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 panor amic imaging in assessment of patients with temporomandibular disorders (TM Ds). Study design. Fifty-five consecutive patients referred for diagnosis and ma nagement of facial pain and jaw dysfunction were included. A single examine r completed the history and clinical examination on all patients. All patie nts received panoramic imaging. On the basis of clinical and radiographic f indings, a subset of patients received advanced imaging modalities. The pan oramic 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 pres ent in TM joint regions in 62%. Altered bony anatomy was seen in 43.6% of p anoramic radiographs. Panoramic imaging did not lead to changes in clinical diagnosis in any of the patients seen, although the findings on the radiog raphs did lead to requests for additional imaging studies in 3 cases, one o f which was later referred for surgical intervention because of radiographi c findings. Conclusion. Clinical findings may be of greater relevance leading to the di agnoses associated with TMD and to determination of the need for additional imaging rather than the use of panoramic imaging in all patients with faci al lain and TMD.