Assessing joint space and condylar position in the people with normal function of temporomandibular joint with cone-beam computed tomography

Abstract

Background:The optimal position of the condyle in glenoid fossa is a fundamental question in dentistry. There is no quantitative standard for the optimal position of mandibular condyle in the glenoid fossa in our population. The purpose of this study is to assess the position of the condyle by cone beam computed tomography (CBCT) images in patient with normal function of temporomandibular joint (TMJ).Materials and Methods:In this cross-sectional study, CBCT images of 40 class I skeletal patients (15 males and 25 females) without history of TMJ disorders were selected. Next, the anterior, superior and posterior joint spaces (Ajs, Sjs, Pjs) were measured on the two true central sagittal slices. Then medial (M) and lateral (L) joint spaces on true coronal view were measured in the right and left sides, separately. After that, P/A ratio, S/A ratio and M/L ratio were calculated. Finally, a paired t-test and independent samples t-test were employed for analysis.Results:The centric position of the condyle in glenoid fossa was more common (92.5%) than other positions. Significant differences in Ajs, Sjs, Pjs, Mjs and Ljs values between two sides were observed (P ≤ 0.05). Additionally, Sjs showed statistically significant differences between the sexes (P = 0.05). P/A ratio and S/A ratio had significant differences between two sides but not between those sexes.Conclusion:The assessment of joint spaces in right and left sides should be done independently. Overall, the measured joint spaces except Sjs are not different in two sexes. The data from this study could be a useful and comparable reference for the clinical assessment of condylar position in patients with normal functional joints.

Sagittal joint spaces of the temporomandibular joint: Systematic review and meta-analysis

“…The meta-analysis showed high levels of heterogeneity among the selected studies what is possibly explained by the high heterogeneity between the selected studies: the sample sizes varies between 24 27 and 464 patients, 31 there are different samples from carefully selected normal joints 19,27 to patients presenting malocclusions 21,26,[31][32][33]35 or temporomandibular disorders 23,24 and different methods 19,25,27 were used to determine the joint spaces (as showed during the systematic review). All these factors may have contributed to high heterogeneity between the samples.…”

“…Aditionally, six prospective [19][20][21][22][23][24] and eleven retrospective [25][26][27][28][29][30][31][32][33][34][35] studies were found that fullfilled the elegibility criteria defined for this review. Six of the selected articles 22,25,27,[32][33][34] used CBCT to assess the TMJ joint space while nine [18][19][20][21]23,26,28,30,35 used conventional CT and three 24,29,31 used linear tomography.…”

“…Seven studies [19][20][21][22][23]28,35 did not present an adequate sample description, with no information about the age or gender. The other eleven 18,[24][25][26][27][29][30][31][32][33][34] showed at least, the number of patients from each gender and data concerning the age of the included sample (mean, standard deviation, minimum and maximum values). The error analysis was presented in seven of the articles.…”

Morphological Variations of the Condyle Using Cone Beam Computed Tomography – A Retrospective Study.

“…Advances in CT has provided an increased accuracy in the diagnosis of degenerative bone changes by limiting the problems encountered during imaging that include superimposition of adjacent structures, different angulations of the condyle, presence of artifacts and mandibular movements during the examination 8 .It was suggested that CT could be reserved for ankylosis of TMJ, complex facial fractures, suspected tumors etc. considering the high dose of radiation and cost involved 9 .Thus, CBCT provides images with high diagnostic quality at a lower exposure and is cost effective when compared to CT.…”

Avaliação da posição condilar em pacientes com DTM antes e após terapia com placa interoclusal estabilizadora por meio de tomografia computadorizada de feixes cônicos

“…Trabalhos recentes foram realizados com o objetivo de avaliar a posição condilar e medir os espaços articulares em pacientes sem sinais e sintomas de DTM articular, por meio de tomografia computadorizada de feixes cônicos (IKEDA; KAWAMURA, 2009;VITRAL et al, 2011;DALILI et al, 2012 Os pacientes participantes desta pesquisa foram tratados com placa interoclusal estabilizadora construída pela técnica preconizada por Okeson (2008). Para que a placa interoclusal estabilizadora tenha eficácia, as cabeças da mandíbula devem estar localizados em uma posição músculo-esqueleticamente estável (ME), que é a relação cêntrica (RC).…”