Clinical findings and associated MRI findings of temporomandibular joint disc degeneration

Background: Temporomandibular disorders (TMD) present with a wide spectrum of symptoms, and many of these are linked to structural changes within the temporomandibular joint (TMJ). Degenerative changes of the TMJ disc, including thinning, perforation, and positional changes, are common in symptomatic patients. MRI is the gold standard for evaluating soft tissues, but the relationship between clinical findings and specific MRI-detected disc degenerations remains unclear. This study aims to review the clinical symptoms reported by patients with TMD and evaluate if these symptoms are linked to MRI findings. Methods: Clinical examinations were conducted on patients presenting with TMJ discomfort between September 2019 and December 2023. Inclusion criteria were patients with suspected TMD who underwent bilateral TMJ MRI with both open- and closed-mouth scans. Exclusion criteria included history of head and neck radiotherapy, previous TMJ treatment or maxillofacial surgery, presence of intense artifacts, and lack of both open- and closed-position TMJ MRI scans. 180 TMJs from 90 patients (60 females, 30 males; mean age 33.5 years, range 15–59) were evaluated. Clinical symptoms such as pain, joint sounds, and trismus were recorded, and MRIs were assessed for TMJ disc position, disc displacement degree, disc degeneration, and TMJ effusion. Results: Statistically significant differences were found in trismus between sexes, with a higher incidence in females (p = 0.04). MRI revealed 112 joints with disc displacement with reduction (DDwR), 51 with displacement without reduction (DDwoR), and 17 healthy joints. Structural abnormalities were observed in 104 TMJs (57.8%), most frequently disc thinning. Pain and osteoarthritis were markedly more prevalent in DDwoR. Conclusions: This study confirmed significant links between clinical symptoms and TMJ disc degeneration. DDwoR was associated with more severe symptoms, including pain and osteoarthritis. MRI remains essential for diagnosing TMJ disorders and guiding treatment. Further prospective studies are needed to validate these findings.

MRI; Temporomandibular disorders; Disc degeneration

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