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

Derwich, Marcin; Mituś-Kenig, Maria; Pawłowska, Elżbieta

doi:10.3390/ijerph17103428

Cited by 14 publications

(9 citation statements)

References 31 publications

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“…Small samples undermine the internal and external validity of a study and large samples tend to transform small differences into statistically significant differences (18). When assessing the TMJ, each patient counts as two TMJs and sample sizes of the assessed literature varied from 11 to 800 (5,8,13,14,(19)(20)(21).…”

Section: Literature Reviewmentioning

confidence: 99%

The morphometric measurements of the temporomandibular joint

Melo¹,

Silva²,

Campos³

et al. 2021

Front Oral Maxillofac Med

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The temporomandibular joint (TMJ) is a synovial joint classified for its surface shape and complex biaxial movements as a ginglimoartrodial joint and presents the widest joint range of movements when compared with the other joints of the human body. The complexity of TMJ morphology has driven researchers to investigate its morphometric features and their relationship with temporomandibular disorders (TMD). Therefore, the knowledge of morphological and morphometric data of each bone component of the TMJ is of paramount importance for identifying bone changes related to the TMJ, in the presence of TMD in symptomatic and non-symptomatic patients. This literature review aims to assess previous studies on the TMJ bone structures morphological and morphometric findings and discuss what these findings implicate on TMDs. The assessed studies varied in sample size and categorization, and measurement methodologies [measurements done directly on specimen, image modality-computed tomography (CT), cone beam computed tomography (CBCT), magnetic resonance imaging (MRI)], study method of choice and main morphometric points). Morphometric measurements of the condyle, articular fossa and articular eminence were assessed in different planes (axial, sagittal and coronal). Male patients present higher condyle and glenoid fossa morphometric measurement values than female patients, however, when considering the articular eminence's inclination/steepness the gender difference is not conclusive. When more than one image method was assessed, a slight difference has been observed between the image modalities. It can be concluded that large, paired samples and longitudinal studies using non-ionizing images are still needed to assess the TMJ morphometric values and its association with internal disorders, age, ethnicity, and gender.

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Section: Literature Reviewmentioning

confidence: 99%

The morphometric measurements of the temporomandibular joint

Melo¹,

Silva²,

Campos³

et al. 2021

Front Oral Maxillofac Med

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“…Minor symptoms may include headache, ear pain, tinnitus, depression, and vertigo. Previous research has investigated associations between clinical symptoms and degenerative changes on CBCT (10)(11)(12)(13). According to Arayasantiparb et al, crepitation had a statistically significant correlation with CBCT findings such as sclerosis, subchondral cyst, erosion, and osteophyte formation (10).…”

Section: Introductionmentioning

confidence: 99%

Analysis of three-dimensional imaging findings and clinical symptoms in patients with temporomandibular joint disorders

Jeon¹,

Lee²,

Choi³

et al. 2021

Quant Imaging Med Surg

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Background: The purpose of this study was to analyze cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) findings in temporomandibular joint disorder (TMD) patients and to comprehensively assess the relationships between these imaging findings and clinical symptoms.Methods: A total of 754 temporomandibular joints (TMJs) in 377 patients with clinical symptoms of TMD who underwent both CBCT and MRI examinations were retrospectively reviewed. Clinical symptoms included TMJ pain, TMJ sound, and limitation of mouth opening. Oral radiologists evaluated osseous changes of the condylar head on CBCT, as well as the disc configuration, internal derangement, and joint effusion on MRI. The frequency of CBCT and MRI findings and the mean and standard deviation of age were analyzed. Logistic regression analysis was used to identify associations between these imaging findings and clinical symptoms using SPSS version 25.0 for Windows (IBM Corp., Armonk, NY, USA). The model fit was evaluated using the Hosmer and Lemeshow test.Results: TMD patients consisted of 294 females and 83 males, and the age group of 20-39 accounted for 47.2% of the patients. Normal findings regarding osseous changes of the condylar head on CBCT were found in 65.1% of the patients. On MRI, a change in disc configuration was found in 54.9% of the patients, internal derangement in 62.6%, and joint effusion in 46.0%. TMJ pain was significantly associated with sclerosis [odds ratio (OR): 3.81], disc displacement without reduction (DDWOR) (OR: 3.22), grade 2 joint effusion (OR: 2.33), and grade 3 joint effusion (OR: 5.54). TMJ sound was significantly associated with disc displacement with reduction (DDWR) (OR: 3.04), DDWOR (OR: 2.50), grade 2 joint effusion (OR: 2.37), and grade 3 joint effusion (OR: 3.23). Limitation of mouth opening was significantly associated with flattened disc configuration (OR: 2.08), folded disc configuration (OR: 2.30), and grade 3 joint effusion (OR: 2.85).Conclusions: CBCT findings had little to do with clinical symptoms. In contrast, MRI findings, including disc configuration, internal derangement, and joint effusion, were associated with clinical symptoms. These results suggest that MRI should be recommended over CBCT for the proper diagnosis of TMD patients.

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“…The study analyzes the same group of patients we have already presented in two of our previous studies [ 18 , 19 ]. There were 50 generally healthy patients included in the study who had been diagnosed with reciprocal clicking with at least one of the temporomandibular joints and 55 generally healthy patients who had never presented any symptoms related to TMD, including reciprocal clicking.…”

Section: Methodsmentioning

confidence: 99%

“…Due to the fact that many patients who are seeking orthodontic treatment present symptoms of temporomandibular joint disorders (TMD), including reciprocal clicking [ 18 ], it seems necessary to check if the reciprocal clicking is related to the mandibular morphology and its position, and if yes, if can we predict development of TMD in the near future on the basis of cephalometric analysis.…”

Section: Introductionmentioning

confidence: 99%

Is the Temporomandibular Joints’ Reciprocal Clicking Related to the Morphology and Position of the Mandible, as Well as to the Sagittal Position of Lower Incisors?—A Case-Control Study

Derwich¹,

Mituś-Kenig

Pawłowska

2021

IJERPH

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The number of patients diagnosed with temporomandibular joint (TMJ) internal derangements, who are seeking orthodontic treatment, is increasing. The aim of the study was to assess the relationship between the presence of TMJ reciprocal clicking and the morphology and position of the mandible, and position of lower incisors, examined on the lateral cephalograms. Fifty patients diagnosed with reciprocal clicking in at least one of the TMJs and 55 patients with no symptoms of TMJ dysfunction were included in the study. Cephalometric analysis was used for the assessment of: skeletal class, sagittal and vertical position of the mandible, angle of the mandible, inclination of the mandibular ramus and the mandibular corpus, as well as for the assessment of the position of the mandibular incisors. The statistical significance level was set at p = 0.05. There were no statistically significant differences between the examined groups regarding the sagittal and vertical position of the mandible, as well as regarding the sagittal position of the mandibular incisors. Presence of TMJ reciprocal clicking is not associated with the position and the morphology of the mandible, as well as with the sagittal position of the mandibular incisors. Patients with early stages of TMJ internal derangements do not present any significant changes in Cephalometrics. Patients diagnosed with TMJ internal derangements before orthodontic treatment require an interdisciplinary approach to the treatment, including physiotherapy.

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

Cited by 14 publications

References 31 publications

The morphometric measurements of the temporomandibular joint

The morphometric measurements of the temporomandibular joint

Analysis of three-dimensional imaging findings and clinical symptoms in patients with temporomandibular joint disorders

Is the Temporomandibular Joints’ Reciprocal Clicking Related to the Morphology and Position of the Mandible, as Well as to the Sagittal Position of Lower Incisors?—A Case-Control Study

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