Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms.

TLDR

The study examined 204 adults with TMJ pain or dysfunction to determine how clinical symptoms and signs correlate with radiographic evidence of joint degeneration using the RDC/TMD. Researchers performed bilateral sagittal tomograms in closed and open positions and applied logistic regression to relate radiographic features (flattening, erosion, osteophytes, sclerosis) to clinical variables such as opening pattern, jaw range, TMJ sounds, pain sites, arthritic disease, psychological scores, age, and gender. Coarse crepitus on opening, lateral excursions, and protrusion, along with a clinical diagnosis of osteoarthritis, older age, and female gender, were significantly associated with degenerative tomographic findings, while limited opening (<40 mm) predicted a posterior condyle‑to‑articular tubercle relationship; no other variables showed significant associations.

Abstract

To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings.Two hundred four adult patients (156 women, 48 men, mean age 40 years) with temporomandibular joint (TMJ) pain/sounds or changes in mandibular motion were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bilateral sagittal corrected TMJ tomograms in closed and open positions were assessed for the presence of flattening, erosion, osteophytes, and sclerosis in the joint components and the range of mandibular motion. Logistic regression analyses were performed with the radiographic findings as the dependent variables and the following clinical variables as independent variables: opening pattern, maximal jaw opening, TMJ sounds, number of painful muscle/TMJ sites, duration of pain, presence of arthritic disease, depression and somatization scores, graded chronic pain, and age and gender.Coarse crepitus on opening/closing (odds ratio [OR] > or = 3.12), on lateral excursions (odds ratio > or = 4.06), and on protrusion (OR > or = 5.30) was associated with increased risk of degenerative findings in tomograms. A clinical diagnosis of osteoarthritis increased the risk of radiographic findings (OR > or = 2.95) and so did increasing age (OR > or = 1.03 per year) and the female gender (OR > or = 2.36). Maximal assisted opening and maximal opening without pain (< 40 mm) was associated with a posterior condyle-to-articular tubercle position (OR > or = 2.60). No other significant associations were observed.Age, gender, and coarse crepitus, but no pain-related variables, were associated with increased risk of degenerative findings in TMJ tomograms. Maximal opening < 40 mm was associated with a posterior condyle-to-articular tubercle relation on opening.