RELATIONSHIP BETWEEN THE DEGENERATIVE CHANGES IN THE MANDIBULAR CONDYLE AND ARTICULAR EMINENCE INCLINATION, HEIGHT, AND SHAPE: A CBCT STUDY
Abstract
Objectives: This study aimed to analyze the articular eminence inclination and height and correlate these findings with the eminence shapes and degenerative condylar changes using cone-beam computed tomography (CBCT).
Materials and Methods: The assessments were established on CBCT images of 566 temporomandibular joints (TMJ) that were included from the computer database. Age and gender were recorded for all individuals. Degenerative changes were examined in the articular surface of the condyle. The articular eminence (AE) inclination and height measurements were performed on central parasagittal slices of the TMJ. The shape of the AE was classified as box, sigmoid, flattened, and deformed.
Results: The prevalence of degenerative changes in the condyle was higher in males, but no significant difference was found (p ˃ 0.05). The AE inclination and height have a relation with gender and age groups. The AE inclination and height results were greater in males (p < 0.05). The reduced mean values of eminence inclination and height in the +50-year-old group were detected (p < 0.05). Sigmoid and box-shaped articular eminence morphologies were more common. The eminence with deformed-shaped was related to two or more degenerative alterations in the condylar head.
Conclusion: The degenerative condylar changes can affect eminence inclination and height by mechanical loading and changed articular dynamics. Gender and age have a significant effect on the AE morphology. The articular eminence shape is influenced by combinations of two or more degenerative changes.
Keywords
Articular eminence Cone-beam computed tomography Degenerative change Mandibular condyle Temporomandibular joint
References
- Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St Louis: Elsevier Health Sciences, 2014.
- Pandis N, Karpac J, Trevino R, Williams B. A radiographic study of condyle position at various depths of cut in dry skulls with axially corrected lateral tomograms. Am J Orthod Dentofacial Orthop 1991; 100: 116–22.
- Estomaguio GA, Yamada K, Saito I. Unilateral condylar bone change, inclination of the posterior slope of the articular eminence and craniofacial morphology. Orthod Waves 2008; 67(3): 113-9.
- Wu CK, Hsu JT, Shen YW, Chen JH, Shen WC, Fuh LJ. Assessments of inclinations of the mandibular fossa by computed tomography in an Asian population. Clin Oral Investig 2012; 16(2): 443-50.
- Csadó K, Márton K, Kivovics P. Anatomical changes in the structure of the temporomandibular joint caused by complete edentulousness. Gerodontology 2012; 29(2): 111-6.
- Kranjčić J, Vojvodić D, Žabarović D, Vodanović M, Komar D, Mehulić K. Differences in articular-eminence inclination between medieval and contemporary human populations. Arch Oral Biol 2012; 57(8): 1147-52.
- Yamada K, Tsuruta A, Hanada K, Hayashi T. Morphology of the articular eminence in temporomandibular joints and condylar bone change. J Oral Rehabil 2004; 31: 438–44.
- Jasinevicius TR, Pyle MA, Lalumandier JA, Nelson S, Kohrs KJ, Türp JC, et al. Asymmetry of the articular eminence in dentate and partially edentulous populations. Cranio 2006; 24: 85–94.
- Baccetti T, Antonini A, Franchi L, Tonti M, Tollaro I. Glenoid fossa position in different facial types: a cephalometric study. Br J Orthod 1997; 24: 55–9.
- Katsavrias EG. The effect of mandibular protrusive (activator) appliances on articular eminence morphology. Angle Orthod 2003; 73: 647–53.
- Kurita H, Ohtsuka A, Kobayashi H, Kurashina K. Flattening of the articular eminence correlates with progressive internal derangement of the temporomandibular joint. Dentomaxillofac Radiol 2000; 29: 277–9.
- Sülün T, Cemgil T, Duc JM, Rammelsberg P, Jӓger L, Gernet W. Morphology of the mandibular fossa and inclination of the articular eminence in patients with internal derangement and in symptom-free volunteers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92: 98–107.
- Schiman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet –P, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupy. J. Oral Facial Pain Headache 2014; 28: 6–27.
- Hintze H, Wiese M, Wenzel A. Cone beam CT and conventional tomography for the detection of morphological temporomandibular joint changes. Dentomaxillofac Radiol 2007; 36: 192–7.
- Kiliç SC, Kiliç N, Sümbüllü MA. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. Int J Oral Maxillofac Surg 2015; 44(10): 1268-74.
- Borahan MO, Mayil M, Pekiner FN. Using cone beam computed tomography to examine the prevalence of condylar bony changes in a Turkish subpopulation. Niger J Clin Pract 2016; 19: 259-66.
- Kurita H, Ohtsuka A, Kobayashi H, Kurashina K. Is the morphology of the articular eminence of the temporomandibular joint a predisposing factor for disc diplacement? Dentomaxillofac Radiol 2000; 29(3): 159-162.
- Çağlayan F, Sümbüllü MA, Akgül HM. Associations between the articular eminence inclination and condylar bone changes, condylar movements, and condyle and fossa shapes. Oral Radiol 2014; 30(1): 84-91.
- İlgüy D, İlgüy M, Fişekçioğlu E, Dölekoğlu S, Ersan N. Articular eminence inclination, height, and condyle morphology on cone beam computed tomography. Sci World J 2014; 761714.
- Sümbüllü MA, Cağlayan F, Akgül HM, Yilmaz AB. Radiological examination of the articular eminence morphology using cone beam CT. Dentomaxillofac Radiol 2012; 41(3): 234-40.
- Paknahad M, Shahidi S, Akhlaghian M, Abolvardi M. Is mandibular fossa morphology and articular eminence inclination associated with temporomandibular dysfunction? J Dent (Shiraz) 2016; 17(2): 134.
- Sa SC, Melo SLS, Melo DPD, Freitas DQ, Campos PSF. Relationship between articular eminence inclination and alterations of the mandibular condyle: a CBCT study. Braz Oral Res 2017; 31:e25.
- Ren YF, Isberg A, Westesson PL. Steepness of the articular eminence in the temporomandibular joint: tomographic comparison between asymptomatic volunteers with normal disk position and patients with disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 80(3): 258-266.
- Žabarović D, Jerolimov V, Carek V, Vojvodić D, Žabarović K, Buković D. The effect of tooth loss on the TM-joint articular eminence inclination. Coll Antropol 2000;24 Suppl 1:37-42.
- Gökalp H, Türkkahraman H, Bzeizi N. Correlation between eminence steepness and condyle disc movements in temporomandibular joints with internal derangements on magnetic resonance imaging. Eur J Orthod 2001; 23: 579–84.
- Katsavrias EG. Morphology of the temporomandibular joint in subjects with Class II Division 2 malocclusions. Am J Orthod Dentofacial Orthop 2006; 129: 470-478.
- Pirttiniemi P, Kantomaa T, Ronning O. Relation of glenoid fossa to craniofacial morphology, studied on dry human skulls. Acta Odontol Scand 1990; 48: 359.
- Wang Y, Liu C, Rohr J, Liu H, He F, Yu J, et al. Tissue interaction is required for glenoid fossa development during temporomandibular joint formation. Dev Dyn 2011; 240: 2466.
- Lee PP, Stanton AR, Schumacher AE, Truelove E, Hollender LG. Osteoarthritis of the temporomandibular joint and increase of the horizontal condylar angle: a longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127(4): 339-350.
- Herring SW, Liu ZJ. Loading of the temporomandibular joint: anatomical and in vivo evidence from the bones. Cells Tissues Organs 200; 169: 193-200.
- Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion-idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop 1996; 110: 8–15.
- Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion-idiopathic condylar resorption. Part II. Am J Orthod Dentofacial Orthop 1996; 110: 117–27. Nitzan DW. The process of lubrication impairment and its involvement in temporomandibular joint disc displacement: a theoretical concept. J Oral Maxillofac Surg 2001; 59: 36–45.
Abstract
Amaç: Bu çalışma, konik ışınlı bilgisayarlı tomografi (KIBT) kullanılarak artiküler eminens (AE) eğim ve yüksekliğini analiz etmeyi ve bu bulguları eminens şekilleri ve dejeneratif kondiler değişiklikler ile ilişkilendirmeyi amaçlamaktadır.
Gereç ve Yöntemler: Toplam 566 temporomandibular eklemin (TME) KIBT görüntüleri değerlendirildi. Tüm bireylerin yaş ve cinsiyet verileri kaydedildi. Kondilin eklem yüzeyindeki dejeneratif değişiklikler incelendi. Artiküler eminens eğim ve yükseklik ölçümleri TME'nin santral parasagital kesitleri üzerinde yapıldı. AE'nin şekli kutu, sigmoid, düz ve deforme olarak sınıflandırıldı.
Bulgular: Kondildeki dejeneratif değişikliklerin prevalansı erkeklerde daha yüksekti, ancak anlamlı bir fark bulunamadı (p ˃ 0.05). AE eğim ve yüksekliğinin cinsiyet ve yaş gruplarıyla ilişkisi vardır. AE eğim ve yükseklik değerleri erkeklerde daha fazlaydı (p < 0.05). +50 yaş grubunda eminens eğim ve yüksekliğinin ortalama değerlerinin azalmış olduğu tespit edildi (p < 0.05). Sigmoid ve kutu şekilli artiküler eminens morfolojileri daha yaygındı. Deforme eminens şekli, kondilin artiküler yüzeyindeki iki veya daha fazla sayıda dejeneratif değişiklik bulunması ile ilişkiliydi.
Sonuç: Kondildeki dejeneratif değişiklikler; mekanik yükleme ve değişen eklem dinamikleri nedeniyle eminens eğim ve yüksekliğini etkileyebilir. Cinsiyet ve yaşın AE morfolojisi üzerinde önemli bir etkisi vardır. Artiküler eminens şekli, iki veya daha fazla dejeneratif değişikliğin kombinasyonlarından etkilenmektedir.
Keywords
Artiküler eminens Konik ışınlı bilgisayarlı tomografi Dejeneratif değişiklik Mandibular kondil Temporomandibular eklem
References
- Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St Louis: Elsevier Health Sciences, 2014.
- Pandis N, Karpac J, Trevino R, Williams B. A radiographic study of condyle position at various depths of cut in dry skulls with axially corrected lateral tomograms. Am J Orthod Dentofacial Orthop 1991; 100: 116–22.
- Estomaguio GA, Yamada K, Saito I. Unilateral condylar bone change, inclination of the posterior slope of the articular eminence and craniofacial morphology. Orthod Waves 2008; 67(3): 113-9.
- Wu CK, Hsu JT, Shen YW, Chen JH, Shen WC, Fuh LJ. Assessments of inclinations of the mandibular fossa by computed tomography in an Asian population. Clin Oral Investig 2012; 16(2): 443-50.
- Csadó K, Márton K, Kivovics P. Anatomical changes in the structure of the temporomandibular joint caused by complete edentulousness. Gerodontology 2012; 29(2): 111-6.
- Kranjčić J, Vojvodić D, Žabarović D, Vodanović M, Komar D, Mehulić K. Differences in articular-eminence inclination between medieval and contemporary human populations. Arch Oral Biol 2012; 57(8): 1147-52.
- Yamada K, Tsuruta A, Hanada K, Hayashi T. Morphology of the articular eminence in temporomandibular joints and condylar bone change. J Oral Rehabil 2004; 31: 438–44.
- Jasinevicius TR, Pyle MA, Lalumandier JA, Nelson S, Kohrs KJ, Türp JC, et al. Asymmetry of the articular eminence in dentate and partially edentulous populations. Cranio 2006; 24: 85–94.
- Baccetti T, Antonini A, Franchi L, Tonti M, Tollaro I. Glenoid fossa position in different facial types: a cephalometric study. Br J Orthod 1997; 24: 55–9.
- Katsavrias EG. The effect of mandibular protrusive (activator) appliances on articular eminence morphology. Angle Orthod 2003; 73: 647–53.
- Kurita H, Ohtsuka A, Kobayashi H, Kurashina K. Flattening of the articular eminence correlates with progressive internal derangement of the temporomandibular joint. Dentomaxillofac Radiol 2000; 29: 277–9.
- Sülün T, Cemgil T, Duc JM, Rammelsberg P, Jӓger L, Gernet W. Morphology of the mandibular fossa and inclination of the articular eminence in patients with internal derangement and in symptom-free volunteers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92: 98–107.
- Schiman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet –P, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupy. J. Oral Facial Pain Headache 2014; 28: 6–27.
- Hintze H, Wiese M, Wenzel A. Cone beam CT and conventional tomography for the detection of morphological temporomandibular joint changes. Dentomaxillofac Radiol 2007; 36: 192–7.
- Kiliç SC, Kiliç N, Sümbüllü MA. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. Int J Oral Maxillofac Surg 2015; 44(10): 1268-74.
- Borahan MO, Mayil M, Pekiner FN. Using cone beam computed tomography to examine the prevalence of condylar bony changes in a Turkish subpopulation. Niger J Clin Pract 2016; 19: 259-66.
- Kurita H, Ohtsuka A, Kobayashi H, Kurashina K. Is the morphology of the articular eminence of the temporomandibular joint a predisposing factor for disc diplacement? Dentomaxillofac Radiol 2000; 29(3): 159-162.
- Çağlayan F, Sümbüllü MA, Akgül HM. Associations between the articular eminence inclination and condylar bone changes, condylar movements, and condyle and fossa shapes. Oral Radiol 2014; 30(1): 84-91.
- İlgüy D, İlgüy M, Fişekçioğlu E, Dölekoğlu S, Ersan N. Articular eminence inclination, height, and condyle morphology on cone beam computed tomography. Sci World J 2014; 761714.
- Sümbüllü MA, Cağlayan F, Akgül HM, Yilmaz AB. Radiological examination of the articular eminence morphology using cone beam CT. Dentomaxillofac Radiol 2012; 41(3): 234-40.
- Paknahad M, Shahidi S, Akhlaghian M, Abolvardi M. Is mandibular fossa morphology and articular eminence inclination associated with temporomandibular dysfunction? J Dent (Shiraz) 2016; 17(2): 134.
- Sa SC, Melo SLS, Melo DPD, Freitas DQ, Campos PSF. Relationship between articular eminence inclination and alterations of the mandibular condyle: a CBCT study. Braz Oral Res 2017; 31:e25.
- Ren YF, Isberg A, Westesson PL. Steepness of the articular eminence in the temporomandibular joint: tomographic comparison between asymptomatic volunteers with normal disk position and patients with disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 80(3): 258-266.
- Žabarović D, Jerolimov V, Carek V, Vojvodić D, Žabarović K, Buković D. The effect of tooth loss on the TM-joint articular eminence inclination. Coll Antropol 2000;24 Suppl 1:37-42.
- Gökalp H, Türkkahraman H, Bzeizi N. Correlation between eminence steepness and condyle disc movements in temporomandibular joints with internal derangements on magnetic resonance imaging. Eur J Orthod 2001; 23: 579–84.
- Katsavrias EG. Morphology of the temporomandibular joint in subjects with Class II Division 2 malocclusions. Am J Orthod Dentofacial Orthop 2006; 129: 470-478.
- Pirttiniemi P, Kantomaa T, Ronning O. Relation of glenoid fossa to craniofacial morphology, studied on dry human skulls. Acta Odontol Scand 1990; 48: 359.
- Wang Y, Liu C, Rohr J, Liu H, He F, Yu J, et al. Tissue interaction is required for glenoid fossa development during temporomandibular joint formation. Dev Dyn 2011; 240: 2466.
- Lee PP, Stanton AR, Schumacher AE, Truelove E, Hollender LG. Osteoarthritis of the temporomandibular joint and increase of the horizontal condylar angle: a longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127(4): 339-350.
- Herring SW, Liu ZJ. Loading of the temporomandibular joint: anatomical and in vivo evidence from the bones. Cells Tissues Organs 200; 169: 193-200.
- Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion-idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop 1996; 110: 8–15.
- Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion-idiopathic condylar resorption. Part II. Am J Orthod Dentofacial Orthop 1996; 110: 117–27. Nitzan DW. The process of lubrication impairment and its involvement in temporomandibular joint disc displacement: a theoretical concept. J Oral Maxillofac Surg 2001; 59: 36–45.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research Articles |
| Authors | |
| Publication Date | January 3, 2022 |
| Submission Date | June 9, 2021 |
| Published in Issue | Year 2021Volume: 24 Issue: 4 |
Cited By
The relationship between bony changes of the mandibular condyle and eichner index
Journal of Clinical Densitometry
https://doi.org/10.1016/j.jocd.2024.101507
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