Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms.
OBJECTIVE
To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Wiese
Mie
M
Department of Oral Radiology, School of Dentistry, Faculty of Health Sciences, University of Aarhus, Denmark. mwi@odont.ku.dk
Svensson
Peter
P
Bakke
Merete
M
List
Thomas
T
Hintze
Hanne
H
Petersson
Arne
A
Knutsson
Kerstin
K
Wenzel
Ann
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000175:diagnosis; D003863:Depression / Q000175:diagnosis; D005157:Facial Pain / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging; D008410:Masticatory Muscles / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000000981:diagnostic imaging; D054850:Osteophyte / Q000175:diagnosis / Q000000981:diagnostic imaging; D010026:Osteosclerosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D016059:Range of Motion, Articular / Q000502:physiology; D012737:Sex Factors; D013001:Somatoform Disorders / Q000175:diagnosis; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods