Vergleichende Auswertung von Realtime(Echtzeit)-MRT-Aufnahmen des Kiefergelenks bei Bildraten von 3 und 15 Bildern pro Sekunde mit der klinischen Untersuchung anhand der RDC/TMD
von Kim Maureen Brinkmann geb. Runge
Datum der mündl. Prüfung:2023-02-16
Betreuer:Dr. Torsten Wassmann
Gutachter:Prof. Dr. Matthias Rödiger
Gutachter:Prof. Dr. Philipp Franz Meyer-Marcotty
EnglischMany anatomical structures are involved in the movement of the temporo mandibular joint and can lead to variety of pain in patients' joints. Valid diagnostic tools are necessary to find the correct diagnosis and therapy for patients with painful function of the TMJ. The number of affected patients in daily dentists´ lives is high. In the past, the RDC/TMD as a clinical examination sheet and the static MRI as an imaging tool was the gold standard to find pathologies in the TMJ. In this study, 34 subjects were clinically examined through the RDC/TMD and by imaging through the new technique of the real-time mri (videos with 15 frames/second resolution). The two diagnoses were compared. A high specificity was found for the new technique of realtime-mri. A high interrater agreement (kappa) of the three examiners (dentists) was found by evaluation of the visibility of the anatomy and physiology of joint structures. Also, a high intrarater agreement was verified by comparing the evaluation of the visibility of the structures in real-time mri videos with a resolution of 3 frames/second (a former study) and currently 15 frames/second. The latest resolution leads to even better visibility of some joint structures in dynamic movements, especially disc displacements, which is important in evaluating the function or also the efficiency of therapeutic methods, which is not given through static mri imaging. Another advantage is the improved efficiency and higher patients comfort by reducing the recording times. A larger cohort of patients is necessary to emphasize these results. Regarding the future, the modification of the RDC/TMD to DC/TMD and the development from single to multi-slice, simultaneous recordings of both joints in different sections implies even more validity in examining orofacial pain.
Keywords: Temporo mandibular disorder; Real time mri; RDC/CMD; TMD diagnosis; temporo mandibular joint; Imaging of TMJ