A ressonância magnética na avaliação do deslocamento do disco articular

: revisão sistemática

Abstract

Introduction: Intra-articular disorders of the temporomandibular joint (TMJ), represent one of the most common musculoskeletal disorders in adult. These conditions may appear as a set of signs and symptoms such as articular sounds, orofacial pain and mandibular disfunction. Among the intra-articular disorders of the TMJ, the internal derangement, also known as disc displacement, may be defined as an abnormal relation between the articular disc and surrounding structures. Considering the high prevalence of this pathology and the wide range of clinical features and pattern, in many cases, it turns out to be difficult for oral healthcare professionals, make a diagnosis. Despite the fact that its diagnosis
is based on a precise anamnesis and clinical and functional examination of the patient suffering of signs and symptoms of temporomandibular disorder, it may be challenging, in many cases, to determine the type of pathology and its aetiology. In such occasions, the clinician may outline the indication for medical imaging. Magnetic resonance imaging (MRI) is considered the Gold standard imaging modality for the evaluation of TMJ as it allows for high-precision images of intra-articular structures, namely the disc and surrounding tissues. The present review aims to clarify the relevance and indication of MRI for the diagnosis of TMJ articular disc displacement. Material and Methods: Based on PRISMA recommendations, a literature search was performed in PubMed/MEDLINE®, Web of Science® e Cochrane® (Central trials), until May 2021. A search strategy was used combining MeSH terms and free text terms
according to each database specifications. The search and study selection for this review, were carried out, independently, by two reviewers (LM and PF).
Results: Six hundred papers appeared through database research. After excluding duplicated and triplicated papers, 544 studies were evaluated by title and abstract, of which 58 were selected for full text evaluation in the eligibility assessment. Fifteen studies fulfilled the criteria and were included in the qualitative analysis of this systematic review. The studies included in this review used MRI to assess the intraarticular anatomical structures of the TMJ, namely the disc and its relations with the surrounding tissues, with technical and clinical specifications of each study. Conclusion: Despite the heterogeneity in the methodology applied in the reviewed studies, can be concluded that MRI is indicated, as a complementary diagnostic tool, in case of symptoms warning for disc pathology, allowing a qualitative and quantitative analysis of the integrity of the disc and surrounding structures, beyond providing a direct observation of the kinematics of the disc regarding the condyle and articular eminence.

Date of Award	27 Jul 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Patrícia Fonseca (Supervisor) & Helena Salgado (Co-Supervisor)