Tmj imaging

TMJ IMAGING
Dr.Manisha Saxena
2 nd year PG
Oral medicine and Radiology
27-04-2021

Contents
• Introduction to TMJ Imaging Modalities of TMJ
• 1. Imaging of osseous structures
• 2. Imaging of soft tissues
• 3. Abnormal Findings in TMJ
• 4. References
27-04-2021

Anatomy of TMJ
• TMJ is a ginglymo-diarthroidal joint that is freely mobile with superior
and inferior joint spaces separated by articular disc.
• “Ginglymus” meaning a hinge joint, allowing motion only backward and
forward in one plane,
• “Arthrodia” meaning a joint of which permits a gliding motion of the
surfaces
27-04-2021

Components of TMJ
• 1. Glenoid Fossa & Articular Eminence/Protuberance
• 2. Mandibular Condyle
• 3. Articular Disk & Capsule
• 4. Synovial Fluid
• 5. Discal Ligaments
• 6. Posterior Attachment or Retrodiscal Tissue or Bilaminar Zone
• 7. Ligaments associated with TMJ
• 8. Muscles of Mastication
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TMJ imaging technique
• 1. Plain radiography
• 2. Panormic radiography
• 3.CBCT
• 4. Ultrasonography
• 5. MRI
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TMJ Imaging
Osseous structure Soft tissue
Plain
radiography
Panormic
radiography
CT
CBCT
Arthrography
MRI
USG
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Imaging of osseous structure
27-04-2021

Plain radiography( Transcranial)
Most common and most well-established plain film technique for TMJ
This disadvantage is partly compensated for by the fact that most of the early
osseous changes occur laterally in the joint.
It visualize the sagittal view of the lateral aspects of condyle and temporal
component. It is taken in open and close mouth positions.
TMJ Imaging: A Review .Irfan Ashraf Baba..International Journal of Contemporary Medical Research ,
Volume 3 | Issue 8 | August 2016
An intensifying screen of 7 to 15 impulses with a fast film and exposure time
at 65 kVp and 10 mA is used.
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Film position: • flat against patients ear • Centered over TM joint of
interest • Against facial skin parallel to sagittal plane
Position of patient: Head adjusted so sagittal plane is vertical & ala tragus
line parallel to floor
Central Ray 1. The central ray is direct at an angle of 250 (+ve angulation)
from the opposite side, through the cranium and above the petrous ridge
of the temporal bone.
2. The horizontal angulation can be individually corrected for the condylar
long axis, or an average 200 anterior angle may be used.
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Transcranial view in closed and open mouth position
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Transpharyngeal view
• Central ray- Directed from opp side cranially at angle(-5 to -10 degrees)
• Beneath the zygomatic arch, through sigmoid notch posteriorly across
pharynx at the condyle
• Comparison of both condylar heads
Film placement-
Patient holds the cassette flat against patients Ear Centered over TM joint of
interest. Against facial skin parallel to sagittal plane ½ inch anterior to EAM.
It give a sagittal view of the medial pole of condyle.
The patient's mouth is open and a bite block is insert for stability.
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Transorbital projection
A anterior view of the TMJ, perpendicular to transcranial and
transpharyngeal projections.
It is done in open mouth position and depicts entire medial-lateral
aspect of condyle.
The cassette is placed behind the patient's head, perpendicular to the x-
ray beam. The patient open the mouth maximally .
This view is useful for visualize the condyle fractures.
X- ray beam is directed from the front of the patient through the
ipsilateral orbit from medial canthus of eye and TMJ of interest.
TMJ Radiography ( Imaging)
27-04-2021

• Film position – Behind the head
• Patient position – Cathomeatal line should be 10 degree to the
horizontal with the head tipped downwards.
• Central ray – Tube head in front of patient near the medial canthus of
ipsilateral eye.
• Directed at an angle of +20 degree to strike at right angle to cassette.
27-04-2021

Submentovertex projection
Useful for viewing condyles, zygomatic arches, base of skull and sphenoid
sinuses.
It demonstrate osseous changes from skull base tumors, fractures of
zygomatic arches and integrity and aeration of the sphenoid sinuses.
Image receptor –Positioned parallel to the patients transverse plane. Patient
neck is extended as backwards as possible with cathomeatal line parallel to
the image receptor.
Central beam is directed perpendicular to the image receptor, from below
the mandible towards the vertex of the skull.
White and Pharoah’s Oral radiology
27-04-2021

Panormic radiography
• Panoramic radiography does not appear in the list of imaging techniques
provided by RDC/TMD.
• Only the lateral part of the condyle can be assessed with this technique,
being limited due to the superimposition of the zygomatic arch and the
base of the skull .
• Panoramic radiography can help evaluate the following:
IMAGING MODALITIES FOR TEMPOROMANDIBULAR JOINT DISORDERS: AN UPDATE .DANIEL TALMACEANU et. Clujul Medical Vol. 91, No. 3, 2018: 280-287
Degenerative bone changes (only in late stages; it is inadequate for
the early detection of osseous modifications);
• asymmetries of the condyles,
• hyperplasia, hypoplasia;
• trauma and tumors
• Thick image layers
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The panoramic radiography does not reveal the functional status of the joint
and has a relatively low specificity and sensitivity when compared with CT .
Panoramic radiography: important asymmetry between right and left mandibular condyle
IMAGING MODALITIES FOR TEMPOROMANDIBULAR JOINT DISORDERS: AN UPDATE .DANIEL TALMACEANU et. Clujul Medical Vol. 91, No. 3, 2018: 280-
287
27-04-2021

Computed Tomography
• First used for TMJ evaluation in 1980 .
• CT is considered to be the best method for assessing osseous pathologic
conditions of TMJ. It allows a multi planar reconstruction , obtaining 3D
images in closed and opened-mouth positions .
• Signs of degenerative changes in the joint, like surface erosions,
osteophytes, remodeling, subcortical sclerosis, can be evaluated .
• Basically focus on : intactness of the cortex, normal size and shape of the
condyles and their centered position in the fossa, the adequate joint
spaces, centric relation loading zone.
27-04-2021

CBCT
• The main disadvantage of CT, compared to other radiological methods, is
the high cost and the radiation exposure.
• After being introduced in1990, CBCT is now most widely used
Low radiation
dose
High spatial
resolution
IMAGING MODALITIES FOR TEMPOROMANDIBULAR JOINT DISORDERS:
27-04-2021

• Studies developed by Hintze et al. found no significant differences
between conventional tomography and cone beam CT in the detection of
morphological TMJ changes.
• A review published by Silvia Caruso et al pointed out the main
contributions of cone beam CT in the field of TMJ:
287
27-04-2021

Cone beam CT of the right TMJ: flattening and erosions of the mandibular condyle. Sagittal plane (a),
coronal plane (b).
IMAGING MODALITIES FOR TEMPOROMANDIBULAR JOINT DISORDERS: AN UPDATE .DANIEL TALMACEANU et. Clujul Medical Vol. 91, No. 3, 2018:
280-287
27-04-2021

Cone beam CT of TMJ: left condyle hyperplasia (arrow). Coronal plane (a), axial plane (b).
287
27-04-2021

• Soft tissue evaluation is not
possible.
• Artifact may occur due to
patient movement
Limitation of CBCT
27-04-2021

MRI
• MRI is currently considered the reference method for imaging the soft
tissue structures of the TMJ (articular disc, synovial membrane, lateral
pterygoid muscle) .
• The best imaging modality in diagnosing disc displacements .
• MRI could also detect the early signs of TMJ dysfunction, like thickening of
anterior or posterior band, rupture of retrodiscal tissue, changes in shape
of the disc, joint effusion .
27-04-2021

• Images can be obtained in all planes (sagittal, axial, coronal).
• T1 weighted images – osseous tissue
• T2 – Inflammation and joint effusion.
• PD (proton density) – Visualize disc condyle relationship.
27-04-2021

• The slice thickness is important for image quality.
• The most frequent used section thickness is 3 mm. Reducing the slice
thickness improves the quality of the images, but requires longer scanning
time .
Sagittal, proton density, MRI of a normal TMJ: mouth-closed (a), mouth-opened (b). The disc (arrow) is in a correct
position
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Sagittal, proton density, MRI of an anterior disc displacement with reduction: mouth-closed (a), mouth-opened (b).
The displaced disc (arrow) returns to its normal position at maximal mouth opening.
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Drawings (sagittal oblique views) illustrate disk displacement in the closed-mouth position. (a) A
pathologic condition is considered to be present if the angle between the posterior band and the vertical orientation
of the condyle (twelve o’clock position) exceeds 10°.
(b) Rammelsberg et al recommended that anterior disk displacement of up to 30° be considered normal to better
correlate disk displacement with clinical
symptoms of TMJ dysfunction.
MR Imaging of Temporomandibular Joint Dysfunction: A Pictorial Review. Xavier Tomas. RadioGraphics 2006; 26:765–781
27-04-2021

Limitation of MRI
• The disadvantages of the MRI investigation-
1. It is costly and time consuming;
2. Restricted use in patients with claustrophobia;
3. There is a possibility of missing the portion of condyle having a pseudo
cyst .
27-04-2021

Ultrasonography
• It was first used for TMJ exploration in 1991, by Nabeih et al, using a 3.5
MHz transducer .
• Scanning transducer of 7.5–12 MHz frequency is presently used.
• Patient sits in semi reclining position.
• The transducer is placed over the joint parallel to the long axis of the
mandible.
• The disc is situated between two hyperechoic lines represented by the
mandibular condyle and the articular eminence .
TMJ Imaging: A Review .Irfan Ashraf Baba.International Journal of Contemporary Medical Research. Volume 3 | Issue 8 | August 2016
27-04-2021

• During the examination it is possible to directly observe the joint disk
move when the mouth is opening and closing.
• If the disc is displaced in the closed-mouth position, the diagnosis is
disc displacement. If the disc returns to its normal position during
opening, the diagnosis is disc displacement with reduction
• A 70–85 % agreement was seen in studies comparing the results of
MRI and USG.
27-04-2021

High-resolution US of an anterior disc displacement without reduction: mouth-closed (a), mouth-opened (b). 1 - articular
eminence; 2 – articular disc; 3 - mandibular condyle
IMAGING MODALITIES FOR TEMPOROMANDIBULAR JOINT DISORDERS: AN UPDATE .DANIEL TALMACEANU et. Clujul Medical Vol. 91, No. 3, 2018: 280-287
27-04-2021

Arthrography
• Nørgaard in the 1940s.
• Arthrography is indicated for an evaluation of the soft-tissue components
of the TMJ, especially disk position, function, and morphology in those
patients presenting with a suspected internal derangement .
Single
contrast
• Radiopaque dye is injected
in both joint spaces.
Double
contrast
• Small amount of air is
injected after dye
27-04-2021

Radionuclide imaging
• It is based on radiotracer method, which assumes that radioactive atoms or
molecules in an organism behave in a manner identical to that their stable
counterparts because they are chemically indistinguishable .
• The TMJ is ideal for SPECT (single proton emission computed tomography), as
TMJ is a small joint situated close to the skull base.
• In normal individual, the perfusion is symmetrical .
• Sensitivity is high, its specificity is low.
• Inflammation, trauma or tumors increase the local isotope concentration.
• Use as a screening method.
27-04-2021

Applied aspect
• Bifid condyle
• /double headed condyle
Coronal reformatted computed tomography image through the temporomandibular
joint (TMJ) demonstrates bifid left mandibular condyle. It can be noted that one of the
condyles (arrow) is smaller than the other. Advanced degenerative changes are noted
in bilateral TMJ.
Imaging of temporomandibular joint.Bag A K et al. WJR.August 28, 2014|Volume 6|Issue 8|
27-04-2021

Foramen of Huschke
Foramen of Huschke. Sagittal reformatted CT
image through the temporomandibular joint demonstrates a
focal defect (arrow) in the tympanic plate.
Persistence of developmental
defect in tympanic plate.
With growth , this defect changes in
position from inferior to anterior
and usually closes by the 5th year of
life. Rarely, a 3-4 mm defect persists.
It act as a path of communication
between the EAC and TMJ or
infratemporal fossa allowing the
spread of infection, inflammation or
tumor
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Condylar hypoplasia
• 1/2 brachial anomaly
• Treacher collins syndrome
Congenital
• Local-Trauma,infection
• Systemic – RA, toxic agents
Acquired
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OPG shows condylar aplasia on the right side, condylar hypoplasia on the left side, prominent
antigonial notch, and hypoplasia of mandible.
Condylar aplasia and hypoplasia –A rare case. Peeyush Shivhare. Case Report | Open Access
Volume 2013 |Article ID 745602
27-04-2021

Condylar hyperplasia
• Increase in volume of condyle
• Unilateral
• 2/3 decade of life.
• Causes- Hormonal influence on osteogenesis,
trauma
• Facial asymmetry
• Rotating chin towards affected side.
• Resection of the hyperplastic condyle causes the abnormal growth to cease
and restores facial symmetry
27-04-2021

Condylar hyperplasia. Panoramic reformation of the source CT data including both the
temporomandibular joints of a young patient demonstrates hyperplasia of the left condyle
in comparison to the right side.
27-04-2021

Coronoid hyperplasia
• An elongation of the coronoid process of the mandible.
• Acquired or developmental
• Most often diagnosed in young men who have a long history of
progressive limitation of mouth opening.
• Jacob disease- Prejoint develops between hyperplastic coronoid
process and posterior surface of zygoma.
27-04-2021

First case of bilateral coronoid hyperplasia in monozygotic twin sisters—a new aetiological perspective? Sunil Dixit Khandavilli 16
Sept.2016pages441–443(2016)
27-04-2021

Idiopathic condylar resorption
• Condylosis /“cheerleader syndrome.
• Teenage girls
• Rapidly progressing condylar erosion resulting in increased joint space.
27-04-2021

Causes Estrogen influence on osteogenesis
Avascular necrosis
TMJ internal derangement
27-04-2021

Morphologic changes in idiopathic condylar resorption with different degrees of bone loss
Author links open overlay panelYifanHeBS Vol.123 issue 3September 2019, Pages 332-
340
27-04-2021

Pneumatization
• Extensive pneumatization of the mastoid bone can involve the glenoid
fossa and articular eminence.
• Important to know before any TMJ surgery
• Complications can occur during TMJ surgery due to forceful flap retraction,
dissection or with placement of screws in cases where fossa-eminence
prostheses are required.
27-04-2021

Internal derangements of TMJ
• Internal derangement (ID) is defined as a mechanical fault of the joint that
interferes with smooth joint function.
• Disc displacement is the most common cause of ID.
• Up to 34% of asymptomatic volunteers can have anterior disc displacement
and 23% of patients with derangement can have normal disc positon.
• The displacement can be anterior, anterolateral, anteromedial, lateral,
medial and posterior.
• Anterior disc displacement can be – with reduction (ADR)
without reduction.(ADNR)
White and Pharoh’s Principles of Radiology
27-04-2021

• On MRI, the normal disc has a low signal intensity relative to the signal
from the joint space immediately surrounding it.
• In other words, the disc signal is lower (i.e., darker). In contrast, the signal
intensity of the posterior attachment is usually higher (i.e.,brighter).
• the normal biconcave disc has a “bow tie” shape
• In the closed mouth position, the normal disc is positioned with the thick
posterior band located either directly superior to or slightly anterior to the
condylar head.(12 ‘o clock)
• The thin intermediate zone of the disc is located anterior to the condyle.
• In all positions of mouth opening, the thin intermediate zone should
remain the articulating surface of the disc between the condyle and the
articular eminence.
27-04-2021

ADR
• Disc returns to normal position
on opening the mouth
producing “reciprocal click”
ADNR
• There is limited mouth opening
and deviation of the jaw to the
affected side(closed lock)
27-04-2021

Sagittal proton density weighted magnetic resonance imaging (MRI) in the closed mouth position demonstrates
anterior displacement of the disk (arrow) in front of the mandibular condyle (the letter, c); B: Sagittal proton
density weighted MRI in the open mouth position demonstrates reduction of the disk (arrow) between the
articular eminence (the letter, a) and the mandibular condyle (the letter, c).
27-04-2021

Posterior disc displacement is a rare entity and accounts for only
0.01% to 0.001% of all disc displacement.
27-04-2021

Sagittal T2-weighted magnetic resonance image shows fluid effusion in superior joint cavity (arrow) and
anterior displacement and folded deformity of articular disc (arrowhead
27-04-2021

Osteochondritis dissecans and avascular
necrosis
• Common clinical features of OCD/AVN of the mandibular condyle
include pain and joint disability. Pain is commonly over the joint and
along the third division of the trigeminal nerve.
• Radiologic changes of OCD and AVN of the mandibular condyle are
frequently associated with joint effusion and internal derangement of
the disc.
27-04-2021

Loose bodies/Joint mice
• Common clinical symptoms associated with loose bodies include pain,
periauricular swelling, decreased range of
jaw motion, crepitation and unilateral deviation of the jaw during mouth
opening.
Primary /secondary synovial chondromatosis.
27-04-2021

Ankylosis
• Fusion of mandibular condyle with glenoid fossa.
• Unable to open the mouth.
• Bony/Fibrous.
27-04-2021

27-04-2021
Use of indomethacin as an adjuvant to surgery for recurrent temporomandibular joint ankylosis in adults.NJOMS 2014
vol 5 issue 2
Krushna Bhat

Association between the clinical features of and types of temporomandibular joint ankylosis based on a modified classification
system Long Xia Scientific reports.19 July 2019
27-04-2021

TMJ osteoarthritis(DJD)
• Breakdown of the articulating fibrocartilage covering the bony components
of the joint leading to eventual deterioration of the osseous structures.
• DJD is thought to occur when the ability of the joint to adapt to excessive
joint loading forces.
Acute trauma ,hypermobility
Abnormal loading by parafunction habbit
Disc displacement
White and Pharoh Principles of Radiology 2 SA edition
27-04-2021

Imaging feature of TJD
• Osseous changes in DJD are more accurately depicted on CT images.
• manifest as small to large “bites” or “scoops” out of the articulating
surfaces of the joint, resulting in loss of the continuity of the cortices and
eventual loss of bone volume.
White and Pharoh Principles of Radiology 2 SA
edition
27-04-2021

Imaging Sci Dent. 2018 Mar;48(1):1-9.
Ely cyst
27-04-2021

Rheumatoid arthritis
• heterogeneous group of systemic disorders that manifests as synovial
membrane inflammation in several joints.
• The TMJ becomes involved in approximately 1/2 of affected patients.
• The characteristic imaging findings are a result of villous synovitis, which
leads to formation of synovial granulomatous tissue (pannus) that grows
into fibrocartilage and bone, releasing enzymes that destroy the articular
surfaces and underlying bone.
White and Pharoh Principles of Radiology 2 SA edition
27-04-2021

• Patients with TMJ involvement complain of swelling, pain, tenderness,
stiffness on opening, limited range of motion, and crepitus.
• The chin appears receded, and an anterior open bite is a common
finding because the condyles settle in an anterosuperior position as the
articulating components are progressively destroyed.
White and Pharoh’s Principles of radiology
27-04-2021

• CT imaging - assessment of the osseous .
• MRI - demonstrate the pannus, joint effusions, marrow edema, and disc
abnormalities
Bilateral TMJ Involvement in Rheumatoid Arthritis. Pritesh B. Ruparelia. Case Report | Open Access Volume 2014 |Article ID 262430
Scooped out area of
erosion in
posterosuperior aspect
of head of condyle
giving appearance of
mouthpiece of flute.
27-04-2021

Chondrocalcinosis/Pseudogout
• Acute /Chronic synovitis and ppt. of calcium pyrophosphate dihydrate
crystal in joint space.
• Classical gout –Monosodium urate monohydrate crystals.
Massive Calcium Pyrophosphate Dihydrate Crystal Deposition Disease: A Cause of Pain of the Temporomandibular Joint .Kathlyn Marsot-
Dupuch. American Journal of Neuroradiology May 2004, 25 (5) 876-879;
27-04-2021

Tumors of TMJ
Benign Tumors of Temporomandibular Joint.By Mehmet Emre Yurttutan. December 20th 2017 DOI: 10.5772/intechopen.72302
27-04-2021

Tumor like condition
• Synovial chondromatosis
• Synovial chondromatosis (SC) is a benign condition with
chondrometaplasia of the synovial membrane and formation of
cartilaginous nodules.
• These nodules can become detached and form loose bodies which later
calcify.
• Synovial chondromatosis typically involves large joints, such as the
knee, hip, and elbow. It is rare in TMJ.
• superior compartment of TMJ
• The radiologic findings of SC include calcified loose bodies, soft tissue
swelling, widening of the joint space, irregularities of the joint surface,
and sclerosis of the glenoid fossa and/or mandibular condyle.
27-04-2021

Axial CT image shows multifocal calcified loose bodies (arrow) within a low-attenuated soft tissue mass anterior to the
right mandibular condyle. (b) Coronal CT image also shows loose bodies (arrow). It shows bony erosion of glenoid fossa
(arrowhead) and widening of joint space but does not show extra-articular extension. (c) Follow-up CT obtained after 10
months confirms complete removal of intra-articular mass and calcifications and the absence of recurrence
Synovial chondromatosis in the temporomandibular joint: a case with typical imaging features and pathological findings
S W Lim.BJR. 2011 Nov; 84(1007): e215–e218.
27-04-2021

(a) T1 weighted (W) sagittal image shows multiple loose bodies, most of which have small and low
signal intensity (SI) within a soft tissue mass (arrows). The soft tissue mass shows high SI because of
fluid collection in it which represents expanded articular cavity. (b) Post-contrast T1W coronal MR image
shows a soft tissue mass (arrows) expanding into the right temporomandibular joint space.
27-04-2021

Malignant neoplasm
• Primary /Metastatic
• Primary rare include Chondrosarcoma, Osteosarcoma, Synovial sarcoma
and fibrosarcoma of joint capsule.
• Extrinsic malignant neoplasm may include Salivary gland malignancy,
rhabdomyosarcoma.
• Metastatic lesions originating from breast, kidney, , prostrate, lung and
thyroid .
27-04-2021

Dislocation
• Condyle outside the mandibular fossa but inside the capsule.
• Bilateral
• Condyle is displaced anteriorly and superiorly
• Inability to close the mouth
• Muscle spasm
• Reduction done by applying pressure in downward and backward
direction.
27-04-2021

Fractures
AOFoundationclassificationofhigh-neckandlow-neck
mandibular condylar fractures.
27-04-2021

Imaging of mandibular fractures: a pictorial review Cosimo Nardi. Insights into Imaging volume 11, Article number: 30 (2020)
27-04-2021

Coronoid process Fracture
Imaging of mandibular fractures: a pictorial review Cosimo Nardi. Insights into Imaging volume 11, Article number: 30 (2020)
27-04-2021

Diagnostic
task
Panormic Transcranial Skull views Tomograph
y
Arthrograph
y
CBCT MRI
Ankylosis
bony
0 0 0 ++ 0 +++ +
Ankylosis
fibrous
0 0 0 0 0 ++ +++
Arthritis + + 0 ++ 0 ++ +++
Anomaly + + + ++ 0 +++ ++
Disc
positions
0 0 0 0 ++ + +++
Fractures ++ + ++ ++ 0 +++ ++
Inflammator
y condition
0 0 0 + ++ + +++
Radiographic appearances of TMJ anomalies in relation to various imaging
techniques
TMJ Imaging: A Review Irfan Ashraf Baba International Journal of Contemporary Medical Research . Volume 3 | Issue 8 | August 2016
27-04-2021

Conclusion
• The reliability of a complex joint such as that of the jaw is the result of a
stable interaction of soft tissue and bony structures. In spite of its daily
exposure to wear and tear, simple changes in the TMJ are rare.
• Imaging of TMJ should be performed on a case by case basis
depending upon clinical signs and symptoms.
• Understanding of the TMJ anatomy, biomechanics, and the imaging
manifestations of diseases is important to accurately recognize and
manage these various pathologies.
27-04-2021

References
• TMJ Imaging: A Review .Irfan Ashraf Baba..International Journal of Contemporary Medical Research ,Volume 3 | Issue 8 |
August 2016
• IMAGING MODALITIES FOR TEMPOROMANDIBULAR JOINT DISORDERS: AN UPDATE .DANIEL TALMACEANU et. Clujul Medical Vol.
91, No. 3, 2018: 280-287
• Imaging of temporomandibular joint.Bag A K et al. WJR.August 28, 2014|Volume 6|Issue 8|
• Condylar aplasia and hypoplasia –A rare case. Peeyush Shivhare. Case Report | Open Access Volume 2013 |Article ID 745602
• Imaging of mandibular fractures: a pictorial review Cosimo Nardi. Insights into Imaging volume 11, Article number: 30 (2020)
• Imaging of mandibular fractures: a pictorial review Cosimo Nardi. Insights into Imaging volume 11, Article number: 30 (2020)
27-04-2021

• First case of bilateral coronoid hyperplasia in monozygotic twin sisters—a new aetiological perspective? Sunil Dixit Khandavilli 16
Sept.2016pages441–443(2016)
• Morphologic changes in idiopathic condylar resorption with different degrees of bone loss Author links open overlay
panelYifanHeBS Vol.123 issue 3September 2019, Pages 332-340
• Association between the clinical features of and types of temporomandibular joint ankylosis based on a modified classification
system Long Xia Scientific reports.19 July 2019
• Imaging Sci Dent. 2018 Mar;48(1):1-9.
• Bilateral TMJ Involvement in Rheumatoid Arthritis. Pritesh B. Ruparelia. Case Report | Open AccessVolume 2014 |Article ID 262430
• Massive Calcium Pyrophosphate Dihydrate Crystal Deposition Disease: A Cause of Pain of the Temporomandibular Joint .Kathlyn
Marsot-Dupuch. American Journal of Neuroradiology May 2004, 25 (5) 876-879
• Benign Tumors of Temporomandibular Joint.By Mehmet Emre Yurttutan. December 20th 2017 DOI: 10.5772/intechopen.72302
• Synovial chondromatosis in the temporomandibular joint: a case with typical imaging features and pathological findings
• S W Lim.BJR. 2011 Nov; 84(1007): e215–e218.
27-04-2021

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