The assessment of osseous changes in the temporomandibular joint using cone beam computed tomography
Aim: To compare osseous changes in the mandibular condyles in patients presenting to the Oral Health Center, Tygerburg Campus, with and without clicking of the temporomandibular joint. Background: Clicking of the temporomandibular joint (TMJ) is not a normal occurrence in its form or function. A chronic click may lead to the development of osteoarthritis. A clinical finding of clicking of the joint can reflect osseous changes of the bony structures and form part of the early signs of degenerative joint diseases. These osseous changes can be detected on Cone Beam Computed Tomography (CBCT) images. The purpose of this study is to confirm the presence osseous changes of the joint and institute the early management of these patients. Failure to intervene in the early stages could result in disease progression to possible osteoarthritis. CBCT imaging will be used to assess osseous changes in the temporomandibular joints with reference to erosions, flattening, lipping, sclerosis and osteophyte formation. Materials and methods: 25 patient records were selected for a control group and 25 patients that attended the Oral Health center were screened for asymptomatic clicking of the temporomandibular joints. Osseous changes of the 100 condyles were examined by the author and a senior member of the department. Changes were recorded when consensus was reached on the presence of any changes. Cone Beam Computed Tomography was used to assess the joints in both groups. Results: Age and gender showed no statistical significance between the 2 groups. The proportion of ‘yes’ for the variables showed that sclerosis (right) was statistically significant when comparing case versus control groups (P = 0.002). A chi-squared test applied to the data resulted in observed chi-square = 15.68, df = 1, p-value = 7.501e-05, (<0.0001) confirming that the discrimination is statistically significant. Conclusion: Osseous changes were found in both the control and case group. The case group exhibited equal or greater prevalence of osseous changes. Patients with asymptomatic click of the temporomandibular joints demonstrate osseous changes.