The utility of panoramic imaging of the temporomandibular joint in patients with temporomandibular disorders

Objective. The objective of this study was to evaluate the utility of panoramic imaging in assessment of patients with temporomandibular disorders (TMDs). Study design. Fifty-five consecutive patients referred for diagnosis and management of facial pain and jaw dysfunction were included. A single examiner completed the history and clinical examination on all patients. All patients received panoramic imaging. On the basis of clinical and radiographic findings, a subset of patients received advanced imaging modalities. The panoramic radiographs were interpreted by 2 examiners; if any disagreement was noted, a third examiner interpreted the radiographs. Results. Seventy-five percent of the patients had complaints of facial pain, and 75 h exhibited tenderness in masticatory muscles. Tenderness was present in TM joint regions in 62%. Altered bony anatomy was seen in 43.6% of panoramic radiographs. Panoramic imaging did not lead to changes in clinical diagnosis in any of the patients seen, although the findings on the radiographs did lead to requests for additional imaging studies in 3 cases, one of which was later referred for surgical intervention because of radiographic findings. Conclusion. Clinical findings may be of greater relevance leading to the diagnoses associated with TMD and to determination of the need for additional imaging rather than the use of panoramic imaging in all patients with facial lain and TMD.