Show Notes
When is it appropriate to consider an MRI for your TMD patient? What’s actually involved in MRI of the TMJ? Can you use any MRI machine, or is the choice of imaging center crucial? And who should be reporting on these scans — does it really matter? (Hint: yes, it does!) Dr. Kevin Lotzof, a straight-talking radiologist, joins Jaz for a controversial deep dive into the role of MRI in Temporomandibular Disorders. While many experts downplay its importance, Kevin argues that TMJs are under-imaged and under-diagnosed — and that we may be missing critical pathology. They explore the practicalities of imaging, how to set expectations with your patients, and why strong but differing views in TMD care can ultimately help you refine your own clinical approach. https://youtu.be/-yo_Qx4Zg5Q Watch PDP265 on YouTube Protrusive Dental Pearl: Adopt the mindset of “Find the cancer today.” When carrying out examinations—whether soft tissue or extraoral—approach it with the intention of detecting oral or skin cancers early. This mindset helps clinicians look beyond just teeth, catch unusual or suspicious lesions, and potentially save lives. Key Takeaways TMJ is often overlooked but is crucial for overall health. MRI is essential for accurate TMJ diagnosis. Cone beam CT cannot replace MRI for TMD assessment. Patients with headaches may have undiagnosed TMD. Education on TMJ imaging is lacking among dental professionals. Asymptomatic patients should still be scanned for TMJ issues. The quality of imaging directly impacts diagnosis accuracy. Patients often feel anxious about MRI procedures. Understanding patient perspectives can improve care. There is a need for better collaboration between dentists and radiologists. Highlight of the episode: 00:00 Teaser 00:55 Intro 05:20 Protrusive dental pearl 06:36 Interview with Dr. Kevin Lotzof 09:38 Under-Imaging and Differing Perspectives 13:27 Access and MRI Centers in the UK 17:51 TMJ MRI: Patient Expectations 22:17 Midroll 25:53 Open MRI Machines 27:26 Ideal Candidates for MRI Imaging 29:55 Cone Beam CT vs. MRI 31:53 Screening and Asymptomatic Patients 38:43 Centers with Reliable TMJ Imaging 41:27 Encouragement for General Dentists 46:33 Outro Where to Get Reliable TMJ Imaging ⭐ Top Pick: Orion, Wimpole Street, London (Full contact details available via the Protrusive Guidance App) 🏙️ Other London Options: Spire Bushey, Circle Hendon, Cavell, Kings Oak, Circle Healthcare Center Learn more about TMJ radiographic imaging in PDP223: Understanding TMD Radiographic Imaging – Pano vs CBCT vs MRI #PDPMainEpisodes #OcclusionTMDandSplints #CareerDevelopment This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance. This episode meets GDC Outcomes A and C. AGD Subject Code: 730 ORAL MEDICINE, ORAL DIAGNOSIS, ORAL PATHOLOGY (Imaging techniques) Aim: To highlight the importance of MRI in the diagnosis and management of temporomandibular joint (TMJ) disorders, ensuring safe and effective orthodontic and restorative treatment planning. Dentists will be able to: Explain why MRI is superior to clinical examination and CBCT in diagnosing TMJ pathology. Identify the key indications for TMJ MRI, including both dental and non-dental symptoms. Recognize the limitations of poor imaging technique and reporting in TMJ diagnosis
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