Evaluation of the anterior meniscal displacement with reduction by High-Resolution Ultrasonography pulsed wave Doppler mode (PWD). A pilot study

Year 2020, Volume: 4 Issue: 1, 1 - 6, 30.06.2020

Alaa Alsafadı , Juan Luis Cobo İvan Menéndez Juan David Muriel Teresa Cobo

https://doi.org/10.35333/ERD.2020.179

Abstract

Introduction: The temporomandibular joint
disorder (TMD) refers to mandibular dysfunction caused by reduced function of
the primary structures that compose the temporomandibular joint (TMJ) or other structures
related to the TMJ or by the interaction of these structures with each other. Ultrasound
imaging (USI) can not only demonstrate soft tissue alterations but also
visualize hard tissue alterations. Pulsed-wave Doppler mode is a widely used technique in the study of movable
structures, particularly the vascular system.

Material and Methods: 16 patients (32 TMJ)
were included in this study, grouped in 10 women’s and 6 men’s). Extraoral and intraoral examination of the TMJ was realized to detect
anterior disc displacement with reduction. Ultrasonography high resolution
examination was carried out by LOGIQ e Healthcare^® with a 16 MHz
high frequency transducer. A musculoskeletal L8-18i wideband linear array was
used for pulsed wave doppler mode examination.

Results: Fourteen
patients presented anterior disc displacement with reduction, and 2 patients
presented normal disc position. When meniscal displacement is detected, PWD
mode presents a distinct waveform on the timeline of the exploration.

Conclusion: Pulsed-wave Doppler mode provides an advantage in USI, helping
to confirm the existence of anterior disc displacement or crepitation. USI is a
noninvasive technique with no radiation exposure and permits static and dynamic
exploration of the TMJ with a short examination time, low cost, and no contraindications
or special patient preparation.

Keywords

Temporomandibular joint, Ultrasonography, Articular disc, Disc displacement, PWD mode, Doppler

Supporting Institution

Instituto Asturiano de Odontología

References

• 1. Bender, M.E., Lipin, R.B. and Goudy, S.L. (2018) Development of the pediatric temporomandibular joint. Oral and Maxillofacial Surgery Clinics of North America, 30, 1-9.
• 2. Stocum, D.L. and Roberts, W.E. (2018) Part I: development and physiology of the temporomandibular joint. Current Osteoporosis Reports, 16, 360-368.
• 3. Molinari F, Manicone PF, Raffaelli L, Raffaelli R, Pirronti T, Bonomo L. Temporomandibular Joint Soft-Tissue Pathology, I: Disc Abnormalities. Semin Ultrasound, CT MRI. 2007;28(3):192–204.
• 4. Alomar X, Medrano J, Cabratosa J, Clavero JA, Lorente M, Serra I, et al. Anatomy of the Temporomandibular Joint. Semin Ultrasound, CT MRI. 2007;28(3):170–83.
• 5. Azlağ Pekince K, Çağlayan F, Pekince A. The efficacy and limitations of USI for diagnosing TMJ internal derangements. Oral Radiol. 2019;0(0):0.
• 6. Pringle JH. Displacement of the mandibular meniscus and its treatment. Br J Surg. 1918;6(23):385–9.
• 7. Badel T, Marotti M, Keros J, Kern J, Krolo I. Magnetic resonance imaging study on temporomandibular joint morphology. Coll Antropol. 2009;33(2):455–60.
• 8. Yılmaz D, Kamburoğlu K. Comparison of the effectiveness of high resolution ultrasound with MRI in patients with temporomandibular joint dısorders. Dentomaxillofacial Radiol. 2019;20180349.
• 9. Klatkiewicz T, Gawriołek K, Pobudek Radzikowska M, Czajka-Jakubowska A. Ultrasonography in the Diagnosis of Temporomandibular Disorders: A Meta-Analysis. Med Sci Monit . 2018;24:812–7.
• 10. Emshoff R, Jank S, Rudisch A, Walch C, Bodner G. Error patterns and observer variations in the high-resolution ultrasonography imaging evaluation of the disk position of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(3):369–75.
• 11. Emshoff R, Brandlmaier I, Bodner G, Rudisch A. Condylar erosion and disc displacement: Detection with high-resolution ultrasonography. J Oral Maxillofac Surg. 2003;61(8):877–81.
• 12. Emshoff R, Bertram S, Rudisch A, Gaßner R. The diagnostic value of ultrasonography to determine the temporomandibular joint disk position. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84(6):688–96.
• 13. Emshoff R, Jank S, Bertram S, Rudisch A, Bodner G. Disk Displacement of the Temporomandibular Joint Sonography Versus MR Imaging. American Journal of Roentgenology Vol. 2002;(June 2000):1557–62.
• 14. Katzberg RW. Is ultrasonography of the temporomandibular joint ready for prime time? Is there a “window” of opportunity? J Oral Maxillofac Surg. 2012;70(6):1310–4.
• 15. Jank S, Emshoff R, Norer B, Missmann M, Nicasi A, Strobl H, et al. Diagnostic quality of dynamic high-resolution ultrasonography of the TMJ - A pilot study. Int J Oral Maxillofac Surg. 2005;34(2):132–7.
• 16. Stagnitti A, Marini A, Impara L, Drudi FM, Lo mele L, Lillo Odoardi G. Duplex Doppler ultrasound study of the temporomandibular joint. J Ultrasound. 2012;15(2):111–4.
• 17. Osiewicz MA, Lobbezoo F, Loster BW, Loster JE, Manfredini D. Frequency of temporomandibular disorders diagnoses based on RDC/TMD in a Polish patient population. Cranio - J Craniomandib Pract. 2018;36(5):304–10.
• 18. Kalyan US, Moturi K, Rayalu KP. The Role of Ultrasound in Diagnosis of Temporomandibular Joint Disc Displacement : A Case – Control Study. J Maxillofac Oral Surg. 2017
• 19. Nabeih YB, Speculand B. Ultrasonography as a diagnostic aid in temporomandibular joint dysfunction. Int J Oral Maxillofac Surg. 1991;20(3):182–6.
• 20. Thomas AE, Kurup S, Kumar SP, Chandy ML, Jose R. Diagnostic efficiency of high-resolution ultrasonography in patients with chronic temporomandibular disorders. Oral Radiol. 2016;32(3):160–6.
• 21. Su N, van Wijk AJ, Visscher CM, Lobbezoo F, van der Heijden GJMG. Diagnostic value of ultrasonography for the detection of disc displacements in the temporomandibular joint: a systematic review and meta-analysis. Clin Oral Investig. 2018
• 22. Elias FM, Birman EG, Matsuda CK, de Souza Oliveira IR, Jorge WA. Ultrasonographic findings in normal temporomandibular joints. Braz Oral Res. 2006;20(1):25–32.
• 23. Jank S, Zangerl A, Kloss FR, Laimer K, Missmann M, Schroeder D, et al. High resolution ultrasound investigation of the temporomandibular joint in patients with chronic polyarthritis. Int J Oral Maxillofac Surg. 2011;40(1):45–9.
• 24. Hayashi T, Ito J, Koyama J, Yamada K. The accuracy of sonography for evaluation of internal derangement of the temporomandibular joint in asymptomatic elementary school children: comparison with MR and CT. AJNR Am J Neuroradiol . 2001;22(4):728–34.
• 25. Manfredini D, Tognini F, Melchiorre D, Zampa V, Bosco M. Ultrasound assessment of increased capsular width as a predictor of temporomandibular joint effusion. Dentomaxillofacial Radiol. 2003;32(6):359–64.
• 26. Kaya K, Dulgeroglu D, Unsal-Delialioglu S, Babadag M, Tacal T, Barlak A, et al. Diagnostic value of ultrasonography in the evaluation of the temporomandibular joint anterior disc displacement. J Cranio-Maxillofacial Surg. 2010;38(5):391–5.
• 27. Dong XY, He S, Zhu L, Dong TY, Pan SS, Tang LJ, et al. The diagnostic value of high-resolution ultrasonography for the detection of anterior disc displacement of the temporomandibular joint: A meta-analysis employing the HSROC statistical model. Int J Oral Maxillofac Surg. 2015;44(7):852–8.
• 28. Tognini F, Manfredini D, Melchiorre D, Bosco M. Comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement. J Oral Rehabil. 2005;32(4):248–53.