title: The utility of panoramic imaging of the temporomandibular joint in patients with temporomandibular disorders.
abstract: OBJECTIVE
  The objective of this study was to evaluate the utility of panoramic imaging in assessment of patients with temporomandibular disorders (TMDs).
  
  
  METHODS
  Fifty-five consecutive patients referred for diagnosis and management of facial pain and jaw dysfunction were included. A single examiner completed the history and clinical examination on all patients. All patients received panoramic imaging. On the basis of clinical and radiographic findings, a subset of patients received advanced imaging modalities. The panoramic radiographs were interpreted by 2 examiners; if any disagreement was noted, a third examiner interpreted the radiographs.
  
  
  RESULTS
  Seventy-five percent of the patients had complaints of facial pain, and 75% exhibited tenderness in masticatory muscles. Tenderness was present in TM joint regions in 62%. Altered bony anatomy was seen in 43.6% of panoramic radiographs. Panoramic imaging did not lead to changes in clinical diagnosis in any of the patients seen, although the findings on the radiographs did lead to requests for additional imaging studies in 3 cases, one of which was later referred for surgical intervention because of radiographic findings.
  
  
  CONCLUSIONS
  Clinical findings may be of greater relevance leading to the diagnoses associated with TMD and to determination of the need for additional imaging rather than the use of panoramic imaging in all patients with facial pain and TMD.
authors.affiliation: Department of Dentistry,, Vancouver Hospital and Health Sciences Centre, British Columbia, Canada.
authors.forename: J B
authors.initials: JB
authors.lastname: Epstein
authors.forename: J
authors.initials: J
authors.lastname: Caldwell
authors.forename: G
authors.initials: G
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000000981:diagnostic imaging; D002648:Child; D005157:Facial Pain / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006261:Headache / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D008410:Masticatory Muscles / Q000503:physiopathology; D008875:Middle Aged; D015588:Observer Variation; D010003:Osteoarthritis / Q000000981:diagnostic imaging; D011862:Radiography, Panoramic; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging*; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014056:Tomography, X-Ray; D014057:Tomography, X-Ray Computed; D014963:X-Ray Intensifying Screens