Temporomandibular Joint Anatomy Assessed by CBCT Images.

The issue of the artifacts associated with the patient’s accidental movements during the acquisition is not yet resolved, which can be a problem in the pediatric population, especially in case of no compliance. In addition, a further technical problem is the Hounsfield Units (HU) distortion, so that CBCT cannot be used to estimate bone density (bone density is estimated using micro-CT). A further limitation is that the decrease of the radiation dose is accompanied by a proportional decrease in image quality, especially with regard to the contrast resolution, so the soft tissues are not displayed well, especially if internally positioned, near to bone structures [24], such as, the TMJ articular disc. Finally, in growing individuals, CBCT imaging has some limitations when it tries to highlight the changes in the deeper structures of the condylar head (e.g., cysts) that are not well detectable with CBCT images if the cortex of condylar head has not yet reached its final maturity and density. This seems to happen because the segmentation of the CBCT images is based on the thresholding and, when the cortex is not mature, is consequently restricted to delineate the cortical region, without taking possible changes in the deeper zones into account.

This brief review represents only an initial classification of recently published data.

Although CBCT helped to clarify some aspects of the morphology of the mandibular condyle (form, volume, surface, location, and symmetry of the condyles) additional studies will be necessary in future, constructed with longitudinal methodology, especially in growing subjects.

https://europepmc.org/article/pmc/pmc5312052

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