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Does the horizontal condylar angle have a relationship to temporomandibular joint osteoarthritis and condylar position? A cone-beam computed tomography study
Affiliations- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
- Department of Statistics, Faculty of Sciences, Gazi University, Ankara, Turkey
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Abstract
Background: The aim of the study was to evaluate the relationship between the horizontal condylar angle (HCA), temporomandibular joint osteoarthritis (TMJ OA), and condylar position on cone-beam computed tomography (CBCT) images.
Materials and methods: Based on TMJ OA, joints were classified as affected and the unaffected. According to the OA condition of their joints, three groups of patients were formed: control group (n = 159, 41.1%), unilateral group (n = 121, 31.3%), and bilateral group (n = 107, 27.6%). In total, the HCAs of 774 TMJs of 387 patients were measured and their condylar positions were determined as concentric (n = 184, 23.8%), posterior (n = 338, 43.7%), and anterior (n = 252, 32.5%).
Results: The mean HCA of the bilateral group (22.7 ± 7.6°) was greater than those in both the control (19.5 ± 6.4°) and the unilateral (20.5 ± 6.5°) groups (p < 0.05). However, the difference was not statistically significant between the control and unilateral group (p > 0.05). In total patients, unlike the unilateral group, the affected joints had a greater mean HCA than the unaffected joints (p < 0.05). The mean HCAs of the joints according to the condylar position were as concentric: 20.6 ± 6.7°, posterior: 21.1 ± 7.8°, and anterior: 20.2 ± 7.9° (p > 0.05).
Conclusions: While the HCA increased in the presence of TMJ OA, no relationship was found between HCA and three different condylar positions.
Abstract
Background: The aim of the study was to evaluate the relationship between the horizontal condylar angle (HCA), temporomandibular joint osteoarthritis (TMJ OA), and condylar position on cone-beam computed tomography (CBCT) images.
Materials and methods: Based on TMJ OA, joints were classified as affected and the unaffected. According to the OA condition of their joints, three groups of patients were formed: control group (n = 159, 41.1%), unilateral group (n = 121, 31.3%), and bilateral group (n = 107, 27.6%). In total, the HCAs of 774 TMJs of 387 patients were measured and their condylar positions were determined as concentric (n = 184, 23.8%), posterior (n = 338, 43.7%), and anterior (n = 252, 32.5%).
Results: The mean HCA of the bilateral group (22.7 ± 7.6°) was greater than those in both the control (19.5 ± 6.4°) and the unilateral (20.5 ± 6.5°) groups (p < 0.05). However, the difference was not statistically significant between the control and unilateral group (p > 0.05). In total patients, unlike the unilateral group, the affected joints had a greater mean HCA than the unaffected joints (p < 0.05). The mean HCAs of the joints according to the condylar position were as concentric: 20.6 ± 6.7°, posterior: 21.1 ± 7.8°, and anterior: 20.2 ± 7.9° (p > 0.05).
Conclusions: While the HCA increased in the presence of TMJ OA, no relationship was found between HCA and three different condylar positions.
Keywords
horizontal condylar angle, temporomandibular joint osteoarthritis, condylar position, cone-beam computed tomography
About this articleTitle
Does the horizontal condylar angle have a relationship to temporomandibular joint osteoarthritis and condylar position? A cone-beam computed tomography study
Journal
Issue
Article type
Original article
Pages
723-731
Published online
2021-08-03
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4738
Article views/downloads
1004
DOI
Pubmed
Bibliographic record
Folia Morphol 2022;81(3):723-731.
Keywords
horizontal condylar angle
temporomandibular joint osteoarthritis
condylar position
cone-beam computed tomography
Authors
U. Pamukcu
H. Tetik
I. Peker
B. Altunkaynak
Z. Zafersoy Akarslan
References (38)- Ahmad M, Hollender L, Anderson Q, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107(6): 844–860.
- Al-Rawi NH, Uthman AT, Sodeify SM. Spatial analysis of mandibular condyles in patients with temporomandibular disorders and normal controls using cone beam computed tomography. Eur J Dent. 2017; 11(1): 99–105.
- Benson BW, Frederiksen NL. A reliability comparison of submentovertex and zonographic methods of horizontal condylar angle estimation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 86(3): 370–375.
- Cho BH, Jung YH. Osteoarthritic changes and condylar positioning of the temporomandibular joint in Korean children and adolescents. Imaging Sci Dent. 2012; 42(3): 169–174.
- Christiansen EL, Thompson JR, Kopp SF, et al. Radiographic signs of temporomandibular joint diseases: an investigation utilizing X-ray computed tomography. Dentomaxillofac Radiol. 1985; 14(2): 83–91.
- Crusoé-Rebello IM, Campos PS, Rubira IR, et al. Evaluation of the relation between the horizontal condylar angle and the internal derangement of the TMJ - a magnetic resonance imaging study. Pesqui Odontol Bras. 2003; 17(2): 176–182.
- Derwich M, Mitus-Kenig M, Pawlowska E. Interdisciplinary approach to the temporomandibular joint osteoarthritis-review of the literature. Medicina (Kaunas). 2020; 56(5).
- Ebner KA, Otis LL, Zakhary R, et al. Axial temporomandibular joint morphology: a correlative study of radiographic and gross anatomic findings. Oral Surg Oral Med Oral Pathol. 1990; 69(2): 247–252.
- Eisenburger M, Haubitz B, Schmelzeisen R, et al. The human mandibular intercondylar angle measured by computed tomography. Arch Oral Biol. 1999; 44(11): 947–951.
- Ha MH, Kim YI, Park SB, et al. Cone-beam computed tomographic evaluation of the condylar remodeling occurring after mandibular set-back by bilateral sagittal split ramus osteotomy and rigid fixation. Korean J Orthod. 2013; 43(6): 263–270.
- Hüls A, Schulte W, Voigt K. Neue Aspekte der Myoarthropathien durch die computertomographie. Dtsch Zahnarztl Z. 1981; 36(12): 776–786.
- Junhasavasdikul T, Abadeh A, Tolend M, et al. Developing a reference MRI database for temporomandibular joints in healthy children and adolescents. Pediatr Radiol. 2018; 48(8): 1113–1122.
- Kurita H, Ohtsuka A, Kobayashi H, et al. Relationship between increased horizontal condylar angle and resorption of the posterosuperior region of the lateral pole of the mandibular condyle in temporomandibular joint internal derangement. Dentomaxillofac Radiol. 2003; 32(1): 26–29.
- Lee PP, Stanton AR, Hollender LG. Greater mandibular horizontal condylar angle is associated with temporomandibular joint osteoarthritis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017; 123(4): 502–507.
- Lee PP, Stanton AR, Schumacher AE, et al. Osteoarthritis of the temporomandibular joint and increase of the horizontal condylar angle: a longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019; 127(4): 339–350.
- Mischkowski RA, Pulsfort R, Ritter L, et al. Geometric accuracy of a newly developed cone-beam device for maxillofacial imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104(4): 551–559.
- Ohlmann B, Rammelsberg P, Henschel V, et al. Prediction of TMJ arthralgia according to clinical diagnosis and MRI findings. Int J Prosthodont. 2006; 19(4): 333–338.
- Paknahad M, Shahidi S. Association between mandibular condylar position and clinical dysfunction index. J Craniomaxillofac Surg. 2015; 43(4): 432–436.
- Paknahad M, Shahidi S, Iranpour S, et al. Cone-beam computed tomographic assessment of mandibular condylar position in patients with temporomandibular joint dysfunction and in healthy subjects. Int J Dent. 2015; 2015: 301796.
- Palconet G, Ludlow JB, Tyndall DA, et al. Correlating cone beam CT results with temporomandibular joint pain of osteoarthritic origin. Dentomaxillofac Radiol. 2012; 41(2): 126–130.
- Pullinger A, Hollender L, Solberg W, et al. A tomographic study of mandibular condyle position in an asymptomatic population. J Prosthet Dent. 1985; 53(5): 706–713.
- Pullinger AG, Solberg WK, Hollender L, et al. Tomographic analysis of mandibular condyle position in diagnostic subgroups of temporomandibular disorders. J Prosthet Dent. 1986; 55(6): 723–729.
- Raustia AM, Pyhtinen J. Morphology of the condyles and mandibular fossa as seen by computed tomography. J Prosthet Dent. 1990; 63(1): 77–82.
- Robinson de Senna B, Marques LS, França JP, et al. Condyle-disk-fossa position and relationship to clinical signs and symptoms of temporomandibular disorders in women. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108(3): e117–e124.
- Sato H, Fujii T, Kitamori H. The clinical significance of the horizontal condylar angle in patients with temporomandibular disorders. Cranio. 1997; 15(3): 229–235.
- Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006; 72(1): 75–80.
- Seo BY, An JS, Chang MS, et al. Changes in condylar dimensions in temporomandibular joints with disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020; 129(1): 72–79.
- Shokri A, Zarch HH, Hafezmaleki F, et al. Comparative assessment of condylar position in patients with temporomandibular disorder (TMD) and asymptomatic patients using cone-beam computed tomography. Dent Med Probl. 2019; 56(1): 81–87.
- Sülün T, Akkayan B, Duc JM, et al. Axial condyle morphology and horizontal condylar angle in patients with internal derangement compared to asymptomatic volunteers. Cranio. 2001; 19(4): 237–245.
- Taylor R, Ware W, Fowler D, et al. A study of temporomandibular joint morphology and its relationship to the dentition. Oral Surgery, Oral Medicine, Oral Pathology. 1972; 33(6): 1002–1013.
- Teng HD, Shu JH, Sun TH, et al. [Three-dimensional morphological changes in the temporomandibular joints of patients with anterior disc displacement with reduction]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2021; 39(2): 203–208.
- Torres MG, Crusoé-Rebello IM, Rosário M, et al. Morphometric features of the mandibular condyle and association with disk abnormalities. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016; 121(5): 566–572.
- Ueki K, Degerliyurt K, Hashiba Y, et al. Horizontal changes in the condylar head after sagittal split ramus osteotomy with bent plate fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106(5): 656–661.
- Wang XD, Zhang JN, Gan YH, et al. Current understanding of pathogenesis and treatment of TMJ osteoarthritis. J Dent Res. 2015; 94(5): 666–673.
- Westesson PL, Bifano JA, Tallents RH, et al. Increased horizontal angle of the mandibular condyle in abnormal temporomandibular joints. A magnetic resonance imaging study. Oral Surg Oral Med Oral Pathol. 1991; 72(3): 359–363.
- Westesson PL, Liedberg J. Horizontal condylar angle in relation to internal derangement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol. 1987; 64(4): 391–394.
- Westesson PL, Rohlin M. Internal derangement related to osteoarthrosis in temporomandibular joint autopsy specimens. Oral Surg Oral Med Oral Pathol. 1984; 57(1): 17–22.
- Williamson PC, Major PW, Nebbe B, et al. Landmark identification error in submentovertex cephalometrics. A computerized method for determining the condylar long axis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 86(3): 360–369.
