To evaluate the presence of TMJ disc perforation on MRI and investigate its associations with internal disc derangements, disc configuration, condylar bone marrow signal patterns, joint effusion, and demographic or clinical variables such as age, sex, dental status, and pain severity.
This study will prospectively evaluate temporomandibular joint (TMJ) disc perforation using magnetic resonance imaging (MRI) in a diverse adult population. The investigation will focus on identifying the prevalence of disc perforation and examining its relationship with key TMJ structural and functional parameters. Specifically, the study will assess internal disc derangements, variations in disc morphology, condylar bone marrow signal characteristics, and the presence of joint effusion. In addition, demographic and clinical factors-including age, sex, dental status, and pain severity-will be analyzed to determine their potential association with disc perforation. MRI-based assessments will be performed using standardized imaging protocols, and all findings will be systematically recorded and evaluated. By integrating radiologic and clinical data, the study aims to improve the understanding of factors contributing to TMJ disc perforation and to support future diagnostic and therapeutic strategies.
Study Type
OBSERVATIONAL
Enrollment
282
Recep Tayyip Erdoğan University Faculty of Dentistry
Rize, Turkey (Türkiye)
Presence of TMJ Disc Perforation
Dichotomous outcome (Yes/No) indicating the presence of temporomandibular joint disc perforation, determined from closed- and open-mouth MRI images assessed by an experienced radiologist/oral and maxillofacial surgeon. Unit of Measure: Percentage of joints with MRI-confirmed disc perforation
Time frame: At MRI assessment (baseline, single time point)
Disc Configuration Distribution
Categorical outcome describing temporomandibular joint disc morphology classified as biconcave, concave, flattened, folded, amorphous, or perforated, determined from closed-mouth MRI images evaluated by an experienced radiologist/oral and maxillofacial surgeon. Unit of Measure: Percentage of joints in each disc morphology category
Time frame: At MRI assessment (baseline)
Disc Position (Closed/Open-mouth)
Categorical: Normal, Anterior Disc Displacement with Reduction (ADDWR), Anterior Disc Displacement without Reduction (ADDWoR). Determined by posterior band position relative to condyle on closed- and open-mouth images. Unit of Measure: Percentage of joints in each internal disc status category
Time frame: At MRI assessment (baseline)
Condylar Bone Marrow Signal Pattern
Categorical: Normal, Edema, Sclerosis, Combined Edema and Sclerosis. Proportion of joints with each signal pattern on PDWI and T2WI. Unit of Measure: Percentage of joints in each bone marrow signal pattern category
Time frame: At MRI assessment (baseline)
Joint Effusion Grade
Ordinal: Grade 0-3 on T2WI (Grade 0 = no effusion; Grade 1 = dot/linear; Grade 2 = bands; Grade 3 = accumulation). Distribution of effusion grades. Unit of Measure: Percentage of joints in each effusion grade
Time frame: At MRI assessment (baseline)
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Pain Severity (VAS per TMJ)
Continuous outcome describing temporomandibular joint pain intensity, measured using the Visual Analogue Scale (VAS; 0-10) as reported by patients and recorded by an oral and maxillofacial surgeon. Unit of Measure: Mean VAS pain score per joint (0-10)
Time frame: At clinical assessment coincident with MRI (baseline): retrospective clinical data
Dental Status
Discrete outcome describing the number of missing permanent teeth, with individual tooth numbers recorded according to the dental charting system. Unit of Measure: Number of missing teeth per patient
Time frame: At clinical assessment (baseline): retrospective clinical data