ADAPTIVE CAPABILITIES OF THE TEMPOROMANDIBULAR JOINT: A CONE BEAM COMPUTED TOMOGRAPHY PILOT STUDY

Background The term temporomandibular disorders (TMDs) is a common broad clinical descriptor for a group of clinical signs and symptoms. Morphologic changes may underlie the clinical presentation. Objective This blinded case-control study aimed to correlate osseous changes of the condylar head in patients presenting to the Orofacial Pain Clinic with TMD-related complaints. Materials and Methods Institutional review board approval was obtained, and 60 patients (30 study patients and 30 age- and gender-matched controls; age 18–40 years) were enrolled. After a clinical examination, each subject underwent cone beam computed tomography (CBCT) of the temporomandibular joints (TMJs). The Revised Diagnostic Criteria (RDC)/TMD Diagnostic Form was used to record and assess clinical TMJ findings and InVivo v6.0 software to visualize and assess condylar volume and morphologic changes. The findings were recorded on an Excel spreadsheet. Results Remodeling was primarily observed in the anteromedial, anterolateral, and posterior condylar surfaces. Clinical findings included disk displacement, temporalis and TMJ headache, and pain in the temporalis and masseter muscles and lateral pole of the TMJ. Condylar dimensional changes between groups were found to be nonsignificant. The results demonstrated that reduction in condylar volume correlated significantly with clinical evidence of disk displacement. Discussion Although osseous changes in older age groups have been well documented, changes seen in younger patients are not well reported in the literature.