OPG ve KIBT skorları arasında belirgin farklılık olduğu, KIBT ile daha çok değişiklik tespit edildiği görülmüştür.
Sonuç: Bu bilgiler ışığında, TME muayenesi sürecinde özellikle dejeneratif değişikliklerin tespitinde klinik muayene bulgularının dikkatlice irdelenmesi, OPG bulgularının tek başına yetersiz olabileceği ve gerekli durumlarda ileri görüntülemeden faydalanılması erken tanı açısından dikkate alınması gereken önemli noktalardır.

Anahtar Kelimeler

• Temporomandibular Disfonkisyonu
• Panoramik Radyografi
• Konik Işınlı Bilgisayarlı Tomografi

Evaluation of the Efficiency of Panoramic Radiography with Cone Beam Computed Tomography in the Assessment of Condylar Degenerative Changes

Öz

Aim: The aim of this study is to evaluate the efficiency of panoramic radiography (OPG) in the assessment of condylar degenerative changes in patients of temporomandibular dysfunction.
Materials and Methods: OPG and cone beam computed tomography (CBCT) images of 40 patients with temporomandibular dysfunction were included for this study. All images were evaluated for 5 possible condylar degenerative alterations.
Results: There was a significant difference between OPG and KIBT scores in the detection of erosion, flattening and osteophyte, which were among the common changes.
Conclusion: At this point, considering the fact that OPG findings may alone be insufficient, careful examination of clinical examination findings and appropriate use of advanced imaging are important points to be considered in early diagnosis of condylar degenerative changes during the TMJ examination.

Anahtar Kelimeler

• Panoramic Radigoraphy
• Cone Beam Computed Tomography
• Temporomandibular Dysfunction

Kaynakça

1. 1. Okeson JP. Management of Temporomandibular Disorders and Occlusion. Vol 5th ed. St. Louis: Mosby; 2003.
2. 2. Scarfe WC, Farman AG. Diagnostic imaging of the temporomandibular joint. İn White SC, Pharoah MJ. Oral Radiology, Principles and Interpretation. Vol 6th ed. Noida: Elsevier, 2010; p. 473–8.
3. 3. Springer SP, Greenberg SM, Glick M. Temporomandibular disorders. in Greenberg SM, Glick M. Burket’s Oral Medicine Diagnosis and Treatment. Vol 9th ed, Ontario :BC Decker, 2003; p. 230–2.
4. 4. Bäck K, Ahlqwist M, Hakeberg M, Dahlström L. Occurrence of signs of osteoarthritis/arthrosis in the temporomandibular joint on panoramic radiographs in Swedish women. Community dent oral epidemiol 2017; 45(5):478-84.
5. 5. Shetty US, Burde KN, Naikmasur VG, Sattur AP. Assessment of condylar changes in patients with temporomandibular joint pain using digital volumetric tomography. Radiol Res Pract 2014; 1.
6. 6. Honey OB, Scarfe WC, Hilgers MJ, Klueber K, Silveira AM, Haskell BS, Farman AG. Accuracy of cone-beam computed tomography imaging of the temporomandibular joint: comparisons with panoramic radiology and linear tomography. Am J Orthod Dentofacial Orthop 2007; 132(4):429-38.
7. 7. Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis Cartilage 2013; 21: 16–21.
8. 8. Wenham CY, Conaghan PG. New horizons in osteoarthritis. Age Ageing 2013; 42: 272– 8.

9. 9. Felson DT. Osteoarthritis: priorities for osteoarthritis research: much to be done. Nat Rev Rheumatol 2014; 10: 447–8.
10. 10. Brooks LS, Brand JW, Gibbs SJ, Hollender L, Lurie AG, Omnell KA et al. Imaging of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83(5): 609-18.
11. 11. Blaschke DD. Temporomandibular joint. Oral Radiology Principles and Interpretion vol 2nd ed. Toronto: CV Mosby Co, 1987; p.658- 70.
12. 12. Westesson PL, Katzberg RW, Tallents RH, Sanchez- Woodworth RE, Svensson SA. CT and MR of the temporomandibular joint: comparison with autopsy specimens. AJR Am J Roentgenol 1987; 148: 1165–71.
13. 13. Alkhader M, Kuribayashi A, Ohbayashi N, Nakamura S, Kurabayashi T. Usefulness of cone beam computed tomography in temporomandibular joints with soft tissue pathology. Dentomaxillofac Radiol 2010; 39: 343–8.
14. 14. Hilgers ML, Scarfe WC, Scheetz JP, Farman AG. Accuracy of linear temporomandibular joint measurements with cone beam computed tomography and digital cephalometric radiography. Am J Orthod Dentofacial Orthop 2005; 128: 803–11.
15. 15. Zhang ZL, Cheng JG, Li G, Zhang JZ, Zhang ZY, Ma XC. Measurement accuracy of temporomandibular joint space in Promax 3-dimensional cone-beam computerized tomography images. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: 112–17.
16. 16. Marques AP, Perrella A, Arita ES, Pereira MF, CavalcantiMde G. Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography. Braz Oral Res 2010; 24: 467–74.
17. 17. Patel A, Tee BC, Fields H, Jones E, Chaudhry J, Sun Z. Evaluation of conebeam computed tomography in the diagnosis of simulated small osseous defects in the mandibular condyle. Am J Orthod Dentofacial Orthop 2014; 145: 143–56.
18. 18. Larheim TA, Abrahamsson AK, Kristensen ML, Arvidsson LZ. Temporomandibular joint diagnostics using CBCT. Dentomaxillofacial Radiology. 2015; 44(1):20140235.
19. 19. Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 844– 60.
20. 20. Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol 2009; 38: 141–7.
21. 21. Nah KS. Condylar bony changes in patients with temporomandibular disorders: a CBCT study. Imaging Sci Dent 2012; 42: 249–53.
22. 22. dos Anjos Pontual ML, Freire JS, Barbosa JM, Frazao MA, dos Anjos Pontual A. Evaluation of bone changes in the temporomandibular joint using cone beam CT. Dentomaxillofac Radiol 2012; 41: 24–9.
23. 23. Shetty US, Burde KN, Naikmasur VG, Sattur AP. Assessment of condylar changes in patients with temporomandibular joint pain using digital volumetric tomography. Radiol Res pract. 2014.
24. 24. Lee DY, Kim YJ, Song YH et al. Comparison of bony changes between panoramic radiograph and cone beam computed tomographic images in patients with temporomandibular joint disorders. Korean Journal of Orthodontics. 2010; 40(6): 364–72.
25. 25. Dos Anjos Pontual ML, Freire JSL, Barbosa JMN, Frazao MAG, Dos Anjos Pontual A. Evaluation of bone changes in the temporomandibular joint using cone beam CT. Dentomaxillofac Radiol. 2012; 41(1): 24–29.