Top

Head & Face Medicine

Published in:

Open Access 01-12-2021 | Osteoarthrosis | Research

Condylar erosion is predictive of painful closed lock of the temporomandibular joint: a magnetic resonance imaging study

Authors: Rüdiger Emshoff, Annika Bertram, Linus Hupp, Ansgar Rudisch

Published in: Head & Face Medicine | Issue 1/2021

Abstract

Background

To assess whether magnetic resonance imaging (MRI) findings of condylar erosion (CE) are predictive of a specific clinical diagnosis of painful closed lock of the temporomandibular joint (TMJ), and to determine the strength of association between CE and types of internal derangement (ID).

Methods

Based upon sample size estimation, this retrospective paired-design study involved 62 patients, aged between 18 and 67 years. Inclusion criteria were the presence of a unilateral clinical diagnosis of arthralgia coexisting with disk displacement without reduction (‘AR and DDwoR/wLO’), assigned according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I, and the absence of signs and symptoms of TMJ pain and dysfunction on the contralateral TMJ side. Bilateral sagittal and coronal MR images were obtained to establish the prevalence of CE and TMJ ID types of disk displacement with (DDR) and without reduction (DDNR). Logistic regression analysis was used to compute odds ratios for CE and ID types. Confounding variables adjusted for were age, sex, time since pain onset, pain intensity, and type of ID.

Results

In the regression analysis, the MRI items of DDR (p = 0.533) and DDNR (p = 0.204) dropped out as nonsignificant in the diagnostic clinical ‘AR and DDwoR/wLO’ group. Significant increases in the risk of ‘AR and DDwoR’ occurred with CE (3.1:1 odds ratio; p = 0.026). The presence of CE was significantly related to DDNR (adjusted OR = 43.9; p < 0.001).

Conclusions

The data suggest CE as a dominant factor in the definition of painful closed lock of the TMJ, support the view that joint locking needs to be considered as a frequent symptom of osteoarthritis, and emphasize a strong association between the MRI items of CE and DDNR.

Okeson JP. Orofacial pain: guidelines for assessment, diagnosis, and management. Chicago: Quintessence; 1996. p. 113–84.

Dworkin SF, Huggins KH, LeResche L, Von Korff M, Howard J, Truelove E, et al. Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls. JADA. 1990;120(3):273–81. https://doi.org/10.14219/jada.archive.1990.0043.CrossRefPubMed

LeResche L. Research diagnostic criteria for temporomandibular disorders. In: Fricton JR, Dubner R, editors. Orofacial pain and temporomandibular disorders. New York: Raven Press; 1995. p. 189–203.

Dworkin RH. Which individuals with acute pain are most likely to develop a chronic pain syndrome? Pain Forum. 1997;6(2):127–36. https://doi.org/10.1016/S1082-3174(97)70009-6.CrossRef

Larheim TA. Role of magnetic resonance imaging in the clinical diagnosis of the temporomandibular joint. Cells Tissues Organs. 2005;180(1):6–21. https://doi.org/10.1159/000086194.CrossRefPubMed

Peck CC, Goulet JP, Lobbezoo F, Schiffman EL, Alstergren P, Anderson GC, et al. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil. 2014;41:2e23.

Takahara N, Nakagawa S, Sumikura K, Kabasawa Y, Sakamoto I, Harada H. Association of Temporomandibular Joint Pain According to magnetic resonance imaging findings in temporomandibular disorder patients. J Oral Maxillofac Surg. 2017;75(9):1848–55. https://doi.org/10.1016/j.joms.2017.03.026.CrossRefPubMed

Tasaki MM, Westesson P-L. Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging. Radiology. 1993;186(3):723–9. https://doi.org/10.1148/radiology.186.3.8430181.CrossRefPubMed

Milam SB. Articular disk displacements and degenerative temporomandibular joint disease. In: Sessle BJ, Bryant PS, Dionne RA, editors. Temporomandibular disorders and related pain conditions: Progress in pain research and management: IASP Press; 1995. p. 89–112.

10.

Sokoloff L. Pathology and pathogenesis of osteoarthrosis. In: DJ MC, Hollander JL, editors. Arthritis and allied conditions: A textbook of rheumatology: Lea & Febiger; 1979. p. 1135–53.

11.

Emshoff R. Pathophysiology of Intracapsular inflammation and degeneration. In: Greene CS, Laskin DM, editors. Treatment of Temporomandibular Disorders: Bridging the Gap between Advances in Research and Clinical Patient Management: Quintessence Publishing; 2013. p. 33–46.

12.

Cevidanes LH, Hajati AK, Paniagua B, Lim PF, Walker DG, Palconet G, et al. Quantification of condylar resorption in temporomandibular joint osteoarthritis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110(1):110–7. https://doi.org/10.1016/j.tripleo.2010.01.008.CrossRefPubMedPubMedCentral

13.

Emshoff R, Bertram F, Schnabl D, Stigler R, Steinmaßl O, Rudisch A. Condylar erosion in patients with chronic temporomandibular joint arthralgia: a cone-beam computed tomography study. J Oral Maxillofac Surg. 2016;74(7):1343e1–8. https://doi.org/10.1016/j.joms.2016.01.029.CrossRef

14.

Campos MI, Campos PS, Cangussu MC, Guimarães RC, Line SR. Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle. Int J Oral Maxillofac Surg. 2008;37(6):529–34. https://doi.org/10.1016/j.ijom.2008.02.011.CrossRefPubMed

15.

Gil C, Santos KC, Dutra ME, Kodaira SK, Oliveira JX. MRI analysis of the relationship between bone changes in the temporomandibular joint and articular disc position in symptomatic patients. Dentomaxillofac Radiol. 2012;41(5):367–72. https://doi.org/10.1259/dmfr/79317853.CrossRefPubMedPubMedCentral

16.

Silva MAG, Pantoja LLQ, Dutra-Horstmann KL, Valladares-Neto J, Wolff FL, Porporatti AL, et al. Prevalence of degenerative disease in temporomandibular disorder patients with disc displacement: A systematic review and meta-analysis. J Craniomaxillofac Surg. 2020;25:S1010–5182(20)30186–4.

17.

Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301–55.PubMed

18.

Minakuchi H, Kuboki T, Matsuka Y, Maekawa K, Yatani H, Yamashita A. Randomized controlled evaluation of non-surgical treatments for temporomandibular joint anterior disk displacement without reduction. J Dent Res. 2001;80(3):924–8. https://doi.org/10.1177/00220345010800031501.CrossRefPubMed

19.

Price DD, McGrath PA, Rafii A. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45–56. https://doi.org/10.1016/0304-3959(83)90126-4.CrossRefPubMed

20.

Tasaki MM, Westesson P-L, Isberg AM, Ren Y-F, Tallents RH. Classification and prevalence of temporomandibular joint disc displacement in patients and asymptomatic volunteers. Am J Orthod Dentofac Orthop. 1996;109(3):249–62. https://doi.org/10.1016/S0889-5406(96)70148-8.CrossRef

21.

Dias IM, Cordeiro PC, Devito KL, Tavares ML, Leite IC, Tesch RS. Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis. Int J Oral Maxillofac Surg. 2016;45(3):313–7. https://doi.org/10.1016/j.ijom.2015.09.016.CrossRefPubMed

22.

Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, 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. 2009;107(6):844–60. https://doi.org/10.1016/j.tripleo.2009.02.023.

23.

Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol. 2009;38(3):141–7. https://doi.org/10.1259/dmfr/59263880.CrossRefPubMed

24.

Emshoff R, Brandlmaier I, Bertram S, Rudisch A. Risk factors for temporomandibular joint pain in patients with disc displacement without reduction - a magnetic resonance imaging study. J Oral Rehabil. 2003;30(5):537–43. https://doi.org/10.1046/j.1365-2842.2003.01111.x.CrossRefPubMed

25.

Emshoff R, Innerhofer K, Rudisch A, Bertram S. The biological concept of “internal derangement and osteoarthrosis”: a diagnostic approach in patients with temporomandibular joint pain? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(1):39–44. https://doi.org/10.1067/moe.2002.117451.CrossRefPubMed

26.

Emshoff R, Rudisch A, Innerhofer K, Bösch R, Bertram S. Temporomandibular joint internal derangement type III: relationship to magnetic resonance imaging findings of internal derangement and osteoarthrosis. An intraindividual approach. Int J Oral Maxillofac Surg. 2001;30(5):390–6. https://doi.org/10.1054/ijom.2001.0068.CrossRefPubMed

27.

Emshoff R, Innerhofer K, Rudisch A, Bertram S. Clinical versus magnetic resonance imaging findings with internal derangement of the temporomandibular joint: an evaluation of anterior disc displacement without reduction. J Oral Maxillofac Surg. 2002;60(1):36–41. https://doi.org/10.1053/joms.2002.29071.CrossRefPubMed

28.

Marguelles RE, Carpentier P, Yung LP, Defrennes D, Pharaboz C. Clinical diagnosis compared with findings of magnetic resonance in 242 patients with internal derangement of the TMJ. J Orofac Pain. 1995;9:244–53.

29.

Uşümez S, Oz F, Güray E. Comparison of clinical and magnetic resonance imaging diagnoses in patients with TMD history. J Oral Rehabil. 2004;31(1):52–6. https://doi.org/10.1111/j.1365-2842.2004.01065.x.CrossRefPubMed

30.

Ekberg E, Hansson LG, List T, Eriksson L, Sahlström LE, Petersson A. Can MRI Observations Predict Treatment Outcome of Lavage in Patients with Painful TMJ Disc Displacement without Reduction? J Oral Maxillofac Res. 2015;30(6):e5.

31.

Haley DP, Schiffman EL, Lindgren BR, Anderson Q, Andreasen K. The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain. J Am Dent Assoc. 2001;132(4):476–81. https://doi.org/10.14219/jada.archive.2001.0210.CrossRefPubMed

32.

Hosgor H. The relationship between temporomandibular joint effusion and pain in patients with internal derangement. J Craniomaxillofac Surg. 2019;47(6):940–4. https://doi.org/10.1016/j.jcms.2019.03.010.CrossRefPubMed

33.

Jerele C, Avsenik J, Šurlan PK. MRI characteristics of the asymptomatic temporomandibular joint in patients with unilateral temporomandibular joint disorder. Oral Radiol. 2020;18(3):469–75. https://doi.org/10.1007/s11282-020-00483-6.CrossRef

34.

Lin WC, Lo CP, Chiang IC, Hsu CC, Hsu WL, Liu DW. The use of pseudo-dynamic magnetic resonance imaging for evaluating the relationship between temporomandibular joint anterior disc displacement and joint pain. Int J Oral Maxillofac Surg. 2012;41(12):1501–4. https://doi.org/10.1016/j.ijom.2012.05.023.CrossRefPubMed

35.

Lei J, Han J, Liu M, Zhang Y, Yap AU, Fu KY. Degenerative temporomandibular joint changes associated with recent-onset disc displacement without reduction in adolescents and young adults. J Craniomaxillofac Surg. 2017;45(3):408–13. https://doi.org/10.1016/j.jcms.2016.12.017.CrossRefPubMed

36.

Cömert Kiliç S, Kiliç N, Sümbüllü MA. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. Int J Oral Maxillofac Surg. 2015;44(10):1268–74. https://doi.org/10.1016/j.ijom.2015.06.023.CrossRefPubMed

37.

Shahidi S, Salehi P, Abedi P, Dehbozorgi M, Hamedani S, Berahman N. Comparison of the bony changes of TMJ in patients with and without TMD complaints using CBCT. J Dent (Shiraz). 2018;19(2):142–9.

38.

Arden N, Nevitt MC. Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol. 2006;20(1):3–25. https://doi.org/10.1016/j.berh.2005.09.007.CrossRefPubMed

39.

Kang SC, Lee DG, Choi JH, Kim ST, Kim YK, Ahn HJ. Association between estrogen receptor polymorphism and pain susceptibility in female temporomandibular joint osteoarthritis patients. Int J Oral Maxillofac Surg. 2007;36(5):391–4. https://doi.org/10.1016/j.ijom.2006.12.004.CrossRefPubMed

40.

Witulski S, Vogl TJ, Rehart S, Ottl P. Evaluation of the TMJ by means of clinical TMD examination and MRI diagnostics in patients with rheumatoid arthritis. Biomed Res Int. 2014;2014:328560.CrossRef

41.

Asakawa-Tanne Y, Su S, Kunimatsu R, Hirose N, Mitsuyoshi T, Okamoto Y, et al. Effects of enzymatic degradation after loading in temporomandibular joint. J Dent Res. 2015;94(2):337–43. https://doi.org/10.1177/0022034514560588.

42.

Moncada G, Cortés D, Millas R, Marholz C. Relationship between disk position and degenerative bone changes in temporomandibular joints of young subjects with TMD. An MRI study. Clin Pediatr Dent. 2014;38(3):269–76. https://doi.org/10.17796/jcpd.38.3.w43m8474433n7ur2.CrossRef

43.

Zhang J, Jiao K, Zhang M, Zhou T, Liu XD, Yu SB, et al. Occlusal effects on longitudinal bone alterations of the temporomandibular joint. J Dent Res. 2013;92(3):253–9. https://doi.org/10.1177/0022034512473482.

44.

Nitzan DW, Mahler Y, Simkin A. Intra-articular pressure measurements in patients with suddenly developing, severely limited mouth opening. J Oral Maxillofac Surg. 1992;50(10):1038–42. https://doi.org/10.1016/0278-2391(92)90485-I.CrossRefPubMed

45.

Peretta R, Manfredini D. Future perspectives in TMD pathology. In: Manfredini D, editor. Current Concepts on Temporomandibular Disorders: Quintessence Publishing; 2010. p. 153–68.

46.

Rahamim E, Better H, Dagan A, Nitzan DW. Electron microscope and biochemical observations of the surface active phospholipids on the articular surfaces and in the synovial fluid of the temporomandibular joint: a preliminary investigation. J Oral Maxillofac Surg. 2001;59(11):1326–32. https://doi.org/10.1053/joms.2001.27530.CrossRefPubMed

47.

Wright V, Dowson D, Longfied MD. Joint stiffness--its characterization and significance. Biomed Eng. 1969;4(1):8–14.PubMed

48.

Nitzan DW. The process of lubrication impairment and its involvement in temporomandibular joint disc displacement: a theoretical concept. J Oral Maxillofac Surg. 2001;59(1):36–45. https://doi.org/10.1053/joms.2001.19278.CrossRefPubMed

49.

Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res. 2008;87(4):296–307. https://doi.org/10.1177/154405910808700406.CrossRefPubMed

50.

Tanaka E, Hirose M, Koolstra JH, van Eijden TM, Iwabuchi Y, Fujita R. Modeling of the effect of friction in the temporomandibular joint on displacement of its disc during prolonged clenching. J Oral Maxillofac Surg. 2008;6:462–8.CrossRef

51.

Tanaka E, Detamore MS, Tanimoto K, Kawai N. Lubrication of the temporomandibular joint. Ann Biomed Eng. 2008;36(1):14–29. https://doi.org/10.1007/s10439-007-9401-z.CrossRefPubMed

52.

Hatcher DC. Progressive condylar resorption: pathologic processes and imaging considerations. Semin Orthod. 2013;19(2):97–105. https://doi.org/10.1053/j.sodo.2012.11.005.CrossRef

53.

Kellenberger CJ, Bucheli J, Schroeder-Kohler S, Saurenmann RK, Colombo V, Ettlin DA. Temporomandibular joint magnetic resonance imaging findings in adolescents with anterior disk displacement compared to those with juvenile idiopathic arthritis. J Oral Rehabil. 2019;46(1):14–22. https://doi.org/10.1111/joor.12720.CrossRefPubMed

54.

Arvidsson LZ, Smith H-J, Flatø B, Larheim TA. Temporomandibular joint ndings in adults with long-standing juvenile idiopathic arthritis: CT and MR imaging assessment. Radiology. 2010;256(1):191–200. https://doi.org/10.1148/radiol.10091810.CrossRefPubMed

55.

Kristensen KD, Schmidt B, Stoustrup P, Pedersen TK. Idiopathic condylar resorptions: 3-dimensional condylar bony deformation, signs and symptoms. Am J Orthod Dentofac Orthop. 2017;152(2):214–23. https://doi.org/10.1016/j.ajodo.2016.12.020.CrossRef

56.

Bertram S, Moriggls A, Rudish A, Emshoff R. Structural characteristics of bilateral temporomandibular joint disc displacement without reduction and osteoarthrosis are important determinants of horizontal mandibular and vertical ramus deficiency: a magnetic resonance imaging study. J Oral Maxillofac Surg. 2011;69:1898e1904.CrossRef

57.

Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240(4857):1285–93. https://doi.org/10.1126/science.3287615.CrossRefPubMed

58.

Orsini MG, Terada S, Kuboki T, Matsuka Y, Yamashita A, Clark GT. Diagnostic value of four criteria to interprete temporomandibular joint normal disc position on magnetic resonance imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86(4):489–97. https://doi.org/10.1016/S1079-2104(98)90380-8.CrossRefPubMed

59.

Provenzano Mde M, Chilvarquer I, Fenyo-Pereira M. How should the articular disk position be analyzed? J Oral Maxillofac Surg. 2012;70(7):1534–9. https://doi.org/10.1016/j.joms.2011.08.004.CrossRefPubMed

60.

Katzberg RW, Westesson PL, Tallents RH, Drake CM. Anatomic disorders of the temporomandibular joint disc in asymptomatic subjects. J Oral Maxillofac Surg. 1996;54(2):147–53. https://doi.org/10.1016/S0278-2391(96)90435-8.CrossRefPubMed

61.

American Society of Temporomandibular Joint Surgeons. Guidelines for diagnosis and management of disorders involving the temporomandibular joint and related musculoskeletal structures. Cranio. 2003;21:68–76.CrossRef

62.

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 and orofacial pain special interest group. J Oral Facial Pain Headache. 2014;28(1):6–27. https://doi.org/10.11607/jop.1151.

63.

Israel HA. Internal derangement of the temporomandibular joint: new perspectives on an old problem. Oral Maxillofac Surg Clin North Am. 2016;28(3):313–33. https://doi.org/10.1016/j.coms.2016.03.009.CrossRefPubMed

Title: Condylar erosion is predictive of painful closed lock of the temporomandibular joint: a magnetic resonance imaging study
Authors: Rüdiger Emshoff
Annika Bertram
Linus Hupp
Ansgar Rudisch
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Osteoarthrosis
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Craniomandibular Dysfunction and Stress
Osteoarthrosis
Published in: Head & Face Medicine / Issue 1/2021
Electronic ISSN: 1746-160X
DOI: https://doi.org/10.1186/s13005-021-00291-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Condylar erosion is predictive of painful closed lock of the temporomandibular joint: a magnetic resonance imaging study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Expression of SOX2 and OCT4 in odontogenic cysts and tumors

Head and neck melanoma: outcome and predictors in a population-based cohort study

Esthetic and functional reconstruction of large mandibular defects using free fibula flap and implant-retained prosthetics - a case series with long-term follow-up

SARS-CoV-2 and regular patient treatment – from the use of rapid antigen testing up to treatment specific precaution measures

The University Münster model surgery system for orthognathic surgery - The digital update

Eyes wide shut: necessity and effect of adjunctive procedures after decompression surgery in patients with endocrine orbitopathy