Evaluation of Diagnostic Criteria from Computerized Axiography to Detect Internal Derangements of the TMJ

ABSTRACT

Objective of this study was to evaluate the diagnostic value of 3-D computed axiography to detect anterior disk displacements (ADD) of the TMJ. 65 patients with MRI confirmed ADD with reduction and 27 patients with ADD without reduction were examined by 3-D computed axiography. 44 healthy volunteers with normal disk position and joint function served as controls. A descriptive analysis of the axiographic opening/closing cycle revealed significantly higher rates of abrupt deviations, accelerations/decelerations, and crossings for ADD with reduction compared to healthy volunteers. A new axiographic index reduced the number of false positive to 10% and false negative to 14% of the diagnosis. ADD without reduction was characterized by significantly shorter opening curves. The optimum split point at 11 mm, resulted in 10% false positive and 20% false negative diagnosis. However, the diagnostic value of computed axiography was reduced by the significant influence of the clicking or limited joint on the contralateral TMJ.

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Notes on contributors

Peter Rammelsberg

Dr. Peter Rammelsberg received his M.D. degree from the University of Wuerzburg, Germany in 1985 and his D.D.S. degree from the same university in 1986. From 1985 to 1986 Dr. Rammelsberg was an assistant in the Department of Periodontics at the University of Wuerzburg. From 1986–1991 he was an assistant at the University of Regensburg, Germany, Department of Prosthodontics (including removable and fixed prosthodontics and TMJ). Since 1991, Dr. Rammelsberg has been a Professor in the Department of Prosthodontics at the University of Munich.

Peter Pospiech

Dr. Peter Reinhard Pospiech received his M.D. degree in 1987 from the University of Duesseldorf, Germany, and his D.D.S. degree in 1988 from the same university. From 1987 to 1990 Dr. Pospiech was an assistant in the Department of Prosthodontics at the University of Regensburg. Since 1991 he has been a Professor in the Department of Prosthodontics at the University of Munich.

Hans C. May

Dr. Hans-Christian May received his M.D. degree from the University of Hamburg, Germany in 1990. He has been with the Department of Prosthodontics at the University of Munich since 1991, and he received his D.D.S. degree in 1995 from the University of Munich, Germany.

Wolfgang Gernet

Dr. Wolfgang Gernet received his M.D. degree from the University of Freiburg in 1973 and his D.D.S. degree from the same university in 1974. From 1974 to 1984 Dr. Gernet was an assistant and professor at the Department of Prosthodontics at the University of Freiburg. He became Director of the department in 1984 and served in that capacity until 1990. He was also Dean of the Faculty of Medicine at the University of Regensburg from 1987 to 1989. Since 1990 Dr. Gernet has been the Director of the Department of Prosthodontics at the University of Munich, Germany.