Abstract
Three-dimensional imaging methods are widely used for evaluation of bony changes of temporomandibular joint (TMJ). Besides, lateral and posterio-anterior TMJ projections in both closed- and open-jaw positions for each temporomandibular joint are used as two-dimensional diagnostic tools. The purpose of the present study was to compare effective and mean organ absorbed doses of plain radiography techniques with those of different modalities of cone beam computed tomography (CBCT) scanning of an adult’s temporomandibular joint. PCXMC 2.0 software was used to calculate mean organ and effective doses. A NewTom CBCT device (Newtom 5G XL; QR systems; Verona, Italy) was simulated at 360° rotation using a 6 × 6 cm2 FOV in standard and high-resolution modes. Lateral and posterio-anterior TMJ plain projections were simulated according to recommendations of the manufacturer of the Planmeca ProMax® 2D S3 device. Doses for both projections were simulated with Monte Carlo methods and the International Commission on radiological protection adult reference computational phantoms. The highest mean organ absorbed doses occurred in bone surfaces, salivary glands, and skull for posterio-anterior TMJ and lateral TMJ, and for CBCT scanning in all examinations. The effective doses of posterio-anterior and lateral TMJ plain radiographs were found to be higher than those of the Standard Mode-Eco Scan CBCT. Therefore, the lowest effective dose was calculated in Standard Mode-Eco Scan CBCT. It is concluded that NewTom 5G XL Standard Mode-Eco Scan CBCT can be used instead of plain radiographs (lateral and posterio-anterior TMJ) in temporomandibular joint imaging as it allows visualizing the three-dimensional structure of the temporomandibular joint as an advantage.
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The data that support the findings of this study are available from the corresponding author (HE) upon reasonable request.
References
Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL et al (2009) Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107(6):844–860
Annals of ICRP publication 103, Valentin J (ed) (2007) The 2007 recommendations of the international commission on radiological protection. Elsevier
Blaschke DD, Blaschke TJ (1981) Normal TMJ bony relationships in centric occlusion. J Dent Res 60(2):98–104
de Oliveira RL, Gaêta-Araujo H, Rosado LPL, Mouzinho-Machado S, Oliveira-Santos C, Freitas DQ et al (2023) Do cone-beam computed tomography low-dose protocols affect the evaluation of the temporomandibular joint? J Oral Rehabil 50(1):1–11
Distefano S, Cannarozzo MG, Spagnuolo G, Bucci MB, Lo Giudice R (2023) The “dedicated” C.B.C.T. in dentistry. Int J Environ Res Public Health 20(11):5954
Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 6(4):301–355
Ernst M, Manser P, Dula K, Volken W, Stampanoni MF, Fix MK (2017) TLD measurements and Monte Carlo calculations of head and neck organ and effective doses for cone beam computed tomography using 3D Accuitomo 170. Dentomaxillofac Radiol 46(7):20170047
Habets LL, Bezuur JN, Naeiji M, Hansson TL (1988) The Orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil 15(5):465–471
Hintze H, Wiese M, Wenzel A (2009) Comparison of three radiographic methods for detection of morphological temporomandibular joint changes: panoramic, scanographic and tomographic examination. Dentomaxillofac Radiol 38(3):134–140
Honey OB, Scarfe WC, Hilgers MJ, Klueber K, Silveira AM, Haskell BS et al (2007) Accuracy of cone-beam computed tomography imaging of the temporomandibular joint: comparisons with panoramic radiology and linear tomography. Am J Orthod Dentofacial Orthop 132(4):429–438
Im YG, Lee JS, Park JI, Lim HS, Kim BG, Kim JH (2018) Diagnostic accuracy and reliability of panoramic temporomandibular joint (TMJ) radiography to detect bony lesions in patients with TMJ osteoarthritis. J Dent Sci 13(4):396–404
Iskanderani D, Nilsson M, Alstergren P, Hellén-Halme K (2020) Dose distributions in adult and child head phantoms for panoramic and cone beam computed tomography imaging of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol 130(2):200–208
Könönen M, Kilpinen E (1990) Comparison of three radiographic methods in screening of temporomandibular joint involvement in patients with psoriatic arthritis. Acta Odontol Scand 48(4):271–277
Larheim TA, Kolbenstvedt A (1984) High-resolution computed tomography of the osseous temporomandibular joint. Some normal and abnormal appearances. Acta Radiol Diagn (stockh) 25(6):465–469
Librizzi ZT, Tadinada AS, Valiyaparambil JV, Lurie AG, Mallya SM (2011) Cone-beam computed tomography to detect erosions of the temporomandibular joint: Effect of field of view and voxel size on diagnostic efficacy and effective dose. Am J Orthod Dentofacial Orthop 140(1):e25–e30
Ludlow JB, Davies KL, Tyndall DA (1995) Temporomandibular joint imaging: a comparative study of diagnostic accuracy for the detection of bone change with biplanar multidirectional tomography and panoramic images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 80(6):735–743
Ludlow JB, Davies-Ludlow LE, White SC (2008) Patient risk related to common dental radiographic examinations: the impact of 2007 International Commission on Radiological Protection recommendations regarding dose calculation. J Am Dent Assoc 139(9):1237–1243
Mawani F, Lam EW, Heo G, McKee I, Raboud DW, Major PW (2005) Condylar shape analysis using panoramic radiography units and conventional tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99(3):341–348
Morant JJ, Salvadó M, Hernández-Girón I, Casanovas R, Ortega R, Calzado A (2013) Dosimetry of a cone beam CT device for oral and maxillofacial radiology using Monte Carlo techniques and ICRP adult reference computational phantoms. Dentomaxillofac Radiol 42(3):92555893
Okeson JP (1997) Current terminology and diagnostic classification schemes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83(1):61–64
Petersson A (2010) What you can and cannot see in TMJ imaging—an overview related to the RDC/TMD diagnostic system. J Oral Rehabil 37(10):771–778
Pullinger AG, Hollender L, Solberg WK, Petersson A (1985) A tomographic study of mandibular condyle position in an asymptomatic population. J Prosthet Dent 53(5):706–713
Salemi F, Shokri A, Mortazavi H, Baharvand M (2015) Diagnosis of simulated condylar bone defects using panoramic radiography, spiral tomography and cone-beam computed tomography: A comparison study. J Clin Exp Dent 7(1):e34–e39
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YD and HE were responsible for the conceptualization and acquisition of the data. RS and GCA were responsible for the methodology. YD, HE and RS were responsible for the writing, review, and/or revision of the manuscript. YD, HE, RS and GCA were responsible for the administrative, technical, or material support. All authors read and approved the final manuscript.
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Deniz, Y., Eren, H., Sessiz, R. et al. Comparison of CBCT radiation doses with conventional radiographs in TMJ imaging using Monte Carlo simulations. Radiat Environ Biophys 63, 39–45 (2024). https://doi.org/10.1007/s00411-023-01057-w
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DOI: https://doi.org/10.1007/s00411-023-01057-w