Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Joint Space Analysis Using Cone-beam Computed Tomography Imaging in Patients Diagnosed with Temporomandibular Joint Osteoarthritis and Occlusal Changes

  • Hyun-Jeong Park (Department of Oral Medicine, School of Dentistry, Chosun University) ;
  • Yo-Seob Seo (Department of Oral and Maxillofacial Radiology, School of Dentistry, Chosun University) ;
  • Jong-Won Kim (Department of Dentistry, Graduate School, Chosun University) ;
  • Sun-Kyoung Yu (Department of Oral Anatomy, School of Dentistry, Chosun University) ;
  • Ji-Won Ryu (Department of Oral Medicine, School of Dentistry, Chosun University)
  • Received : 2023.12.11
  • Accepted : 2023.12.15
  • Published : 2023.12.30
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Abstract

Purpose: This pilot study aimed to evaluate changes in joint space (JS) using cone-beam computed tomography (CBCT) images of patients diagnosed with temporomandibular joint (TMJ) osteoarthritis (OA) and to determine the association between occlusal changes and JS. Methods: CBCT images were used to measure the anterior, superior, and posterior JSs of the sagittal plane. The differences in JS values over time and between groups were compared. The percentage change in the anteroposterior position of the mandibular condyle between groups was also analyzed. Results: Thirty-four subjects (mean age=43.91±20.13), comprising eight males (23.5%) and 26 females (76.5%), were divided into 18 patients with no change in occlusion (NCO) and 16 patients with a change in occlusion (CO) during TMJ OA. The JS measurements of the study subjects showed a decrease in anterior joint space (AJS) values over time. There was no difference in JS measurements between the groups at T1 and T2. AJS values measured at T1 were lower in the CO group than in the NCO group, but the difference was not statistically significant. In both groups, a posterior position of the mandibular condyle was initially observed with high frequency. However, there is a statistically significant difference in CBCT images taken after occlusal changes, with an increased frequency of condyles observed in the anterior or central positions. Conclusions: In conclusion, AJS decreased over time in TMJ OA, and the mandibular condyle became more anteriorly positioned with occlusal changes. Therefore, clinicians should diligently monitor mandibular condyle morphology and JS using CBCT, along with the patient's clinical symptoms, to treat and control TMJ OA effectively.

Keywords

Acknowledgement

This study was supported by a research grant from Chosun University, 2020.

References

  1. Sirin G, Amuk M. Radiographic changes in the temporomandibular joint related to medication in rheumatic diseases. Dentomaxillofac Radiol 2021;50:20200557.
  2. Iturriaga V, Bornhardt T, Velasquez N. Temporomandibular joint: review of anatomy and clinical implications. Dent Clin North Am 2023;67:199-209.
  3. Melou C, Pellen-Mussi P, Jeanne S, Novella A, Tricot-Doleux S, Chauvel-Lebret D. Osteoarthritis of the temporomandibular joint: a Nnarrative overview. Medicina (Kaunas) 2022;59:8.
  4. Liu Q, Yang H, Zhang M, et al. Initiation and progression of dental-stimulated temporomandibular joints osteoarthritis. Osteoarthritis Cartilage 2021;29:633-642.
  5. Li B, Guan G, Mei L, Jiao K, Li H. Pathological mechanism of chondrocytes and the surrounding environment during osteoarthritis of temporomandibular joint. J Cell Mol Med 2021;25:4902-4911.
  6. 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;72:968-979.
  7. Caldas W, Conti AC, Janson G, Conti PC. Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice. J Appl Oral Sci 2016;24:411-419.
  8. Talaat W, Al Bayatti S, Al Kawas S. CBCT analysis of bony changes associated with temporomandibular disorders. Cranio 2016;34:88-94.
  9. Walewski LA, de Souza Tolentino E, Yamashita FC, Iwaki LCV, da Silva MC. Cone beam computed tomography study of osteoarthritic alterations in the osseous components of temporomandibular joints in asymptomatic patients according to skeletal pattern, gender, and age. Oral Surg Oral Med Oral Pathol Oral Radiol 2019;128:70-77.
  10. Kapila SD, Nervina JM. CBCT in orthodontics: assessment of treatment outcomes and indications for its use. Dentomaxillofac Radiol 2015;44:20140282.
  11. Michelotti A, Iodice G. The role of orthodontics in temporomandibular disorders. J Oral Rehabil 2010;37:411-429.
  12. Lee YH, Hong IK, An JS. Anterior joint space narrowing in patients with temporomandibular disorder. J Orofac Orthop 2019;80:116-127.
  13. Alhammadi MS, Almashraqi AA, Thawaba AA, Fayed MMS, Aboalnaga AA. Dimensional and positional temporomandibular joint osseous characteristics in normodivergent facial patterns with and without temporomandibular disorders. Clin Oral Investig 2023;27:5011-5020.
  14. Seo YS, Park HJ, Yu SK, Jeong SR, Ryu JW. Evaluation of cortical bone formation on mandibular condyle in asymptomatic adolescents and young adults using cone-beam computed tomography. Life (Basel) 2022;12:2032.
  15. Vitral RW, Telles Cde S, Fraga MR, de Oliveira RS, Tanaka OM. Computed tomography evaluation of temporomandibular joint alterations in patients with class II division 1 subdivision malocclusions: condyle-fossa relationship. Am J Orthod Dentofacial Orthop 2004;126:48-52.
  16. Dygas S, Szarmach I, Radej I. Assessment of the morphology and degenerative changes in the temporomandibular joint using CBCT according to the orthodontic approach: a scoping review. Biomed Res Int 2022;2022:6863014.
  17. Fraga MR, Rodrigues AF, Ribeiro LC, Campos MJ, Vitral RW. Anteroposterior condylar position: a comparative study between subjects with normal occlusion and patients with Class I, Class II Division 1, and Class III malocclusions. Med Sci Monit 2013;19:903-907.
  18. Al-Wesabi SN, Abotaleb B, Al-Shujaa EA, et al. Three dimensional condylar positional and morphological changes following mandibular reconstruction based on CBCT analysis: a prospective study. Head Face Med 2023;19:3.
  19. Salaorni C, Palla S. Condylar rotation and anterior translation in healthy human temporomandibular joints. Schweiz Monatsschr Zahnmed 1994;104:415-422.
  20. Delpachitra SN, Dimitroulis G. Osteoarthritis of the temporomandibular joint: a review of aetiology and pathogenesis. Br J Oral Maxillofac Surg 2022;60:387-396.
  21. Abrahamsson AK, Kristensen M, Arvidsson LZ, Kvien TK, Larheim TA, Haugen IK. Frequency of temporomandibular joint osteoarthritis and related symptoms in a hand osteoarthritis cohort. Osteoarthritis Cartilage 2017;25:654-657.
  22. Sonnesen L, Petersson A, Wiese M, Jensen KE, Svanholt P, Bakke M. Osseous osteoarthritic-like changes and joint mobility of the temporomandibular joints and upper cervical spine: is there a relation? Oral Surg Oral Med Oral Pathol Oral Radiol 2017;123:273-279.
  23. Okeson JP. Treatment of temporomandibular joint disorders. In: Management of temporomandibular disorders and occlusion. 8th ed. Elsevier; 2019. pp. 346-356.
  24. Ravelo V, Olate G, de Moraes M, Huentequeo C, Sacco R, Olate S. Condylar positional changes in skeletal class II and class III malocclusions after bimaxillary orthognathic surgery. J Pers Med 2023;13:1544.
  25. Al-Rawi NH, Uthman AT, Sodeify SM. Spatial analysis of mandibular condyles in patients with temporomandibular disorders and normal controls using cone beam computed tomography. Eur J Dent 2017;11:99-105.
  26. Tanaka E, Yamano E, Inubushi T, Kuroda S. Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage. Korean J Orthod 2012;42:144-154.