Diagnostic significance and evaluation of alterations in the superior joint space for temporomandibular joint fracture detection.

Abstract

Objective: To comprehensively assess the diagnostic significance of variations in the superior joint space (SJS) of the temporomandibular joint (TMJ) for the detection of TMJ fractures through spiral computed tomography (CT) scans.

Methods: A retrospective analysis was conducted of CT scans of 32 patients with clinically confirmed TMJ fractures and 30 controls without fractures. The SJS was meticulously measured using the Kamelchuk method. Statistical analyses, including the Wilcoxon signed-rank test for paired comparisons, the Mann-Whitney U test for comparisons between groups, and ROC curve analysis for evaluating diagnostic performance, were performed to rigorously quantify the diagnostic importance of SJS changes. Binary logistic regression modeling was also applied to validate the accuracy of the assessment and determine the odds ratio (OR).

Results: In the fracture group, statistically significant differences were observed in the SJS of bilateral TMJs (p < 0.05), whereas no significant difference was noted in the control group. The mean SJS on the fractured side was 3.75 mm, notably greater than the bilateral mean of 3.03 mm in the control group (p < 0.001). The discrepancy in SJS between sides in the fracture group (0.82 mm) significantly surpassed that of the control group (0.19 mm, p < 0.001). Utilizing an optimal threshold SJS difference of 0.62 mm, the diagnostic sensitivity was 63.30%, specificity was 86.70%, and accuracy was 76.70%, with an OR of 21.00 (95% CI: 4.198-105.038).

Conclusion: This study found that changes in the SJS caused by TMJ fractures have significant diagnostic value in fracture detection, serving as a reliable tool for early and accurate diagnosis. By utilizing early identification and diagnosis via spiral CT, the study evaluated the changes in the SJS induced by fractures, providing crucial diagnostic information for clinical practice. This discovery emphasizes the pivotal role of SJS changes in identifying TMJ fractures and offers new diagnostic methods and insights for clinical practice.