Association of temporomandibular joint morphology in patients with and without temporomandibular joint dysfunction: A cone-beam computed tomography based study

Dent Res J (Isfahan). 2020 Sep 7;17(5):338-346. eCollection 2020 Sep-Oct.

Abstract

Background: The etiology of temporomandibular disorders (TMDs) is complex and associated with multiple predisposing and initiating factors. Articular eminence morphology and steep eminence inclination have been postulated as the etiological factors, but there has been no clear evidence of association of morphology of the temporomandibular joints (TMJ) complex as a probable predisposing factor in the pathogenesis of TMDs.

Materials and methods: This was a cross-sectional, case-control study, and cone-beam computed tomography scans, and the evaluation was performed for 60 joints in 30 patients with symptomatic TMDs and for 40 healthy joints of 20 age-matched patients. One-way ANOVA, post hoc, unpaired t-test, Chi-square, and intra-class correlation coefficient test were used to determine the correlation between the TMJ articular eminence inclination, height, condylar bone changes, condyle, and fossa shapes with symptomatic TMDs. The P < 0.05 were considered statistically significant.

Results: There was a statistically significant difference of articular eminence inclination and height with a steeper eminence inclination in the control group (P = 0.044*, and 0.035*). The condylar bone changes were found to be significantly more in the TMJ disorder group (P = 0.001*). There was no significant association of condyle and fossa shapes (P = 0.482 and 0.689) and of articular eminence inclination and height with condylar bone changes (P = 0.695, 0.498, 0.192, and 0.823) and condyle shapes (P = 0.389, 0.521, 0.260, and 0.387). The eminence inclination was not associated with fossa shapes (P = 0.471 and 0.086), but eminence height was associated with fossa shapes in the TMJ disorder group (P = 0.043* and 0.111).

Conclusion: The results depicted that there was no significant association between TMJ complex anatomy and TMJ disorders in the present study population.

Keywords: Articular eminence inclination; cone-beam computed tomography; eminence height; pneumatized articular eminence; temporomandibular joint; temporomandibular joint disorder.