Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography

Abstract

Degenerative arthritis is an age-related disease. The progression and severity of osseous changes in the condylar head and mandibular fossa are increased with age. In older age groups, patients are expected to have more frequent and severe progressive degenerative bony changes due to the development of TMJ osteoarthritis than patients in younger age groups.

Evaluation of bone changes in the temporomandibular joint using cone beam CT

“…15,16 In our study, 78% of the patients were female and 22% were male. LeResche 15 found that pain in the temporomandibular region is twice as common in women than in men.…”

“…27,28 In our study, flattening and osteophyte degenerative bone changes were the predominant findings. This was verified by Güler et al 24 using MRI in patients who had bruxism, by Alexious et al 16 who, using CBCT, found erosion, flattening and osteophytes to be the most common radiographic finding of the condyle and by Campos et al, 23 who found osteophytes and erosion to be more prevalent in their MRI study.…”

“…The classification of condylar mobility was (a) hypomobility, (b) normal mobility and (c) hypermobility Women 63 25 187 75 250 78 Men 29 42 40 58 69 22 Total 92 29 227 71 319 100 Age group (years) 10-29 21 40 31 60 52 16 30-39 29 31 64 69 93 30 40-49 16 26 46 74 62 19 50-59 11 24 35 76 46 14 60-69 9 24 29 76 38 12 70-79 1 6 15 94 16 5 80-89 5 42 7 58 12 4 Total 92 29 227 71 319 100 n, number of patients TMJ bone changes evaluation using CBCT characteristics with regards to internal derangements and found that hormonal factors do not seem to play a significant role in the manifestation of internal derangements in TMJs. According to Alexious et al, 16 patients in older age groups are expected to have more frequent and severe bone changes than those in younger age groups. In our study, with the exception of patients aged 80-89 years, the prevalence of bone changes increased with age, as reported by Foucart et al, 19 who assessed the TMJs of patients with disc displacement without reduction, and in agreement with LeResche, 15 who found that pain in the TMJ region occurs in approximately 10% of the population over the age of 18 years.…”

“…When assessing the influence of horizontal angulation on the degenerative bone changes in the TMJ, Cruzoé-Rebello et al 18 suggested that one joint influences the other and for that reason they cannot be considered separately, as in the study by Nebbe et al 21 and Alexious et al 16 The movements of the mandible are co-ordinated by both joints, which are functionally unified, and the functional unification could justify the high prevalence of bilateral bone changes, as observed by Katzberg 22 and in our study. Moreover, in our study, in spite of having a higher prevalence of left-side TMJs with bone changes, the difference was not significant compared with the prevalence on the right side.…”

“…In order to avoid misinterpretation, bone changes had to be found in at least two consecutive slices. The bone changes evaluated were flattening (a flat bony contour deviating from the convex form), erosion (an area of decreased density of the cortical bone and the adjacent subcortical bone), osteophytes (marginal bony outgrowths on the condyle), sclerosis (an area of increased density of cortical bone extending into the bone marrow) 16 and pseudocysts (well-circumscribed osteolytic adjacent subcortical bone area without cortical destruction). The bone changes are shown in Figure 1.…”