Corrected TMJ Tomography: Effectiveness of Alternatives to SMV Tracing

An axial (SMV) radiograph has been widely used to determine parasagittal head position in TMJ tomograms. The purpose of this study was to investigate the efficacy of alternative anatomic methods for patient positioning in TMJ tomograms. The positioning methods studied included (1) rotation of the patient's head toward the film plane on the basis of the condylar orientation as determined by an SMV radiograph, (2) arbitrary rotation of the patient's head 20 degrees toward the film plane, (3) placement of the zygomatic arch parallel to the film plane, and (4) positioning of the posterior occlusal plane parallel to the film plane. Statistical analysis of the accuracy of the positioning techniques revealed no differences in the SMV, the zygomatic arch, and the arbitrary 20 degrees positioning. Aligning the posterior occlusal plane did not adequately align the mandible into a favorable radiographic position.