The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Correlations of temporomandibular joint morphology and position using cone-beam computed tomography and dynamic functional analysis in orthodontic patients: A cross-sectional study

  • Bin Xu (Department of Orthodontics, School of Dentistry, Kyung Hee University) ;
  • Jung-Jin Park (Department of Orthodontics, Dental Hospital, Kyung Hee University Hospital at Gangdong) ;
  • Seong-Hun Kim (Department of Orthodontics, School of Dentistry, Kyung Hee University)
  • Received : 2024.05.16
  • Accepted : 2024.09.04
  • Published : 2024.09.25
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Abstract

Objective: To correlate temporomandibular joint (TMJ) morphology and position with cone-beam computed tomography (CBCT) images, Joint Vibration Analysis (JVA), and Jaw Tracker (JT) to develop a radiation-free, dynamic method for screening and monitoring the TMJ in orthodontic patients. Methods: A total of 236 orthodontic patients without symptoms of TMJ disorders who had undergone CBCT were selected for the JVA and JT tests in this cross-sectional study. TMJ position and morphology were measured using a three-dimensional analysis software. JT measurements involved six opening-closing cycles, and JVA measurements were performed using a metronome to guide the mouth opening-closing movements of the patients. The correlations among the three measuring devices were evaluated. Results: Abnormalities in condylar surface morphology affected the mandibular range of motion. The cut-off value results show that when various measurement groups are within a certain range, abnormalities may be observed in morphology (area under the curve, 0.81; P < 0.001). A 300/< 300 Hz ratio ≥ 0.09 suggested abnormal morphology (P < 0.05). Correlations were observed among the maximum opening velocity, maximum vertical opening position, and joint spaces in the JT measurements. Correlations were also observed between the > 300/< 300 Hz ratio, median frequency, total integral, integral < 300 Hz, and peak frequency with joint spaces in the JVA measurements. Conclusions: JT and JVA may serve as rapid, non-invasive, and radiation-free dynamic diagnostic tools for monitoring and screening TMJ abnormalities before and during orthodontic treatment.

Keywords

Acknowledgement

This article is partly from the PhD Thesis of BX. The authors express their gratitude to Dr Heon Jae Cho, CEO of 3D ONS Company, Seoul for supporting the article preparation.

References

  1. Adern B, Stenvinkel C, Sahlqvist L, Tegelberg A. Prevalence of temporomandibular dysfunction and pain in adult general practice patients. Acta Odontol Scand 2014;72:585-90. https://doi.org/10.3109/00016357.2013.878390
  2. de Leeuw R, Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. 5th ed. Chicago: Quintessence Publishing Co.; 2013. https://www.amazon.com/Orofacial-Pain-Guidelines-Assessment-Management/dp/0867156104
  3. Talaat W, Al Bayatti S, Al Kawas S. CBCT analysis of bony changes associated with temporomandibular disorders. Cranio 2016;34:88-94. https://doi.org/10.1179/2151090315y.0000000002
  4. Kandasamy S, Greene CS, Rinchuse DJ, Stockstill JW. TMD and orthodontics: a clinical guide for the orthodontist. Cham: Springer; 2015. https://search.worldcat.org/ko/title/918983957
  5. Mohlin B, Axelsson S, Paulin G, Pietila T, Bondemark L, Brattstrom V, et al. TMD in relation to malocclusion and orthodontic treatment. Angle Orthod 2007;77:542-8. https://doi.org/10.2319/0003-3219(2007)077[0542:Tirtma]2.0.Co;2
  6. Fernandez-Gonzalez FJ, Canigral A, Lopez-Caballo JL, Brizuela A, Moreno-Hay I, Del Rio-Highsmith J, et al. Influence of orthodontic treatment on temporomandibular disorders. A systematic review. J Clin Exp Dent 2015;7:e320-7. https://doi.org/10.4317/jced.52037
  7. Leite RA, Rodrigues JF, Sakima MT, Sakima T. Relationship between temporomandibular disorders and orthodontic treatment: a literature review. Dental Press J Orthod 2013;18:150-7. https://doi.org/10.1590/s2176-94512013000100027
  8. Wyatt WE. Preventing adverse effects on the temporomandibular joint through orthodontic treatment. Am J Orthod Dentofacial Orthop 1987;91:493-9. https://doi.org/10.1016/0889-5406(87)90006-0
  9. Derwich M, Mitus-Kenig M, Pawlowska E. Interdisciplinary approach to the temporomandibular joint osteoarthritis-review of the literature. Medicina (Kaunas) 2020;56:225. https://doi.org/10.3390/medicina56050225
  10. Radke JC, Kamyszek GJ, Kull RS, Velasco GR. TMJ symptoms reduce chewing amplitude and velocity, and increase variability. Cranio 2019;37:12-9. https://doi.org/10.1080/08869634.2017.1365421
  11. Huang ZS, Lin XF, Li XL. Characteristics of temporomandibular joint vibrations in anterior disk displacement with reduction in adults. Cranio 2011;29:276-83. https://doi.org/10.1179/crn.2011.041
  12. Sutter B, Radke J. The complementary diagnostic relationship between jaw tracking and MR Imaging. Adv Dent Tech 2020:12067. https://adtt.scholasticahq.com/article/12067-the-complementarydiagnostic-relationship-between-jaw-tracking-andmr-imaging
  13. Celic R, Jerolimov V, Knezovic Zlataric D. Relationship of slightly limited mandibular movements to temporomandibular disorders. Braz Dent J 2004;15:151-4. https://doi.org/10.1590/s0103-64402004000200012
  14. Look JO, Schiffman EL, Truelove EL, Ahmad M. Reliability and validity of Axis I of the research Diagnostic Criteria For Temporomandibular Disorders (RDC/TMD) with proposed revisions. J Oral Rehabil 2010;37:744-59. https://doi.org/10.1111/j.1365-2842.2010.02121.x
  15. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* Network* and Orofacial Pain Special Interest Group† . J Oral Facial Pain Headache 2014;28:6-27. https://doi.org/10.11607/jop.1151
  16. Woodford SC, Robinson DL, Mehl A, Lee PVS, Ackland DC. Measurement of normal and pathological mandibular and temporomandibular joint kinematics: a systematic review. J Biomech 2020;111:109994. https://doi.org/10.1016/j.jbiomech.2020.109994
  17. Barao VA, Gallo AK, Zuim PR, Garcia AR, Assuncao WG. Effect of occlusal splint treatment on the temperature of different muscles in patients with TMD. J Prosthodont Res 2011;55:19-23. https://doi.org/10.1016/j.jpor.2010.06.001
  18. Matsubara R, Yanagi Y, Oki K, Hisatomi M, Santos KC, Bamgbose BO, et al. Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders. Dentomaxillofac Radiol 2018;47:20170412. https://doi.org/10.1259/dmfr.20170412
  19. Jeon KJ, Kim YH, Ha EG, Choi HS, Ahn HJ, Lee JR, et al. Quantitative analysis of the mouth opening movement of temporomandibular joint disorder patients according to disc position using computer vision: a pilot study. Quant Imaging Med Surg 2022;12:1909-18. https://doi.org/10.21037/qims21-629
  20. Henderson SE, Tudares MA, Tashman S, Almarza AJ. Decreased temporomandibular joint range of motion in a model of early osteoarthritis in the rabbit. J Oral Maxillofac Surg 2015;73:1695-705. https://doi.org/10.1016/j.joms.2015.03.042
  21. Comert Kilic S, Kilic N, Sumbullu MA. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. Int J Oral Maxillofac Surg 2015;44:1268-74. https://doi.org/10.1016/j.ijom.2015.06.023
  22. Lee YH, Hong IK, An JS. Anterior joint space narrowing in patients with temporomandibular disorder. J Orofac Orthop 2019;80:116-27. https://doi.org/10.1007/s00056-019-00172-y
  23. Muto T, Kanazawa M. The relationship between maximal jaw opening and size of skeleton: a cephalometric study. J Oral Rehabil 1996;23:22-4. https://doi.org/10.1111/j.1365-2842.1996.tb00807.x
  24. Dijkstra PU, de Bont LG, Stegenga B, Boering G. Temporomandibular joint mobility assessment: a comparison between four methods. J Oral Rehabil 1995;22:439-44. https://doi.org/10.1111/j.1365-2842.1995.tb00798.x
  25. Fukui T, Tsuruta M, Murata K, Wakimoto Y, Tokiwa H, Kuwahara Y. Correlation between facial morphology, mouth opening ability, and condylar movement during opening-closing jaw movements in female adults with normal occlusion. Eur J Orthod 2002;24:327-36. https://doi.org/10.1093/ejo/24.4.327
  26. Tamimi DF, Hatcher D. Specialty imaging: temporomandibular joint. Philadelphia: Elsevier; 2016. https://search.worldcat.org/ko/title/956278042
  27. Liu ZJ, Wang HY, Pu WY. A comparative electromyographic study of the lateral pterygoid muscle and arthrography in patients with temporomandibular joint disturbance syndrome sounds. J Prosthet Dent 1989;62:229-33. https://doi.org/10.1016/0022-3913(89)90319-3
  28. Gage JP. Collagen biosynthesis related to temporomandibular joint clicking in childhood. J Prosthet Dent 1985;53:714-7. https://doi.org/10.1016/0022-3913(85)90030-7
  29. Cimic S, Zaja M, Kraljevic Simunkovic S, Kopic M, Catic A. Influence of occlusal interference on the mandibular condylar position. Acta Stomatol Croat 2016;50:116-21. https://doi.org/10.1564/asc50/2/3
  30. Harris MD, Van Sickels JE, Alder M. Factors influencing condylar position after the bilateral sagittal split osteotomy fixed with bicortical screws. J Oral Maxillofac Surg 1999;57:650-4; discussion 654-5. https://doi.org/10.1016/s0278-2391(99)90422-6
  31. Schellhas KP, Wilkes CH. Temporomandibular joint inflammation: comparison of MR fast scanning with T1- and T2-weighted imaging techniques. AJR Am J Roentgenol 1989;153:93-8. https://doi.org/10.2214/ajr.153.1.93
  32. Oberg T, Carlsson GE, Fajers CM. The temporomandibular joint. A morphologic study on a human autopsy material. Acta Odontol Scand 1971;29:349-84. https://doi.org/10.3109/00016357109026526