IMPACT OF TMJ RADIOGRAPHS ON CLINICIAN DECISION-MAKING

Objectives. This study examined the influence of lateral and frontal t emporomandibular joint tomograms on the initial diagnosis and treatmen t plan of patients having facial or preauricular pain or temporomandib ular joint disorders. Study design. Five or six general dentists, all with experience in treating patients with disorders of the temporOmand ibular joint, examined records of 105 patients from a university-based orofacial pain clinic. The examiners proposed a diagnosis and treatme nt plan for each patient without the benefit of tomograms. They then r epeated this procedure after study of the radiographs. The impact of t he radiographs was measured as the change in pre- versus postradiograp hic diagnosis and treatment plan. Results. The availability of temporo mandibular joint tomograms changed or modified diagnosis in 65% of the judgments and influenced treatment recommendations in 40%. These chan ges were substantive for 21% of the diagnoses and 22% of the treatment plans. The strongest correlation in both diagnosis and treatment plan was with radiographic detection of osseous changes. New information a bout condyle position had less effect on clinical decisions. Conclusio ns. These findings indicate that temporomandibular joint tomograms pla y a valuable role in influencing clinician's diagnosis and treatment p lan of patients with disorders of the temporomandibular joint.