Zaara, A Baig, Brenda Yeung
Adeyinka Dayo
Oral Medicine, University of Pennsylvania School of Dental Medicine
Introduction
Temporomandibular joint (TMJ) disorder has been a highly dynamic and evolving study, and the diagnosis of this disorder has advanced past subjective clinical findings to detailed imaging diagnostic features. CBCT enables the doctor to look at the unique anatomy of the TMJ from a 3D point of view. We looked at the CBCT of Orthodontic patients to document osseous changes that may signal degenerative processes. Our study strictly considered TMJ degenerative joint disease from a radiographic and imaging perspective using distinct osseous morphology.
Methods
A retrospective chart review was completed by evaluating the electronic records of orthodontic patients attending University of Pennsylvania School of Dental Medicine from January 2015 to December 2020. IRB approval was obtained. All orthodontic patients with a large field of view (FOV) CBCT that captured the TMJ were included. to allow the evaluation of its osseous structure. Descriptive statistics was carried out to document proportions of the evaluated variables.
Results
There were variations between the affectation of the right and left TMJs. Subchondral sclerosis of the left and right condyles was the most prevalent at 78%, followed by thickening of the cortex bilaterally at 66%, both are signs of functional remodeling. The third most prevalent condition was flattening of the condyles with 53% mild flattening on the right side and 63% on the left condyle. Erosions, osteophyte formation, lacunae and ankyloses, which are obvious signs of progressive degeneration of the osseous structures of the TMJs, were less prevalent. Calcifications within the articular joint space was rarely observed, (1%).
Conclusion
Our study documents the proportion of degenerative osseous changes in the TMJ and hence alerts the Orthodontist of prevailing conditions. The information on the osseous morphology and health status of the TMJ is invaluable for the Orthodontist who uses occlusal forces to re-align teeth.