Detection of degenerative temporomandibular changes using cone beam CT: a scoping review on technical parameters, evaluation criteria, and calibration.

Abstract

To provide an overview of how Cone Beam Computed Tomography (CBCT) has been used in the assessment of degenerative changes of the temporomandibular joint (TMJ), with emphasis on image acquisition protocols, examiner calibration, and the criteria used for assessing and diagnosing TMJ structures. Searches were performed on PubMed, Embase, Scopus, and Web of Science databases on March 5, 2025. In vivo studies with a sample of adult individuals and which used CBCT to evaluate degenerative changes were included. Studies that did not discriminate voxel size, kV, or mA parameters and those without information on the degenerative changes assessed or the criteria used for image evaluation were excluded. Twenty-four studies were included. A wide variation in CBCT acquisition parameters was verified (voxel size varied from 0.076 mm to 0.3 mm, kV values were between 70 and 120, and mA between 3 and 38) which appear not to influence the detection of degenerative changes. The diverse criteria for CBCT assessment employed, many of which not validated, demonstrate a lack of standardization in TMJ assessment across the scientific literature. Furthermore, examiner calibration was not reported by 14 studies. Voxel size does not seem to significantly influence the detection of degenerative changes. The studies show a lack of examiner calibration, as well as inconsistencies in the standardization of acquisition parameters and evaluation protocols for CBCT imaging of the TMJ. Standardized and validated criteria are needed to enhance diagnostic accuracy and comparability among studies.