The utility of panoramic radiography in temporomandibular joint assessment.
OBJECTIVE
Panoramic radiography was used to determine (1) intrarater and inter-rater reliability in assessing temporomandibular joint (TMJ) condylar morphology; (2) alteration in condylar shape in patients with temporomandibular disorders (TMD) and controls when matched by age, gender, and state of dentition; and (3) prevalence of condylar abnormalities in individuals with and without TMD.


METHODS
One hundred panoramic radiographs were randomly selected from a hospital clinic (45 TMD and 55 non-TMD patients). The images were cropped to include only the temporomandibular apparatus and were independently evaluated by three examiners without knowledge of the patient's clinical status. Multiple statistical tests were performed to evaluate the accumulated data.


RESULTS
Intrarater reliability demonstrated substantial agreement, while inter-rater reliability was fair. There was no difference in condylar morphology between patient groups, but mild condylar change was prevalent in all age groups, regardless of TMD status.


CONCLUSIONS
Morphological condylar abnormalities are present on panoramic images in all adult age ranges, regardless of status of the dentition or presence of TMD. Condylar shape alone is not an indicator of TMD, and minor condylar discrepancies may have no significance in TMD.
Crow
H C
HC
Department of Oral Diagnostic Sciences, TMD and Orofacial Pain Program, University at Buffalo, Buffalo, NY 14214, USA. hccrow@buffalo.edu
Parks
E
E
Campbell
J H
JH
Stucki
D S
DS
Daggy
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005096:Exostoses / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015588:Observer Variation; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*