Browse > Article
http://dx.doi.org/10.14476/jomp.2019.44.2.45

Could Crepitus Be an Indication for Early Temporomandibular Joint Osteoarthritis?  

Ju, Hye-Min (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital)
Lee, Sun-Hee (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital)
Jeon, Hye-Mi (Department of Oral Medicine, Pusan National University Hospital)
Kim, Kyung-Hee (Department of Oral Medicine, Inje University Busan Paik Hospital)
Ahn, Yong-Woo (Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University)
Ok, Soo-Min (Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University)
Jeong, Sung-Hee (Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University)
Publication Information
Journal of Oral Medicine and Pain / v.44, no.2, 2019 , pp. 45-53 More about this Journal
Abstract
Purpose: To determine whether crepitus may be a clinical indication for early temporomandibular joint (TMJ) osteoarthritis (OA) and to investigate the correlation between crepitus and the occurrence of TMJ OA with respect to factors, such as patient sex, age, chewing habits, and diagnosis. Methods: This is retrospective analysis of clinical data for 162 TMJs. The criteria for a joint to be included in this study was a minimum of two cone-beam computed tomography (CBCT) scans performed with no OA observed during the initial scan. The Diagnostic Criteria for Temporomandibular Disorders was used for OA diagnosis. Crepitus was recorded when it was objectively palpated during the follow-up period. Correlations between various patient factors and progression to TMJ OA were calculated using the Pearson's chi-square test. A linear-by-linear association was used to analyze trends of OA progression with increasing age. Results: Among the 162 joints, 101 progressed to OA and 61 did not. In the joints where crepitus had been present before OA was confirmed at next or last CBCT, OA progressed at a high rate, and especially higher in female and older patients (p<0.01). Patients in the pain-related disorder group with crepitus were observed to have higher rates of OA progression compared to patients in the intra-articular disorder group (p<0.01). Conclusions: If a patient experiences pain in the TMJs and crepitus, close monitoring through regular CBCT scans is necessary even if there is no evidence of radiologically confirmed OA after the first CBCT.
Keywords
Crepitus; Early osteoarthritis; Temporomandibular joint; The Diagnostic Criteria for Temporomandibular Disorders;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Hajati AK, Nasstrom K, Alstergren P, Bratt J, Kopp S. Temporomandibular joint bone tissue resorption in patients with early rheumatoid arthritis can be predicted by joint crepitus and plasma glutamate level. Mediators Inflamm 2010;2010:627803.   DOI
2 Schiphof D, van Middelkoop M, de Klerk BM, et al. Crepitus is a first indication of patellofemoral osteoarthritis (and not of tibiofemoral osteoarthritis). Osteoarthritis Cartilage 2014;22:631-638.   DOI
3 Akerman S, Kopp S, Nilner M, Petersson A, Rohlin M. Relationship between clinical and radiologic findings of the temporomandibular joint in rheumatoid arthritis. Oral Surg Oral Med Oral Pathol 1988;66:639-643.   DOI
4 Holmlund AB, Axelsson S. Temporomandibular arthropathy: correlation between clinical signs and symptoms and arthroscopic findings. Int J Oral Maxillofac Surg 1996;25:178-181.   DOI
5 Madry H, Kon E, Condello V, et al. Early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 2016;24:1753-1762.   DOI
6 Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St. Louis, Mo.: Elsevier Inc.; 2013. pp. 317-361.
7 Guarda-Nardini L, Piccotti F, Mogno G, Favero L, Manfredini D. Age-related differences in temporomandibular disorder diagnoses. Cranio 2012;30:103-109.   DOI
8 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;41:24-29.   DOI
9 Wang XD, Kou XX, Meng Z, et al. Estrogen aggravates iodoacetate-induced temporomandibular joint osteoarthritis. J Dent Res 2013;92:918-924.   DOI
10 Zhao YP, Zhang ZY, Wu YT, Zhang WL, Ma XC. 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:e27-34.
11 Susami T, Kuroda T, Yano Y, Nakamura T. Growth changes and orthodontic treatment in a patient with condylolysis. Am J Orthod Dentofacial Orthop 1992;102:295-301.   DOI
12 Widmalm SE, Westesson PL, Kim IK, Pereira FJ Jr, Lundh H, Tasaki MM. Temporomandibular joint pathosis related to sex, age, and dentition in autopsy material. Oral Surg Oral Med Oral Pathol 1994;78:416-425.   DOI
13 Pereira FJ Jr, Lundh H, Westesson PL. Morphologic changes in the temporomandibular joint in different age groups. An autopsy investigation. Oral Surg Oral Med Oral Pathol 1994;78:279-287.   DOI
14 Wiese M, Svensson P, Bakke M, et al. Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms. J Orofac Pain 2008;22:239-251.
15 Kim K, Wojczynska A, Lee JY. The incidence of osteoarthritic change on computed tomography of Korean temporomandibular disorder patients diagnosed by RDC/TMD; a retrospective study. Acta Odontol Scand 2016;74:337-342.   DOI
16 Koyama E, Saunders C, Salhab I, et al. Lubricin is required for the structural integrity and post-natal maintenance of TMJ. J Dent Res 2014;93:663-670.   DOI
17 Guarda-Nardini L, Manfredini D, Stifano M, Staffieri A, Marioni G. Intra-articular injection of hyaluronic acid for temporomandibular joint osteoarthritis in elderly patients. Stomatologija 2009;11:60-65.
18 Cortes D, Exss E, Marholz C, Millas R, Moncada G. Association between disk position and degenerative bone changes of the temporomandibular joints: an imaging study in subjects with TMD. Cranio 2011;29:117-126.   DOI
19 Hill A, Duran J, Purcell P. Lubricin protects the temporomandibular joint surfaces from degeneration. PLoS One 2014;9:e106497.   DOI
20 Moncada G, Cortes D, Millas R, Marholz C. Relationship between disk position and degenerative bone changes in temporomandibular joints of young subjects with TMD. An MRI study. J Clin Pediatr Dent 2014;38:269-276.   DOI
21 Nishimura M, Segami N, Kaneyama K, Suzuki T, Miyamaru M. Relationships between pain-related mediators and both synovitis and joint pain in patients with internal derangements and osteoarthritis of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:328-332.   DOI
22 Vernal R, Velasquez E, Gamonal J, Garcia-Sanz JA, Silva A, Sanz M. Expression of proinflammatory cytokines in osteoarthritis of the temporomandibular joint. Arch Oral Biol 2008;53:910-915.   DOI
23 Wang XD, Kou XX, Mao JJ, Gan YH, Zhou YH. Sustained inflammation induces degeneration of the temporomandibular joint. J Dent Res 2012;91:499-505.   DOI
24 Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St. Louis, Mo.: Elsevier Inc.; 2013. pp. 129-169.
25 Lopez-Cedrun J, Santana-Mora U, Pombo M, et al. Jaw biodynamic data for 24 patients with chronic unilateral temporomandibular disorder. Sci Data 2017;4:170168.   DOI
26 Reinhardt R, Tremel T, Wehrbein H, Reinhardt W. The unilateral chewing phenomenon, occlusion, and TMD. Cranio 2006;24:166-170.   DOI
27 Das SK. TMJ osteoarthritis and early diagnosis. J Oral Biol Craniofac Res 2013;3:109-110.   DOI
28 Jeon HM, Ahn YW, Jeong SH, et al. Pattern analysis of patients with temporomandibular disorders resulting from unilateral mastication due to chronic periodontitis. J Periodontal Implant Sci 2017;47:211-218.   DOI
29 Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014;28:6-27.   DOI
30 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;44:1268-1274.   DOI
31 Robinson JL, Cass K, Aronson R, et al. Sex differences in the estrogen-dependent regulation of temporomandibular joint remodeling in altered loading. Osteoarthritis Cartilage 2017;25:533-543.   DOI
32 Yao W, Qu N, Lu Z, Yang S. The application of T1 and T2 relaxation time and magnetization transfer ratios to the early diagnosis of patellar cartilage osteoarthritis. Skeletal Radiol 2009;38:1055-1062.   DOI
33 Liess C, Lusse S, Karger N, Heller M, Gluer CC. Detection of changes in cartilage water content using MRI T2-mapping in vivo. Osteoarthritis Cartilage 2002;10:907-913.   DOI
34 Lo GH, Strayhorn MT, Driban JB, Price LL, Eaton CB, Mcalindon TE. Subjective crepitus as a risk factor for incident symptomatic knee osteoarthritis: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 2018;70:53-60.   DOI