Ultrasound evaluation of the temporomandibular joint in healthy children and adolescents

Yıl 2021, , 175 - 180, 30.08.2021

Hatice Arıöz Habibi , Zuhal Bayramoğlu , Emine Çalışkan , Mehmet Öztürk

https://doi.org/10.30565/medalanya.895129

Öz

Aim: The purpose of this study was to investigate normative values of the distance between the most lateral point of the articular capsule and the most lateral point of the mandibular condyle (LCCD), in children and adolescents. Since the disc is not always visible on ultrasound, LCCD measurement is a very practical indirect indicator for evaluating TMJ.

Methods: This prospective study evaluated 141 temporomandibular joints distance of 141 pediatric individuals with a median age of 9 years (5-13) for boys and 11 years (6.5-14) for girls, comprising 69 boys and 72 girls. LCCD measurements were made with the participants in the closed mouth position, and the relationship of these values with weight, height, age, gender and body mass index (BMI) was evaluated.

Results: Median LCCD values in age groups 2 and 3 were significantly higher than the age group 1 (p=0.001). There was no significant difference between median LCCD values in age group 2 and age group 3 (p=0.5). No significant difference was found among the median LCCD values of the males 1.5 mm (1.2-1.8) and females 1.4 mm (1.1-1.6).

Conclusion: LCDD values increased with age, but no significant difference shown among the genders. However, a negative relation was detected with BMI. This study provides the normative quantitative values of TMJ distance which could be a reference point for upcoming studies. US is a diagnostic method that can be used in the follow-up and screening of children with TMD risk and general population. Since it does not include radiation, it can be safely repeated.

Anahtar Kelimeler

Children, temporomandibular joint, Ultrasonography.

Sağlıklı Çocuklarda Temporomandibular Eklemin Ultrason ile Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı, çocuklarda ve ergenlerde eklem kapsülünün lateral noktası ile mandibular kondilin en lateral noktası (LCCD) arasındaki mesafenin referans değerlerini belirlemektir. Disk ultrasonda her zaman görünmediğinden, LCCD ölçümü temporomandibular eklemi(TME) değerlendirmek için dolaylı bir gösterge olmakla beraber çok pratiktir.

Yöntemler: Prospektif çalışmamızda, medyan yaşı erkeklerde 9 (5-13) ve kızlarda 11 (6.5-14) olan, 69 erkek ve 72 kız olgunun toplamda 141 TME mesafesi değerlendirildi. Katılımcılar yaş gruplarına göre 3’e ayrıldı. Ultrasonda yapılan LCCD ölçümlerinin cinsiyet, yaş, boy, kilo, vücut kitle indeksi (VKİ) ile korelasyonı değerlendirildi.

Bulgular: Grup 2 ve 3’ün LCCD değeri grup 1’den anlamlı derecede yüksekti (p = 0,001). Ancak Grup 2 ve 3 arasında anlamlı fark yoktu (p = 0,5). LCCD değerleri erkeklerde 1,5 mm (1,2-1,8) ve kızlarda 1,4 mm (1,1-1,6) olarak bulundu.

Sonuç: Çalışmamızda LCDD değerleri yaşla birlikte artış göstermekle beraber cinsiyetler arası anlamlı fark saptanmadı. LCCD ile VKİ arasında negatif bir ilişki tespit edildi. Bu çalışma, gelecekteki çalışmalar için referans olabilecek TME mesafesinin normatif değerlerini sağlamaktadır. Ultrason, temporomandibular hastalık riski olan çocukların ve genel popülasyonun tarama ve takibinde kullanılabilecek bir tanı yöntemidir. Radyasyon içermediği için güvenle tekrarlanabilir.

Çocuk, Temporomandibular Eklem, Ultrasonografi

Anahtar Kelimeler

Çocuk;, Temporomandibular Eklem, Ultrasonografi

Kaynakça

• 1. Ribeiro RF, Tallents RH, Katzberg RW, Murphy WC, Moss ME, Magalhaes AC, et al. The prevalence of disc displacement in symptomatic and asymptomatic volunteers aged 6 to 25 years. J Orofacial Pain. 1997;11:37–47. PMID: 10332309
• 2. 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. DOI: 10.12659/MSM.908810
• 3. Tomas X, Pomes J, Berenguer J, Quinto L, Nicolau C, Mercader JM, Castro V. MR imaging of temporomandibular joint dysfunction: a pictorial review. Radiographics. 2006;26(3):765–81. DOI: 10.1148/rg.263055091
• 4. Boeddinghaus R, Whyte A. Trends in maxillofacial imaging. Clin Radiol. 2018;73(1):4–18. DOI: 10.1016/j.crad.2017.02.015
• 5. Elias FM, Goldenberg Birman E, Matsuda CK, Souza Oliveira IR, Jorge WA. Ultrasonographic findings in normal temporomandibular joints. Braz Oral Res. 2006;20(1):25–32. DOI: 10.1590/s1806-83242006000100006
• 6. Tamimi D, Kocasarac HD, Mardini S. Imaging of the temporomandibular joint. Semin Roentgenol. 2019;54(3):282–301. DOI: 10.1053/j.ro.2019.03.007 7. Özden M, Savaş S. Clinical Findings and Treatment Manifestations of Temporomandibular Disorders in Children and Young Adults: Review of The Literature. Journal of Ege University School of Dentistry. 2016;37(2):66–74. DOI: 10.5505/eudfd.2016.30306.
• 8. Siva Kalyan U, MoturiK Rayalu P. The role of ultrasound in diagnosis of temporomandibular joint disc displacement: a case control study. J Maxillofac Oral Surg. 2018;17:383–8. DOI: 10.1007/s12663-017-1061-4.
• 9. Butts R, Dunning J, Perreault T, Mettille J, Escaloni J. Pathoanatomical characteristics of temporomandibular dysfunction: Where do we stand? (Narrative review part 1). J Bodyw Mov Ther. 2017;21(3):534–40. DOI: 10.1016/j.jbmt.2017.05.017
• 10. Takashima M, Arai Y, Kawamura A, Hayashi T, Takagi R. Quantitative evaluation of masseter muscle stiffness in patients with temporomandibular disorders using shear wave elastography. J Prosthodont Res. 2017;61(4):432–8. DOI: 10.1016/j.jpor.2017.01.003
• 11. Muhtarogullari M, Demirel F, Saygili G. Temporomandibular disorders in Turkish children with mixed and primary dentition: prevalence of signs and symptoms. Turk J Pediatr 2004;46(2):159–63. PMID: 15214746
• 12. Seraj B, Ahmadi R, Mirkarimi M, Ghadimi S, Beheshti M. Temporomandibular disorders and parafunctional habits in children and adolescence: a Review. Journal of Dentistry of Tehran University of Medical Sciences. 2009;6(1):37–45.
• 13. Küçükeşmen Ç, Sönmez H. Temporomandiular joint dysfunction syndrome in children and adolescences S.D.Ü. Tıp Fak. Derg. 2007;14(3):39–47.
• 14. 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. PMID: 11290488
• 15. Barbosa Tde S, Miyakoda LS, Pocztaruk Rde L, Rocha CP, Gavião MB. Temporomandibular disorders and bruxism in childhood and adolescence: review of the literature. Int J Pediatr Otorhinolaryngol. 2008;72(3):299-314. DOI: 10.1016/j.ijporl.2007.11.006
• 16. Du J, Jiang Q, Mei L, Yang R, Wen J, Lin S, Li H. Effect of high fat diet and excessive compressive mechanical force on pathologic changes of temporomandibular joint. Sci Rep. 2020; 10(1):17457. DOI: 10.1038/s41598-020-74326-z
• 17. Assaf AT, Kahl-Nieke B, Feddersen J, Habermann CR. Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis? Dentomaxillofac Radiol. 2013;42(3):20110379. DOI: 10.1259/dmfr.20110379
• 18. Larheim TA, Westesson P, Sano T. Temporomandibular joint disk displacement: comparison in asymptomatic volunteers and patients. Radiology. 2001;218:428–32. DOI: 10.1148/radiology.218.2.r01fe11428