Browse > Article

Factors related to the Condylar Bony Change in Patients with Osteoarthritis of Temporomandibular Joint  

Park, Mi-Sung (Dept. of Oral Medicine, School of Dentistry, Wonkwang University and Wonkwang Dental Research Institute)
Han, Kyung-Soo (Dept. of Oral Medicine, School of Dentistry, Wonkwang University and Wonkwang Dental Research Institute)
Jung, Dae-Yeon (Dept. of Oral Medicine, School of Dentistry, Wonkwang University and Wonkwang Dental Research Institute)
Publication Information
Journal of Oral Medicine and Pain / v.28, no.2, 2003 , pp. 219-231 More about this Journal
Abstract
The purpose of this study was to investigate the relationship between the degree of condylar bony change and clinical signs and symptoms, and to seek the related factors for estimation of osteoarthrosis in patients with osteoarthritis(OA) of temporomandibular joint(TMJ). 175 patients with temporomandibular disorders and 102 general dental patients were selected, and they were classified into the experimental and the control group, respectively. Clinical examination related to the mandibular function, occlusal condition, and subjective recording for the chief complaints using visual analogue scale(VAS) was performed in the experimental group. Plain radiographs, panoramic and transcranial, were taken in both groups. Some items related to mandibular height were measured and condylar bony change were assessed and numbered according to the criteria based on Boering's report, that was, 0 : no bony change, 1: flattening, 2: erosion, 3: shortening or dimensional shrinkage. The data collected were analyzed by SPSS $Windows^{\circledR}$ and prediction equation for the estimation of osteoarthrosis was produced by multiple regression analysis. Ramus heights were higher in the control group, but condylar heights were higher in the experimental group. As a result, the ratio of condylar heights to ramus heights was higher in the experimental group. Degree of condylar bony change in women was also slightly higher in the experimental group. Comparison of mandibular heights between right and left side did not show any significant difference in all observed cases, and comparison of condylar change between right and left side also did not show any significant difference in almost all observed cases. But the correlationship between right and left side were highly positive. Almost not significant correlation was observed between pain during mandibular functional movement and condylar bony change, and only anterior openbite was related to the degree of condylar bony change in both male and female patients with temporomandibular disorders. VAS scores in the first visit were not correlated with condylar bony change. Male subjects in the experimental group showed positive correlation between history of joint sound duration and condylar bony change. Significant factors for the prediction of degree of osteoarthrosis for male subjects in the experimental group were ramus height and amount of anterior overjet, and for female subjects in the experimental group, were ramus height, clenching habit and retroepicondylar height.
Keywords
Osteoarthritis; Condylar height; TMD;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Brandt KD, Slemenda CW : Osteoarthritis. Epidemiology, pathology and pathogenesis. In Schumacher HR Jr. editor: Primer on rheumatic disease. ed 10. Atlanta, 1993. Arthritis Foundation
2 Rasmussen OC : Temporomandibular arthropathy: clinical, radiologic and therapeutic aspects with emphasis on diagnosis. Int J Oral Surg, 12 : 365-397, 1983   DOI   PUBMED
3 de Bont LGM, Boering G, Liem RSB : Osteoarthritis of the the temporomandibular joint: A light microscopic and scanning electron microscopic study of the articular cartilage of the mandibular condyle. J Oral Maxillofac Surg, 43 : 481-488, 1985
4 Madsen B : Normal variations in anatomy, condylar movements and arthrosis frequency of the temporomandibular joints. Acta Radiol, 4 : 273-288, 1966
5 Nickerson JW Jr., Boering G : Natural course of osteoarthrosis as it relates to internal derangement of the temporomandibular joint. in Merill RG, (ed). Oral and and maxillofacial surgery clinics of North America. Disorders of the TMJ 1: Diagnosis and arthroscopy. Philadelphia, WB Saunders Company, 1989. pp. 27-45
6 Stegenga B, de Bont LGM, de Leeuw R, Boering G : Assessment of mandibular function impairment associated with temporomandibular joint osteoarthrosis and internal derangements. J Orofacial Pain, 7 : 183-195, 1993
7 de Leeuw R, Boering G, Stegenga B, de Bont LGM : Temporomandibular joints osteoarthrosis: clinical and radiographic characteristics 30 years after non-surgical treatment: a preliminary report. J Craniomandib Pract 11 : 15-24, 1993
8 Rönning O, Väliaho M-L, Laaksonen A-L : The involvement of the temporomandibular joint in juvenile rheumatoid arthritis. Scand J Rheumatol, 3 : 89-96, 1974
9 de Bont LGM, Boering G, Liem RSB : Osteoarthritis and internal derangement of the temporomandibular joint: a light microscopic study. J Oral Maxillofac Surg, 44 : 634-643, 1986
10 Tronje G : Image distortion in rotational panoramic radiography. Dentomaxillofac Radiol, Suppl 3, 1982
11 Westesson P-L : Structural hard-tissue changes in temporomandibular joints with internal derangement. Oral Surg Oral Med, Oral Pathol, 59 : 220-224, 1985
12 Westesson P-L, Rohlin M : Internal derangement related to osteoarthrosis in temporomandibular autopsy specimens. Oral Surg Oral Med Oral Pathol, 57 : 17-29, 1984
13 Toller PA : Osteoarthrosis of the mandibular condyle. Br Dent J, 134 : 223-231, 1973   DOI   PUBMED   ScienceOn
14 Farrar WB, McCarty WL : A clinical outline of temporomandibular joint diagnosis and treatment. 7th ed. Montgomery: Normandie Publications, 1982, pp. 53-88
15 Lund TM, Manson-Hing LR : A study of focal troughs of three panoramic dental x-ray machines. Ⅰ. The area of sharpness. Oral Surg Oral Med Oral Pathol, 39 : 318-328, 1975
16 Kjellberg H. Ekestubbe A, Kiliaridis S, Thilander B : Condylar height on panoramic radiographs. A methodologic study with a clinical application. Acta Odontol Scand, 52 : 43-50, 1994
17 McDavid WD, Tronje G, Welander U: Imaging characteristics of seven panoramic x-ray units. Chapter 4. Horizontal and vertical magnification. Dentomaxillofac Radiol, supple 8 : 29-34, 1985
18 de Leeuw R, Boering G, Stegenga B, Bont LGM : Radiographic signs of temporomandibular joint osteoarthrosis and internal derangement 30 years after nonsurgical treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 79 : 382-392, 1995
19 Meikle MC : Remodeling, in Sarnat BG, Laskin DM (eds): The temporomandibular joint: Biologic diagnosis and treatment. ed 3. Springfield, IL, Thomas, 1979, pp. 205-226
20 Mankin HJ, Brandt KD : Biochemistry and metabolism of cartilage in osteoarthritis, in Moskowitz RW, Howell DS, Goldberg VM (eds): Osteoarthritis, Diagnosis and Management. Philadelphia, Saunders, 1984, pp. 71-78
21 de Bont LGM, Liem RSB, Boering G : Ultrastructure of the articular cartilage of the mandibular condyle: aging and degeneration. Oral Surg Oral Med Oral Pathol, 60 : 631-641, 1985
22 Larheim TA, Höyeraal HM, Stabrun AE, Haanaes HR : The temporomandibular joint in juvenile rheumatoid arthritis. Scand J Rheumatol, 11 : 5-12, 1982   PUBMED
23 Mejersjö C, Carlsson GE : Long-term results of treatment for temporomandibular joint pain-dysfunction. J Prosthet Dent, 49 : 809-815, 1983   DOI   ScienceOn
24 de Leeuw R, Boering G, Stegenga B, de Bont LGM : Clinical signs of TMJ osteoarthrosis and internal derangement 30 years after non-surgical treatment. J Orofacial Pain. 8 : 12-18, 1994
25 Brooks SL, Westesson PL, Eriksson L et al : Prevalence of osseous changes in the temporomandibular joint of asymptomatic persons without internal derangement. Oral Surg Oral Med Oral Pathol, 73 : 122-126, 1992
26 Lamont-Havers RW : Arthritis of the temporomandibular joint. Dent Clin N Am, 10 : 621-626, 1966
27 Rasmussen OC : Logitudinal study of transpharyngeal radiography in temporo- mandibular arthropathy. Scand J Dent Res, 88 : 257-268, 1980   PUBMED
28 Wilkes CH : Internal derangement of the temporomandibular joint: pathologic vatiations. Arch Otolaryngol Head Neck Surg, 115 : 469-477, 1989   DOI   PUBMED   ScienceOn
29 Moskowitz RW: Introduction, in Moskowitz RW, Howell DS, Goldberg VM (eds) : Osteoarthritis, Diagnosis and Management. Philadelphia, Saunders, 1984, pp. 68-71
30 Zach GA, Langland OE, Sippy FH : The use of the orthopantomogram in longitudinal studies. Angle Orthod, 39 : 42-50, 1969   PUBMED
31 Athanasiou EA, Melsen B, Mavreas D, Kimmel FP : Stomatognathic function of patients who seek orthognathic surgery to correct dentofacial deformities. Int J Adult Orthod Orthognath Surg, 4 : 239-254, 1989
32 Eriksson L, Westesson PL : Clinical and radiological study of patients with anterior disc displacement. Swed Dent J, 7 : 55-64, 1983   PUBMED
33 Kreutziger KL, Mahan PE : Temporomandibular degenerative joint disease.Ⅰ. Anatomy, pathophysiology and clinical description. Oral Surg, 40 : 165-182, 1995
34 Ehrlich GE : Inflammatory osteoarthritis. Ⅰ. The clinical syndromes. J Chron Dis, 25 : 317-328, 1972
35 Mejersjö C, Hollender L : Radiography of the temporomandibular joint in female patients with TMJ pain or dysfunction: a seven year follow-up. Acta Radiol Diagn, 25 : 169-176, 1984
36 de Leeuw R, Boering G, Stegenga B, de Bont LGM : Symptoms of TMJ osteoarthrosis and internal derangement 30 years after non-surgical treatment. J Craniomandib Pract 13 : 81-88, 1995
37 Okeson JP: Fundamentals of occlusion and temporomandibular disorders. ed 4. St Louis, Mosby, 1998
38 Habets LLMH, Bezuur JN, Naeiji M, Hansson TL : The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. Ⅱ. The vertical symmetry. J Oral Rehabil, 15 : 465-471, 1988
39 Lund TM, Manson-Hing LR : A study of focal troughs of three panoramic dental x-ray machines. Ⅱ. Image dimensions. Oral Surg Oral Med Oral Pathol, 39 : 647-653, 1975
40 Stegenga B, de Bont LGM, Boering G : Osteoarthrosis as the cause of craniomandibular pain and dysfunction: a unifying concept. J Oral Maxillofac Surg, 47 : 249-256, 1989
41 Larheim TA, Svanaes DB : Reproducibility of rotational panoramic radiography: mandibular linear dimensions and angles. Am J Orthod Dentofac Orthop, 90 : 45-51, 1986   DOI   ScienceOn
42 Hall MB, Brown RW, Baughanan RA : Histological appearance of the bilaminar zone in internal derangement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol, 58 : 375-383, 1987
43 Rönning O, Väliaho M-L : Progress of mandibular condyle lesions in juvenile rheumatoid arthritis. Proc Finn Dent Soc, 77 : 151-157, 1981