Can provision of additional arthroscopic video material improve accuracy of assessment of temporomandibular joint disorders by dental Non-experts vs. MRI alone: An exploratory study in 3rd to 5th year German dental students.

PURPOSE: This exploratory study aimed to determine whether non-experts in the field of temporomandibular disorders (TMDs) are capable of correctly assessing various intra-articular TMDs based on magnetic resonance imaging (MRI), and whether supplementing corresponding arthroscopic imaging findings will enhance accuracy of their assessments.

METHODS

Non-experts for the purposes of this study were recruited from German dental students. After a focused instruction on TMDs, they completed two evaluation rounds to identify and assess selected pathologies of arthrogenic TMDs in patient cases. Initially, participants were provided with MRI images only; in a second round, additional arthroscopic video material was provided. Statistical analysis was performed to evaluate responses, and inter-rater reliability among non-experts was determined.

RESULTS

94 participants evaluated a total of 30 MRI scans of the temporomandibular joint (TMJ) obtained from 27 patients who had also undergone arthroscopy. Their assessment showed the relatively highest agreement with the correct diagnosis for disc perforations (68.2-71.9%) and when using both MRI and arthroscopy material. Synovitis showed the lowest agreement, and was more successfully detected based on arthroscopy (47.2%) alone. Overall, there was only slight to fair agreement among the study participants across diagnoses (Kappa 0.074-0.358). Non-experts showed significant inconsistencies in interpreting MRI and arthroscopic imaging, with only limited concordance with the actual diagnosis and an agreement rate of less than 71.9%.

CONCLUSION

Dental students/Non-experts are unlikely to effectively interpret MRIs for the management of intra-articular TMDs based solely on their academic training. Enhanced curricular and postgraduate education in this area is therefore strongly recommended.