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CONDYLAR OSSEOUS ABNORMALITIES ASSESSMENTS FOR TEMPOROMANDIBULAR JOINT DISORDER UTILZIING CONE BEAM COMPUTED TOMOGRAPHY (CBCT)
Chung, Chan Kwon
Chung, Chan Kwon
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2025-05
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Oral Biology
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https://doi.org/10.34944/drhv-t679
Abstract
Objective: The temporomandibular joint (TMJ) is one of the most used joints in human body and it is primarily used for the masticatory system. It consists of anatomical structures such as condyle, articular disc, retro discal tissue, synovial membrane, and joint capsules which demonstrates complex, but organized movements. Temporomandibular joint disorder (TMD) is when there is disorganization of this joint, in which the etiology is poorly understood. There are many tools that can be utilized to aid in diagnosis of the TMD, which includes CBCT. By taking the CBCT, it will show changes in the condylar osseous contour, condylar position, and angle of the condyle. The purpose of this study is to evaluate the condylar osseous abnormalities and measure the angulation from the neck of condylar notch to head using cone beam computed tomography (CBCT) scans. Gonial angle will also be measured secondarily to see the association. Other variables such as gender, ethnicity, age, dentition status, and systemic considerations that can affect condylar changes will also be evaluated.
Methods: Retrospective analysis of 687 Maxillary CBCT scans of patients treated at the Temple Kornberg School of dentistry were analyzed using Xelis software. Age, gender, ethnicity, and dentition status, parafunctional habit, and TMJ symptoms were recorded for each patient in the study. For each scan the right and left angle of mandibular condyle and gonial angle were measured. Descriptive statistics, bivariate analyses, and multivariable regression analyses were performed using “R” statistical software.
Results: This study included 687 patients, subdivided by gender into 313 were male and 374 were female. Based on ethnicity: there were 262 African Americans, 70 Asians, 274 Caucasians, and 81 Hispanics. 124 of the patients had a complete mandibular dentitions, and 563 patients had missing at least 1 tooth missing in the mandible. The average right condylar angles were 153.43° and the average left condylar angles were 155.46°, while right average gonial angles were 140.59° and left average gonial angles were 142.08°. Condylar angles were varied by gender, with males having higher values. Statistical analysis showed significant associations between condylar shape, position, and angle with age, dentition, parafunctional habits, and TMJ symptoms. Ethnicity and gender had less influential associations. The right gonial angle showed a weak correlation with TMJ symptoms, while the left gonial angle demonstrated a stronger association. No significant relationships were found between gonial angles and age, gender, ethnicity, or dentition.
Conclusions: This study underscores the importance of CBCT imaging in diagnosing TMJ abnormalities, providing valuable insights into early detection and potential intervention strategies. Future research incorporating magnetic resonance imaging (MRI) for soft tissue evaluation alongside with CBCT may enhance diagnostic precision and treatment planning for TMD.
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