Imaging Sci Dent.  2012 Dec;42(4):249-253. 10.5624/isd.2012.42.4.249.

Condylar bony changes in patients with temporomandibular disorders: a CBCT study

• Nah KS

• KMID: 1806792
• DOI: http://doi.org/10.5624/isd.2012.42.4.249

Abstract

PURPOSE
Diagnosis of osteoarthritis most commonly depends on clinical and radiographic findings. The present study attempted to observe the bony changes in temporomandibular joint (TMJ) patients from all age groups.
MATERIALS AND METHODS
The first-visit clinical records and cone beam computed tomography (CBCT) data of 440 TMJs from 220 consecutive TMJ patients were reviewed retrospectively.
RESULTS
The most frequent condylar bony change observed was sclerosis (133 joints, 30.2%) followed by surface erosion (129 joints, 29.3%), flattening of the articular surface (112 joints, 25.5%), and deviation in form (58 joints, 13.2%), which included 33 TMJs in a cane-shape, 16 with a lateral or medial pole depression, 6 with posterior condylar surface flattening, and 3 with a bifid-shaped condyle. Fifty-three joints (12.0%) showed hypoplastic condyles but only 1 joint showed hyperplasia. Osteophyte was found in 35 joints (8.0%) and subcortical cyst in 24 joints (5.5%), 5 of which had surface erosion as well. One hundred nineteen joints (27.0%) had only one kind of condylar bony change, 66 joints (15.0%) had two, 52 joints (11.8%) had three, 12 joints (5.0%) had four, and 6 joints (1.4%) had five kinds of condylar bony changes at the same time. Eighty-five (65.9%) of 129 joints with surface erosion had pain recorded at the chief complaint.
CONCLUSION
With more widespread use of CBCT, more specific or detailed guidelines for osteoarthritis are needed.

Keyword

Cone-Beam Computed Tomography; Temporomandibular Joint; Osteoarthritis; Pain

MeSH Terms

Cone-Beam Computed Tomography
Depression
Humans
Hyperplasia
Joints
Osteoarthritis
Osteophyte
Sclerosis
Temporomandibular Joint

Figure

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  Fig. 1 Generalized sclerosis of the right condyle (35/F).

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  Fig. 2 Surface erosion of the right condyle (15/F).

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  Fig. 3 Cane-shaped remodeling of both condyles (16/F).

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  Fig. 4 Lateral pole depression of the right condyle (20/M).

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  Fig. 5 Medial pole flattening of the left condyle (15/M).

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  Fig. 6 Posterior surface flattening of the right condyle (61/M).

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  Fig. 7 Posterior surface erosion of the right condyle (34/F).

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  Fig. 8 Superior surface flattening of the right condyle (41/F).

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