Evaluation of fonseca anamnestic index and magnetic resonance imaging findings in patients with temporomandibular joint pain

The temporomandibular joint (TMJ) exhibits a complex structure, and consequently, disorders affecting its components can manifest as various temporomandibular disorders (TMDs). These conditions encompass pathologies involving the internal structures of the TMJ, masticatory muscles, or adjacent tissues, often presenting with distinct symptoms, collectively referred to as TMDs. In the literature, TMDs are categorized using various classification systems. One such system, the Diagnostic Criteria for Temporomandibular Joint Disorders (TMD/TK), serves as a comprehensive assessment tool but necessitates specialized training for accurate implementation. Additionally, the Fonseca Anamnestic Index (FAI) has been proposed to gauge TMD severity based on signs and symptoms. The primary objective of this study is to compare the FAI, widely adopted for TMD assessment, with magnetic resonance imaging (MRI), regarded as the gold standard method for evaluating TMDs, to assess the suitability of the FAI for clinical use. In this study, we assessed 221 patients exhibiting TMD symptoms. Initial evaluations involved FAI assessments, followed by analysis of bilateral TMJ MRIs. TMD severity, as determined by FAI scores, was categorized into distinct levels. Subsequently, MRI examinations scrutinized condyle degeneration, disc morphology, disc-condyle relationship, and effusion status in the same patient cohort. The resulting MRI findings were juxtaposed with TMD severity determined by FAI scores. Notably, no statistically significant relationship was observed between TMD severity assessed by FAI and certain MRI findings, such as a normal disc-condyle relationship, disc displacement with or without reduction, or disc structure. Moreover, there was no substantial positive correlation between increasing condyle degeneration severity and TMD severity according to FAI scores. Effusion, indicative of inflammation and associated with pain, also exhibited no positive correlation with TMD severity as assessed by FAI. In conclusion, the comparative analysis indicates that FAI scoring for TMD severity lacks robust support from MRI findings.