Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Comparison of Symptomatic and Asymptomatic Temporomandibular Joints in Unilateral Temporomandibular Joint Disorder: A Morphometric Study
Tek Taraflı Temporomandibular Eklem Bozukluğunda Semptomatik ve Asemptomatik Temporomandibular Eklemin Karşılaştırılması: Morfometrik Bir Çalışma
Hasan CAMCIa, Ömer EKİCİb
aDepartment of Orthodontics, Afyonkarahisar Health Sciences University Faculty of Dentistry, Afyonkarahisar, TURKIYE
bDepartment of Oral and Maxillofacial Surgery, Afyonkarahisar Health Sciences University Faculty of Dentistry, Afyonkarahisar, TURKIYE
Turkiye Klinikleri J Dental Sci. 2022;28(1):113-21
doi: 10.5336/dentalsci.2021-81271
Article Language: EN
Full Text
ABSTRACT
 Objective: To compare healthy and affected joints of patients with the unilateral temporomandibular disorder (TMD) via morphometric measurements of radiographic images. Material and Methods: Forty-one patients aged 16 to 56 years were included in the research. All individuals had chronic unilateral TMD and at least one of the following symptoms had to be unilaterally present in patients: joint pain, joint sound or movement limitation. In order to evaluate a total of 82 temporomandibular joints, 3 angular and 3 linear measurements on orthopantomogram (OPG) and 2 angular and 12 linear measurements on lateral temporomandibular joints image (LTI) were performed. AudaxCeph Version 5.X orthodontic software was used for morphometric measurements. The findings were compared using Student's t-test and Mann-Whitney U test. Results: No significant difference was found between the healthy side and the affected side in all parameters of both OPG and LTI assessments (p>0.05). Conclusion: In patients with unilateral TMD, the hard tissue characteristics of healthy and affected sides were similar.

Keywords: Temporomandibular joint disorders; morphometric analysis; orthopantomogram; lateral temporomandibular joints image
ÖZET
 Amaç: Radyografik görüntülerin morfometrik ölçümleriyle tek taraflı temporomandibular bozukluk (TMB) hastalarının sağlıklı ve etkilenmiş eklemlerini karşılaştırmak. Gereç ve Yöntemler: Araştırmaya 16-56 yaş arası 41 hasta dâhil edildi. Tüm bireyler kronik tek taraflı TMB'ye sahipti ve hastalarda aşağıdaki semptomlardan en az birinin tek taraflı olması gerekiyordu; eklem ağrısı, eklem sesi veya hareket kısıtlılığı. Toplamda 82 temporomandibular eklemi değerlendirmek için ortopantomogramda (OPG) 3 açı ve 3 uzunluk ölçümü ve lateral temporomandibular eklem görüntüsünde (LTG) 2 açı ve 12 uzunluk ölçümü yapıldı. Morfometrik ölçümler için AudaxCeph Version 5.X ortodontik yazılımı kullanıldı. Bulgular Student t-testi ve Mann-Whitney U testi kullanılarak karşılaştırıldı. Bulgular: Hem OPG hem de LTG değerlendirmelerinin tüm parametrelerinde sağlıklı taraf ile etkilenen taraf arasında anlamlı bir fark bulunmadı (p>0,05). Sonuç: Tek taraflı TMB şikâyeti olan hastaların sert doku sagittal yön değerlendirmelerinde belirtilen özellikler sağlıklı ve etkilenen taraflarda benzerdi.

Anahtar Kelimeler: Temporomandibular eklem bozuklukları; morfometrik analiz; ortopantomogram; lateral temporomandibular eklem görüntüsü
REFERENCES:
  1. Dellavia C, Rodella LF, Pellecchia R, Barzani G. Detailed anatomy of the temporomandibular joint. In: Connelly ST, Tartaglia GM, Silva RG, eds. Contemporary Management of Temporomandibular Disorders. 1st ed. Switzerland: Springer International Publishing; 2019. p.51-70. [Crossref] 
  2. Mahdian N, Dostálová T, Danĕk J, Nedoma J, Kohout J, Hubáček M, et al. 3D reconstruction of TMJ after resection of the cyst and the stress-strain analyses. Comput Methods Programs Biomed. 2013;110(3):279-89. [Crossref]  [PubMed] 
  3. Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res. 2008;87(4):296-307. [Crossref]  [PubMed] 
  4. Troeltzsch M, Troeltzsch M, Cronin RJ, Brodine AH, Frankenberger R, Messlinger K. Prevalence and association of headaches, temporomandibular joint disorders, and occlusal interferences. J Prosthet Dent. 2011;105(6):410-7. [Crossref]  [PubMed] 
  5. Melis M, Di Giosia M. The role of genetic factors in the etiology of temporomandibular disorders: a review. The Journal of Craniomandibular & Sleep Practice. 2016;34(1):43-51. [Crossref]  [PubMed] 
  6. Bevilaqua-Grossi D, Chaves TC, de Oliveira AS. Cervical spine signs and symptoms: perpetuating rather than predisposing factors for temporomandibular disorders in women. J Appl Oral Sci. 2007;15(4):259-64. [Crossref]  [PubMed]  [PMC] 
  7. Matsubara R, Yanagi Y, Oki K, Hisatomi M, Santos KC, Bamgbose BO, et al. Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders. Dentomaxillofac Radiol. 2018;47(4):20170412. [Crossref]  [PubMed]  [PMC] 
  8. Barbosa Tde S, Miyakoda LS, Pocztaruk Rde L, Rocha CP, Gavião MB. Temporomandibular disorders and bruxism in childhood and adolescence: review of the literature. Int J Pediatr Otorhinolaryngol. 2008;72(3):299-314. [Crossref]  [PubMed] 
  9. Lalue-Sanches M, Gonzaga AR, Guimaraes AS, Ribeiro EC. Disc displacement with reduction of the temporomandibular joint: the real need for treatment. J Pain Reli. 2015;4(5):1-5. [Crossref] 
  10. Hegde V. A review of the disorders of the temperomandibular joint. The Journal of Indian Prosthodontic Society. 2005;5(2):56-61. [Link] 
  11. Dupuy-Bonafé I, Otal P, Montal S, Bonafé A, Maldonado IL. Biometry of the temporomandibular joint using computerized tomography. Surg Radiol Anat. 2014;36(9):933-9. [Crossref]  [PubMed] 
  12. Coombs MC, Bonthius DJ, Nie X, Lecholop MK, Steed MB, Yao H. Effect of measurement technique on TMJ mandibular condyle and articular disc morphometry: CBCT, MRI, and physical measurements. J Oral Maxillofac Surg. 2019;77(1):42-53. [Crossref]  [PubMed]  [PMC] 
  13. Crow HC, Parks E, Campbell JH, Stucki DS, Daggy J. The utility of panoramic radiography in temporomandibular joint assessment. Dentomaxillofac Radiol. 2005;34(2):91-5. [Crossref]  [PubMed] 
  14. Anderson GC, Gonzalez YM, Ohrbach R, Truelove EL, Sommers E, Look JO, et al. The research diagnostic criteria for temporomandibular disorders. VI: future directions. J Orofac Pain. 2010;24(1):79-88. [PubMed]  [PMC] 
  15. Kjellberg H, Ekestubbe A, Kiliaridis S, Thilander B. Condylar height on panoramic radiographs. A methodologic study with a clinical application. Acta Odontol Scand. 1994;52(1):43-50. [Crossref]  [PubMed] 
  16. Pullinger AG, Seligman DA. Multifactorial analysis of differences in temporomandibular joint hard tissue anatomic relationships between disk displacement with and without reduction in women. J Prosthet Dent. 2001;86(4):407-19. [Crossref]  [PubMed] 
  17. Chantaracherd P, John MT, Hodges JS, Schiffman EL. Temporomandibular joint disorders' impact on pain, function, and disability. J Dent Res. 2015;94(3 Suppl):79S-86S. [Crossref]  [PubMed]  [PMC] 
  18. Slade GD, Diatchenko L, Ohrbach R, Maixner W. Orthodontic treatment, genetic factors and risk of temporomandibular disorder. Semin Orthod. 2008;14(2):146-56. [Crossref]  [PubMed]  [PMC] 
  19. Hegde S, Bn P, Shetty SR. Morphological and radiological variations of mandibular condyles in health and diseases: a systematic review. Dentistry. 2013;3(1):1-5. [Link] 
  20. Vieira-Queiroz I, Gomes Torres MG, de Oliveira-Santos C, Flores Campos PS, Crusoé-Rebello IM. Biometric parameters of the temporomandibular joint and association with disc displacement and pain: a magnetic resonance imaging study. Int J Oral Maxillofac Surg. 2013;42(6):765-70. [Crossref]  [PubMed] 
  21. Hansson LG, Westesson PL, Eriksson L. Comparison of tomography and midfield magnetic resonance imaging for osseous changes of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82(6):698-703. [Crossref]  [PubMed] 
  22. Pullinger AG, White SC. Efficacy of TMJ radiographs in terms of expected versus actual findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(3):367-74. [Crossref]  [PubMed] 
  23. White SC, Pullinger AG. Impact of TMJ radiographs on clinician decision making. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(3):375-81. [Crossref]  [PubMed] 
  24. Joo JK, Lim YJ, Kwon HB, Ahn SJ. Panoramic radiographic evaluation of the mandibular morphological changes in elderly dentate and edentulous subjects. Acta Odontol Scand. 2013;71(2):357-62. [Crossref]  [PubMed] 
  25. Kaya D. Is there any difference between gonial angle values measured on digital lateral cephalograms and orthopantomograms? Turkish J Orthod. 2020;1;33(2):72-6. [Crossref]  [PubMed]  [PMC] 
  26. Larheim TA, Svanaes DB. Reproducibility of rotational panoramic radiography: mandibular linear dimensions and angles. Am J Orthod Dentofacial Orthop. 1986;90(1):45-51. [Crossref]  [PubMed] 
  27. Mattila K, Altonen M, Haavikko K. Determination of the gonial angle from the orthopantomogram. Angle Orthod. 1977;47(2):107-10. [PubMed] 
  28. Xie QF, Ainamo A. Correlation of gonial angle size with cortical thickness, height of the mandibular residual body, and duration of edentulism. J Prosthet Dent. 2004;91(5):477-82. [Crossref]  [PubMed] 
  29. Türp JC, Vach W, Harbich K, Alt KW, Strub JR. Determining mandibular condyle and ramus height with the help of an Orthopantomogram--a valid method? J Oral Rehabil. 1996;23(6):395-400. [Crossref]  [PubMed] 
  30. Zhuo Z, Cai X, Xie Q. Is anterior disc displacement without reduction associated with temporomandibular joint condylar height in juvenile patients younger than 20 years? J Oral Maxillofac Surg. 2015;73(5):843-9. [Crossref]  [PubMed] 
  31. Takayama Y, Miura E, Yuasa M, Kobayashi K, Hosoi T. Comparison of occlusal condition and prevalence of bone change in the condyle of patients with and without temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(1):104-12. [Crossref]  [PubMed] 
  32. Kurita H, Koike T, Narikawa J, Nakatsuka A, Kobayashi H, Kurashina K. Relationship between alteration of horizontal size and bony morphological change in the mandibular condyle. Dentomaxillofac Radiol. 2003;32(6):355-8. [Crossref]  [PubMed] 
  33. de Leeuw R, Boering G, van der Kuijl B, Stegenga B. Hard and soft tissue imaging of the temporomandibular joint 30 years after diagnosis of osteoarthrosis and internal derangement. J Oral Maxillofac Surg. 1996;54(11):1270-80; discussion 1280-1. [Crossref]  [PubMed] 
  34. Mathew AL, Sholapurkar AA, Pai KM. Condylar changes and ıts association with age, TMD, and dentition status: a cross-sectional study. Int J Dent. 2011;2011:413639. [Crossref]  [PubMed]  [PMC] 
  35. Boskey AL, Coleman R. Aging and bone. J Dent Res. 2010;89(12):1333-48. [Crossref]  [PubMed]  [PMC] 

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