Condylar Erosion in Patients With Chronic Temporomandibular Joint Arthralgia: A Cone-Beam Computed Tomography Study

Abstract

The objective of this study was to assess the association between temporomandibular joint (TMJ) condylar erosion and chronic TMJ arthralgia. Based on a sample size estimation, this case-and-control study involved 198 patients 16 to 73years old recruited from a routine clinical practice (99 cases, patients with chronic TMJ arthralgia and mean pain duration of 16.4months; 99 controls, asymptomatic patients without a history of orofacial pain). The clinical diagnosis of arthralgia was made according to the Research Diagnostic Criteria for Temporomandibular Disorders. Cone-beam computed tomographic (CBCT) images were evaluated for the presence or absence of erosive osseous changes of the TMJ condyle. Severity of TMJ condylar erosion was classified as grade 0 (absence of erosion), grade I (slight erosion), grade II (moderate erosion), or grade III (extensive erosion). Logistic regression analysis was used to assess the association between chronic TMJ arthralgia and condylar erosion, adjusting for age, gender, number of missing posterior teeth, and number of dental quadrants with missing posterior teeth. TMJ condylar erosion was found in 59.6% of cases and 21.2% of controls. There was a significant association between TMJ arthralgia and degree of condylar erosion (P < .001). The odds ratio that a TMJ with condylar erosion grade II might belong to the TMJ arthralgia group was strong (3.1:1; 95% confidence interval [CI], 1.17 to 8.09) and significant (P= .023). Significant increases in risk of TMJ arthralgia occurred with condylar erosion grade III (7.7:1; 95% CI, 3.09 to 19.18; P < .001). The study provides evidence of an association between TMJ condylar erosion and chronic TMJ arthralgia.