Impact of routine open-mouth osseous temporomandibular joint tomography on diagnosis and therapeutic options.

Objectives: The aim of this study was to evaluate the impact of routine open mouth osseous temporomandibular joint (TMJ) tomography on diagnosis and treatment planning of TMJ conditions. Investigating the need for such images is important to justify the additional radiation exposure imparted by such procedures.

Study Design: The records of patients who underwent closed- and open-mouth osseous TMJ tomography (planar film tomography up to the beginning of 2006; cone beam computed tomography from 2006 onward) were reviewed. Three examiners formulated a diagnosis and treatment plan based on the history, clinical findings, and tomography interpretation reports of closed-mouth images. Then they reviewed the interpretations of the open-mouth images and recorded whether they would change their original diagnosis and/or treatment plan on the basis of the findings. Descriptive analysis of the results was performed.

Results: The impact of routine open-mouth imaging on diagnosis and treatment planning was variable among the examiners. Examiners 1, 2, and 3 had a change in diagnosis in 7%, 5%, and 3% of cases, respectively, and a change in treatment plan in 1%, 1%, and 8%, respectively.

Conclusions: Routine open-mouth osseous TMJ tomography had a minimal impact on diagnosis and treatment planning of TMJ conditions, which varied according to the treating clinician.