Correlation between patient complaint, temporomandibular disorder diagnosis and mandible head morphology

Gabriel Rodrigues Oliveira, Vinicius Fabris, Atais Bacchi, Milena Bortolotto Felippe, Antônio Sérgio Guimarães, Aloísio Oro Spazzin

Abstract


The aim of this study was to evaluate the correlation between patient complaints, clinical diagnosis of temporomandibular disorder (TMD) based on the diagnostic criteria for TMD, and morphology of the mandibular condyle obtained by cone-beam computed tomography (CB-CT). Data were collected from 40 patients. The anatomy of the mandibular condyle was assessed using CB-CT, the diagnosis of TMD according to diagnostic criteria for TMD, and patients' complaints was registered at the appointment. Data were explored and all statistical references were completed in bicaudal tests, with 95% confidence level (α=0.05). The Chi-squared test was used with Bonferroni correction (z-tests). Main complaints found were grouped as muscular, articular, muscular and articular, or headache and articular symptoms. Clinical diagnosis of TMD involved myalgia, local myalgia, myofascial pain, myofascial pain with reference, myofascial pain with arthralgia, arthralgia, or disc displacement with reduction. At least one joint showed condylar flattening, erosion, sclerosis, or osteophytes. No correlation was observed between main complaints, clinical diagnosis, and morphology of the mandibular condyle in all comparisons. The findings suggest that due to the absence of clinical and morphological correlation, CB-CTs should be requested only in specific cases, when doubt remain after careful TMD diagnosis, to avoid their over-indication.


Keywords


Temporomandibular Joint. Facial Pain. Cone Beam Computerized Tomography.

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References


Calixtre LB, Grüninger BLS, Chaves TC, Oliveira AB. Is there an association between anxiety/depression and temporomandibular disorders in college students? J Appl Oral Sci. 2014 Jan-Feb;22(1):15-21. doi: 10.1590/1678-775720130054.

NICDR National Institute of Dental and Craniofacial Research. Facial Pain. http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/FacialPain/ (accessed 1/09/2017).

Wiese M, Svensson P, Bakke M, List T, Hintze H, Petersson A, et al. Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms. J Orofac Pain. 2008 Summer;22(3):239-51.

Muir CB, Goss AN. The radiologic morphology of painfull temporomandibular joints. Oral Surg Oral Med Oral Pathol. 1990 Sep;70(3):335-59.

Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Jun;107(6):844-60. doi: 10.1016/j.tripleo.2009.02.023.

Krishnamoorthy B, Mamatha N, Kumar VA. TMJ imaging by CBCT: current scenario. Ann Maxillofac Surg. 2013 Jan;3(1):80–3. doi: 10.4103/2231-0746.110069.

Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014 Winter;28(1):6-27. doi: 10.11607/jop.1151.

Dos Anjos Pontual ML, Freire JSL, Barbosa JMN, Frazão MAG, dos Anjos Pontual AA. Evaluation of bone changes in the temporomandibular joint using cone beam CT. Dentomaxillofacial Radiology. 2012 Jan;41(1):24-9. doi: 10.1259/dmfr/17815139.

Loeser JD, Treede RD. The Kyoto protocol of IASP basic pain terminology. Pain. 2008 Jul;137(3):473–7. doi: 10.1016/j.pain.2008.04.025.

Jamison RN, Rudy TE, Penzien DB, Mosley TH, Jr. Cognitive-behavioral classifications of chronic pain: replication and extension of empirically derived patient profiles. Pain. 1994 Jun;57(3):277–92.

Ferraz AM Jr, Devito KL, Guimarães JP. Temporomandibular disorder in patients with juvenile idiopathic arthritis: clinical evaluation and correlation with the findings of cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Sep;114(3):e51-7. doi: 10.1016/j.oooo.2012.02.010.

Wiese M, Wenzel A, Hintze H, Petersson A, Knutsson K, Bakke M, et al. Osseous changes and condyle position in TMJ tomograms: impact of RDC/TMD clinical diagnoses on agreement between expected and actual findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Aug;106(2):e52-63. doi: 10.1016/j.tripleo.2008.03.021.

Barghan S, Tetradis S, Mallya SM. Application of cone beam computed tomography for assessment of the temporomandibular joints. Austral Dent J. 2012 Mar;57(1 Suppl):109-18. doi: 10.1111/j.1834-7819.2011.01663.x.

Petersson A. What you can and cannot see in TMJ imaging – an overview related to the RDC⁄TMD diagnostic system. J Oral Rehabil. 2010 Oct;37(10):771-8. doi: 10.1111/j.1365-2842.2010.02108.x.

Westesson PL, Katzberg RW, Tallents RH, Sanchez-Woodworth RE, Svensson SA. CT and MR of the temporomandibular joint: comparison with autopsy specimens. AJR Am J Roentgenol. 1987 Jun;148(6):1165-71.




DOI: https://doi.org/10.18256/2238-510X.2020.v9i1.3664

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