Abstract
Background Available knowledge about disorders of temporomandibular joint structures and their association with orthodontic variables are still lacking. Objectives This article is aimed at to identifying studies and presenting current information on the relationship between morphology diversity and the occurrence of degenerative changes in structures of the temporomandibular joint (TMJ) assessed by cone-beam computed tomography (CBCT) in the context of craniofacial morphology and malocclusion. Search Methods. The review was conducted by analyzing the PubMed (including Medline), Cochrane Library, Web of Science, and Scopus electronic databases up to November 2021 using two different comprehensive search strategies based on keywords as well as additional manual searches. Eligibility Criteria. Selection of the literature was carried out according to the PRISMA-ScR checklist. Methodological quality of the selected studies was evaluated using JBI Critical Appraisal Tool. Results The electronic databases search revealed 3331 records. After applying the eligibility criteria and JBI assessment, a total of 33 studies were extracted and selected to the study. The review was divided into 4 parts, in which the following correlations were assessed in terms of orthodontic variables: TMJ degenerative changes, joint space and condylar position, condylar shape, TMJ articular eminence, and fossa. Conclusions Skeletal and dental class II malocclusion with a retrognathic mandible, a hypodivergent skeletal pattern with a steep mandibular plane, and significant lateral mandibular displacement can be risk factors for developing radiographically detectable degenerative changes. Patients with skeletal and dental class III malocclusion as well as a hyperdivergent skeletal pattern may be at greater risk of TMD occurrence compared with other groups. Further studies are necessary to clarify the relationship between the position of the condylar processes and the presence of degenerative changes in the temporomandibular joints among orthodontic patients.
Highlights
Cone-beam computed tomography (CBCT) in dentistry was implemented more widely in Europe in 1998 [1] and in the USA in 2001 [2]
Quantitative assessments of the degree of inclination of the articular eminence, glenoid fossa depth or joint space measurements due to ethnic differences, and the location of additional structures, as well as a lack of established standards for the range of values obtained, have proven to be problematic. Researchers such as Ikeda and Kawamura have attempted to tackle these issues by assessing the optimal position of the articular heads in the sagittal section at three points in patients without signs of dysfunction and showing compliance of maximal occlusion with the central relation based on magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) [10]
Of the 33 papers included in the review, only 6 articles addressed the association of degenerative changes in the temporomandibular joint (TMJ), diagnosed by CBCT, with maxillofacial morphology and malocclusion [11, 38,39,40,41,42]
Summary
Cone-beam computed tomography (CBCT) in dentistry was implemented more widely in Europe in 1998 [1] and in the USA in 2001 [2]. Quantitative assessments of the degree of inclination of the articular eminence, glenoid fossa depth or joint space measurements due to ethnic differences, and the location of additional structures (joint discs), as well as a lack of established standards for the range of values obtained, have proven to be problematic. Researchers such as Ikeda and Kawamura have attempted to tackle these issues by assessing the optimal position of the articular heads in the sagittal section at three points (anterior, superior, and posterior joint spaces) in patients without signs of dysfunction and showing compliance of maximal occlusion with the central relation based on MRI and CBCT [10]. Further studies are necessary to clarify the relationship between the position of the condylar processes and the presence of degenerative changes in the temporomandibular joints among orthodontic patients
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