Temporomandibular Joints’ Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking—A Case Control Study

Marcin Derwich,Elzbieta Pawlowska,Maria Mitus-Kenig

doi:10.3390/ijerph17103428

Marcin Derwich, Elzbieta Pawlowska + Show 1 more

Open Access

https://doi.org/10.3390/ijerph17103428

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Abstract

Background: Patients referred for orthodontic treatment often present symptoms of temporomandibular joints’ disorders (TMD), predominantly clicking. The objective was to analyze the morphology of the temporomandibular joints in cone-beam computed tomography (CBCT) images based on the presence of reciprocal clicking before orthodontic treatment. Methods: 105 participants took part in the study. 210 temporomandibular joints (TMJs) were allocated into one of two groups regarding the presence of reciprocal clicking. Morphology of condyle’s head, glenoid fossa, and articular eminence as well as condylar head position in the glenoid fossa and osteoarthritic changes in the area of the condylar head were examined for each TMJ in the CBCT images. Statistical analysis was performed with STATISTICA version 12.0. The following tests were performed: U-Mann Whitney, Kruskal-Wallis, t-Student, and chi-square. The statistical significance level was p = 0.05 for all the measurements included. Results: Significantly smaller condylar A-P dimension (p = 0.040) characterized temporomandibular joints with reciprocal clicking. Condyles were substantially more often positioned posteriorly (p = 0.043) and were significantly more often accompanied by subcortical cysts and pathologic osteoarthritic bone changes (p < 0.001). Conclusions: The early stages of internal derangements stay with alterations in morphology and position of TMJs as well as with the presence of osteoarthritic changes.

Highlights

The anatomical structures forming the temporomandibular joint include: the articular surface on the temporal bone, the condyle, the articular disc, the bilaminar zone, and the joint capsule strengthened with ligaments [1,2,3]
The study aimed to compare the morphology of the temporomandibular joints, including mandibular condyle, glenoid fossa, articular eminence, and the position of the condyle in glenoid fossa and presence of osteoarthritic changes in cone-beam computed tomography (CBCT) images based on the presence of reciprocal clicking before orthodontic treatment
Excluded from the study were all the cases with: the age below 16 and above 60 years old, anterior disc displacement without reduction, temporomandibular joint ankylosis, pregnancy, rheumatological diseases, oncological diseases, people who had undergone radiotherapy, patients who had ever had any traumas in the field of head and neck, people who had been treated orthodontically at least once in the past, and those who did not agree to take part in the study [1,8,9]

Summary

Introduction

The anatomical structures forming the temporomandibular joint include: the articular surface on the temporal bone (which consists of the articular fossa, called the mandibular fossa, that is localized in the posterior part and the anteriorly localized articular eminence), the condyle, the articular disc, the bilaminar zone ( known as the retro-discal tissue), and the joint capsule strengthened with ligaments [1,2,3]. Images based on the presence of reciprocal clicking before orthodontic treatment. 210 temporomandibular joints (TMJs) were allocated into one of two groups regarding the presence of reciprocal clicking. Morphology of condyle’s head, glenoid fossa, and articular eminence as well as condylar head position in the glenoid fossa and osteoarthritic changes in the area of the condylar head were examined for each TMJ in the CBCT images.

Methods

Discussion

Conclusion