Comparative evaluation of CBCT and MRI in detecting simulated TMJ disc displacement: An in vitro study

Temporomandibular joint (TMJ) disc displacement is a common clinical condition, yet disagreement persists regarding the optimal imaging modality for its diagnosis. Therefore, it is of interest to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) in detecting simulated TMJ disc displacement in twenty fresh-frozen human cadaveric specimens. Disc displacements including anterior displacement with and without reduction, medial displacement and lateral displacement were created and independently assessed by three blinded, calibrated oral and maxillofacial radiologists. MRI demonstrated significantly higher diagnostic accuracy (94.2%) than CBCT (71.8%) (p < 0.001), with superior sensitivity, specificity and inter-observer agreement (κ = 0.89 vs 0.62). Thus, we show MRI as the imaging modality of choice for evaluating TMJ disc displacement, while CBCT serves as a complementary tool for assessing associated osseous changes.