Nuclear magnetic resonance imaging exploration of the temporo-mandibular- j o i n t

SUMMARY The Temporo-Mandibular Joint (TMJ) diarthrosis by nature, is situated between two anatomical entities, one fixe the cranium, the other mobile, the mandibule. The articular surfaces of these two components are in congruence by means of the disc which role in the mandibular movement is major, for it lets the condyle free in its movements like sliding, turning, and revolving under loading. TMJ, permanently sollicited, is moved by musculo-ligamental complex. Its symptomatology in pathologic cases is numerous, it is the reflect of several affections which the origin could be inflammator y, traumatic, mecanic, functionnal or abnormalitive.This study is attached, thanks to a review of the literature, to evocate in an exhaustive way, the different clinical situations linked with this joint and to search how to define the position of MRI in its exploration.This, without reminding the advantages and drawbacks of the conventionnal procedures as CTscanning, endoscopy, scintigraphy, arthrotomography, and surgery. MRI, even whether it is a non-invasive procedure above all else, however, it is not a cure-all. It has to be practiced wisely. Actually this procedure of exploration shows his value, with a judicious choice of sequences in paraclinical test of cranio-mandibular disorders. It is useful in the confirmation of diagnosis, the gravity of the outcome, the pre and postsurgical outcome, or the controle of efficiency of surgical treatment, for it is able to visualize the main anatomical components linked with these disorders particulary the disc and its movement. In this aim we are attached ourselves to draw up a draft test easy, precise, and reprodicible in in both of static and dynamic methods. However, it is useful to support that for others pathologies as rhumatoid or congenital deseases, MRI seemsdebatable without any real specificity images. Finally, in a practical point of view it is major that the odontologist strives to considerate some important elements wich adjoin the indications of this explorative procedure. It concerns to take in consideration: the waited output in relation with the pathology clinically suspected, the violence of substitution tests, the ratio cost/profit compared to the one of other possible investigations (Med Buccale Chir Buccale 2002;8;7-36).