Assessment of Morphological Alterations of Temporomandibular Joint Articular Surfaces in Patients with Temporomandibular Dysfunction

Year 2021, Volume: 22 Issue: 3, 229 - 234, 30.12.2021

Rüya Sessiz Ak Emre Köse

https://doi.org/10.4274/meandros.galenos.2021.07108

Cited By: 2

Abstract

Objective: This study aimed to examine the distribution of condyle and articular fossa shapes in patients with temporomandibular joint dysfunction (TMD) and their relationship with each other using cone-beam computed tomography (CBCT) images.
Materials and Methods: CBCT scans of 134 patients (268 joints) with TMD were evaluated retrospectively. In the coronal and sagittal views, condyles were classified based on the following basic shapes: round, oval, flattened, and triangular. Shapes of the articular fossa were classified as oval, triangular, angled, and trapezoidal. The evaluation was made in the sagittal and coronal sections where the articular fossa and mandibular condyle were most clearly seen. Data were analyzed using the chi-square test.
Results: Sagittal-oval and coronal-flattened condyles were seen more frequently than other shapes. Identical sagittal and coronal condyles were observed in 83 joints (30.97%). In sagittal sections, the shapes of the articular fossa were oval in 128 (47.8%), angular in 68 (25.4%), trapezoid in 50 (18.7%), and triangular in 22 (8.2%) patients. The most common fossa shape was oval in each shape of the condyles in sagittal and coronal sections. No relationship was found between gender or age groups and shapes of the articular fossa and condyle in all sections.
Conclusion: Knowledge of condyle and fossa shapes may help clinicians understand morphological bone changes in patients with TMD. CBCT can be used as an accurate diagnostic tool when three-dimensional examinations of TMJ bone surfaces are necessary.

Keywords

Cone-beam computed tomography , mandibular condyle , temporomandibular joint

References

• 1. Okeson JP. *Management of Temporomandibular Disorders and Occlusion-E-Book*. Elsevier Health Sciences; 2019.
• 2. Yalcin ED, Ararat E. Cone-Beam Computed Tomography Study of Mandibular Condylar Morphology. *J Craniofac Surg* 2019; 30: 2621-4.
• 3. Nah KS. Condylar bony changes in patients with temporomandibular disorders: a CBCT study. *Imaging Sci Dent* 2012; 42: 249-53.
• 4. Miettinen O, Anttonen V, Patinen P, Päkkilä J, Tjäderhane L, Sipilä K. Prevalence of Temporomandibular Disorder Symptoms and Their Association with Alcohol and Smoking Habits. *J Oral Facial Pain Headache* 2017; 31: 30-6.
• 5. 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: 844-60.
• 6. Al-koshab M, Nambiar P, John J. Assessment of condyle and glenoid fossa morphology using CBCT in South-East Asians. *PLoS One* 2015; 10: e0121682.
• 7. de Boer EW, Dijkstra PU, Stegenga B, de Bont LG, Spijkervet FK. Value of cone-beam computed tomography in the process of diagnosis and management of disorders of the temporomandibular joint. *Br J Oral Maxillofac Surg* 2014; 52: 241-6.
• 8. Rozylo-Kalinowska I, Orhan K. *Imaging of the Temporomandibular Joint*. Springer International Publishing; 2019: 10: 978-3.
• 9. Ozdede M, Apaydın BK. Temporomandibular Eklem Görüntülemesi. In: Ozcan I, editor. *Oral Radyoloji Akıl Notları*. Ankara: Güneş Tıp Kitabevleri; 2020: 375-90.
• 10. Hashimoto K, Arai Y, Iwai K, Araki M, Kawashima S, Terakado M. A comparison of a new limited cone beam computed tomography machine for dental use with a multidetector row helical CT machine. *Oral Surg Oral Med Oral Pathol Oral Radiol Endod* 2003; 95: 371-7.
• 11. Danforth RA, Dus I, Mah J. 3-D volume imaging for dentistry: a new dimension. *J Calif Dent Assoc* 2003; 31: 817-23.
• 12. Navallas M, Inarejos EJ, Iglesias E, Cho Lee GY, Rodríguez N, Antón J. MR Imaging of the Temporomandibular Joint in Juvenile Idiopathic Arthritis: Technique and Findings. *Radiographics* 2017; 37: 595-612.
• 13. Cortés D, Exss E, Marholz C, Millas R, Moncada G. Association between disk position and degenerative bone changes of the temporomandibular joints: an imaging study in subjects with TMD. *Cranio* 2011; 29: 117-26.
• 14. Katsavrias EG. Morphology of the temporomandibular joint in subjects with Class II Division 2 malocclusions. *Am J Orthod Dentofacial Orthop* 2006; 129: 470-8.
• 15. Yasa Y, Akgül HM. Comparative cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals. *Oral Radiol* 2018; 34: 31-9.
• 16. Çağlayan F, Sümbüllü MA, Akgül HM. Associations between the articular eminence inclination and condylar bone changes, condylar movements, and condyle and fossa shapes. *Oral Radiology* 2013; 30: 84-91.
• 17. Santos KC, Dutra ME, Warmling LV, Oliveira JX. Correlation among the changes observed in temporomandibular joint internal derangements assessed by magnetic resonance in symptomatic patients. *J Oral Maxillofac Surg* 2013; 71: 1504-12.
• 18. Matsumoto K, Kameoka S, Amemiya T, Yamada H, Araki M, Iwai K, et al. Discrepancy of coronal morphology between mandibular condyle and fossa is related to pathogenesis of anterior disk displacement of the temporomandibular joint. *Oral Surg Oral Med Oral Pathol Oral Radiol* 2013; 116: 626-32.
• 19. Tassoker M, Kabakci ADA, Akin D, Sener S. Evaluation of mandibular notch, coronoid process, and mandibular condyle configurations with cone beam computed tomography. *Biomed Res* 2017; 28: 8327-35.
• 20. de Farias JF, Melo SL, Bento PM, Oliveira LS, Campos PS, de Melo DP. Correlation between temporomandibular joint morphology and disc displacement by MRI. *Dentomaxillofac Radiol* 2015; 44: 20150023.
• 21. Cimen M, Işik AO, Gedik R. A radiological method on the classification of human mandibular condyles. *Okajimas Folia Anat Jpn* 1999; 76: 263-72.
• 22. Suomalainen A, Kiljunen T, Käser Y, Peltola J, Kortesniemi M. Dosimetry and image quality of four dental cone beam computed tomography scanners compared with multislice computed tomography scanners. *Dentomaxillofac Radiol* 2009; 38: 367-78.
• 23. Hintze H, Wiese M, Wenzel A. Cone beam CT and conventional tomography for the detection of morphological temporomandibular joint changes. *Dentomaxillofac Radiol* 2007; 36: 192-7.
• 24. Sülün T, Akkayan B, Duc JM, Rammelsberg P, Tuncer N, Gernet W. Axial condyle morphology and horizontal condylar angle in patients with internal derangement compared to asymptomatic volunteers. *Cranio* 2001; 19: 237-45.