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Objectives <p>Temporomandibular joint disorders (TMDs) require precise imaging of both osseous and soft-tissue components for accurate diagnosis. Current diagnostic protocols often necessitate separate cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) scans, increasing cost, complexity, and patient burden. This study aimed to develop and validate the Sivan 3D CBCT Volumetric Imaging Protocol, a novel post-processing technique designed to enable simultaneous high-resolution visualization of the temporomandibular joint (TMJ) disc, retrodiscal tissue, and adjacent osseous structures using a single CBCT data set.</p> Methods <p>This retrospective study analyzed anonymized CBCT volumes from 42 patients diagnosed with TMD. The data sets were processed using NNT software, incorporating dual-mode volumetric rendering, voxel intensity modulation, and anisotropic filtering. Fifteen expert raters assessed conventional CBCT, enhanced CBCT, and MR images across eight diagnostic parameters using a 5-point Likert scale. Inter- and intra-rater reliability was assessed using intraclass correlation coefficients (ICC), and statistical comparisons were performed using one-way ANOVA, Tukey’s post-hoc test, and Cohen’s <i>d</i> effect size analysis.</p> Results <p>Enhanced CBCT images showed excellent inter- and intra-rater reliability (ICC &gt; 0.95) and significantly outperformed conventional CBCT and MRI in visualizing both soft and hard TMJ structures (<i>p</i> &lt; 0.001), with large effect sizes (Cohen’s <i>d</i> &gt; 2.3), especially for disc and retrodiscal tissue delineation.</p> Conclusions <p>The Sivan 3D CBCT Volumetric Imaging Protocol provides a robust, single-modality alternative to MRI for comprehensive TMJ evaluation, improving diagnostic accuracy, efficiency, and accessibility in clinical settings with limited MRI availability.</p>

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The Sivan three-dimensional cone-beam computed tomography volumetric imaging protocol: a novel dual-mode rendering technique for integrated visualization of temporomandibular joint disc and osseous structures to evaluate temporomandibular joint disorders

  • 期刊论文

  • 发表日期：

    2025年8月21日

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  • Sivan Sathish,
  • Ankita Jain

摘要

Objectives

Temporomandibular joint disorders (TMDs) require precise imaging of both osseous and soft-tissue components for accurate diagnosis. Current diagnostic protocols often necessitate separate cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) scans, increasing cost, complexity, and patient burden. This study aimed to develop and validate the Sivan 3D CBCT Volumetric Imaging Protocol, a novel post-processing technique designed to enable simultaneous high-resolution visualization of the temporomandibular joint (TMJ) disc, retrodiscal tissue, and adjacent osseous structures using a single CBCT data set.

Methods

This retrospective study analyzed anonymized CBCT volumes from 42 patients diagnosed with TMD. The data sets were processed using NNT software, incorporating dual-mode volumetric rendering, voxel intensity modulation, and anisotropic filtering. Fifteen expert raters assessed conventional CBCT, enhanced CBCT, and MR images across eight diagnostic parameters using a 5-point Likert scale. Inter- and intra-rater reliability was assessed using intraclass correlation coefficients (ICC), and statistical comparisons were performed using one-way ANOVA, Tukey’s post-hoc test, and Cohen’s d effect size analysis.

Results

Enhanced CBCT images showed excellent inter- and intra-rater reliability (ICC > 0.95) and significantly outperformed conventional CBCT and MRI in visualizing both soft and hard TMJ structures (p < 0.001), with large effect sizes (Cohen’s d > 2.3), especially for disc and retrodiscal tissue delineation.

Conclusions

The Sivan 3D CBCT Volumetric Imaging Protocol provides a robust, single-modality alternative to MRI for comprehensive TMJ evaluation, improving diagnostic accuracy, efficiency, and accessibility in clinical settings with limited MRI availability.