TMJ Radiography

1. TMJ Radiography • Jon K. Park, D.D.S., M.S. • University of Maryland School of Dentistry • Department of Oral Medicine • Baltimore, MD 21201

2. TMJ Radiography • Radiographs Used • Panoramic • Lateral Transcranial • Transmaxillary • PA Towne • Tomogram • Lateral • PA Tomo • CT • MRI

3. TMJ Radiography • Panoramic • Used as a “scout” film

4. TMJ radiographs • Lateral Transcranial • Generally taken in “rest, closed, and open” positions • Shows condylar morphology, lateral aspect • Not good for evaluation of condylar position

5. TMJ radiography • Transmaxillary • Taken in open position • Evaluates the superior aspect of the condyles from medial to lateral • Taken through orbit, AP view

6. Lateral Transcranial • Use TMJ Board • X-ray tube position • 11 deg. Down • 1 in above and 1 inch behind EAM • Align with opposite condyle

7. TMJ radiography • PA Towne • Taken in the “open” position • Evaluates medial and lateral poles of condyle • Patient must be able to open adequately for this film to be of any use

8. TMJ Tomogram • Lateral • Evaluates condylar position and condylar morphology • Lateral, Open view • Evaluates condylar translation • PA Tomogram

9. TMJ CT and MRI • CT • Evaluates osseous and soft tissue components • Generally does not show the meniscus • MRI • Good for assessing the meniscus and soft tissue

10. TMJ Arthrography • Demonstrates meniscus • Must be done under fluoroscopy • Radiopaque dye injection • Contraindicated with iodine sensitive patients

11. Lateral transcranial radiograph Closed Open Rest

12. Lateral Transcranial – closed view

40. Transpharyngeal (Parma) view

41. MRI

42. MRI - TMJ

47. Flattening of the condyle

48. TMJ Radiography • Jon K. Park, D.D.S., M.S. • University of Maryland School of Dentistry • Department of Oral Medicine • Baltimore, MD 21201