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Evaluation of TMJ by conventional transcranial radiography and indirect digitized images to determine condylar position in primary dentition.

The aim of this study was to evaluate temporomandibular joint radiographs of children in primary dentition, obtained by conventional transcranial radiography, indirect digitization, digitized images using 3D and brightness/contrast tools. Condyle position was also determined measuring anterior, superior and posterior joint space. The X-Ray machine GE-1000 and the head positioner Accurad 200 were used. Radiographs were digitized using a scanner with transparency and registered in Adobe Photoshop 5.0. Images were evaluated by four examiners as follows: 0--unacceptably quality; 1--poorly diagnostic quality; 2--optimal visualization quality. Articular space was measured using a digital caliper. A significant difference (Sign Test) was found between conventional radiography and the remaining modalities (Conventional/Unenhanced p<0.001; Conventional/3D p<0.001; Conventional/Brightness and Contrast p=0.017). The mean distance of anterior, superior and posterior regions was 2.2(0.5), 3.5(0.9) and 3.9(1.2) mm, respectively. Conventional and brightness/contrast digitized radiographs showed higher diagnostic quality. The posterior joint space was larger than the anterior one, demonstrating anterior condylar position.