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Introdução: O diagnóstico de um distúrbio temporomandibular (DTM) é baseado numa cuidada anamnese e correto exame clínico, com recurso a exames complementares de diagnóstico para avaliação dos fatores predisponentes. Objetivos: Aferir o grau de previsibilidade da ortopantomografia digital (OPG-D) na avaliação anatómica da articulação temporomandibular (ATM) tendo como referência a assertividade da cone-beam computed tomography (CBCT). Materiais e Métodos: Estudou-se uma amostra de 30 pacientes da Clínica Dentária Universitária de Viseu, com OPG-D e CBCT no processo clínico. Aplicou-se o Questionário Anamnésico de Fonseca (QAF) e em cada exame imagiológico analisou-se a morfologia condilar, a inclinação da parede posterior da eminência articular (EA) e a localização do côndilo na cavidade glenóide do lado direito e do lado esquerdo. Na OPG-D foi também avaliada a desdentação bimaxilar. Os dados recolhidos foram interpretados no IBM® SPSS Statistics, para um nível de significância de 5%. Resultados: A amostra obtida é maioritariamente do género feminino com idade inferior a 40 anos, dentição completa e DTM leve. No plano sagital verificou-se uma elevada prevalência da forma plana em idades superiores a 40 anos e em pacientes com DTM. No total da avaliação da morfologia condilar há uma concordância de 80% entre a CBCT e a OPG-D. Na classe mais jovem e em pacientes com DTM, observou-se uma média de inclinação da EA maior e uma maior frequência de deslocamento posterior do côndilo. Existe uma correlação de aproximadamente 0,78 entre a OPG-D e a CBCT na avaliação da inclinação, em ambos os lados. Quanto à localização do côndilo na cavidade glenóide, há uma concordância de 23,3% entre os dois exames imagiológicos. Conclusões: Com base nos resultados obtidos e no trabalho desenvolvido, conclui-se que o Médico Dentista generalista não deve negligenciar ou descartar a OPG-D na avaliação de fatores predisponentes de DTM, nomeadamente na avaliação da morfologia condilar, da inclinação da parede posterior da EA e de possíveis assimetrias articulares com a finalidade de obtenção de um diagnóstico precoce dos mesmos.
Introduction: The diagnosis of a temporomandibular disorder is based on a careful anamnesis and correct clinical examination, with the use of complementary diagnostic exams to evaluate predisposing factors. Aims: To assess the degree of predictability of digital ortopantomography (D-OPG) in the anatomical evaluation of the temporomandibular joint, using as reference the assertiveness of cone-beam computed tomography (CBCT). Materials and Methods: We studied a sample of 30 patients from the University Clinic of Viseu, with an D-OPG and a CBCT in the clinical process. The Fonseca Anamnestic Questionnaire (QAF) were applied and in each imaging examination the condylar morphology, the slope of the posterior wall of the articular eminence (AE) and the location of the condyle in the glenoid cavity on the right and left side were analyzed. Bimaxillary dentation was also evaluated in the D-OPG. The data collected were interpreted in the IBM® SPSS Statistics software for a significance level of 5%. Results: The sample obtained is mostly female under 40 years of age, with complete dentition and mild TMD. In the sagittal plane, there was a high prevalence of the flat form in ages over 40 years and in patients with TMD. In the total evaluation of condylar morphology there is an agreement of 80% between CBCT and D-OPG. In the younger class and in patients with TMD, a higher mean AE inclination and a greater frequency of posterior condyle displacement were observed. There is a correlation of approximately 0,78 between D-OPG and CBCT in the evaluation of slope, on both sides. Regarding the location of the condyle in the glenoid cavity, there is an agreement of 23,3% between the two imaging exams. Conclusions: Based on the results obtained and the work developed, it is concluded that the Dentist should not neglect D-OPG in the assessment of predisposing factors of TMD, especially in the evaluation of condylar morphology, in the evaluation of the posterior wall of the AE and possible joint asymmetries in order to obtain an early diagnosis of them.
Introduction: The diagnosis of a temporomandibular disorder is based on a careful anamnesis and correct clinical examination, with the use of complementary diagnostic exams to evaluate predisposing factors. Aims: To assess the degree of predictability of digital ortopantomography (D-OPG) in the anatomical evaluation of the temporomandibular joint, using as reference the assertiveness of cone-beam computed tomography (CBCT). Materials and Methods: We studied a sample of 30 patients from the University Clinic of Viseu, with an D-OPG and a CBCT in the clinical process. The Fonseca Anamnestic Questionnaire (QAF) were applied and in each imaging examination the condylar morphology, the slope of the posterior wall of the articular eminence (AE) and the location of the condyle in the glenoid cavity on the right and left side were analyzed. Bimaxillary dentation was also evaluated in the D-OPG. The data collected were interpreted in the IBM® SPSS Statistics software for a significance level of 5%. Results: The sample obtained is mostly female under 40 years of age, with complete dentition and mild TMD. In the sagittal plane, there was a high prevalence of the flat form in ages over 40 years and in patients with TMD. In the total evaluation of condylar morphology there is an agreement of 80% between CBCT and D-OPG. In the younger class and in patients with TMD, a higher mean AE inclination and a greater frequency of posterior condyle displacement were observed. There is a correlation of approximately 0,78 between D-OPG and CBCT in the evaluation of slope, on both sides. Regarding the location of the condyle in the glenoid cavity, there is an agreement of 23,3% between the two imaging exams. Conclusions: Based on the results obtained and the work developed, it is concluded that the Dentist should not neglect D-OPG in the assessment of predisposing factors of TMD, especially in the evaluation of condylar morphology, in the evaluation of the posterior wall of the AE and possible joint asymmetries in order to obtain an early diagnosis of them.
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Articulação temporomandibular Distúrbios temporomandibulares Tomografia computorizada Tomografia computorizada de feixe cónico Ortopantomografia digital Radiografia panorâmica Temporomandibular joint Temporomandibular disorders Computed tomography Cone-beam computed tomography Digital ortopantomography Panoramic radiography