Exploring the effect of disc displacement on the risk and severity of condylar erosion in adult temporomandibular disorder patients: A CBCT and MRI study

J Oral Rehabil. 2024 Jul;51(7):1166-1174. doi: 10.1111/joor.13688. Epub 2024 Mar 21.

Abstract

Objective: The objective of the study was to investigate the relationship between types of disc displacement (DD) diagnosed by magnetic resonance imaging (MRI), and the risk (presence or absence) and severity of condylar erosion (CE) graded using cone-beam computed tomography (CBCT) in adult Temporomandibular disorders (TMD) patients.

Methods: A total of 353 TMD patients (283 females, 70 males) underwent MRI scans to categorise DD as normal (NA), anterior displacement with reduction (ADDR), or anterior displacement without reduction (ADDNR). CE severity was graded on a scale of 0-3 (absence, mild, moderate or severe) using CBCT. To establish the plausibility and cut-off points for CE diagnosis, the severity of CE was then further divided into three classifications: Grade 0 versus 1 + 2 + 3; Grades 0 + 1 versus 2 + 3; Grades 0 + 1 + 2 versus 3. Logistic regression analysis was performed, adjusting for age, gender and joint correlation.

Results: ADDNR significantly increased the risk of CE compared with NA (OR = 10.04, 95% CI: [6.41, 15.73]) and showed a significant increase in CE severity across all classifications (ORs = 10.04-18.95). The effects of ADDNR were significant in both genders (p < .001) and had a greater impact in females. ADDR was predominantly associated with mild CE.

Conclusions: ADDNR significantly increased the risk and severity of CE independent of gender when compared to NA, whereas ADDR was mainly associated with mild CE. Slight cortical discontinuity may represent a subclinical diagnosis requiring further investigation.

Keywords: condylar erosion; cone‐beam computed tomography; disc displacement; magnetic resonance imaging; temporomandibular disorders.

MeSH terms

  • Adult
  • Cone-Beam Computed Tomography*
  • Female
  • Humans
  • Joint Dislocations* / diagnostic imaging
  • Joint Dislocations* / pathology
  • Magnetic Resonance Imaging*
  • Male
  • Mandibular Condyle* / diagnostic imaging
  • Mandibular Condyle* / pathology
  • Middle Aged
  • Risk Factors
  • Severity of Illness Index
  • Temporomandibular Joint Disc* / diagnostic imaging
  • Temporomandibular Joint Disc* / pathology
  • Temporomandibular Joint Disorders* / diagnostic imaging
  • Temporomandibular Joint Disorders* / pathology
  • Temporomandibular Joint Disorders* / physiopathology
  • Young Adult