Fuessinger Marc Anton, Russe Maximilian Frederik, Brandenburg Leonard Simon, Metzger Marc Christian, Schulze Johannes, Schlager Stefan, Semper-Hogg Wiebke
Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
Department of Radiology, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
BMC Oral Health. 2025 May 10;25(1):709. doi: 10.1186/s12903-025-06081-4.
Osseous pathologies of the temporomandibular joint (TMJ) such as degenerative joint disease, trauma, and deformity contribute to orofacial morbidity and are considered a major factor in temporomandibular dysfunction. Cone beam computed tomography (CBCT) is a recommended diagnostic tool in imaging of osseous tissue pathologies. However, CBCT contributes to patient radiation exposure, and limiting the CBCT field of view (FOV) may reduce it. This study aims to investigate the possibility and clinical applicability of optimizing the size and location of the FOVs for CBCT capture of the TMJ.
Three-dimensional CBCT data sets in which the bilateral positions and dimensions of the TMJs were analyzed. A total of 201 data sets with 402 condyles were mapped in relation to the CBCT device. By transformation into a common coordinate space using the device's chin rest as a joint denominator, we were able to determine the optimal size and location for uni- and bilateral capture of the TMJ for both best-case and worst-case scenarios with regard to patient positioning.
The minimal FOVs for unilateral capture were H 28.2 mm × R 22.9 mm in the best-case scenario assuming optimal patient positioning and H 47.0 mm × R 28.3 mm in the worst-case scenario with rotational deviation along the transversal axis. For bilateral capture, we determined the best-case FOV as H 24.9 mm × R 66.5 mm and the worst-case FOV as H 42.8 mm × R 66.7 mm.
This research yields indication-specific FOVs for both uni- and bilateral imaging of the TMJ. Considering the best clinical practices for CBCT imaging, clinically feasible FOV dimensions in consideration of the technical specifications of common CBCT devices can be suggested. The clinical application of the results may help reducing radiation exposure of patients receiving CBCT imaging of the TMJ. The transferability of the present results to other CBCT devices requires further research.
The study is registered in the German Trial Register with the number DRKS00026149, 2024/02/21.
颞下颌关节（TMJ）的骨性病变，如退行性关节病、创伤和畸形，会导致口面部疾病，被认为是颞下颌功能障碍的主要因素。锥形束计算机断层扫描（CBCT）是骨组织病变成像中推荐的诊断工具。然而，CBCT会增加患者的辐射暴露，限制CBCT视野（FOV）可能会减少辐射。本研究旨在探讨优化CBCT采集颞下颌关节时FOV的大小和位置的可能性及临床适用性。
分析颞下颌关节双侧位置和尺寸的三维CBCT数据集。总共201个数据集（包含402个髁突）与CBCT设备相关联进行映射。通过以设备的颏托作为共同分母转换到共同坐标空间，我们能够确定在患者定位的最佳和最坏情况下单侧和双侧采集颞下颌关节的最佳大小和位置。
在假设患者定位最佳的最佳情况下，单侧采集的最小FOV为H 28.2 mm×R 22.9 mm；在沿横轴有旋转偏差的最坏情况下，单侧采集的最小FOV为H 47.0 mm×R 28.3 mm。对于双侧采集，我们确定最佳情况下的FOV为H 24.9 mm×R 66.5 mm，最坏情况下的FOV为H 42.8 mm×R 66.7 mm。
本研究得出了颞下颌关节单侧和双侧成像的特定适应症FOV。考虑到CBCT成像的最佳临床实践，可以根据常见CBCT设备的技术规格提出临床上可行的FOV尺寸。该结果的临床应用可能有助于减少接受颞下颌关节CBCT成像患者的辐射暴露。本研究结果对其他CBCT设备的可转移性需要进一步研究。
该研究已在德国试验注册中心注册，注册号为DRKS00026149，注册日期为2024年2月21日。
