Journal Article

Morphometric analysis of TMJ, condyle and its association with dental attrition using cone beam computed tomography – An observational study

Ramasamy, S, Deepak, J John Hearty, Deepthi, D Angeline

2024

Overview

Introduction: Temporomandibular joint (TMJ) has many anatomic and functional features that make it special and complex among the joints of the human body. Condylar remodeling is a physiologic process that aims to adapt the structure of the TMJ to meet the functional demands of the individual. Dental attrition has a multifactor etiology and a commonly accepted dental wear. Repetitive chronic trauma due to clenching and grinding habits may stimulate altered muscle activity, remodeling of joint which may occasionally initiate a degenerative process. Various imaging modalities have been used to assess TMJ's morphology. Cone beam computed tomography (CBCT) images are known as the best to assess bone structures. The knowledge of morphological and morphometric data of each bone component of the TMJ is of paramount importance for identifying bone changes related to the TMJ. Aims and Objectives: To determine the level and severity of dental attrition and its relation to signs of TMJ dysfunction and condylar changes analyzed morphometrically using cone beam computed tomography. Methodology: Patients for the study were selected with dental attrition above the age of 20 for CBCT imaging for other diagnosis during the period from January 2022 to December 2023. The study group will comprise of a sample size with 120 subjects who are divided into 3 three groups, Group I- Age 20-40, Group - II -Age 41 -60, Group - Ш - Age above 60. After scoring the individual teeth by Smith and Knight in 1984, CBCT images were taken using Sirona Orthophos xg 3D machine and were examined by double observer. Morphometric evaluation of the condyle was recorded. Data were entered into the computer and analyzed using SPSS software version 26.0. Chi square test, t - test was done for statistical analysis. Results: A total of 120 patients which includes 63 males and 57 females in this study were evaluated. On comparison of each parameter between genders there were moderate variations in all parameters and statistically significant, variations were found in right and left anterior space and left condylar superior space. The morphometric parameters were generally larger in males when compared to females marginally. Significant variations were seen in right and left side for all parameters with statistically significant P value less than 0.05 except for roof of glenoid fossa. Morphometric analysis of TMJ is significantly decreased in group 3 compared to group 2 and group 1. Various levels of attrition ranging from 0.4 to 2.9, they are broadly divided into 2 subgroups depending on their attrition score 0.1 to 1.5 and 1.6 to 3.0 where significant variations are seen between 2 subgroups. Conclusion: This study concludes CBCT is a accurate and reliable diagnostic tool in evaluation of TMJ morphometrics, thus depicting morphometric changes have a limited association varing between severity of the attrition score.

• Publisher: Journal of Advanced Medical and Dental Sciences Research (JAMDSR)
• Subject: Age / Attrition / Bone imaging / Chi-square test / Computed tomography / Data analysis / Evaluation / Females / Joints (anatomy) / Males / Medical imaging / Morphology / Morphometry / Muscle function / Observational studies / Parameters / Statistical analysis / Statistical significance / Subgroups / Teeth / Temporomandibular joint disorders / Tomography / Trauma / Variation