TMD researcher wins INfORM award for innovative MRI study

A graduate student in the School of Dentistry’s Division of TMD and Orofacial Pain received the INfORM Samuel F Dworkin Predoctoral Award for her research into the use of MRIs in oral health diagnosis.

The International Association for Dental Research granted the award to Beth Groenke, DDS, MS, for a presentation given virtually to the International Network for Orofacial pain & Related disorders Methodology (INfORM) conference originally scheduled for 2020, but held virtually instead.

Groenke completed her DDS at the University of Missouri - Kansas City before practicing as a general dentist for seven years. Throughout her program and her work, she felt the pull toward TMD and orofacial pain.

“I was always intrigued by TMD and orofacial pain,” she said. “Though I worked with excellent faculty, many of them couldn’t give me satisfactory answers on managing my TMD patients.” Citing a poor understanding of the field, Groenke decided she wanted to learn more.

She decided to attend the University of Minnesota’s Orofacial Pain program “because of its excellent mix of clinical and research opportunities, which gave me the opportunity to learn the clinical aspects of pain management and use my undergraduate engineering skills again.” After completing a master’s degree in dentistry, she has continued researching with the dental MRI development team.

As part of her research, Groenke works with Donald Nixdorf, DDS, MS, to explore the use of MRI as a diagnostic tool. In particular, her study on detecting vertical root fractures was the focus of her award-winning presentation.

“In orofacial pain, we see patients who have had root canals who then present with pain perceived in the tooth,” she explained. One potential cause of that pain is a vertical root fracture, which extends from the tip of the root toward the dental crown.

Early and specific detection is key for this kind of pain: if the dentist can detect a vertical root fracture, they know to extract or amputate part of the tooth and easily eliminate the pain. However, if the pain stems from another cause like neuropathy or TMD, that same surgery can actually make the problem worse.

That’s where Groenke’s research comes in: the most common imaging tools used by dentists, like CBCT scans, can often miss these small fractures. “Our research aimed to explore if dental MRI could detect these very small fractures,” as well as evaluating the sensitivity and specificity of MRI to detect fractures compared with more frequently used tools like a CBCT.

In a study of 115 extracted teeth, Groenke found that the MRI performed similarly to the CBCT scan in terms of sensitivity and specificity, and was able to identify smaller fractures than those previously reported for CBCT scans.

“This is encouraging for the future of dentistry because based on this research, MRI is performing at an equivalent level to existing technologies,” even though the MRI’s use in dentistry is in earlier stages.

Groenke is grateful to have received the Samuel F. Dworkin award for this work. “Within the orofacial pain field, the INfORM network is well-known to be comprised of many preeminent researchers from all over the world,” she explained. “I was extremely honored to receive the award.”

For Groenke, the award is confirmation of what she already knows: this field, and this lab, are where she’s meant to be.

“I love that it’s cutting edge,” she said. “Only a handful of other groups in the world are working to develop MRI for dentistry, and I don’t believe any of them are pushing the boundaries of technology quite like our group is.”

As part of the award, Groenke becomes a judge for next year’s presentations.

KEY TAKEAWAYS

• Tooth pain after a root canal can either come from a vertical root fracture or other, non-tooth causes.
• Early and specific detection of root fractures is needed to determine a treatment plan: surgery, for a fracture, or non-surgical medical intervention for other orofacial pain.
• Traditional CBCT methods can miss small fractures, leading to a delay in treatment.
• A study led by Beth Groenke, DDS, MS, found that MRIs can detect small vertical root fractures, with the same level of sensitivity and specificity as CBCT.