Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle

doi:10.1016/j.ijom.2008.02.011

International Journal of Oral and Maxillofacial Surgery

Volume 37, Issue 6, June 2008, Pages 529-534

https://doi.org/10.1016/j.ijom.2008.02.011 Get rights and content

Abstract

The aim of this study was to investigate temporomandibular joint (TMJ) pain and magnetic resonance imaging characteristics in 104 TMJs with and 58 without degenerative changes of the condyle, such as osteophytes, erosion, avascular necrosis, subcondral cyst and intra-articular loose bodies. TMJ images were also assessed for flattening, retropositioning and hypomobility of condyle and disc displacement. Comparison of the TMJ side-related data showed a significant relationship between disc displacement without reduction (DDwoR) and the presence of degenerative bony changes (p = 0.00). Flattening, retropositioning and hypomobility of condyle showed no significant difference in relation to the presence or absence of degenerative bony changes. Retropositioning of the condyle was significantly associated to disc displacement with reduction (DDwR) (p = 0.00), while condylar hypomobility was significantly more frequent in TMJ with DDwoR (p < 0.05). Independent of the presence or type of DD, TMJ pain was more frequent in the presence of degenerative bony changes. When considering only DDwR, TMJ pain was significantly associated to a degenerative condition (p = 0.03). When there were no degenerative bony changes, TMJ pain was significantly more frequent in DDwoR (p = 0.04). Despite the present findings, the absence of symptoms in some patients with condylar bony changes suggests that the diagnosis of osteoarthritis should be established by evaluation of magnetic resonance images in association with clinical examination.

Section snippets

Material and methods

This study was carried out with the approval of the FOP/UNICAMP Ethics Committee (096/2005) and informed consent was obtained from all patients. The study group comprised 81 males and females selected from patients that underwent MRI in a private clinic between 2001 and 2005.

The scans were performed using a Signa Horizon system model scanner (General Electric, Milwaukee, WI, USA), at a magnetic field magnitude of 1.5 T, using a bilateral radiofrequency surface coil of 6.5 × 6.5 cm. Images were

Results

This study assessed MRI characteristics and TMJ pain in 81 patients (162 TMJs), 69 (86%) female and 12 (14%) male. The mean age was 40.8 years (range 15-76 years). Forty-two patients (52%) reported unilateral TMJ pain, 17 (21%) bilateral TMJ pain, and 22 (27%) reported no joint pain. Out of the 22 patients without joint pain, 18 reported muscle pain and/or joint sounds, while 4 were totally asymptomatic.

There were 58 TMJs without and 104 with degenerative changes of the condyle. Osteophytes

Discussion

In this retrospective study, MRI characteristics and TMJ pain were compared between 104 TMJs with and 58 TMJs without condylar bony changes. In agreement with a previous report¹¹, osteophytes and erosion were the most prevalent bony changes observed on MRI (Fig. 1).

In the present study, degenerative bony changes were significantly related to DDwoR when compared to DDwR or absence of DD (Table 2). This result complies with all previous studies1, 4, 6, 8, 11, 26, 29, 43 but one³⁶. These data

Acknowledgement

We are thankful to Dr. Delfin Gonzalez Miranda, Delfin Clinic, for access to MR images.

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Citation Excerpt :
Most of the patients diagnosed with ID and DDwoR present dysfunction symptoms with or without chronic joint pain. As the disease progresses, further degeneration is observed in imaging tests (Campos et al., 2008; Koh et al., 2009) and direct arthroscopic inspection (Machoň et al., 2012). McCain and Hossameldin (2011) were the first to describe the technique of arthroscopic disc fixation, placing titanium screws and, later, resorbable pins.
Discopexy using resorbable pins is an arthroscopic technique to treat internal derangement of the TMJ, restoring the normal relationship between disc, condyle, and temporal bone. The objective of our study was to assess the 5-year clinical outcome of a series of patients treated with this technique.
A study was conducted on a series of patients who underwent arthroscopic discopexy using resorbable pins between January 2007 and February 2018. All the patients were refractory to conservative treatment and classified as Wilkes stage III. Clinical data were recorded at 1-year, 3-year, and 5-year visits. Pre- and postoperative evaluation parameters were: joint pain (VAS scale), mandibular movements (mm), and articular locking and clicking.
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^☆: This study was supported by grants from FAPESP.

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Clinical PaperTMJ DisordersAnalysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle☆

Abstract

Section snippets

Material and methods

Results

Discussion

Acknowledgement

J Am Dent Assoc

Int J Oral Maxillofac Surg

Int J Oral Maxillofac Surg

Int J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Am Dent Assoc

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Int J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Br J Oral Maxillofac Surg

J Oral Maxillofac Surg

Int J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Int J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Br J Oral Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Int J Oral Maxillofac Surg

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Clinical Paper
TMJ Disorders
Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle☆