Comparison of Temporomandibular Joint Radiograph Images in Axiolateral Projection of Schuller Method with Angles of 25°and 30° Caudal

Abstract

Temporomandibular Joint (TMJ) is a hinge joint that connects the upper jaw and lower jaw. The projection used is the Schuller method axiolateral projection with 25° and 30° caudal angles, aiming to see the most optimal angles and produce informative diagnostic images. The study used a quantitative experimental method. Conducted at the DIII Radiology Laboratory, Baiturrahmah University, Padang in May 2025 with three male subjects as samples. Each sample was photographed using 25° and 30° caudal angles, then the image results were evaluated by 5 radiologists and 25 radiographers through an anatomical quality assessment questionnaire, which included the clarity of the TMJ structure, its relationship to the MAE, the mandibular condyle, the glenoid fossa, and the articular disc. The data were analyzed using the Wilcoxon test through the SPSS program. The results showed that the open mouth projection, 25° caudal angle resulted in the Temporomandibular Joint not experiencing superposition, the MAE was in the middle, the discus was open, the condyle and glenoid fossa appeared optimal. The close mouth projection, 30° caudal angle of the TMJ was also seen overall. The Wilcoxon statistical test showed a p-value = 0.000 (<0.05), meaning there was a significant difference between the radiographic results of the two angles. Thus, the 25° caudal angle of the open mouth resulted in optimal Temporomandibular Joint anatomy supported by a higher rank value (18.29) and at the 30° caudal angle with a mean rank (15.97).