Osteoarthrosis of Temporomandibular Joint Related to the Defects of Posterior Dentition: A Retrospective Study.

Jitka Levorová,Vladimír Machoň,René Foltán,Anasuya Guha

doi:10.14712/23362936.2016.18

Jitka Levorová, Vladimír Machoň + Show 2 more

Open Access

https://doi.org/10.14712/23362936.2016.18

Copy DOI

Abstract

Osteoarthrosis (OA) of temporomandibular joint (TMJ) is a progressive degenerative disease, gradually affecting cartilage, synovial membrane and bone structures. OA of TMJ clinically manifests with joint noises, pain and restricted mouth opening. In late stages, it results in severe damage of TMJ structures and development of ankylosis. Osteoarthrosis is a multifactorial disease; the occurrence is associated with TMJ overloading. The cohort included 619 patients [538 women (87%) and 81 men (13%), with average age 40.6 years (age range 8-89 years)] with TMJ disorder, who were examined in the year 2014 in Department of Dental Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic. The aim of this retrospective study was to analyse, if the lack of posterior teeth (supporting teeth zones) is the main etiologic factor of osteoarthrosis of TMJ. Diagnosis of OA was established on the clinical signs and the panoramic X-ray signs. Simultaneously other etiologic factors of OA were assessed. The presence of OA changes on X-ray had 171 patients (i.e. 27.6% of the total number of 619). 17.5% from these patients with OA had defect in posterior dentition. Other aetiological factors (stress, skeletal or vertebrogenous disorders) showed higher incidence of OA changes on X-ray. Defect of posterior dentition is not negligible, but it is not the main aetiological factor for osteoarthrosis of TMJ.

Highlights

Temporomandibular joint (TMJ) osteoarthrosis (OA) is a chronic disease, which manifests with progressive degenerative changes of joint structures
Osteoarthrosis was evaluated based on the presence of degenerative changes on the panoramic radiograph; the study included both symptomatic and non-symptomatic patents with OA.To evaluate the defects of the support zones, panoramic radiographs and clinical examination were used
The examined group consisted of 619 patients (TMJ disorder, without further osteological, autoimmune, rheumatoid, metabolic diseases). 538 women (87%) and 81 men (13%)

Summary

Introduction

Temporomandibular joint (TMJ) osteoarthrosis (OA) is a chronic disease, which manifests with progressive degenerative changes of joint structures. Late stages of the disease, the height of the condylar process may be shortened This condition leads to anterior open bite and development of Angle Class II (Figure 2). Degenerative changes of joint surfaces and disc perforation are risk factors for the development of ankylosis (pathological fusion between mandibular condylar head and glenoid fossa) (Figure 3).The most extensive arthritic changes and ankylosis are an indication for total joint replacement (Figure 4); other treatment modalities for OA are conservative, miniinvasive (arthrocenthesis, arthroscopy) or other types of open surgery, based on the severity of degenerative changes (Mercuri, 2008; Adebajo, 2009; Machoň and Hirjak, 2014)

Methods

Results

Discussion

Conclusion