Evaluation of the relationship between clinical finding clinical findings and hard and soft tissue changes in magnetic resonance images in temporomandibular joint disfunctions

The temporamandibular joint differs from many joints in the body not only because of the complex movement of the condyle involved in its structure, but also because of its function in the formation of integrated jaw movements. There is a disc made of fibrocartilage between skeletal structures of the unit consist of hard and soft tissues, Joint pathologies occur with different clinical symptoms due to various factors. Imaging is indicated when there is severe dysfunction. Temporomandibular joint disorders were described the field of dentistry with an article published by Costen in 1934. Symptoms of temporomandibular joint disorders are very common and at least one of the symptoms is seen in 50-60% of the general population. Joint sounds are one of the most common symptoms of temporomandibular joint disorders. However, in most cases they are not associated with pain or reduced mouth opening. Long-term studies have been conducted to determine the need for treatment of click sound. The aim of the thesis is to evaluate the diagnostic value of the click sound using MRI. In addition, sensitivity, specificity, PPD, NPD, accuracy of DC/TMD, which is a current clinical examination protocol, was measured using MRI as the gold standard and degenerative changes and lateral pterygoid muscle changes in patients with and without reduction were evaluated. A total of 100 joint images were examined which including 25 patients with click sounds and 25 TMD patients without clicking. As a result of the clinical examination, 20% of the study group was diagnosed as healthy, 28% with reduction disc displacement, 38% disc displacement with reduction with intermittent locking, and 14% with disc displacement without reduction without limited opening. The sensitivity, specificity and accuracy of reduction disc displacement ,which was diagnosed with click sound, were 37.25%, 87.76% and 62%, respectively. Sensitivity, specificity, PPD and PPD of DC/TMD were 83%, 53%, 60% and 74%, respectively. When we evaluated all the findings, it was found that the clinical accuracy of DC/TMD was sufficient but the click sound was not sufficient for the diagnosis; It should be evaluated together with symptoms such as limitation of mouth opening and locking. Keywords: Temporomandibular joint, Magnetic resonance imaging, Temporomandibular joint disorders, Diagnostic Criteria