EVALUATION OF TEMPOROMANDIBULAR JOINT CBCT FINDINGS OF OSTEOARTHRITIS IN DIFFERENT PATIENT GROUPS

Abstract

AIM The aim of this study is to evaluate the presence and findings of osteoarthritis based on CBCT images according to different age and gender groups. MATERIAL AND METHODS CBCT images of 764 temporomandibular joints (TMJ) were analyzed retrospectively. Osteoarthritis (OA) findings were grouped as normal or flattened, erosion, sclerosis, subchondral cyst, and osteophyte. These groups were evaluated separately for both sexes and for five separate decades. RESULTS While pseudocyst and flattening among osteoarthritis findings were more common in men, sclerosis was significantly more common in women (p<0.05). Osteoarthritis findings were rarely observed in the 20-29 age group. While erosion and flattening were significantly higher in the 60-69 age group, sclerosis was observed at a higher rate in the 50-59 age group (p<0.05). CONCLUSIONS In women, sclerosis as a sign of OA, and in men, flattening is in the foreground. While the frequency of normal articular eminence decreased regularly with age, flattening, erosion and sclerosis were observed as signs of OA with an increasing rate in advanced age.

Keywords

• osteoarthritis
• computed beam CT
• temporomandibular joints

References

1. 1. Lories RJ, Luyten FP. Osteoarthritis as a whole joint disease.The bone-cartilage unit in osteoarthritis. Nat Rev Rheumatol 2011;7:43–49
2. 2. Poole AR. Osteoarthritis as a whole joint disease. HSS J 2012;8(1):4–6
3. 3. Jacofsky, David J, Anderson, Meredith L, Wolff III, Luther H. Osteoarthritis Hospital Physician 2005;41(7):17–25
4. 4. Jiao K, Niu LN, Wang MQ, Dai J, Yu SB, Liu XD et al. Subchondral bone loss following orthodontically induced cartilage degradation in the mandibular condyles of rats. Bone 2011;48:362–371
5. 5. Dijkgraaf LC, Liem RS, de Bont LG. Ultrastructural characteristics of the synovial membrane in osteoarthritic temporomandibular joints. J Oral Maxillofac Surg 1997;55(11):1269–1279
6. 6. Reny de Leeuw, Gary D Klasser (eds). Orofacial Pain: guidelines for assessment, diagnosis, and management 5th edn. Quintessence Books. 2013
7. 7. Surya Sudhakar GV, Laxmi MS, Rahman T, Anand DS. Long term management of temporomandibular joint degenerative changes and osteoarthritis: an attempt. Clin Cancer Investig J 2018;7:90-6
8. 8. Mejersjö C, Hollender L. Radiography of the temporomandibular joint in female patients with TMJ pain or dysfunction. Acta Radiol Diagn (Stockh) 1984;25:169-76

9. 9. Song H, Lee JY, Huh K, Park JW. Long-term changes of temporomandibular joint osteoarthritis on computed tomography. Sci Rep 2020;10:6731
10. 10. Arieta-Miranda JM, Silva-Valencia M, Flores-Mir C, Paredes Sampen NA, Arriola-Guillen LE. Spatial analysis of condyle position according to sagittal skeletal relationship, assessed by cone beam computed tomography. Prog Orthod 2013;14:36
11. 11. Okeson, JP. Temporomandibular disorders and occlusion. 4th edn. St. Louis: Mosby, Inc;1995
12. 12. Tanrisever S, Orhan M, Bahsi I, Yalcin ED. Anatomical evaluation of the craniovertebral junction on cone-beam computed tomography images. Surg Radiol Anat 2020;42:797–815
13. 13. Bahsi I, Orhan M, Kervancioglu P, Yalcin ED, Aktan AM. Anatomical evaluation of nasopalatine canal on cone beam computed tomography images. Folia Morphol (Warsz) 2019;78:153–162
14. 14. Schmitter M, Essig M, Seneadza V, Balke Z, Schröder J, Rammelsberg P. Prevalence of clinical and radiographic signs of osteoarthrosis of the temporomandibular joint in an older persons community. Dentomaxillofacial Radiology 2010;39(4):231-234
15. 15. Carlsson GE. Epidemiology and treatment need for temporomandibular disorders. Journal of orofacial pain 1999;13(4)
16. 16. Öterberg T, Carlsson GE, Wedel A, Johansson U. A cross-sectional and longitudinal study of craniomandibular dysfunction in an elderly population. Journal of Craniomandibular Disorders 1992;6(4)
17. 17. Salonen L, Hellden L, Carlsson G. Prevalence of signs and symptoms of dysfunction in the masticatory system: an epidemiologic study in an adult Swedish population. J Craniomandib Disord 1990; 4: 241–250
18. 18. NORHEIM PW, DAHL BL. Some self‐reported symptoms of temporomandibular joint dysfunction in a population in Northern Norway. Journal of oral rehabilitation 1978;5(1):63-68
19. 19. Lohmander LS, Dalén N, Englund G, Hämäläinen M, Jensen EM, Karlsson K. Intra-articular hyaluronan injections in the treatment of osteoarthritis on the knee. A randomized, double blind, placebo controlled trial. Hyaluronan Multicentre Trial Group. Ann Rheum Dis 1996;55:424e431
20. 20. Zarb GA, Carlsson GE. Temporomandibular disorders: osteoarthritis. J Orofac Pain 1999;13:295e306
21. 21. John MT, Dworkin SF, Mancl LA. Reliability of clinical temporomandibular disorder diagnoses. Pain 2005;118(1-2):61-69
22. 22. Kiliç SC, Kiliç N, Sümbüllü M. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. International journal of oral and maxillofacial surgery 2015;44(10):1268-1274
23. 23. Ludlow JB, Davies-Ludlow L, Brooks S, Howerton W. Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofacial Radiology 2006;35(4):219-226
24. 24. Larheim T, Abrahamsson A, Kristensen M, Arvidsson L. Temporomandibular joint diagnostics using CBCT. Dentomaxillofacial Radiology 2014;44(1):20140235
25. 25. Widmalm SE, Westesson P-L, Kim I-K, Pereira Jr FJ, Lundh H, Tasaki MM. Temporomandibular joint pathosis related to sex, age, and dentition in autopsy material. Oral surgery, oral medicine, oral pathology 1994;78(4):416-425
26. 26. Ishibashi H, Takenoshita Y, Ishibashi K, Oka M. Age-related changes in the human mandibular condyle: a morphologic, radiologic, and histologic study. Journal of oral and maxillofacial surgery 1995;53(9):1016-1023
27. 27. Yasuoka T, Nakashima M, Okuda T, Tatematsu N. Effect of estrogen replacement on temporomandibular joint remodeling in ovariectomized rats. Journal of oral and maxillofacial surgery 2000;58(2):189-196
28. 28. 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 science in dentistry 2020;50(3):245
29. 29. Koç N. Evaluation of osteoarthritic changes in the temporomandibular joint and their correlations with age: A retrospective CBCT study. Dental and medical problems 2020;57(1):67-72
30. 30. Soydan D, Doğan S, Canger EM, Coşgunarslan A, Akgün IE, Kış HC. Effect of internal derangements and degenerative bone changes on the minimum thickness of the roof of the glenoid fossa in temporomandibular joint. Oral radiology 2020;36(1):25-31