Tomography as an aid to detect macroscopic changes of the temporomandibular joint An autopsy study of the aged

The aim of this study was to evaluate the possibility of detecting macroscopic changes of the temporomandibular joint with the aid of tomographic examination. Forty-four autopsy specimens were examined with corrected sagittal and frontal tomography. The tomograms were evaluated without comparative assessment of the macroscopic appearance. The diagnostic sensitivity, specificity, and predictive values were calculated. Diagnostic accuracy depends on the severity, extent, and localization of the macroscopic changes. All joints with severe and extensive macroscopic changes were identified on tomograms; two thirds of the joints with moderate changes were correctly diagnosed. Macroscopic changes of the condyle were more frequently detected than those of the temporal component. The specificity for single areas of the joints was higher than the sensitivity--that is, normal areas were more easily assessed than areas with changes.