Data sources

Medline, the Cochrane Library databases and reference list of review articles were searched.

Study selection

Three examiners selected publications. To be included the publication had to elucidate the diagnostic thinking efficacy and/or therapeutic efficacy of MRI and/or CT in the diagnosis of disc displacement, inflammatory disorders (capsulitis, synovitis) and osteoarthrosis of the temporomandibular joint (TMJ). Publications related to trauma, tumours, systemic diseases, synovial chondromatosis; cadaver studies; narrative literature reviews; and studies of other TMJ imaging methods were excluded. 


Data extraction and synthesis

Data were extracted by three examiners with disputes being settled by consensus. Study quality was assessed using the QUADAS tool.1 No synthesis was performed as only one study was identified.

Results

One study was judged relevant. This study evaluated evidence of the efficacy of MRI in the diagnosis of disc position and configuration, disc perforation, joint effusion, and osseous and bone marrow changes in the temporomandibular joint, but no publication reported diagnostic thinking efficacy or therapeutic efficacy. 


Conclusions

The absence of studies on the therapeutic efficacy of MRI and CT on TMJD reinforces the need for investment in decision-making studies; meanwhile, sectional imaging tests should be prescribed with caution, especially when health budgets are limited.



Cita original

Sergio Uribe.  The impact of imaging technologies on temporomandibular joint disorder diagnosis . Evidence-Based Dentistry 12, 113-114 (2011) | doi:10.1038/sj.ebd.6400828

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La Odontología basada en la Evidencia (OBE) integra tres importantes elementos de la práctica clínica:
- la experiencia y habilidad del dentista,
- las expectivas y preferencias del paciente y
- la mejor y mas actualizada evidencia disponible
La OBE es un enfoque para la práctica clínica - un enfoque acerca de como tomar decisiones - y la evidencia científica es solo una herramienta más que un dentista informado utiliza para tomar las mejores decisiones de tratamiento.