Department of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
Department of Biomedical Imaging and Image-guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, Austria.
J Anat. 2019 May;234(5):718-727. doi: 10.1111/joa.12951. Epub 2019 Feb 20.
Temporomandibular joint disorders (TMD) are common dysfunctions of the masticatory region and are often linked to dislocation or changes of the temporomandibular joint (TMJ) disc. Magnetic resonance imaging (MRI) is the gold standard for TMJ imaging but standard clinical sequences do not deliver a sufficient resolution and contrast for the creation of detailed meshes of the TMJ disc. Additionally, bony structures cannot be captured appropriately using standard MRI sequences due to their low signal intensity. The objective of this study was to enable researchers to create high resolution representations of all structures of the TMJ and consequently investigate morphological as well as positional changes of the masticatory system. To create meshes of the bony structures, a single computed tomography (CT) scan was acquired. In addition, a high-resolution MRI sequence was produced, which is used to collect the thickness and position change of the disc for various static postures using bite blocks. Changes in thickness of the TMJ disc as well as disc translation were measured. The newly developed workflow successfully allows researchers to create high resolution models of all structures of the TMJ for various static positions, enabling the investigation of TMJ disc translation and deformation. Discs were thinnest in the lateral part and moved mainly anteriorly and slightly medially. The procedure offers the most comprehensive picture of disc positioning and thickness changes reported to date. The presented data can be used for the development of a biomechanical computer model of TMJ anatomy and to investigate dynamic and static loads on the components of the system, which could be useful for the prediction of TMD onset.
颞下颌关节紊乱(TMD)是咀嚼区域常见的功能障碍,常与颞下颌关节(TMJ)脱位或关节盘改变有关。磁共振成像(MRI)是 TMJ 成像的金标准,但标准临床序列无法提供足够的分辨率和对比度来创建 TMJ 盘的详细网格。此外,由于骨结构的信号强度低,标准 MRI 序列无法适当地捕获它们。本研究的目的是使研究人员能够创建 TMJ 所有结构的高分辨率表示,并因此研究咀嚼系统的形态和位置变化。为了创建骨结构的网格,仅采集了一次计算机断层扫描(CT)。此外,还产生了一种高分辨率 MRI 序列,该序列用于使用咬合块收集各种静态姿势下的盘片厚度和位置变化。测量了 TMJ 盘片的厚度变化和盘片移位。新开发的工作流程成功地允许研究人员为各种静态位置创建 TMJ 所有结构的高分辨率模型,从而能够研究 TMJ 盘片移位和变形。盘片在外侧部分最薄,主要向前和稍微向内侧移动。该程序提供了迄今为止报告的盘片定位和厚度变化的最全面的图像。所提供的数据可用于开发 TMJ 解剖的生物力学计算机模型,并研究系统组件的动态和静态负载,这对于预测 TMD 的发生可能很有用。