Abstract
This study aimed to understand long-term changes of the osteoarthritic temporomandibular joint (TMJ) condyle using computed tomography (CT) and to verify its correlation with clinical characteristics of temporomandibular disorders. Eighty-nine patients (152 joints; 76 female, 13 male) who had taken follow-up CTs (mean follow-up period: 644.58 ± 325.71 days) at least once in addition to their initial evaluation were selected. Cross-sectional demographic and clinical data and longitudinal CT images were collected. Data were analyzed by analysis of variance and logistic regression. Overall destructive change index (number of TMJ condyle sections in which destructive change was observed) decreased from 1.56 to 0.66. Improvement was seen in 93 joints (61.2%) and 27 joints (17.8%) worsened. In the pain positive group, both initial and final destructive change index were significantly higher compared to the pain negative group (p = 0.04). Occlusal stabilization splint therapy and nonsteroidal anti-inflammatory drug administration showed a significant effect on improving the prognosis of TMJ osteoarthritis (p = 0.015 and 0.011). In conclusion, TMJ osteoarthritis showed long-term improvement in the majority of cases. TMJ osteoarthritis accompanied by pain showed unfavorable prognosis with additional bone destruction. Occlusal stabilization splint and nonsteroidal anti-inflammatory drug administration were beneficial on the prognosis of TMJ osteoarthritis.
Highlights
Signs and symptoms of temporomandibular joint (TMJ) OA include pain, movement limitations, clicking and crepitus sounds, and most critically joint deformity that can be identified through radiographic imaging
TMJ OA is a relatively common phenomenon that appears in patients complaining of TMD symptoms but it can be incidentally identified during the course of any dental procedure
Deformity of the TMJ condyle due to OA can be confirmed with radiography and diagnosis is becoming more effective with the development of imaging modalities such as computed tomography
Summary
Signs and symptoms of temporomandibular joint (TMJ) OA include pain, movement limitations, clicking and crepitus sounds, and most critically joint deformity that can be identified through radiographic imaging. Osseous changes of TMJ OA manifest as flattening, osteophyte formation, sclerosis, erosion, joint mice, and subchondral bone cysts. The TMJ condyle is a small bone that is surrounded by various adjacent structures that make visualizing detailed bony status difficult with plain radiography. Computed tomography (CT) images provide an advantageous view of osseous changes by allowing visualization of the bony structure in multiple dimensions with superior reliability and accuracy compared to panoramic radiographs and conventional tomography[5,6]. The disagreement between the severity of clinical symptoms and radiographic evidence is well described in several previous studies of TMJ OA based on CT results. On the other hand other studies state that factors such as age and gender have a larger impact on TMJ OA prognosis[7,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
