Bone Marrow, Magnetic Resonance Imaging, Temporomandibular Joint Disc Displacement
Conditions
Brief summary
To evaluate the presence of TMJ disc perforation on MRI and investigate its associations with internal disc derangements, disc configuration, condylar bone marrow signal patterns, joint effusion, and demographic or clinical variables such as age, sex, dental status, and pain severity.
Detailed description
This study will prospectively evaluate temporomandibular joint (TMJ) disc perforation using magnetic resonance imaging (MRI) in a diverse adult population. The investigation will focus on identifying the prevalence of disc perforation and examining its relationship with key TMJ structural and functional parameters. Specifically, the study will assess internal disc derangements, variations in disc morphology, condylar bone marrow signal characteristics, and the presence of joint effusion. In addition, demographic and clinical factors-including age, sex, dental status, and pain severity-will be analyzed to determine their potential association with disc perforation. MRI-based assessments will be performed using standardized imaging protocols, and all findings will be systematically recorded and evaluated. By integrating radiologic and clinical data, the study aims to improve the understanding of factors contributing to TMJ disc perforation and to support future diagnostic and therapeutic strategies.
Interventions
None listed
Sponsors
Recep Tayyip Erdogan University Training and Research Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
14 Years to 79 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients with available temporomandibular joint (TMJ) MRI scans (both open- and closed-mouth) * Age ≥14 years * Complete clinical records including Visual Analogue Scale (VAS) pain scores and dental status * Willingness to participate in the study and provide informed consent (for prospective studies)
Exclusion criteria
* Presence of systemic disorders affecting bone metabolism, including rheumatoid arthritis, chronic systemic corticosteroid therapy, Paget's disease, hypo- or hyperparathyroidism, osteomalacia, or renal osteodystrophy * History of medications that could alter bone architecture * Current orthodontic treatment * History of head and neck trauma or surgery * Presence of head and neck cystic or tumoral pathology * Prior radiotherapy or chemotherapy * Pregnancy * Presence of ferromagnetic objects in the head (contraindication to MRI)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of TMJ Disc Perforation | At MRI assessment (baseline, single time point) | Dichotomous outcome (Yes/No) indicating the presence of temporomandibular joint disc perforation, determined from closed- and open-mouth MRI images assessed by an experienced radiologist/oral and maxillofacial surgeon. Unit of Measure: Percentage of joints with MRI-confirmed disc perforation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disc Position (Closed/Open-mouth) | At MRI assessment (baseline) | Categorical: Normal, Anterior Disc Displacement with Reduction (ADDWR), Anterior Disc Displacement without Reduction (ADDWoR). Determined by posterior band position relative to condyle on closed- and open-mouth images. Unit of Measure: Percentage of joints in each internal disc status category |
| Condylar Bone Marrow Signal Pattern | At MRI assessment (baseline) | Categorical: Normal, Edema, Sclerosis, Combined Edema and Sclerosis. Proportion of joints with each signal pattern on PDWI and T2WI. Unit of Measure: Percentage of joints in each bone marrow signal pattern category |
| Disc Configuration Distribution | At MRI assessment (baseline) | Categorical outcome describing temporomandibular joint disc morphology classified as biconcave, concave, flattened, folded, amorphous, or perforated, determined from closed-mouth MRI images evaluated by an experienced radiologist/oral and maxillofacial surgeon. Unit of Measure: Percentage of joints in each disc morphology category |
| Pain Severity (VAS per TMJ) | At clinical assessment coincident with MRI (baseline): retrospective clinical data | Continuous outcome describing temporomandibular joint pain intensity, measured using the Visual Analogue Scale (VAS; 0-10) as reported by patients and recorded by an oral and maxillofacial surgeon. Unit of Measure: Mean VAS pain score per joint (0-10) |
| Dental Status | At clinical assessment (baseline): retrospective clinical data | Discrete outcome describing the number of missing permanent teeth, with individual tooth numbers recorded according to the dental charting system. Unit of Measure: Number of missing teeth per patient |
| Joint Effusion Grade | At MRI assessment (baseline) | Ordinal: Grade 0-3 on T2WI (Grade 0 = no effusion; Grade 1 = dot/linear; Grade 2 = bands; Grade 3 = accumulation). Distribution of effusion grades. Unit of Measure: Percentage of joints in each effusion grade |
Countries
Turkey (Türkiye)
Outcome results
None listed