Panoramic imaging of the temporomandibular joint: an experimental study using cadaveric skulls.

The purpose of this study was to determine if condylar morphology can be accurately depicted on the panoramic radiograph and if variations in condylar anatomy affect the radiographic appearance of the condyle. The shape and angulation of the condyle were determined on 8 cadaveric human skulls. Lead foil markers were then placed on the articulating surface and lateral and medial pole of each condyle. A panoramic radiograph was made of each skull and the position of the markers was assessed. The true shape of the condyles was not recognizable on any of the panoramic images. The exact location of the articulating surface and medial and lateral poles could not be predicted on the panoramic images without markers. The location of these structures varied depending on the amount of condylar angulation. Because of the radiographic variations produced by differences in condylar angulation, it is not possible to accurately determine condylar morphology on the panoramic radiograph. Therefore, its value in providing the detailed information needed to guide diagnosis and treatment of the temporomandibular joint patient is limited.