Objective. To develop an improved methodology for assessing the relative position of the elements of the temporomandibular joint in the analysis of computed tomograms and analyze its reproducibility. Materials and methods. Using an improved technique, calculations of TMJ parameters were performed on computed tomograms (CT) of the facial region of the skull in 15 patients aged 18—25 years. CT scans were performed for patients according to orthodontic indications. To assess the reliability of the proposed technique, it was analyzed by two operators — a radiologist with 10 years of professional experience and a first-year clinical resident. Two series of all measurements were performed with an interval of 7 days (T1 and T2, respectively). The intraoperative and interoperative reproducibility of the method was evaluated using the intraclass correlation coefficient (ICC). An ICC value greater than 0.75 was interpreted as a sign of good reproducibility. Additionally, the consistency of measurements between operators was analyzed using the Bland—Altman method. Results. Using an improved technique, 960 measurements were performed and analyzed. There were no statistically significant differences between the measurement series for all the parameters studied, regardless of the operator (p>0.05). Analysis of the intraoperative and interoperative reproducibility of the method showed that the ICC values for all parameters ranged from 0.82 to 0.94 and from 0.78 to 0.95, respectively, which indicated high consistency between the measurement series for both specialists have determined good reproducibility. In general, the analysis of the obtained results indicates the high reproducibility of the proposed methodology. Conclusion. An improved technique has been developed for assessing the relative position of the elements of the temporomandibular joint in the analysis of computed tomograms, which is based on determining the position of the head of the mandible relative to the actual anatomical boundaries of the articular cavity. The proposed technique makes it possible to study TMJ on CT with a high level of reproducibility and can be used for practical and scientific purposes.
Nadtochiy et al. (Thu,) studied this question.