This study aims to determine if a large anterior and reduced posterior/superior joint space is highly predictable for disc displacement. From patients with temporomandibular disorders symptoms, fifty-two experimental joints and fourteen control joints were included. The cone beam computed tomography (CBCT) images were used to calculate posterior-to-anterior (P-A) and superior-to-anterior (S-A) joint space ratios, while disc position was determined using magnetic resonance imaging (MRI). One-way analysis of covariance test and receiver operating characteristics analysis were carried out. The results showed that among the 52 experimental joints, 45 were diagnosed as disc displacement and 7 as normal disc positions (N). All 14 control joints showed normal disc positions. The P-A ratio was 1.46 ± 0.21, 0.99 ± 0.23, and 0.86 ± 0.30 in the control, N, and DD groups, respectively (p < 0.001). The S-A ratio was 1.80 ± 0.27, 1.44 ± 0.33, and 1.08 ± 0.35 in the control, N, and DD groups, respectively (p < 0.001). When an altered P-A ratio and/or S-A ratio are observed on the CBCT, the diagnosis of disc displacement is quite predictable with high sensitivity and specificity.
Endodontic perforations are serious complications encountered in the dental setting. Early detection, diagnosis, and proper management of perforations are crucial for a favorable prognosis. However, there are a limited number of studies that provide an overview of perforations, emphasizing these three strategies: prevention, diagnostic challenges, and management. The objective of this narrative review is to highlight the multifaceted components of endodontic perforations while also identifying the most effective methods used in their detection, diagnosis, and management. An electronic literature search was conducted using various databases and applying keywords for articles published in English. Eligible papers were reviewed further to gather relevant information. The results of the literature search found that, although perforations are relatively uncommon occurrences in the clinical setting, they still need to be understood for the prevention and treatment of these iatrogenic complications. The combination of case complexity and limited operator experience often determines the likelihood of endodontic perforation occurrence. Accurate diagnosis and identification of perforations rely heavily on the combination of clinical examination and advanced imaging technologies. In recent times, new technologies have emerged and hope to contribute to a decreased occurrence of endodontic perforations and increased prognosis in cases that do arise.