Kadın TMD Hastalarında Kondil Şeklinin ve Artiküler Eminens Morfolojisi ile Yaşa Bağlı Değişikliklerin İlişkisinin KIBT ile Değerlendirilmesi

Yıl 2019, Cilt: 3 Sayı: 2, 69 - 73, 30.12.2019

Berceste Polat Akmansoy , Şebnem Erçalık Yalçınkaya

https://doi.org/10.35333/ERD.2019.107

Öz

Amaç: Bu çalışmanın amacı temporomandibular eklem rahatsızlığı (TMR) olan bir grup kadın hastada kondil şeklinin ve artiküler eminens eğimi ile yaşa bağlı değişikliklerin ilişkisinin değerlendirilmesidir.

Metot: TMR’si bulunan yaşları 18-45 arasında değişen 32 kadın hastanın 64 adet temporomandibular ekleminin KIBT görüntüleri sagittal ve koronal kesitlerde değerlendirildi. Kondil şekli görsel olarak değerlendirildi ve artiküler eminens eğimi “best-fit” ve “top-roof” metotları ile belirlendi. Ayrıca artiküler eminens yüksekliği de ölçüldü. Hastalar 18-30 ve 31-45 olarak iki yaş grubuna ayrıldı. Verilerin kıyaslanmasının istatistiksel analizi için SPSS yazılımı ile uygulanan “Mann-Whitney-U test” kullanıldı.

Bulgular: Sagittal düzlemde en sık görülen kondil şekli düz (% 39.1) iken koronal düzlemde üçgen (% 43.8) olarak tespit edildi. Koronal kesitte üçgen kondil başı şeklinin görülme oranı % 31.3 olarak belirlendi. İki yaş grubu arasında artiküler eminens eğimi ve yüksekliği açısından istatistiksel olarak anlamlı bir fark bulunamadı.

Sonuç: Kadın TMR hastalarında üçgen ve düz kondil başı tipleri en sık görülen kondil başı tipleri olarak saptanmıştır. AE eğiminin 18-30 yaş grubunda daha yüksek bulunmasına rağmen diğer grup ile arasında istatistiksel olarak anlamlı bir fark belirlenememiştir.

Anahtar Kelimeler

Temporomandibular eklem rahatsızlıkları, konik ışınlı bilgisayarlı tomografi, artiküler eminens eğimi ve yüksekliği, kondil şekli

Cone Beam CT Evaluations of Condyle Shape and Age-Related Associations of Articular Eminence Morphology in Female TMD Patients

Öz

Aim: The aim of this study was to assess condyle shape and the relationship between age-related associations and articular eminence (AE) inclination in a group of female patients with temporomandibular disorder (TMD).

Methods: CBCT images of 64 temporomandibular joints (TMJs) of 32 female TMD patients (18-45-year-old) were evaluated sagittally and coronally. Condyle shape was assessed visually and the inclination of AE was analyzed using with best-fit and top-roof methods. AE heights were also measured. The patients were grouped into two age groups: 18 to 30- and 31 to 45-year-old. Data were statistically analyzed with SPSS software using Mann-Whitney-U test.
Results: The most frequently observed condyle shape was flattened (39,1 %) in sagittal plane and triangular (43,8 %) in coronal plane. Triangular condyle shape was seen in 31.3% of condyles on coronal sections. No statistically significant differences were seen in two different age groups comparing AE inclination and height.

Conclusion: Triangular and flattened condyles were the most frequent condyle shape in female TMD patients. Although AE inclination was highest between the ages of 18-30, there was no statistical significance.

Anahtar Kelimeler

Temporomandibular joint disorders, cone beam computed tomography, articular eminence inclination and height, condyle shape

Kaynakça

• 1. Pandis N, Karpac J, Trevino R, Williams B: A radiographic study of condyle position at various depths of cut in dry skulls with axially corrected lateral tomograms. Am J Orthod Dentofacial Orthop 1991;100:116-122.
• 2. Katsavrias EG: Changes in articular eminence inclination during the craniofacial growth period. Angle Orthod 2002;72:258-264.
• 3. Sümbüllü MA, Çağlayan F, Akgül HM, Yılmaz AB: Radiological examination of the articular eminence morphology using cone beam CT. Dentomaxillofac Radiol 2012;41:234-240.
• 4. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 4th ed. St Louis, Mo: Mosby-Year Book; 1998:127-146.
• 5. Katsavrias EG: Morphology of the temporomandibular joint in subjects with class II division 2 malocclusions. Am J Orthod Dentofacial Orthop 2006;129:470-478.
• 6. Bae S, Park MS, Han JW, Kim YJ: Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints. Maxillofac Plast Reconstr Surg 2017;39(1):19.
• 7. Shahidi S, Salehi P, Abedi P, Dehbozorgi M, Hamedani S, Berahman N: Comparison of the Bony Changes of TMJ in Patients With and Without TMD Complaints Using CBCT. J Dent (Shiraz) 2018;19(2):142-149.
• 8. Warren MP, Fried JL: Temporomandibular disorders and hormones in womens. Cell Tiss Org 2001;169:187-192.
• 9. Koyama J, Nishiyama H, Hayashi T: Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofac Radiol 2007;36:472-477.
• 10. Mazzetto MO, Rodrigues CA, Magri LV, Melchior MO, Paiva G. Severity of TMD related to age, sex and electromyographic analysis. Braz Dent J 2014;25(1):54-8.
• 11. Talmaceanu D, Lenghel LM, Bolog N, Hedesiu M, Buduru S, Rotar H, Baciut M, Baciut G: Imaging modalities for temporomandibular joint disorders: an update. Clujul Med. 2018;91(3):280-287.
• 12. Westesson PL, Katzberg RW, Tallents RH, Sanchez‑Woodworth RE, Svensson SA: CT and MR of the temporomandibular joint: comparison with autopsy specimens. Am J Roentgenol 1987;148:1165‑71.
• 13. Hedge S, Praveen BN, Shetty SR: Morphological and radiological variations of mandibular condyles in health and diseases: a systematic review. Dentistry 2013;3 (1):1-5.
• 14. Pontual ML, Freire JS, Barbosa JM, Fraza MA, Pontual A, Silveira MM: Evaluation of bone changes in the temporomandibular joint using cone beam CT. Dentomaxillofac Radiol 2012;41:24‑29.
• 15. Borahan MO, Mayil M, Pekiner FN: Using cone beam computed tomography to examine the prevalence of condylar bony changes in a Turkish subpopulation. Niger J Clin Pract 2016;19(2):259-66.
• 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 Radiol 2014;30:84-91.
• 17. Katsavrias EG: The effect of mandibular protrusive (activator) appliances on articular eminence morphology. Angle Orthod 2003;73:647-653.
• 18. Yamada K, Tsuruta A, Hanada K, Hayashi T: Morphology of the articular eminence in temporomandibular joints and condylar bone change. J Oral Rehabil 2004;31:438-444.
• 19. Estomaguio GA, Yamada K, Ochi K, Hayashi T, Hanada K: Craniofacial morphology and inclination of the posterior slope of the articular eminence in female patients with and without condylar bone change. Cranio 2005;23:257-263.
• 20. Sato S, Kawamura K, Motegi K, Takashi K: Morphology of the mandibular fossa and the articular eminence in temporomandibular joints with anterior disk displacement. Int J Oral Maxillofac Surg 1996;25:236-238.
• 21. Siriwat PP, Jarabak JR: Malocclusion and facial morphology: is there a relationship? The Angle Orthodontist 1985;55(2):127-138.