The usefulness of quantitatively assessing temporomandibular joint disk stiffness with shear wave elastography in adolescents with bruxism


      The objectives of this study were to quantitatively measure temporomandibular joint (TMJ) disk stiffness in adolescents with bruxism using shear wave elastography (SWE) and to examine the relationship between elastography values, patient age, and duration of bruxism.

      Study Design

      This prospective study evaluated 120 TMJ disks of 60 adolescents (30 patients with bruxism and 30 controls). The stiffness of the anterior, intermediate, and posterior parts of the disk was measured. The patient and control groups’ respective quantitative SWE values of elasticity (kilopascals [kPa]) and velocity (meters/second [m/s]) were compared.


      The elasticity and velocity values of the anterior and intermediate parts were significantly higher in the patients than in the controls (P ≤ .013), with no significant difference in the size of the joint space (P = .886). A receiver operating characteristic analysis resulted in sensitivity for the anterior part of 0.80 for kPa and 0.83 for m/s, with specificity of 0.57 (kPa) and 0.60 (m/s). For the intermediate part, the sensitivity was 0.80 for kPa and 0.86 for m/s, with specificity of 0.64 (kPa) and 0.57 (m/s). No correlations were found between the SWE values and patient age (P ≥ .098) or duration of bruxism (P ≥ .134).


      SWE may be useful in the evaluation of TMJ disk stiffness in patients with bruxism.
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        • Lobbezoo F
        • Ahlberg J
        • Glaros AG
        • et al.
        Bruxism defined and graded: an international consensus.
        J Oral Rehabil. 2013; 40: 2-4
        • Bader G
        • Lavigne GJ.
        Sleep bruxism; an overview of an oromandibular sleep movement disorder.
        Sleep Med Rev. 2000; 4: 27-43
        • Manfredini D
        • Restrepo C
        • Diaz-Serrano K
        • et al.
        Prevalence of sleep bruxism in children: a systematic review of the literature.
        J Oral Rehabil. 2013; 40: 631-642
        • Kato T
        • Lavigne GJ.
        Sleep bruxism: a sleep-related movement disorder.
        Sleep Med Clin. 2010; 5: 9-35
        • Lobbezoo F
        • Lavigne GJ.
        Do bruxism and temporomandibular disorders have a cause-and-effect relationship?.
        J Orofac Pain. 1997; 11: 15-23
        • Radin EL
        • Martin RB
        • Burr DB
        • Caterson B
        • Boyd RD
        • Goodwin C.
        Effects of mechanical loading on the tissues of the rabbit knee.
        J Orthop Res. 1984; 2: 221-234
        • Thompson RC
        • Oegema TR
        • Lewis JL
        • Wallace L.
        Osteoarthrotic changes after acute transarticular load: an animal model.
        J Bone Joint Surg. 1991; 73: 990-1001
        • Klatkiewicz T
        • Gawriołek K
        • Pobudek Radzikowska M
        • Czajka-Jakubowska A
        Ultrasonography in the diagnosis of temporomandibular disorders: a meta-analysis.
        Med Sci Monit. 2018; 24: 812-817
        • Tamimi D
        • Kocasarac HD
        • Mardini S.
        Imaging of the temporomandibular joint.
        Semin Roentgenol. 2019; 54: 282-301
        • Siva Kalyan U
        • Moturi K
        • Padma Rayalu P
        The role of ultrasound in diagnosis of temporomandibular joint disc displacement: a case-control study.
        J Maxillofac Oral Surg. 2018; 17: 383-388
        • Creze M
        • Nordez A
        • Soubeyrand M
        • Rocher L
        • Maître X
        • Bellin MF.
        Shear wave sonoelastography of skeletal muscle: basic principles, biomechanical concepts, clinical applications, and future perspectives.
        Skeletal Radiol. 2018; 47: 457-471
        • Gurun E
        • Akdulum I
        • Akyuz M
        • Tokgoz N
        • Ozhan Oktar S
        Shear wave elastography evaluation of meniscus degeneration with magnetic resonance imaging correlation.
        Acad Radiol. 2021; 28: 1383-1388
        • Gürün E
        • Aksakal M
        • Akdulum İ.
        Measuring stiffness of normal medial collateral ligament in healthy volunteers via shear wave elastography.
        Surg Radiol Anat. 2021; 43: 1673-1679
        • Öztürk M
        • Çalışkan E
        • Habibi HA.
        Shear wave elastography of temporomandibular joint disc and masseter muscle stiffness in healthy children and adolescents: a preliminary study.
        Oral Radiol. 2021; 37: 618-624
        • Habibi HA
        • Ozturk M
        • Caliskan E
        • Turan M.
        Quantitative assessment of temporomandibular disc and masseter muscle with shear wave elastography.
        Oral Radiol. 2022; 38: 49-56
        • Neumann DA.
        Kinesiology of the Musculoskeletal System—Foundations for Physical Rehabilitation.
        CV Mosby, St. Louis, MO2002: 357
        • Butts R
        • Dunning J
        • Perreault T
        • Mettille J
        • Escaloni J.
        Pathoanatomical characteristics of temporomandibular dysfunction: where do we stand? (Narrative review part 1).
        J Bodyw Mov Ther. 2017; 21: 534-540
        • Takashima M
        • Arai Y
        • Kawamura A
        • Hayashi T
        • Takagi R.
        Quantitative evaluation of masseter muscle stiffness in patients with temporomandibular disorders using shear wave elastography.
        J Prosthodont Res. 2017; 61: 432-438
        • Manfredini D.
        Etiopathogenesis of disk displacement of the temporomandibular joint: a review of the mechanisms.
        Indian J Dent Res. 2009; 20: 212-221
        • Huang GJ
        • LeResche L
        • Critchlow CW
        • Martin MD
        • Drangsholt MT.
        Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD).
        J Dent Res. 2002; 81: 284-288
        • Thompson RC
        • Oegema TR
        • Lewis JL
        • Wallace L.
        Osteoarthrotic changes after acute transarticular load: an animal model.
        J Bone Joint Surg Am. 1991; 73: 990-1001
        • Commisso MS
        • Martínez-Reina J
        • Mayo J.
        A study of the temporomandibular joint during bruxism.
        Int J Oral Sci. 2014; 6: 116-123
        • Park JY
        • Kim JK
        • Cheon JE
        • Lee MC
        • Han HS.
        Meniscus stiffness measured with shear wave elastography is correlated with meniscus degeneration.
        Ultrasound Med Biol. 2020; 46: 297-304
        • Dieterich AV
        • Yavuz UŞ
        • Petzke F
        • Nordez A
        • Falla D.
        Neck muscle stiffness measured with shear wave elastography in women with chronic nonspecific neck pain.
        J Orthop Sports Phys Ther. 2020; 50: 179-188
        • Hosmer Jr, DW
        • Lemeshow S
        • Sturdivant RX
        Applied Logistic Regression.
        3rd ed. Wiley, New York, NY2013: 177
        • Power M
        • Fell G
        • Wright M.
        Principles for high-quality, high-value testing.
        Evid Based Med. 2013; 18: 5-10