Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations

Kılıç, Songül Cömert; Kılıç, Nihat; Sümbüllü, Muhammed Akif

doi:10.1016/j.ijom.2015.06.023

Cited by 104 publications

(75 citation statements)

References 27 publications

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“…The diagnosis based only on clinical examination without imaging has a sensitivity of 0.55 and a specificity of 0.61 [31]. Cone beam computed tomography (CBCT) is dedicated for the diagnosis of the temporomandibular joint bony structures, including assessment of the shape of the joint surfaces, the head of the condyle, and the width of the articular space [1,21,23,25,27]. There are three major radiographic symptoms of DJD: subcortical pseudocyst, osteophyte, and surface erosion.…”

Section: Discussionmentioning

confidence: 99%

“…In the CBCT images, the presence of the osteoarthritic changes was assessed. The radiographic symptoms of degenerative joint disease are [20,[24][25][26][27][28][29] as follows: flattening of the convex condylar head; erosion (the area of reduced density within the cortex and subcortical bone); osteophytes (bone outgrowths on the surface of the condyles); sclerosis (increased density of the cortical plate or bone tissue under the cortical plate); pseudocysts (osteolytic, well delimited, localized in the subcortical area, the cortical layer does not become destroyed in its course). Figure 1 presents the exemplary osteoarthritic changes found in the TMJ CBCT scans.…”

Section: Protocolmentioning

confidence: 99%

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Morphology of the Temporomandibular Joints Regarding the Presence of Osteoarthritic Changes

Derwich

Mituś-Kenig

Pawłowska

2020

IJERPH

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1) Osteoarthritis, the most common disease of the temporomandibular joints (TMJs), is diagnosed by clinical and radiographic examination. Cone beam computed tomography (CBCT) is a method of choice for the imaging of osteoarthritic changes. The objective was to compare the morphology of the TMJs in CBCT images regarding the number of the osteoarthritic changes diagnosed in the area of the condyle. (2) A total of 105 patients participated in the study; their 210 TMJs were allocated into one of three groups regarding the number of diagnosed osteoarthritic changes: 1 (none or 1 type), 2 (2 types), 3 (3 or more types). The morphology of the TMJ was examined for each TMJ in the CBCT images. Statistical analysis was performed with STATISTICA version 12.0. The statistical significance level was p = 0.05 for all the measurements included. (3) The articular surface flattening was the most common type of the osteoarthritic changes (90%). The condylar A-P dimension differed significantly among the groups (p = 0.0001). The bigger the number of osteoarthritic changes diagnosed in one joint, the smaller the condylar A-P dimension that was observed. (4) The temporomandibular joints' osteoarthritic changes occur very often, even among asymptomatic patients. The increased number of osteoarthritic changes seems to have an impact on the condylar anteroposterior dimension. Author Contributions: Conceptualization, M.D.; methodology, M.D.; validation, M.D., M.M.-K., and E.P.; formal analysis, M.D.; investigation, M.D.; resources, M.D.; writing-original draft preparation, M.D.; writing-review and editing, M.M.-K. and E.P.; visualization, M.D.; supervision, M.M.-K. and E.P.; project administration, M.D., M.M.-K., and E.P. All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding. Conflicts of Interest:The authors declare no conflict of interest.

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Section: Discussionmentioning

confidence: 99%

Section: Protocolmentioning

confidence: 99%

Morphology of the Temporomandibular Joints Regarding the Presence of Osteoarthritic Changes

Derwich

Mituś-Kenig

Pawłowska

2020

IJERPH

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“…As mention before, AC eliminates the inflammatory by-products of synovial fluids and stimulates the normal lubrication properties of synovial membrane ( 31 ).…”

Section: Discussionmentioning

confidence: 96%

Is arthrocentesis of temporomandibular joint with corticosteroids beneficial? A systematic review

Davoudi

Khaki²,

Mohammadi³

et al. 2018

Med Oral

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BackgroundTemporomandibular disorders (TMDs) are musculoskeletal conditions that can inhibit the normal function of temporomandibular joints (TMJs) and affect the patient’s quality of life, negatively. Arthrocentesis (AC) is a minimally invasive surgical procedure used for treating TMDs. The aim of present paper is to evaluate the advantages of administrating corticosteroid (CS) during AC by reviewing high quality released articles.Material and MethodsSearching on Cochrane Library, Web of Science, Google Scholar, PubMed, ProQuest, and Scopus databases were performed with focusing on proper key words. Related titles and abstracts, up to December 2017, were screened and selected based on inclusion criteria. The full text of all randomized controlled trials (RCTs) was extensively read and subjected to quality assessments.ResultsAfter initial search, a total of 2067 articles were included into the study. Finally, 7 studies were reliable enough in methodology and randomization to be included into the study. All of the observed studies showed improvements in jaw functions and pain relief with no statistical differences in both AC and control groups. One study reported painless maximum incisal opening in CS group than the control group.ConclusionsBased on available RCTs, the AC of TMJ with CS seems to result in similar findings to other therapeutic drugs, with no significant differences. Key words:Arthrocentesis, corticosteroid, temporomandibular joints, temporomandibular joint disorders.

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“…Conversely, for the investigation of hard tissues, such as condylar position and osseous changes, other imaging modalities, such as cone-beam computed tomography (CBCT), are more suitable [30, 31]. Yet, in this population-based study, CT scans would not have been allowed by the ethical committee to be used.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, TMJs with signs of osteoarthrosis are not necessarily associated with more symptoms of TMDs than TMJs without osteoarthrosis [84, 85]. On the other hand, clinical signs and symptoms of TMJ osteoarthritis are poorly correlated with osseous changes depicted with computed tomography [86] or CBCT [30]. Indeed, for a long time it has been known that on the basis of radiographic findings it is difficult to differentiate between osteoarthrosis and adaptive remodeling [87].…”

Section: Discussionmentioning

confidence: 99%

Disk displacement, eccentric condylar position, osteoarthrosis – misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts

et al. 2016

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BackgroundClinical decision-making and prognostic statements in individuals with manifest or suspected temporomandibular disorders (TMDs) may involve assessment of (a) the position of articular disc relative to the mandibular condyle, (b) the location of the condyle relative to the temporal joint surfaces, and (c) the depth of the glenoid fossa of the temporomandibular joints (TMJs). The aim of this study was twofold: (1) Determination of the prevalence of these variables in two representative population-based birth cohorts. (2) Reinterpretation of the clinical significance of the findings.MethodsFrom existing magnetic resonance imaging (MRI) scans of the TMJs that had been taken in 2005 and 2006 from 72 subjects born between 1930 and 1932 and between 1950 and 1952, respectively, the condylar position at closed jaw was calculated as percentage displacement of the condyle from absolute centricity. By using the criteria introduced by Orsini et al. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:489-97, 1998), a textbook-like disc position at closed jaw was distinguished from an anterior location. TMJ morphology of the temporal joint surfaces was assessed at open jaw by measuring the depth of the glenoid fossa, using the method proposed by Muto et al. (J Oral Maxillofac Surg 52:1269-72, 1994).Frequency distributions were recorded for the condylar and disc positions at closed jaw.Student’s t-test with independent samples was used as test of significance to detect differences of condylar positions between the age cohorts (1930 vs. 1950) and the sexes. The significance levels were set at 5%. First, the results from the measurement of the age cohorts were compared without differentiation of sexes, i.e., age cohort 1930–1932 versus age cohort 1950–1952. Subsequently, the age cohorts were compared by sex, i.e., men in cohort 1930–1932 versus men in cohort 1950–1952, and women in cohort 1930–1932 women men in cohort 1950–1952.ResultsIn both cohorts, condylar position was characterized by great variability. About 50% of the condyles were located centrically, while the other half was either in an anterior or in a posterior position. In both female cohorts, a posterior position predominated, whereas a centric position prevailed among men. Around 75% of the discs were positioned textbook-like, while the remaining forth was located anteriorly. Age had no statistically significant influence on condylar or on disc position. Conversely, comparison between the age groups revealed a statistically significant decrease of the depth of the glenoid fossa in both older cohorts. This age-dependent changes may be interpreted as flattening of the temporal joint surfaces.ConclusionsWe call for a re-interpretation of imaging findings because they may insinuate pathology which usually is not present. Instead, anterior or posterior positions of the mandibular condyle as well as an anterior location of the articular disc should be construed as a variation of normalcy. Likewise, flattening of articular surfaces of the TMJs may be considered ...

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Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations

Cited by 104 publications

References 27 publications

Morphology of the Temporomandibular Joints Regarding the Presence of Osteoarthritic Changes

Morphology of the Temporomandibular Joints Regarding the Presence of Osteoarthritic Changes

Is arthrocentesis of temporomandibular joint with corticosteroids beneficial? A systematic review

Disk displacement, eccentric condylar position, osteoarthrosis – misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts

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