MRI analysis of the relationship between bone changes in the temporomandibular joint and articular disc position in symptomatic patients

Abstract

Objectives: The aim of this study was to investigate bone changes in the condyle, articular eminence and glenoid fossa in relation to the position of the articular disc. Methods: 148 temporomandibular joints (TMJs) of 74 symptomatic patients who underwent MRI were evaluated. The position of the disc was classified as either normal (N), disc displacement with reduction (DDwR), disc displacement without reduction (DDwoR) and posterior displacement (PD). Bone changes were investigated in the condyle and temporal components of the TMJ and classified as osteophytosis, sclerosis or erosion. Results: There were no bone changes in the glenoid fossa of the temporal bone. Of the total number of TMJs studied, 94 (63.5%) were N, 34 (23%) presented DDwoR, 19 (12.8%) presented DDwR and 1 (0.7%) presented PD. The bone changes in the condyle and posterior aspect of the articular eminence were associated with the position of the disc. The bone changes in the anterior aspect of the articular eminence were not associated with the position of the disc. Conclusion: In cases of DDwoR, bone changes in the condyles were more common. The combination of erosion and osteophytosis in the condyle and the bone changes of the posterior aspect of the articular eminence were associated with disc position.

Osteoarthritic Changes After Superior and Inferior Joint Space Injection of Hyaluronic Acid for the Treatment of Temporomandibular Joint Osteoarthritis With Anterior Disc Displacement Without Reduction: A Cone-Beam Computed Tomographic Evaluation

“…Erosion and osteophyte were extremely common in patients with ADDw/oR and the condyle became small in the follow-up period. 2 Interestingly, some patients with severe degenerative changes at 3 months had reparative remodeling at 9 months. This may be because the condyle still stayed at the early phases of remodeling in susceptible individuals 3 months after treatment.…”

Comparative study of the prevalence of temporomandibular joint osteoarthritic changes in cone beam computed tomograms of patients with or without temporomandibular disorder

“…Similar to the RDC/TMD Validation Project, 3 the osteoarthritic changes considered in the present study were only those detected within the condylar component because of the reportedly lower prevalence of such findings in the temporal component, 9,10 and no attempts were made to designate the extent of the osseous changes because such designations may be highly subjective, difficult to standardize, and reduce reliability. 3 The diagnostic efficacy of CBCT in the detection of morphologic changes of the osseous components of the TMJs has been found to be very high, 11,12 with interactive viewing of CBCT images reportedly being more accurate than viewing of static images.…”

Inclination of the condylar long axis is not related to temporomandibular disc displacement

“…Although the degree of convergence between the condyle and articular eminence varies from person to person, changes occur within the pattern of normality . The imaging methods for anatomical evaluation of the TMJ are computed tomography and magnetic resonance imaging (MRI), with the former being the most commonly chosen for evaluating bone components, and the latter being the gold standard method for assessing disc derangements, as well as being used to study the condylar position and osseous changes …”

“…5 The imaging methods for anatomical evaluation of the TMJ are computed tomography and magnetic resonance imaging (MRI), with the former being the most commonly chosen for evaluating bone components, and the latter being the gold standard method for assessing disc derangements, 6 as well as being used to study the condylar position and osseous changes. 7,8 The condyle has a wide anatomical variation, usually assuming an elliptical configuration, and therefore determining a long axis of two distinct poles: the medial and lateral poles. It has been observed that the lateral pole positions anterior to the medial ones, which leads to an angulation between the long axes of right and left condyles, vary between 140 and 160°.…”