Assessment of the temporomandibular joint condition using two-dimensional ultrasound scanning and doppler ultrasonography methods in patients with chronic inflammatory periodontal diseases

Introduction. Currently, dentists are increasingly detecting changes in the temporomandibular joint in patients with chronic inflammatory periodontal disease.

Aim of the study. To carry out a comprehensive dynamic assessment of the temporomandibular joint (TMJ) condition and the registration of regional blood flow using two-dimensional ultrasound scanning to improve the efficiency of diagnostics of inflammatory periodontal diseases.

Materials and methods. The study included 2 groups of patients: group 1 (control) consisted of 20 volunteers aged 20–25; Group 2 consisted of 52 people aged 25–45 years with moderate chronic periodontitis. For TMJ ultrasound and Doppler ultrasound, a portable ultrasound scanner LogicScan  128 with an HL-10  linear ultrasound transducer  with an operating frequency of 5     to 12 MHz was used.

Results and discussion. During ultrasound examination of the temporomandibular joint and measuring the size of the joint space in patients with moderate chronic periodontitis in a state of relative physiological rest, the following  values were obtained:   in the anterior region – 2.3 ± 0.5 mm; in the upper section – 1.6 ± 0.6 mm; in the posterior section – 1.8 ± 0.3 mm. We also measured the area of the temporomandibular joint disc in various positions. According to ultrasound data, an increase in the size of the joint space from 12.2 to 16.1% and an increase in the area of the articular disc by 17.1 to 36.7% were found in patients with chronic periodontitis. When assessing the trajectory of the articular track, motion delay and joint wedging are determined. In addition, in the color Doppler mapping (CDM) mode, the speed and index indicators of Doppler ultrasonography of the external carotid and temporal arteries were calculated.

Conclusions. Modern diagnostic methods of ultrasound and Doppler mapping, assessing the hemodynamics and functional state of the TMJ, allow early diagnosis of changes in order to prevent the development of TMJ disorders in patients with chronic inflammatory periodontal diseases.

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