Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Evaluation of Articular Eminence Morphology in Patients with Spontaneous Temporomandibular Joint Dislocation Using Cone Beam Computed Tomography

  • Kim, Ji Hoo (Department of Dentistry, Graduate School, Chosun University) ;
  • Park, Hyun-Jeong (Department of Oral Medicine, School of Dentistry, Chosun University) ;
  • Seo, Yo-Seob (Department of Oral and Maxillofacial Radiology, School of Dentistry, Chosun University) ;
  • Ryu, Ji-Won (Department of Oral Medicine, School of Dentistry, Chosun University) ;
  • Ahn, Jong-Mo (Department of Oral Medicine, School of Dentistry, Chosun University)
  • Received : 2022.02.03
  • Accepted : 2022.03.02
  • Published : 2022.03.30
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Abstract

Purpose: This study aimed to broaden our understanding of the predisposing factor and treatment of dislocation by analyzing and evaluating the morphology of the articular eminence (AE) in subjects with temporomandibular joint (TMJ) dislocation using cone beam computed tomography (CBCT). Methods: The subjects were divided into two groups: dislocation (31 subjects) and control (32 subjects). CBCT was used to examine 126 TMJs in 63 subjects (26 males, 37 females). The height, width, and posterior slope of the AE were measured in the parasagittal plane. The posterior slope was measured using the "top-roof line angle (TR angle)" method and the "best-fit line angle (BF angle)" method. The AE on the left side (AEL) and the AE on the right side (AER) of the subjects in the dislocation group were separately analyzed and compared with the control group after taking measurements. The average value of both sides was used when comparing with subjects with bilateral dislocation. Results: Dislocations were more frequent in females (67.7%) than in males (32.3%). The dislocation group showed a gentler TR angle than the control group in the AER and in the average of AE on the both sides (AEB). The same group also showed a wider AE in the AEL and the AER (p<0.05). In subjects with unilateral dislocation, the width of the AE with dislocation was narrower and the TR angle and BF angle was steeper than the other side without dislocation (p<0.05). Conclusions: In subjects with unilateral TMJ dislocation, the posterior slope of the AE is steeper, and the width is narrower at the site of dislocation compared to the site without dislocation. However, in subjects with bilateral TMJ dislocation, AEB were wider, and the mean value of the posterior slope of AEB was gentler than that of the control group.

Keywords

Acknowledgement

This study was supported by research fund from Chosun University Dental Hospital 2021.

References

  1. Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St. Louis: Elsevier/Mosby; 2014. pp. 4-6, 165-166.
  2. Katsavrias EG. Changes in articular eminence inclination during the craniofacial growth period. Angle Orthod 2002;72:258-264.
  3. Sharma NK, Singh AK, Pandey A, Verma V, Singh S. Temporomandibular joint dislocation. Natl J Maxillofac Surg 2015;6:16-20. https://doi.org/10.4103/0975-5950.168212
  4. Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med 2011;7:10. https://doi.org/10.1186/1746-160X-7-10
  5. Guven O. Inappropriate treatments in temporomandibular joint chronic recurrent dislocation: a literature review presenting three particular cases. J Craniofac Surg 2005;16:449-452. https://doi.org/10.1097/01.SCS.0000147389.06617.F8
  6. Shakya S, Ongole R, Sumanth KN, Denny CE. Chronic bilateral dislocation of temporomandibular joint. Kathmandu Univ Med J (KUMJ) 2010;8:251-256. https://doi.org/10.3126/kumj.v8i2.3570
  7. Vasconcelos BC, Porto GG, Neto JP, Vasconcelos CF. Treatment of chronic mandibular dislocations by eminectomy: follow-up of 10 cases and literature review. Med Oral Patol Oral Cir Bucal 2009;14:e593-e596.
  8. Medra AM, Mahrous AM. Glenotemporal osteotomy and bone grafting in the management of chronic recurrent dislocation and hypermobility of the temporomandibular joint. Br J Oral Maxillofac Surg 2008;46:119-122. https://doi.org/10.1016/j.bjoms.2007.08.004
  9. Korean Academy of Orofacial Pain and Oral Medicine. Orofacial pain and temporomandibular disorders. Seoul: Dental Wisdom; 2012. pp. 150.
  10. Kerstens HC, Tuinzing DB, van der Kwast WA. Eminectomy and discoplasty for correction of the displaced temporomandibular joint disc. J Oral Maxillofac Surg 1989;47:150-154. https://doi.org/10.1016/s0278-2391(89)80106-5
  11. 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;80:258-266. https://doi.org/10.1016/S1079-2104(05)80380-4
  12. Hall MB, Gibbs CC, Sclar AG. Association between the prominence of the articular eminence and displaced TMJ disks. Cranio 1985;3:237-239. https://doi.org/10.1080/08869634.1985.11678105
  13. Kerstens HC, Tuinzing DB, Golding RP, Van der Kwast WA. Inclination of the temporomandibular joint eminence and anterior disc displacement. Int J Oral Maxillofac Surg 1989;18:228-232. https://doi.org/10.1016/S0901-5027(89)80059-1
  14. Panmekiate S, Petersson A, Akerman S. Angulation and prominence of the posterior slope of the eminence of the temporomandibular joint in relation to disc position. Dentomaxillofac Radiol 1991;20:205-208. https://doi.org/10.1259/dmfr.20.4.1808008
  15. Fan XC, Singh D, Ma LS, Piehslinger E, Huang XF, Rausch-Fan X. Is there an association between temporomandibular disorders and articular eminence inclination? A systematic review. Diagnostics (Basel) 2020;11:29. https://doi.org/10.3390/diagnostics11010029
  16. Paknahad M, Shahidi S, Akhlaghian M, Abolvardi M. Is mandibular fossa morphology and articular eminence inclination associated with temporomandibular dysfunction? J Dent (Shiraz) 2016;17:134-141.
  17. Rabelo KA, Sousa Melo SL, Torres MGG, Campos PSF, Bento PM, Melo DP. Condyle excursion angle, articular eminence inclination, and temporomandibular joint morphologic relations with disc displacement. J Oral Maxillofac Surg 2017;75:938.e1-938. e10. https://doi.org/10.1016/j.joms.2017.01.019
  18. Sulun T, Cemgil T, Duc JM, Rammelsberg P, Jager 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. https://doi.org/10.1067/moe.2001.114621
  19. Sato S, Kawamura H, Motegi K, Takahashi K. Morphology of the mandibular fossa and the articular eminence in temporomandibular joints with anterior disk displacement. Int J Oral Maxillofac Surg 1996;25:236-238. https://doi.org/10.1016/S0901-5027(96)80037-3
  20. Caglayan F, Sumbullu MA, Akgul HM. Associations between the articular eminence inclination and condylar bone changes, condylar movements, and condyle and fossa shapes. Oral Radiol 2014;30:84-91. https://doi.org/10.1007/s11282-013-0149-x
  21. Cohen A, Sela MC, Shooraki N, Alterman M, Casap N. The influence of articular eminence morphology on temporomandibular joint anterior dislocations. Oral Surg Oral Med Oral Pathol Oral Radiol 2021;131:9-15. https://doi.org/10.1016/j.oooo.2020.07.017
  22. Nam H, Shim YJ, Kang JK. Articular eminence morphology of temporomandibular joint in young Korean adults. J Oral Med Pain 2019;44:59-64. https://doi.org/10.14476/JOMP.2019.44.2.59
  23. Choi DS, Jang IS, Cha BK. Changes in height and inclination of the articular eminence during the growth period. Korean J Orthod 2010;40:411-420. https://doi.org/10.4041/kjod.2010.40.6.411
  24. Isberg A, Westesson PL. Steepness of articular eminence and movement of the condyle and disk in asymptomatic temporomandibular joints. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:152-157. https://doi.org/10.1016/S1079-2104(98)90117-2
  25. Sumbullu MA, Caglayan F, Akgul HM, Yilmaz AB. Radiological examination of the articular eminence morphology using cone beam CT. Dentomaxillofac Radiol 2012;41:234-240. https://doi.org/10.1259/dmfr/24780643
  26. Ugboko VI, Oginni FO, Ajike SO, Olasoji HO, Adebayo ET. A survey of temporomandibular joint dislocation: aetiology, demographics, risk factors and management in 96 Nigerian cases. Int J Oral Maxillofac Surg 2005;34:499-502. https://doi.org/10.1016/j.ijom.2004.10.025
  27. Lewis RP, Buschang PH, Throckmorton GS. Sex differences in mandibular movements during opening and closing. Am J Orthod Dentofacial Orthop 2001;120:294-303. https://doi.org/10.1067/mod.2001.115612
  28. Oh SC, Han JS. Radiographic evaluation of stiffness of articular eminence in the temporomandibular joint(TMJ) of Korean using dental cone-beam CT. J Dent Rehabil Appl Sci 2013;29:163-173. https://doi.org/10.14368/jdras.2013.29.2.163
  29. Humphreys H. Age changes in the temporomandibular joint and their importance in orthodontics. Int J Orthod Oral Surg Radiogr 1932;18:809-815. https://doi.org/10.1016/S0099-6963(32)90116-1
  30. Hinton RJ. Changes in articular eminence morphology with dental function. Am J Phys Anthropol 1981;54:439-455. https://doi.org/10.1002/ajpa.1330540402
  31. 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;16:443-450. https://doi.org/10.1007/s00784-011-0518-y
  32. Ichikawa W, Laskin DM. Anatomic study of the angulation of the lateral and midpoint inclined planes of the articular eminence. Cranio 1989;7:22-26. https://doi.org/10.1080/08869634.1989.11678264
  33. Honey OB, Scarfe WC, Hilgers MJ, et al. Accuracy of cone-beam computed tomography imaging of the temporomandibular joint: comparisons with panoramic radiology and linear tomography. Am J Orthod Dentofacial Orthop 2007;132:429-438. https://doi.org/10.1016/j.ajodo.2005.10.032
  34. Park HJ, Seo YS, Yoon AH, Kim JH, Ryu JW. Assessment of the thickness of the roof of the glenoid fossa using cone beam computed tomography in asymptomatic Korean adult patients. J Oral Med Pain 2019;44:112-117. https://doi.org/10.14476/jomp.2019.44.3.112