Clinical factors associated with radiographic severity of progressive temporomandibular joint osteoarthritis: a retrospective CBCT study

Abstract

Background: Temporomandibular joint (TMJ) osteoarthritis (OA) is a progressive deteriorative joint disorder characterized by loss of cartilage and alterations in subchondral bone architecture. The study aimed to identify clinical baseline parameters most closely associated with radiographic indicators of deteriorative OA severity. Methods: The study consisted of 233 patients with unilateral TMJ arthralgia (204 females, 29 males; mean age 41.9 ± 18.1 years) meeting the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I. Following clinical examination, each patient underwent cone beam computed tomography (CBCT) evaluation of both TMJs. A composite subchondral bone alteration (SBA) grading score of progressive deteriorative OA changes was used including the following items: erosion, resorption, cyst, sclerosis, osteophyte, and flattening; the maximum possible score was 4. Results: Multivariate ordinal regression analysis identified the following factors significantly associated with the severity of condylar SBAs: older age (> 45 years) (odds ratio [OR], 4.53; p < 0.001), having concomitant arthralgia (OR, 1.85; p = 0.035), and higher number of condylar side-related missing posterior teeth (> 4) (OR, 1.80; p = 0.039). Conclusions: The data Suggest that patients older than 45 years who have a concurrent arthralgia, and missing more than 4 posterior teeth may have an increased risk of developing progressive SBAs. By focusing on these clinical factors, patients should be advised of their heightened risk of developing deteriorative SBAs to avoid delayed diagnosis and treatment. Ongoing research is warranted to improve the model, and prove the validity and reliability of the model.