X-ray diagnosis of temporomandibular disorders combined with the pathology of the cervical spine

Abstract

Relevance. Given the high prevalence of temporomandibular disorders and the multiple causes of the disease, specialists assign an important role to the rational diagnosis of temporomandibular disorders.
Material and methods. The study included 84 patients aged 21 to 55 years old. Of these, 69 patients were diagnosed with temporomandibular disorders. They formed group 1. The 2nd control group included 15 patients without TMDs (with no complaints of the dentoalveolar system). All patients underwent X-ray diagnosis: cone beam computed tomography (CBCT) 200 x 170 mm of the skull, including the area of C1 and C2 cervical vertebrae in the closed and open mouth position. The study used the Planmeca ProMax® 3D CT scanner.
Results. All examined patients with TMDs showed the spinous process deviation angles α from the Y axis (p ≤ 0.001), which indicated 100% involvement of the cervical spine in this pathology. Subgroup A comprised 60.1% of the subjects, where the mean angle in the closed mouth position was 12.90 ± 0.55 degrees, and in the open mouth position, the mean value was 9.2 ± 0.48 degrees, the deviation angle decreased by an average of 3.7 degrees. Subgroup B included 39.9% of the subjects, where the average value was 4.50 ± 0.66 degrees in the closed mouth position and 8.40 ± 0.75 degrees in the open mouth position. The angle of deviation increased by 3.9 degrees.
Conclusion. In patients with temporomandibular disorders, the proposed method of CBCT diagnosis (200 x 170) allows detection of the cervical spine (C2 region) pathology by one axial view image in the closed and open mouth position.