Abstract：
OBJECTIVE: Temporomandibular disorders (TMD) are the most common nonodontogenic cause of orofacial pain, leading to morbidity and impairment. TMD presents a diagnostic challenge due to many aetiologies that exhibit comparable symptoms and refer pain to the temporomandibular joint (TMJ) region. Patients may be referred to dental specialists without accounting for all pain sources. This study aims to identify radiographic confounders (RCs) that can be mistaken for TMD in patients undergoing TMJ assessment using cone-beam computed tomography (CBCT).
METHODS: A review of 369 CBCT oral maxillofacial radiology reports of the TMJ acquired between July 2020 and June 2023 was completed. Pertinent RCs were classified as endodontic lesions, impacted dentition, sinus pathologies, root fractures, soft tissue calcifications, and others. The chi-squared test assessed the significance of the relationship between RCs and patient variables.
RESULTS: A total of 283 RCs were identified in 202 of the 369 cases (54.7%). The most frequent findings included sinus abnormalities (32.5%), endodontic lesions (15.2%), impacted dentition (12.7%), and elongated/calcified stylohyoid process (9.2%). Significant associations were found between sinus pathologies with TMD signs (P = .009) and gender (P = .001).
CONCLUSIONS: Our results indicate that RCs that mimic TMD-related symptoms are prevalent in patients referred for TMJ CBCT imaging.
CONCLUSIONS: Clinicians should be aware of these RCs when diagnosing complaints related to the TMJ. We recommend clinicians first obtain dental clearance and investigate all other potential sources of a patient\'s complaint before initiating referrals to avoid unnecessary costs and delays in patient care.
METHODS: A review of 369 CBCT oral maxillofacial radiology reports of the TMJ acquired between July 2020 and June 2023 was completed. Pertinent RCs were classified as endodontic lesions, impacted dentition, sinus pathologies, root fractures, soft tissue calcifications, and others. The chi-squared test assessed the significance of the relationship between RCs and patient variables.
RESULTS: A total of 283 RCs were identified in 202 of the 369 cases (54.7%). The most frequent findings included sinus abnormalities (32.5%), endodontic lesions (15.2%), impacted dentition (12.7%), and elongated/calcified stylohyoid process (9.2%). Significant associations were found between sinus pathologies with TMD signs (P = .009) and gender (P = .001).
CONCLUSIONS: Our results indicate that RCs that mimic TMD-related symptoms are prevalent in patients referred for TMJ CBCT imaging.
CONCLUSIONS: Clinicians should be aware of these RCs when diagnosing complaints related to the TMJ. We recommend clinicians first obtain dental clearance and investigate all other potential sources of a patient\'s complaint before initiating referrals to avoid unnecessary costs and delays in patient care.
摘要：
目的：颞下颌关节紊乱病（TMD）是最常见的非牙源性口腔疼痛，导致发病率和损害。由于许多病因表现出可比的症状并将疼痛指向颞下颌关节（TMJ）区域，TMD提出了诊断挑战。患者可以转诊给牙科专家，而不考虑所有疼痛来源。这项研究旨在确定使用锥形束计算机断层扫描（CBCT）进行TMJ评估的患者中可能被误认为是TMD的放射学混杂因素（RC）。
方法：完成了对2020年7月至2023年6月之间获得的TMJ的369例CBCT口腔颌面放射学报告的审查。相关RC被归类为牙髓病变，阻生牙列,鼻窦病理学,根断裂,软组织钙化,和其他人。卡方检验评估了RC与患者变量之间关系的显著性。
结果：在369例中的202例（54.7%）中，共发现283个RCs。最常见的发现包括鼻窦异常（32.5%），牙髓病变（15.2%），阻生牙列(12.7%),茎舌骨突伸长/钙化(9.2%)。发现鼻窦病变与TMD征象（P=.009）和性别（P=.001）之间存在显着关联。
结论：我们的结果表明，模拟TMD相关症状的RCs在进行TMJCBCT成像的患者中普遍存在。
结论：临床医生在诊断与TMJ相关的投诉时应该注意这些RCs。我们建议临床医生在开始转诊之前首先获得牙齿清除，并调查患者投诉的所有其他潜在来源，以避免不必要的成本和患者护理的延误。
方法：完成了对2020年7月至2023年6月之间获得的TMJ的369例CBCT口腔颌面放射学报告的审查。相关RC被归类为牙髓病变，阻生牙列,鼻窦病理学,根断裂,软组织钙化,和其他人。卡方检验评估了RC与患者变量之间关系的显著性。
结果：在369例中的202例（54.7%）中，共发现283个RCs。最常见的发现包括鼻窦异常（32.5%），牙髓病变（15.2%），阻生牙列(12.7%),茎舌骨突伸长/钙化(9.2%)。发现鼻窦病变与TMD征象（P=.009）和性别（P=.001）之间存在显着关联。
结论：我们的结果表明，模拟TMD相关症状的RCs在进行TMJCBCT成像的患者中普遍存在。
结论：临床医生在诊断与TMJ相关的投诉时应该注意这些RCs。我们建议临床医生在开始转诊之前首先获得牙齿清除，并调查患者投诉的所有其他潜在来源，以避免不必要的成本和患者护理的延误。
