Temporomandibular Joints’ Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking—A Case Control Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Protocol
2.3. Imaging Procedures
2.4. Measurements
2.4.1. Morphology of the Mandibular Condyle
2.4.2. Morphology of the Glenoid Fossa (Mandibular Fossa, Articular Fossa)
2.4.3. Morphology of the Articular Eminence
2.4.4. Assessment of the Anterior, Posterior, and Superior Joint Spaces
2.4.5. Assessment of the Sagittal Position of the Condyle
- P—posterior joint space,
- A—anterior joint space.
- The concentric position of the condyle was diagnosed if the condylar ratio was ±12%.
- The posterior position of the condyle was diagnosed if the condylar ratio was <−12%.
- The anterior position of the condyle was diagnosed if the condylar ratio was >12%.
2.4.6. Frequency of the Osteoarthritic Osseous Changes
2.4.7. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Comparable Characteristics | Unilateral Clicks (N = 25) | Bilateral Clicks (N = 25) | Control (No Clicks) (N = 55) | p-Value |
---|---|---|---|---|
Age | 0.1545 1 | |||
av. (SD) | 26.9 (9.0) | 23.0 (7.4) | 24.9 (7.3) | |
range | 16–47 | 16–42 | 16–44 | |
median | 24.8 | 19.2 | 22.7 | |
95% CI | [23.2; 30.6] | [20.0; 26.1] | [22.9;26.8] | |
Sex | 0.4174 2 | |||
female | 17 (68.0%) | 21 (84.0%) | 41 (74.5%) | |
male | 8 (32.0%) | 4 (16.0%) | 14 (25.5%) |
Comparable Characteristics | Control Group (TMJs with no Clicks) | TMJ’s with Reciprocal Clicking | p-Value |
---|---|---|---|
(N = 135) | (N = 75) | ||
CONDYLE | |||
Shape of condyle head | 0.2839 1 | ||
flattened | 30 (22.2%) | 19 (25.3%) | |
convex | 57 (42.2%) | 23 (30.7%) | |
angled | 18 (13.4%) | 16 (21.3%) | |
round | 30 (22.2%) | 17 (22.7%) | |
Condylar width [mm] | 0.4883 2 | ||
av. (SD) | 19.0 (2.1) | 18.7 (2.3) | |
range | 13.4–23.9 | 11.7–23.1 | |
median | 19.2 | 18.8 | |
25–74% percentile | 17.4–20.4 | 17.2–20.4 | |
95% CI | [18.6;19.3] | [18.2;19.3] | |
Condylar A-P dimension [mm] | 0.0399 3 | ||
av. (SD) | 6.8 (1.2) | 6.3 (1.6) | |
range | 3.5–11.7 | 2.3–11.4 | |
median | 6.7 | 6.3 | |
25–74% percentile | 6.0–7.5 | 5.4–7.4 | |
95% CI | [6.6;7.0] | [5.9;6.6] | |
GLENOID FOSSA | |||
Shape | 0.1261 1 | ||
oval | 77 (57.0%) | 53 (70.7%) | |
trapezoidal | 31 (23.0%) | 15 (20.0%) | |
triangular | 18 (13.3%) | 6 (8.0%) | |
angled | 9 (6.7%) | 1 (1.3%) | |
Depth [mm] | 0.5284 3 | ||
av. (SD) | 9.8 (1.3) | 9.7 (1.5) | |
range | 6.3–12.4 | 6.6–12.9 | |
median | 9.9 | 9.9 | |
25–74% percentile | 8.7–10.9 | 8.7–10.5 | |
95% CI | [9.5; 10.0] | [9.3; 10.0] | |
Length [mm] | 0.3283 3 | ||
av. (SD) | 20.5 (2.3) | 20.1 (1.9) | |
range | 16.1–28.3 | 15.6–26.4 | |
median | 20.2 | 20.1 | |
25–74% percentile | 19.1–21.7 | 19.1–21.4 | |
95% CI | [20.1; 20.9] | [19.7; 20.6] | |
Divergence angle [°] | 0.7879 3 | ||
av. (SD) | 56.7 (14.8) | 55.3 (13.2) | |
range | 26.0–100.5 | 29.2–94.2 | |
median | 55.0 | 56.4 | |
25–74% percentile | 44.8–64.7 | 44.5–64.6 | |
95% CI | [54.2; 59.3] | [52.3; 58.4] | |
ARTICULAR EMINENCE | |||
Height [mm] | 0.7227 2 | ||
av. (SD) | 8.1 (2.1) | 8.0 (2.0) | |
range | 3.6–13.4 | 3.0–13.7 | |
median | 8.2 | 8.1 | |
25–74% percentile | 6.6–9.6 | 6.6–9.3 | |
95% CI | [7.8; 8.5] | [7.5; 8.5] | |
Divergence angle [°] | 0.6435 2 | ||
av. (SD) | 82.9 (14.7) | 81.9 (15.6) | |
range | 49.7–127.6 | 43.7–115.1 | |
median | 81.0 | 83.2 | |
25–74% percentile | 73.0–90.8 | 69.8–91.4 | |
95% CI | [80.4; 85.4] | [78.3; 85.5] | |
CONDYLAR HEAD POSITION | |||
(P-A)/(P+A) [%] | 0.0149 2 | ||
av. (SD) | −2.9 (22.2) | −10.9 (23.2) | |
range | −69.4–56.0 | −55.8–60.9 | |
median | 0.0 | −10.5 | |
25–74% percentile | −15.8–11.6 | −31.6–2.0 | |
95% CI | [−6.7;0.9] | [−16.2; −5.6] | |
Superior | 0.8566 2 | ||
av. (SD) | 3.2 (0.9) | 3.2 (1.0) | |
range | 1.2–6.1 | 1.2–6.5 | |
median | 3.3 | 3.1 | |
25–74% percentile | 2.7–3.8 | 2.5–3.6 | |
95% CI | [3.1;3.4] | [3.0;3.4] | |
Position | 0.0425 1 | ||
anterior | 32 (23.7%) | 10 (13.3%) | |
posterior | 43 (31.9%) | 36 (48.0%) | |
concentric | 60 (44.4%) | 29 (38.7%) | |
OSTEOARTHRITIC CHANGES | |||
Number of osteoarthritic changes | 0.0152 3 | ||
av. (SD) | 2.3 (1.2) | 1.8 (1.1) | |
range | 0.0–5.0 | 0.0–5.0 | |
median | 2 | 2 | |
25–74% percentile | 1.0–3.0 | 1.0–2.0 | |
95% CI | [2.0; 2.5] | [1.6; 2.1] | |
Subcortical sclerosis | 39 (28.9%) | 31 (41.3%) | 0.0668 1 |
Osteophyte | 32 (23.7%) | 25 (33.3%) | 0.1327 1 |
Subcortical cyst | 7 (5.2%) | 16 (21.3%) | 0.0003 1 |
Surface erosion | 55 (40.7%) | 33 (44.0%) | 0.6465 1 |
Articular surface flattening | 121 (89.6%) | 68 (90.7%) | 0.8103 1 |
Generalized sclerosis | 0 (0.0%) | 2 (2.7%) | 0.0566 1 |
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Derwich, M.; Mitus-Kenig, M.; Pawlowska, E. Temporomandibular Joints’ Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking—A Case Control Study. Int. J. Environ. Res. Public Health 2020, 17, 3428. https://doi.org/10.3390/ijerph17103428
Derwich M, Mitus-Kenig M, Pawlowska E. Temporomandibular Joints’ Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking—A Case Control Study. International Journal of Environmental Research and Public Health. 2020; 17(10):3428. https://doi.org/10.3390/ijerph17103428
Chicago/Turabian StyleDerwich, Marcin, Maria Mitus-Kenig, and Elzbieta Pawlowska. 2020. "Temporomandibular Joints’ Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking—A Case Control Study" International Journal of Environmental Research and Public Health 17, no. 10: 3428. https://doi.org/10.3390/ijerph17103428