Title DIJAGNOSTIKA TEMPOROMANDIBULARNOG ZGLOBA UPOTREBOM CBCT-A
Title (english) TEMPOROMANDIBULAR JOING DIAGNOSTICS USING CBCT
Author Matea Marijanović
Mentor Barbara Mady Maričić (mentor)
Committee member Barbara Mady Maričić (predsjednik povjerenstva)
Committee member Margita Belušić (član povjerenstva)
Committee member Vlatka Debeljak (član povjerenstva)
Granter University of Rijeka (Faculty of Dental Medicine) Rijeka
Defense date and country 2021-06-30, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Dental Medicine Oral Medicine
Abstract Temporomandibularni zglob smatra se ginglimoartrodijalnim zglobom. Čine ga artikulacijska
površina temporalne kosti poznata kao zglobna jamica i kondil mandibule koji su obavijeni
zglobnom čahurom. Zglob je zglobnim diskom podijeljen u dvije zglobne šupljine. Prednji
dio diska pričvršćen je za zglobnu čahuru, zglobnu kvržicu i gornju glavu m.pterygoideusa
lateralisa. Stražnji dio povezan je sa mandibularnom jamicom i temporalnom kosti, a naziva
se i retrodiskalno tkivo. Tri glavna ligamenta stabiliziraju zglob, a to su
temporomandibularni, stilomandibularni i sfenomandibularni ligament.
Krvna opskrba temporomandibularnog zgloba prvenstveno dolazi od površinskih temporalnih
i maksilarnih grana a.carotis externe. Ostale grane koje sudjeluju u irigaciji su a.tympanica
anterior, a.auricularis profunda i a.pharyngea ascendens. Živci koji inerviraju TMZ su
auriculotemporalne i maseterične grane n.mandibularisa koji je grana n.trigeminusa.
Skupinu mastikatornih mišića čine četiri para mišića, a to su: m.masseter, m.temporalis,
m.pterygoideus medialis i lateralis. U funkciji mandibule važnu ulogu igra i m.digastricus
koji se ne smatra žvačnim mišićem.
Složena anatomska konfiguracija TMZ-a razlog je razvitka različitih standardiziranih
radiografskih tehnika koje omogućuju točan anatomski prikaz.
Klasična radiološka dijagnostika prikazuje isključivo tvrda tkiva, prikazi su
dvodimenzionalni i često se javlja superponiranje struktura i dijelova baze lubanje.
Magnetna rezonanca pokazuje izuzetan mekotkivni kontrast i omogućuje prikaz struktura
TMZ-a koje se ne mogu prikazati konvencionalnom radiografijom ili kompjuteriziranom
tomografijom kao što su disk i bilaminarna zona.
Kompjuterizirana tomografija (CT) nadmašuje konvencionalnu radiografiju u procjeni
unutarnje poremetnje temporomandibularnog zgloba, kod traumatskih promjena,
degenerativnih procesa i tumora.
CBCT ima određenu prednost u odnosu na ostale tehnike zbog male doze zračenja, manja je
potrebna oprema i sposobnosti stvaranja trodimenzionalnih slika. CBCT je superiornija
metoda u odnosu na druge jer dobro prikazuje koštanu morfologiju i posebno je konstruiran
za potrebe dentalne medicine. Kako CT i MR imaju brojne nedostatke kao što su visoka
cijena, veća izloženost zračenju (CT) i mogućnost snimanja samo u specijaliziranim
ustanovama, CBCT se nametnuo kao poželjnija, prihvatljivija i dostupnija metoda u
dijagnostici TMZ-a.
Abstract (english) The temporomandibular joint is the ginglimoarthrodial joint. It consists of the articulatory
surface of the temporal bone known as the articular fossa and the condyle of the manible
which are surrounded by the capsule. The joint is divided into two joint cavities by an
articular disc. The anterior part of the disc is attached to the capsule, articular eminence and
the upper head of the lateral pterygoid. The posterior part relates to the mandibular fossa and
the temporal bone, also referred to as the retrodiscal tissue. The three main ligaments stabilize
the joint, temporomandibular, stylomandibular and sphenomandibular.
The blood supply to the temporomandibular joint comes primarily from the superficial
temporal and maxillary branches of the external carotid. Other branches involved in irrigation
are the anterior tympanic, deep auricular and ascending pharyngeal arteries. The nerves that
innervate the TMJ are the auriculotemporal and masseteric branches of the mandibular nerve
which is a branch of the trigeminal nerve.
Masticatory muscles are masseter, temporalis, medial pterygoid and lateral pterygoid. The
digastric muscle, which is not considered a masticatory muscle, also plays an important role
in the function of the mandible.
Complicated anatomical configuration of the temporomandibular joint was the reason for
developing standardized radiographic techniques which would provide accurate anatomical
images.
Conventional radiography shows only hard tissues, the images are two-dimensional and
superposition of structures and parts of the skull base often occurs.
Magnetic resonance (MR) has shown exquisite soft tissue contrast and provides a view of the
structures of temporomandibular joint which cannot be differentiated by conventional
radiography or computerized tomography, such as articular disc and retrodiscal tissue.
Computerized tomography (CT) is superior to conventional radiography for evaluating
internal derangements of temporomandibular joint, trauma, degenerative processes and
tumors.
CBCT provides a definite advantage over other techniques due to its low radiation dose to
patient, smaller equipment and ability to provide 3D images. CBCT is a superior method
compared to others because it perfectly shows bone morfology and is specially designed for
dental practice. As CT and MRI have a number of disadvantages such as high cost, higher
radiation exposure (CT) and the possibility of imaging only in specialized institutions, CBCT
43
has imposed itself as a more desirable, acceptable and accessible method in the diagnosis of
TMJ.
Keywords
temporomandibularni zglob
CBCT
Keywords (english)
temporomandibular joint
CBCT
Language croatian
URN:NBN urn:nbn:hr:271:226511
Study programme Title: Dental Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
Type of resource Text
File origin Born digital
Access conditions Access restricted to students and staff of home institution
Terms of use
Created on 2023-01-20 08:10:33