Evaluation of the Relationship Between Temporomandibular Joint Pathologies and Dentition Using Cone Beam Computed Tomography

Year 2026, Volume: 53 Issue: 1, 11 - 17, 25.03.2026

Merve Kucuk Kurtgoz , Zarif Ece Hammudioğlu , Ceren Aktuna Belgin

https://doi.org/10.52037/eads.2026.0003

https://izlik.org/JA24LF73CU

Abstract

Objective: Temporomandibular joint (TMJ) degeneration is an irreversible disease of the TMJ and its exact etiology is still not clearly known today. Cone beam computed tomography (CBCT) is defined as the most advantageous imaging technique for examining TMJ hard tissue degeneration. The aim of this study is to examine the relationship between TMJ degenerations and dentition, age and gender using CBCT. Material and methods: In the study conducted on 1000 CBCTs, the age, gender and dentition status of the patients were recorded. Degenerative bone changes of the condylar head were evaluated and classified as flattening, erosion, osteophytes, ankylosis, sclerosis and subchondral cyst. The effect of age, gender and dentition status on the presence of degenerative changes was then evaluated. Results: It was observed that the flattening and erosion rate was significantly higher in the group with posterior edentulous, and that the flattening, erosion and subchondral cyst rates were significantly higher in the group with anterior edentulous. It was observed that the rate of flattening, erosion, osteophytes and subchondral cysts was significantly higher in the totally edentulous and fully dentate groups. It was observed that the rate of flattening, osteophytes and subchondral cysts was significantly higher in women. Conclusions: This study showed that increasing age and missing teeth in the dentition cause an increase in the frequency of TMJ degenerations. It has been observed that TMJ degeneration also varies in different groups of missing teeth. It has been observed that the incidence of TMJ pathologies increases in women.

Keywords

temporomandibular joint , degenerative change , age , dentition , cone beam computed tomography

Ethical Statement

This study was approved by Ethical Committee of the Hatay Mustafa Kemal University (decision date:11.06.2024, number:05 )

Supporting Institution

NONE

Thanks

NONE

References

• Kranjcic J, Slaus M, Persic S, Vodanovic M, Vojvodic D. Differences in skeletal components of temporomandibular joint of an early medieval and contemporary Croatian population obtained by different methods. Ann Anat. 2016;203:52–58. doi:10.1016/j.aanat.2015.03.004.
• Wang XD, Zhang JN, Gan YH, Zhou YH. Current understanding of pathogenesis and treatment of TMJ osteoarthritis. J Dent Res. 2015;94(5):666–673. doi:10.1177/0022034515574770.
• Zarb GA, Carlsson GE. Temporomandibular disorders: osteoarthritis. J Orofac Pain. 1999;13(4):295–306.
• Zhao YP, Zhang ZY, Wu YT, Zhang WL, Ma XC. Investigation of the clinical and radiographic features of osteoarthrosis of the temporomandibular joints in adolescents and young adults. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111(2):e27–34. doi:10.1016/j.tripleo.2010.09.076.
• Massilla Mani F, Sivasubramanian SS. A study of temporomandibular joint osteoarthritis using computed tomographic imaging. Biomed J. 2016;39(3):201–206. doi:10.1016/j.bj.2016.06.003.
• Weiss R, Read-Fuller A. Cone Beam Computed Tomography in Oral and Maxillofacial Surgery: An Evidence-Based Review. Dent J (Basel). 2019;7(2). doi:10.3390/dj7020052.
• Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res. 1993;72(6):968–979. doi:10.1177/00220345930720061301.
• Uhac I, Kovac Z, Vukovojac S, Zuvić-Butorac M, Grzić R, Delić Z. The effect of occlusal relationships on the occurrence of sounds in the temporomandibular joint. Coll Antropol. 2002;26(1):285–92.
• Luder HU. Factors affecting degeneration in human temporomandibular joints as assessed histologically. Eur J Oral Sci. 2002;110(2):106–113. doi:10.1034/j.1600-0722.2002.11212.x.
• Kalladka M, Quek S, Heir G, Eliav E, Mupparapu M, Viswanath A. Temporomandibular joint osteoarthritis: diagnosis and long-term conservative management: a topic review. J Indian Prosthodont Soc. 2014;14(1):6–15. doi:10.1007/s13191-013-0321-3.
• von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–349. doi:10.1016/j.jclinepi.2007.11.008.
• Farias-Neto A, Martins AP, Sánchez-Ayala A, Rabie AB, Novaes PD, Rizzatti-Barbosa CM. The effect of posterior tooth loss on the expression of type II collagen, IL-1β and VEGF in the condylar cartilage of growing rats. Arch Oral Biol. 2012;57(11):1551–1557. doi:10.1016/j.archoralbio.2012.05.002.
• Kirveskari P, Alanen P. Association between tooth loss and TMJ dysfunction. J Oral Rehabil. 1985;12(3):189–194. doi:10.1111/j.1365-2842.1985.tb00635.x.
• Agustina EM, Hamzah Z, Cholid Z. Potential number of tooth losses in clicking, popping and crepitation of Temporomandibular Disorders (TMD) in elderly. J Dentomaxillofac Sci. 2020;5(3):185–190. doi:10.15562/jdmfs.v5i3.1078.
• Rawat P, Saxena D, Srivastava PA, Sharma A, Swarnakar A, Sharma A. Prevalence and severity of temporomandibular joint disorder in partially versus completely edentulous patients: A systematic review. J Indian Prosthodont Soc. 2023;23(3):218–225. doi:10.4103/jips.jips_136_23.
• Zakir A, Shah MU, Iqbal M, Yasser F, Hussain MW, Riaz A. Frequency of signs and symptoms of Temporomandibular joint problems in completely Edentulous patients. Isra Med J. 2020;12(1):17–21.
• Pascu L, Haiduc RS, Almaşan O, Leucuţa DC. Occlusion and temporomandibular disorders: A scoping review. Medicina. 2025;61(5):791. doi:10.3390/medicina61050791.
• Tabatabaei S, Paknahad M, Poostforoosh M. The effect of tooth loss on the temporomandibular joint space: A CBCT study. Clin Exp Dent Res. 2024;10(1):e845. doi:10.1002/cre2.845.
• Cardoneanu A, Macovei LA, Burlui AM, Mihai IR, Bratoiu I, Rezus II, et al. Temporomandibular joint osteoarthritis: pathogenic mechanisms involving the cartilage and subchondral bone, and potential therapeutic strategies for joint regeneration. Int J Mol Sci. 2022;24(1):171. doi:10.3390/ijms24010171.
• Mélou C, Pellen-Mussi P, Jeanne S, Novella A, Tricot-Doleux S, Chauvel-Lebret D. Osteoarthritis of the temporomandibular joint: a narrative overview. Medicina. 2022;59(1):8. doi:10.3390/medicina59010008.
• Sharma S, Gupta D, Pal U, Jurel SK. Etiological factors of temporomandibular joint disorders. Natl J Maxillofac Surg. 2011;2(2):116–119. doi:10.4103/0975-5950.94463.
• Bertram F, Hupp L, Schnabl D, Rudisch A, Emshoff R. Association Between Missing Posterior Teeth and Occurrence of Temporomandibular Joint Condylar Erosion: A Cone Beam Computed Tomography Study. Int J Prosthodont. 2018;31(1):9–14. doi:10.11607/ijp.5111.
• Görürgöz C, İçen M, Kurt M, Aksoy S, Bakirarar B, Rozylo-Kalinowska I, et al. Degenerative changes of the mandibular condyle in relation to the temporomandibular joint space, gender and age: A multicenter CBCT study. Dent Med Probl. 2023;60(1). doi:10.17219/dmp/147514.
• Winburn AP, Stock MK. Reconsidering osteoarthritis as a skeletal indicator of age at death. Am J Phys Anthropol. 2019;170(3):459–473. doi:10.1002/ajpa.23914.
• Song HJ, Choi HM, Shin BM, Kim YJ, Park MS, Kim C. Age-stratified analysis of temporomandibular joint osteoarthritis using cone-beam computed tomography. Imaging Sci Dent. 2024;54(1):71. doi:10.5624/isd.20230229.
• Alzahrani A, Yadav S, Gandhi V, Lurie AG, Tadinada A. Incidental findings of temporomandibular joint osteoarthritis and its variability based on age and sex. Imaging Sci Dent. 2020;50(3):245. doi:10.5624/isd.2020.50.3.245.
• Vasegh Z, Safi Y, Azar MS, Ahsaie MG, Arianezhad SM. Assessment of bony changes in temporomandibular joint in patients using cone beam computed tomography–a cross sectional study. Head Face Med. 2023;19(1):47. doi:10.1186/s13005-023-00392-z.
• Liu MQ, Chen HM, Yap AUJ, Fu KY. Condylar remodeling accompanying splint therapy: a cone-beam computerized tomography study of patients with temporomandibular joint disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(2):259–265. doi:10.1016/j.oooo.2012.03.004.
• Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(6):844–860. doi:10.1016/j.tripleo.2009.02.023.