Assessment of degenerative changes in the temporomandibular joint: A retrospective cone-beam computed tomography study

Abstract

Context: Degenerative temporomandibular joint (TMJ) disorders may show radiological characteristics similar to remodeling changes in an asymptomatic joint. Aims: The aim of the study was to evaluate the bone changes in the condylar process of the TMJ in patients and associate the changes with age and gender. Settings and Design: The study was conducted in the Department of Oral Medicine and Radiology, AJ Institute of Dental Sciences over a period of 2 years following institutional ethical clearance. Data were retrieved from the computer database and assessed using cone-beam computed tomography (CBCT) (NewTom VGi evo). Subjects and Methods: Two hundred TMJ CBCT images were assessed in 100 patients. The study sample was carefully selected to exclude patients with any medical problems. The same bone changes in the condylar process were found in at least two consecutive slices by a single observer to avoid misinterpretation. Statistical Analysis: Data were collected and subjected to statistical analysis using kappa statistics for intraobserver reliability and using Chi-square test for comparison of parameters (P < 0.05). Results: Out of the 200 TMJs assessed, no changes were seen in 96 (48%) joints. The most common degenerative change seen was flattening, followed by erosion. When associated with gender, a statistically significant difference was found between males and females (P < 0.05). A statistically significant increase in changes was found with age (P < 0.05). The intraobserver agreement in assessing the CBCT images was carried out using kappa statistic and was found to be in almost perfect agreement (κ = 94.59%, P < 0.005). Conclusion: The study revealed a high frequency of TMJ alterations in male patients with degenerative changes, beginning in individuals <25 years of age and increasing with age. The high prevalence of TMJ changes in patients without complaints, suggests that some people with joint structural damage may not display clinical manifestations.

Keywords

• cone-beam computed tomography
• osseous changes
• temporomandibular joint