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Intra-articular calcifications of the temporomandibular joint and associations with degenerative bone alterations

  • Received : 2019.10.04
  • Accepted : 2020.01.27
  • Published : 2020.06.30

Abstract

Purpose: The purpose of this study was to use cone-beam computed tomography (CBCT) images to determine the prevalence of calcifications in the temporomandibular joint (TMJ) and to evaluate any associations between the presence of such calcifications and degenerative bone alterations of the TMJ, sex, or age. Materials and Methods: In this retrospective study, 1,058 CBCT exams were analyzed, and data regarding the presence and quantity of calcifications, the affected side, any degenerative alterations of the condyle, sex, and age were collected. To evaluate associations between the presence of calcifications and sex or age, the Fisher exact test or the Spearman correlation coefficient, respectively, was used. To assess the association between the presence of calcifications and joint bone alterations, the chi-square and Fisher exact tests were used. The significance level adopted was 5% (P<0.05). Results: Twenty-eight patients (2.7%) presented with TMJ calcifications, including 23 women (82.1%) and 5 men (17.9%). Significant correlations were found between the presence of calcifications and age (P<0.05) and between the presence of calcifications and the presence of condylar alterations (P<0.05), with 73.2% of patients with bone alterations having TMJ calcifications. Conclusion: It may be concluded that, although rare (with a prevalence of only 2.7%), intra-articular calcifications are associated with both degenerative bone alterations and age.

Keywords

References

  1. Jibiki M, Shimoda S, Nakagawa Y, Kawasaki K, Asada K, Ishibashi K. Calcifications of the disc of the temporomandibular joint. J Oral Pathol Med 1999; 28: 413-9.
  2. Koyama J, Ito J, Hayashi T, Kobayashi F. Synovial chondromatosis in the temporomandibular joint complicated by displacement and calcification of the articular disk: report of two cases. AJNR Am J Neuroradiol 2001; 22: 1203-6.
  3. Holmlund AB, Eriksson L, Reinholt FP. Synovial chondromatosis of the temporomandibular joint: clinical, surgical and histological aspects. Int J Oral Maxillofac Surg 2003; 32: 143-7. https://doi.org/10.1054/ijom.2002.0300
  4. Ida M, Yoshitake H, Okoch K, Tetsumura A, Ohbayashi N, Amagasa T, et al. An investigation of magnetic resonance imaging features in 14 patients with synovial chondromatosis of the temporomandibular joint. Dentomaxillofac Radiol 2008; 37: 213-9. https://doi.org/10.1259/dmfr/95185114
  5. Balasundaram A, Geist JR, Gordon SC, Klasser GD. Radiographic diagnosis of synovial chondromatosis of the temporomandibular joint: a case report. J Can Dent Assoc 2009 75: 711-4.
  6. Abuabara A, Miles DA, Cruz GV, Passeri LA. Radiological study of three cases of loose bodies in the temporomandibular joint. Braz J Oral Sci 2010; 9: 133-6.
  7. Meng J, Guo C, Yi B, Zhao Y, Luo H, Ma X. Clinical and radiologic findings of synovial chondromatosis affecting the temporomandibular joint. Oral Surg Oral Med Oral Pathol Radiol Endod 2010; 109: 441-8. https://doi.org/10.1016/j.tripleo.2009.09.036
  8. Lim SW, Jeon SJ, Choi SS, Choi KH. Synovial chondromatosis in the temporomandibular joint: a case with typical imaging features and pathological findings. Br J Radiol 2011; 84: e213-6.
  9. Kahraman AS, Kahraman B, Dogan M, Firat C, Samdanci E, Celik T. Synovial chondromatosis of the temporomandibular joint: radiologic and histopathologic findings. J Craniofac Surg 2012; 23: 1211-3. https://doi.org/10.1097/SCS.0b013e3182564a6e
  10. Matsumoto K, Sato T, Iwanari S, Kameoka S, Oki H, Komiyama K, et al. The use of arthrography in the diagnosis of temporomandibular joint synovial chondromatosis. Dentomaxillofac Radiol 2013; 42: 15388284. https://doi.org/10.1259/dmfr/15388284
  11. Valentini V, Arangio P, Egidi S, Capriotti M, Vellone V, Castrechini M, et al. Diagnosis and treatment of synovial chondromatosis of the TMJ: a clinical case. Ann Stomatol (Roma) 2014; 4: 269-72.
  12. Ivask O, Leibur E, Voog-Oras U. Synovial chondromatosis in the temporomandibular joint: case report with review of the literature. Stomatologija 2015; 17: 97-101.
  13. Pinto AA Jr, Ferreira e Costa R, de Sousa SF, Chagas MR, do Carmo MA, de Lacerda JC. Synovial chondromatosis of the temporomandibular joint successfully treated by surgery. Head Neck Pathol 2015; 9: 525-9. https://doi.org/10.1007/s12105-015-0626-0
  14. Brabyn PJ, Capote A, Munoz-Guerra MF, Zylberberg I, Rodriguez-Campo FJ, Naval-Gias L. Arthroscopic management of synovial chondromatosis of the temporomandibular joint. Case series and systematic review. J Maxillofac Oral Surg 2018; 17: 401-9. https://doi.org/10.1007/s12663-018-1102-7
  15. Chen MJ, Yang C, Cai XY, Jiang B, Qiu YT, Zhang XH. Synovial chondromatosis in the inferior compartment of the temporomandibular joint: different stages with different treatments. J Oral Maxillofac Surg 2012; 70: e32-8.
  16. Wang P, Tian Z, Yang J, Yu Q. Synovial chondromatosis of the temporomandibular joint: MRI findings with pathological comparison. Dentomaxillofac Radiol 2012; 41: 110-6. https://doi.org/10.1259/dmfr/36144602
  17. Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, 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. https://doi.org/10.1016/j.tripleo.2009.02.023
  18. Khanna JN, Ramaswami R. Synovial chondromatosis of the temporomandibular joint with intracranial extension-report of two cases. Int J Oral Maxillofac Surg 2017; 46: 1579-83. https://doi.org/10.1016/j.ijom.2017.05.018
  19. Han WH, Meng JH, Li G, Ma XC. Diagnosis of bilateral calcifications of temporomandibular joint disc by image fusion. J Craniofac Surg 2019; 30: e597-8. https://doi.org/10.1097/scs.0000000000005628
  20. Liu X, Wan S, Shen P, Qiu Y, Sah MK, Abdelrehem A, et al. Diagnostic accuracy of synovial chondromatosis of the temporomandibular joint on magnetic resonance imaging. PLoS One 2019; 14: e0209739. https://doi.org/10.1371/journal.pone.0209739
  21. Maffia F, Vellone V, De Quarto C, Runci Anastasi M, Cascone P. Synovial chondromatosis of the temporomandibular joint with glenoid fossa erosion: Disk preservation for spontaneous anatomical recovery. J Craniomaxillofac Surg 2019; 47: 1898-902. https://doi.org/10.1016/j.jcms.2019.10.005
  22. Renno TA, Chung AC, Gitt HA, Correa L, Luz JG. Temporomandibular arthropathies: A retrospective study with histopathological characteristics. Med Oral Patol Oral Cir Bucal 2019; 24: e562-70.
  23. Sozzi D, Bocchialini G, Novelli G, Valente MG, Moltrasio F, Bozzetti A. A rare case of synovial chondromatosis of the inferior TMJ compartment. diagnosis and treatment aspect. Ann Stomatol (Roma) 2016; 6: 91-5.
  24. Campos PS, Freitas CE, Pena N, Gonzalez MO, Almeida SM, Mariz AC, et al. Osteochondritis dissecans of the temporomandibular joint. Dentomaxillofac Radiol 2005; 34: 193-7. https://doi.org/10.1259/dmfr/59267138
  25. Aoyama S, Kino K, Amagasa T, Kayano T, Ichinose S, Kimijima Y. Differential diagnosis of calcium pyrophosphate dihidrate deposition of the temporomandibular joint. Br J Oral Maxillofac Surg 2000; 38: 550-3. https://doi.org/10.1054/bjom.2000.0313
  26. Stoll ML, Amin D, Powell KK, Poholek CH, Strait RH, Aban I, et al. Risk factors for intraarticular heterotopic bone formation in the temporomandibular joint in juvenile idiopathic arthritis. J Rheumatol 2018; 45: 1301-7. https://doi.org/10.3899/jrheum.171306
  27. Ringold S, Thapa M, Shaw EA, Wallace CA. Heterotopic ossification of the temporomandibular joint in juvenile idiopathic arthritis. J Rheumatol 2011; 38: 1423-8. https://doi.org/10.3899/jrheum.101198
  28. Benslama L, Schouman T, Toure S, Chardain J, Goudot P. Synovial chondromatosis of the temporomandibular joint: Report and analysis of 12 cases. J Stomatol Oral Maxillofac Surg 2019; 120: 476-9. https://doi.org/10.1016/j.jormas.2018.12.004
  29. Lee LM, Zhu YM, Zhang DD, Deng YQ, Gu Y. Synovial chondromatosis of the temporomandibular joint: a clinical and arthroscopic study of 16 cases. J Craniomaxillofac Surg 2019; 47: 607-10. https://doi.org/10.1016/j.jcms.2019.02.003
  30. Cevidanes LH, Hajati AK, Paniagua B, Lim PF, Walker DG, Palconet G, et al. Quantification of condylar resorption in temporomandibular joint osteoarthritis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: 110-7. https://doi.org/10.1016/j.tripleo.2010.01.008
  31. dos Anjos Pontual ML, Freire JS, Barbosa JM, Frazao MA, dos Anjos Pontual A. Evaluation of bone changes in the temporomandibular joint using cone beam CT. Dentomaxillofac Radiol 2012; 41: 24-9. https://doi.org/10.1259/dmfr/17815139

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