Aims & Objective: To compare the bony changes in TMJ OA with and without generalized OA & to estimate the prevalence of TMJ OA in generalized OA.

Materials & Methods: The study contained three groups consisting of total 156 patients. The bony changes in TMJ was evaluated according to Ahmed et al criteria, using CBCT and the data was analysed statistically.

Results: TMJ OA in generalized OA was 63.4%. Flattening of TMJ was common finding in group I and II although more in group II. Subchondral sclerosis was found more in group I while osteophytes formation was absent in Group I. According to Ahmed et al criteria, indeterminate osteoarthritis and osteoarthritis was more in group II.

Conclusion: The pattern of bone change is different in TMJ OA with generalized OA and without generalized OA. Therefore, we propose that radiographic evaluation of TMJ should be contemplated in patients with generalized osteoarthritis.

Keywords: Temporomandibular joint osteoarthritis, generalized Osteoarthritis, CBCT.

1. Detamore, M.S., Athanasiou K.A.M. A call to action for bioengineers and dental professionals: directives for the future of TMJ bioengineering. Ann Biomed Eng. 2007;(35):1301–11.
2. Voog U, Alstergren P, Eliasson S, Leibur E, Kallikorm R, Kopp S. Inflammatory mediators and radiographic changes in temporomandibular joints of patients with rheumatoid arthritis. Acta Odontol Scand. 2003;61:57–64.
3. Okeson JP. Management of temporomandibular disorders and occlusion. 7th, edition. St. Louis: Elsevier/Mosby; 2013; 2013. pp. 339-344. p.
4. Bertram S, Rudisch A, Innerhofer K, Pümpel E, Grubwieser G, Emshoff R. Diagnosing TMJ internal derangement and osteoarthritis with magnetic resonance imaging. J Am Dent Assoc. 2001;132:753–61.
5. Limchaichana N, Nilsson H, Ekberg EC, Nilner M, Petersson A. Clinical diagnoses and MRI findings in patients with TMD pain. J Oral Rehabil. 2007;34:237–45.
6. Buckwalter JA, Martin JA. Osteoarthritis. Adv Drug Deliv Rev. 2006;58: 150–67.
7. Nevile BW, Damm DD, Allen CM BJ. Oral and maxillofacial pathology. 2nd ed. saunders, Edinburgh; 2001. 775 p.
8. Dibbets JM, van der Weele LT. Prevalence of structural bony change in the mandibular condyle. Journal of craniomandibular disorders : facial & oral pain. 1992. p. 254–9.
9. Susami T, Kuroda T, Yano Y, Nakamura T. Growth changes and orthodontic treatment in a patient with condylolysis. Am J Orthod Dentofac Orthop . 1992;102:295–301.
10. Ok SM, Heo JY, Ahn YW, Ko MY JS. Comparative analysis: the patterns of temporomandibular disorder among adolescents. Korean J Oral Med. 2012;37:49– 61.
11. Hunter A, Kalathingal S. Diagnostic imaging for temporomandibular disorders and orofacial pain. Dental Clinics of North America. 2013. p. 405–18.
12. Boeddinghaus R, Whyte A. Computed tomography of the temporomandibular joint. Journal of Medical Imaging and Radiation Oncology. 2013. p. 448–54.
13. Stegenga B, de Bont LG, Boering G, van Willigen JD. Tissue responses to degenerative changes in the temporomandibular joint: a review. J Oral Maxillofac Surg. 1991;49:1079–88.
14. De Bont LG, Stegenga B. Pathology of temporomandibular joint internal derangement and osteoarthrosis. Int J Oral Maxillofac Surg. 1993;22:71–4.
15. Wiberg B, Wänman A. Signs of osteoarthrosis of the temporomandibular joints in young patients: a clinical and radiographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86:158–64.
16. Yamada K, Hiruma Y, Hanada K, Hayashi T, Koyama J, Ito J. Condylar bony change and craniofacial morphology in orthodontic patients with temporomandibular disorders (TMD) symptoms: a pilot study using helical computed tomography and magnetic resonance imaging. Clin Orthod Res. 1999;2:133–42.
17. Tsuruta A, Yamada K, Hanada K, Hosogai A, Kohno S, Koyama J, et al. The relationship between morphological changes of the condyle and condylar position in the glenoid fossa. J Orofac Pain. 2004;18:148–55.
18. Takayama Y, Miura E, Yuasa M, Kobayashi K, Hosoi T. Comparison of occlusal condition and prevalence of bone change in the condyle of patients with and without temporomandibular disorders. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2008;105:104–12.
19. Wiese M, Svensson P, Bakke M, List T, Hintze H, Petersson A, Knutsson K WH. Association Between Temporomandibular Joint Symptoms, Signs, and Clinical Diagnosis Using the RDC/TMD and Radiographic Findings in Temporomandibular Joint Tomograms. J Orofac Pain. 2008;22:239–51.
20. Ahmad M,  Hollender  L,  Anderson  Q  et  al.  Research  diagnostic  criteria  for temporomandibular disorders (RDC ⁄ TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;(107):844–60.
21. Ludlow JB, Davies-Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofacial Radiol. 2003;32:229–34
22. Ludlow JB, Ivanovic M. Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2008;106:930–8.
23. Honey OB,  Scarfe  WC,  Hilgers  MJ,  Klueber  K,  Silveira  AM,  Haskell  BS,et      Accuracy   of   cone-beam   computed   tomography   imaging   of   the temporomandibular  joint:  Comparisons  with  panoramic  radiology  and  linear tomography. Am J Orthod Dentofac Orthop. 2007;132:429–38.
24. Dworkin SF,  LeResche    Research  diagnostic  criteria  for  temporoman-dibular disorders review,    criteria,    examinations    and    specifications, critique. J Craniomandib Disord. 1992;6:301–55.
25. Schiffman EL, Ohrbach R, Truelove EL, Tai F, Anderson GC, Pan W, et al. The Research Diagnostic Criteria for Temporomandibular Disorders. V: methods used to establish and validate revised Axis I diagnostic algorithms. J Orofac Pain. United States; 2010;24(1):63–78.
26. Ahmad M, Hollender L, Anderson Q et al. Research diagnostic criteria for temporomandibular disorders (RDC ⁄ TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;(107):844–60.
27. Martinez-Blanco M, Bagan JV, Fons A P-RR. Osteoarthrosis of the temporomandibular joint. A clinical and radiological study of 16 patients. Med Oral. 2004;9:106–15.
28. Ardic F, Gokharman D, Atsu S, Guner S, Yilmaz M, Yorgancioglu R. The comprehensive evaluation of temporomandibular disorders seen in rheumatoid arthritis. Aust Dent J. 2006;51(1):23–8.
29. Gynther GW, Tronje G, Holmlund AB. Radiographic changes in the temporomandibular joint in patients with generalized osteoarthritis and rheumatoid arthritis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(5):613–8.
30. PA T. Osteoarthrosis of mandibular condyle. BDJ. 1973;(134):223–31.
31. Oliveria SA, Felson DT, Reed JI, Cirillo PA, Walker AM. Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum. 1995;38(8):1134–41.
32. Zhao Y, Zhang Z, Wu Y, Zhang W, Ma X. Investigation of the clinical and radiographic features of osteoarthrosis of the temporomandibular joints in adolescents and young adults. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111(2):e27–34.
33. Gray RJ. Pain dysfunction syndrome and osteoarthrosis related to unilateral and bilateral temporomandibular joint symptoms. J Dent. 1986;14:156–9.
34. Wiberg B, Wänman A. Signs of osteoarthrosis of the temporomandibular joints in young patients: a clinical and radiographic study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86(2):158–64.
35. Meng J, Zhang W, Liu D, Zhao Y, Ma X, JH M, et al. [Diagnostic evaluation of the temporomandibular joint osteoarthritis using cone beam computed tomography compared with conventional radiographic technology]. Beijing Da Xue Xue Bao. 2007;39 :26–9.
36. Badel T, Marroti M, Simunković SK, Keros J, Kern J KI. Radiological characteristics of osteoarthritis of temporomandibular joint without disc displacement. Biologorum. 2009;111:289–92.
37. Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol. 2009 Mar [cited 2015 Jan 14];38(3):141–7.
38. Nah K-S. Condylar bony changes in patients with temporomandibular disorders: a CBCT study. Imaging Sci Dent. 2012 Dec;42(4):249–53.
39. Cevidanes LHS,  Hajati AK, Paniagua  B,  Lim PF,  Walker  DG,  Palconet  G, et   al Quantification         of condylar resorption        in temporomandibular   joint Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2010;110(1):110–7.
40. Talaat W, Al Bayatti S AKS. CBCT analysis of bony changes associated with temporomandibular disorders. Cranio 2015 2151090315Y0000000002 [Epub ahead of print]. 2015
41. Palacios-Moreno AM, Chilvarquer I LJ. Radiographic findings, signs and symptoms in temporomandibular joint dysfunctions. Rev Odontol Univ Sa˜o Paulo. 1997;11: 273–8.
42. Katzberg RW. Temporomandibular joint imaging. Radiology. 1989;170: 297–307.
43. Campos MIG, Campos PSF, Cangussu MCT, Guimarães RC, Line SRP. Analysis of magnetic resonance imaging characteri-stics and pain in temporomandibular joints with and without degenerative changes of the condyle. Int J Oral Maxillofac Surg. 2008;37(6):529–34.

Dr Anurag Tripathi

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