CT and MRI in temporomandibular joint diagnosis

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This systematic review looked at the evidence for the diagnostic thinking efficacy and therapeutic efficacy of computed tomography (CT) and (magnetic resonance imaging) MRI in temporomandibular joint disorders (TMJD).  Medline, the Cochrane Library databases and reference list of review articles were searched. Publications considered relevant were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool and publications that critically evaluate systematic reviews.

Only one study was judged relevant. This study evaluated evidence of the efficacy of MRI in the diagnosis of disc position and configuration, disc perforation, joint effusion, and osseous and bone marrow changes in the temporomandibular joint, but no publication reported diagnostic thinking efficacy or therapeutic efficacy.

The authors concluded:

the absence of studies on the therapeutic efficacy of MRI and CT on TMJD reinforces the need for investment in decision-making studies; meanwhile, sectional imaging tests should be prescribed with caution, especially when health budgets are limited.

Ribeiro-Rotta RF, Marques KD, Pacheco MJ, Leles CR. Do computed tomography and magnetic resonance imaging add to temporomandibular joint disorder treatment? A systematic review of diagnostic efficacy. J Oral Rehabil. 2011 Feb;38(2):120-135.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. He is a former editor of the Evidence-Based Dentistry Journal, the chief blogger for the Dental Elf website and a past president of the British Association for the Study of Community Dentistry. He has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Retired from the NHS he is currently a part-time senior lecturer at Dundee Dental School.

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