Diagnosis of TMJ problems made a significant leap forward with the development of Magnetic Resonance Imaging. The MRI is now considered the gold standard in diagnosing disk displacement and degenerative joint disease (DJD). As early as the late 1980’s, the efficacy of using MRI in diagnosing TMJ problems has been referenced in the literature. Fortunately, the dental profession is now recognizing its value, and referring patients for such diagnostic testing.
The beauty of this system is that the images are not captured through the use of x-rays, and thus, there is no radiation exposure to the patient. As its name implies, the MRI captures images by placing a magnetic field around the body. Every cell in the body has a charge. The result is an image that will show the disk (that has no water in it), the bone (full of fat), and muscle (which is a little of both). Patients are guided by the X-ray tech to lie in the magnetic chamber, and then instructed to place the custom bite impressions in their mouth at the correct time. The entire procedure takes about 45 minutes.
The images will be sent to the ordering doctor who will go over it with the patient to explain what the images show, as well as going over the report provided by the radiologist. If the doctor has requested an MRI, there is suspicion that there is damage in one or both of the TMJ’s. Frequently, the problem can be managed conservatively; if not, alternate options for treatment will be discussed.
The MRI has taken the guesswork out of obtaining accurate diagnosis of joint problems. It also helps the patient better understand the nature of their problem by providing a clear understanding of the long-term prognosis of the condition.
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