Condylar appearance in panoramic radiograms of asymptomatic subjects and patients with temporomandibular disorders

Abstract

The usefulness and the limitations of panoramic radiography for the diagnosis of temporomandibular (TM) disorders were evaluated. The condylar shape appearance and the osseous changes were evaluated in asymptomatic 150 subjects (control subjects) and in 142 patients with the TM disorders who were examined by panoramic radiography. The position of the flattening and the osseous changes including osteophyte, bone erosion and osteosclerosis were objectively analyzed to determine the condylar shape. The incidence of the composite flattening type, which exhibits flattening on both the anterior and on other surfaces, was three times higher in the TM patients compared to controls. Thus, this composite type may indicate the presence of TM disorders. The incidence of osseous changes in the patients with TM disorders was significantly higher than controls and increased further in the group with the permolar and/or molar missing. This suggests that the occlusion of molar, teeth is an important factor related to the development of the TM disorders. It was concluded that panoramic radiography was useful for detecting TM disorders, at least in those with osseous changes or flattening.