Assessment of joint space and arthritic changes in temporomandibular joint as visualized on cone beam computed tomography scan

Abstract

Introduction: Cone beam computed tomography (CBCT) has been recognized as a reliable method for the examination of the osseous components of the temporomandibular joint (TMJ). Aims and Objectives: The aim of this study is to assess the joint space and arthritic changes in TMJ, as visualized on the CBCT scan. Materials and Methods: The study comprised 60 patients attending the outpatient department (120 joints) with temporomandibular dysfunction. All the patients were subjected to CBCT scan using Planmeca Promax 3D Mid machine. TMJ evaluation included bony changes (flattening, erosion, osteophytes, sclerosis, Ely's cyst and joint mice) and measurement of joint space (normal, increased, reduced, bony contact) between the condyle and the mandibular fossa. Results: No statistically significant differences were found between symptomatic and asymptomatic joints and radiographic arthritic changes (P = 0.437) and distribution of osseous changes in condyle among the symptomatic and asymptomatic joints (P = 0.428). Statistically significant difference was found between diminution in joint space with increased mean age (P = 0.001). Conclusion: The radiographic findings may not truly reflect the clinical signs and symptoms. Asymptomatic joints may present with radiographic changes and few of the symptomatic joints may fail to reveal radiographic changes. Radiographically manifested osseous changes, i.e., flattening, osteophyte, sclerosis, erosion etc., had no significant correlation with the symptomatic and asymptomatic joints. In older age groups, patients are expected to have severe progressive degenerative bony changes than those in patients of younger age groups.