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Clinical and radiological diagnostics of osteoarthritis of temporomandibular joint

Clinical and radiological findings were compared between the patients with osteoarthritis (OA) of temporomandibular joint (TMJ) and asymptomatic volunteers, both groups with no disc displacement (DD). OA of TMJ in 16 patients (mean age 46.9, 69% women) was diagnosed using RDC/TMD Axis I and manual functional analyses. A control group consisted of 20 selected dental school students (mean age 23.5, 70% women) without any clinical signs or history of DD or OA. Magnetic resonance imaging (MRI) and panoramic imaging were used in this study for all subjects. OA was diagnosed in 20 (62.5%) of all TMJs, in 4 (25%) of the patients bilaterally (20 TMJs with and 12 TMJs without diagnosis of OA). There was a significant difference between active opening of patients (average 42.9 mm) and students (average 52.1 mm) (t-test, p=0.002). There is also no statistical difference between degenerative changes of the condyle of joint with and without OA (p>0.05). In 19% of osteoarthritic joints, flattening of condylar joint surfaces was observed and 22% of the joints were without clinical signs of OA. Sclerosis of the condyle was found in 16% of the joints and osteophyte formation in 9% of TMJs with OA. There were no degenerative changes of the condyle in TMJs of dental students. There is no difference between patients’ TMJs with and without OA (p>0.05). Pronounced shape loss and severe sclerosation of the articular eminence was found in 10 (50%) joints with OA. Moderate shape loss and severe sclerosation of the articular eminence was observed in two students in TMJs bilaterally. The most common imaging findings of osteoarthritic TMJs were sclerosis of the condyle and osteophyte formation. There is a limitation in interpretation of structural bone changes – the gold standard for hard structures analysis is computerized tomography.

temporomandibular joint; osteoarthitis; magnetic resonace imaging

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