Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2019, vol. 56, nr 1, January-March, p. 81–87

doi: 10.17219/dmp/102946

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Comparative assessment of condylar position in patients with temporomandibular disorder (TMD) and asymptomatic patients using cone-beam computed tomography

Ocena porównawcza położenia wyrostka kłykciowego u pacjentów z zaburzeniami stawów skroniowo-żuchwowych i bez objawów klinicznych z wykorzystaniem tomografii stożkowej

Abbas Shokri1,A,F, Hossein Hosseini Zarch2,A,C, Fatemeh Hafezmaleki1,A,B, Ronak Khamechi1,B, Payam Amini3,C, Leila Ramezani1,D,E

1 Dental Implant Research Center, Department of Oral and Maxillofacial Radiology, School of Dentistry, Hamadan University of Medical Sciences, Iran

2 Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Iran

3 Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

Abstract

Background. Temporomandibular disorders (TMD) are the most common reason of non-dental pain in the orofacial region. A clinical examination of the temporomandibular joint (TMJ) with additional imaging is the most recommended procedure for TMD diagnosis.
Objectives. The objective of this study was to evaluate the association between TMD and the condylar position in the glenoid fossa by examining a group of patients suffering from TMD compared with a control group of patients without TMD. In this study, we used cone-beam computed tomography (CBCT) images for measurements.
Material and Methods. Sixty-five symptomatic joints were selected from 48 patients with TMD. Sixtyfive joints were selected from a total of 96 asymptomatic joints in the control group. The superior, anterior and posterior area of the joint, and the steepness of the articular eminence were measured on the CBCT images. The data was analyzed using Pearson’s χ2 test.
Results. The position of the condyle was significantly more posterior in the joints with TMD, and more anterior and centric in the asymptomatic joints. Statistically, the vertical position of the condyle and the steepness of the articular eminence had no significant relation with the occurrence of TMD.
Conclusion. In this study, we observed that the posterior condylar position is more common in TMD patients, but it is not the reason for diagnosing TMD, and the reason of the posterior position of the condyle should be investigated before any decisions pertaining to treatment are made. In future, studies should focus on evaluating how the position of the condyle will change after the treatment of patients with TMD.

Key words

cone-beam computed tomography, temporomandibular disorders, condylar position

Słowa kluczowe

stożkowa tomografia komputerowa, zaburzenia stawów skroniowo-żuchwowych, położenie wyrostka kłykciowego

References (47)

  1. Mazzetto MO, Veneziam GC, Magri LV, Nasr MK, Paiva AF, Paiva G. Evaluation of the condylar position in subjects with temporomandibular joint functional disorders by cone beam computed tomography. Braz Dent Sci. 2014;17(2):77–82.
  2. Manfredini D, Guarda-Nardini L, Winocur E, Piccotti F, Ahlberg J, Lobbezoo F. Research diagnostic criteria for temporomandibular disorders: A systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(4):453–462.
  3. Salemi F, Shokri A, Maleki FH, Farhadian M, Dashti G, Ostovarrad F. Effect of field of view on detection of condyle bone defects using cone beam computed tomography. J Craniofac Surg. 2016;27(3):644–648.
  4. de Sena MF, de Mesquita KSF, Santos FRR, Silva FWGP, Serrano KVD. Prevalence of temporomandibular dysfunction in children and adolescents. Rev Paul Pediatr. 2013;31(4):538–545.
  5. Schiffman E, Ohrbach R, Truelove E, et al.; International RDC/TMD Consortium Network, International Association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28(1):6–27.
  6. Paknahad M, Shahidi S, Iranpour S, Mirhadi S, Paknahad M. Cone-beam computed tomographic assessment of mandibular condylar position in patients with temporomandibular joint dysfunction and in healthy subjects. Int J Dent. 2015;2015:3017966.
  7. Salemi F, Shokri A, Mortazavi H, Baharvand M. Diagnosis of simulated condylar bone defects using panoramic radiography, spiral tomography and cone-beam computed tomography: A comparison study. J Clin Exp Dent. 2015;7(1):e34–e39.
  8. Ikeda K, Kawamura A. Assessment of optimal condylar position with limited cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2009;135(4):495–501.
  9. Paknahad M, Shahidi S. Association between mandibular condylar position and clinical dysfunction index. J Craniomaxillofac Surg. 2015;43(4):432–436.
  10. Al-Koshab M, Nambiar P, John J. Assessment of condyle and glenoid fossa morphology using CBCT in South-East Asians. PLoS ONE. 2015;10(3):e0121682.
  11. Imanimoghaddam M, Madani AS, Mahdavi P, Bagherpour A, Darijani M, Ebrahimnejad H. Evaluation of condylar positions in patients with temporomandibular disorders: A cone-beam computed tomographic study. Imaging Sci Dent. 2016;46(2):127–131.
  12. Ren YF, Isberg A, Westesson PL. Condyle position in the temporomandibular joint. Comparison between asymptomatic volunteers with normal disk position and patients with disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80(1):101–107.
  13. Ikeda K, Kawamura A. Disc displacement and changes in condylar position. Dentomaxillofac Radiol. 2013;42(3):84227642.
  14. Yang HJ, Kim DS, Yi WJ, Hwang SJ. Reduced joint distance during TMJ movement in the posterior condylar position. J Craniomaxillofac Surg. 2013;41(7):e159–e164.
  15. Ahmad M, Hollender L, Anderson Q, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): Development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(6):844–860.
  16. Pullinger AG, Hollender L, Solberg WK, Petersson A. A tomographic study of mandibular condyle position in an asymptomatic population. J Prosthet Dent. 1985;53(5):706–715.
  17. Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol. 2009;38(3):141–147.
  18. Ozkan A, Altug HA, Sencimen M. Senel B. Evaluation of articular eminence morphology and inclination in TMJ internal derangement patients with MRI. Int J Morphol. 2012;30(2):740–744.
  19. Manfredini D, Piccotti F, Ferronato G, Guarda-Nardini L. Age peaks of different RDC/TMD diagnoses in a patient population. J Dent. 2010;38(5):392–399.
  20. Wiese M, Svensson P, Bakke M, et al. Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms. J Orofac Pain. 2008;22(3):239–251.
  21. Zhao YP, Zhang ZY, Wu YT, Zhang WL, Ma XC. Investigation of the clinical and radiographic features of osteoarthrosis of the temporomandibular joints in adolescents and young adults. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111(2):e27–e34.
  22. Petrikowski CG, Grace MGA. Age and gender differences in temporomandibular joint radiographic findings before orthodontic treatment in adolescents. Oral Surg Oral Med Oral Pathol Oral Radiol. 1999;87(3):380–385.
  23. Warren MP, Fried JL. Temporomandibular disorders and hormones in women. Cells Tissues Organs. 2001;169(3):187–192.
  24. Widmalm SE, Westesson PL, Kim IK, Pereira FJ Jr, Lundh H, Tasaki MM. Temporomandibular joint pathosis related to sex, age, and dentition in autopsy material. Oral Surg Oral Med Oral Pathol. 1994;78(4):416–425.
  25. Cho BH, Jung YH. Osteoarthritic changes and condylar positioning of the temporomandibular joint in Korean children and adolescents. Imaging Sci Dent. 2012;42(3):169–174.
  26. Lelis ER, Guimaraes Henriques JC, Tavares M, de Mendonça MR, Fernanades Neto AJ, Almeida Gde A. Cone-beam tomography assessment of the condylar position in asymptomatic and symptomatic young individuals. J Prosthet Dent. 2015;114(3):420–425.
  27. Scapino RP. Histopathology associated with malposition of the human temporomandibular joint disc. J Oral Surg Oral Med Oral Pathol. 1983;55(4):382–397.
  28. Internal derangement related to osteoarthrosis in temporomandibular joint autopsy specimens. Oral Surg Oral Med Oral Pathol. 1984;57(1):17–22.
  29. Incesu L, Taşkaya-Yılmaz N, Öğütcen-Toller M, Uzun E. Relationship of condylar position to disc position and morphology. Eur J Radiol. 2004;51(3):269–273.
  30. Artun J, Hollender LG, Truelove EL. Relationship between orthodontic treatment, condylar position, and internal derangement in the temporomandibular joint. Am J Orthod Dentofacial Orthop. 1992;101(1):48–53.
  31. Ozawa S, Boering G, Kawata T, Tanimoto K, Tanne K. Reconsideration of the TMJ condylar position during internal derangement: Comparison between condylar position on tomogram and degree of disk displacement on MRI. Cranio. 1999;17(2):93–100.
  32. Sugiyama H, Ozawa S, Suei Y, Taguchi A, Tanimoto K, Tanne K. Association of condylar position with anterior disk displacement and disk morphology in patients with internal derangement of the TMJ: A study with axially corrected sagittal tomography and MRI [in Japanese]. J Jpn Soc TMJ. 1997;9:439–449.
  33. Tanne K, Okamoto Y, Su SC, Mitsuyoshi T, Asakawa-Tanne Y, Tanimoto K. Current status of temporomandibular joint disorders and the therapeutic system derived from a series of biomechanical, histological, and biochemical studies. APOS Trends Orthod. 2015;5(1):4–21.
  34. Dawson PE. New definition for relating occlusions to varying conditions of the temporomandibular joint. J Prosthet Dent. 1995;74(6):619–627.
  35. Manzione JV, Tallents RH. “Pseudomeniscus” sign: Potential indicator of repair or remodeling in the temporomandibular joints with internal derangement. Radiology. 1992;185(Suppl):175.
  36. Kurita H, Ohtsuka A, Kobayashi H, Kurashina K. A study of the relationship between the position of the condylar head and displacement of the temporomandibular joint disk. Dentomaxillofac Radiol. 2001;30(3):162–165.
  37. Honey OB, Scarfe WC, Hilgers MJ, et al. Accuracy of cone-beam computed tomography imaging of the temporomandibular joint: Comparisons with panoramic radiology and linear tomography. Am J Orthod Dentofacial Orthop. 2007;132(4):429–438.
  38. Bonilla-Aragon H, Tallents RH, Katzberg RW, Kyrkanides S, Moss ME. Condyle position as a predictor of temporomandibular joint internal derangement. J Prosthet Dent. 1999;82(2):205–208.
  39. Herbosa EG, Rotskoff KS, Ramos BF, Ambrookian HS. Condylar position in superior maxillary repositioning and its effect on the temporomandibular joint. J Oral Maxillofac Surg. 1990;48(7):690–696.
  40. Brand JW, Whinery JG Jr, Anderson QN, Keenan KM. Condylar position as a predictor of temporomandibular joint internal derangement. Oral Surg Oral Med Oral Pathol. 1989;67(4):469–476.
  41. Alexander SR, Moore RN, DuBois LM. Mandibular condyle position: Comparison of articulator mountings and magnetic resonance imaging. Am J Orthod Dentofacial Orthop. 1993;104(3):230–239.
  42. Mazzone N, Matteini C, Incisivo V, Belli E. Temporomandibular joint disorders and maxillomandibular malformations: Role of condylar “repositionin” plate. J Craniofac Surg. 2009;20(3):909–915.
  43. Costa F, Robiony M, Toro C, Sembronio S, Polini F, Politi M. Condylar positioning devices for orthognathic surgery: A literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(2):179–190.
  44. Shahidi S, Vojdani M, Paknahad M. Correlation between articular eminence steepness measured with cone-beam computed tomography and clinical dysfunction index in patients with temporomandibular joint dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(1):91–97.
  45. Toyama M, Kurita K, Koga K, Ogi N. Ankylosis of the temporomandibular joint developing shortly after multiple facial fractures. Int J Oral Maxillofac Surg. 2003;32(4):360–362.
  46. Ren YF, Isberg A, Westesson PL. Steepness of the articular eminence in the temporomandibular joint. Tomographic comparison between asymptomatic volunteers with normal disk position and patients with disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80(3):258–266.
  47. Gökalp H, Türkkahraman H, Bzeizi N. Correlation between eminence steepness and condyle disc movements in temporomandibular joints with internal derangements on magnetic resonance imaging. Eur J Orthod. 2001;23(5):579–584.