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. 2021 Aug;48(8):880-890.
doi: 10.1111/joor.13209. Epub 2021 Jun 8.

Limited implication of initial bone scintigraphy on long-term condylar bone change in temporomandibular disorders-Comparison with cone beam computed tomography at 1 year

Jung Hwan Jo  1 , Sungwoo Bae  2   3 , Joonhyung Gil  2 , Dongkyu Oh  2 , Seoeun Park  1   4 , Gi Jeong Cheon  2   5   6 , Ji Woon Park  1   4   7
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Limited implication of initial bone scintigraphy on long-term condylar bone change in temporomandibular disorders-Comparison with cone beam computed tomography at 1 year

Jung Hwan Jo et al. J Oral Rehabil. 2021 Aug.

Abstract

Background: The current diagnostic criteria for temporomandibular disorders (TMD) do not require imaging for the diagnosis of degenerative joint disease (DJD) of the temporomandibular joint (TMJ) condyle, and there is a lack of data investigating the effectiveness of imaging modalities in predicting long-term TMJ DJD prognosis.

Objectives: To verify the association between initial bone scintigraphy results and long-term DJD bone changes occurring in the TMJ condyle on cone beam computed tomography (CBCT).

Methods: Initial bone scintigraphy, panoramic radiography and CBCT results were analysed in relation to long-term (12 months) TMJ DJD bone change on CBCTs in 55 TMD patients (110 joints). Clinical and radiographic indices were statistically analysed among three groups (improved, no change, and worsened) based on long-term TMJ DJD prognosis calculated by destructive change index (DCI).

Results: Neither the uptake ratio nor visual assessment results from initial bone scintigraphy showed a significant difference according to long-term condylar bone change groups. The cut-off value of bone scintigraphy uptake ratio was 2.53 for long-term worsening of TMJ DJD. Worsening of TMJ DJD was significantly associated with the diagnosis based on panoramic radiography (p = .011) and CBCT (p < .001). Initial DCI (β = -.291, p = .046) had a significant association with long-term worsening of TMJ DJD.

Conclusion: Initial bone scintigraphy results did not show sufficiently close associations with long-term TMJ DJD prognosis. This should be considered in the selection process of imaging modalities for TMJ DJD patients. Future studies are needed to develop prognostic indices that comprise both clinical and imaging contents for improved predictive ability.

Keywords: bone scintigraphy; cone beam computed tomography; pain; panoramic radiography; prognosis; temporomandibular joint degenerative joint disease.

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