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. 2024 Aug 22;16(8):e67518.
doi: 10.7759/cureus.67518. eCollection 2024 Aug.

Correlation Between Radiological Changes of the Temporomandibular Joint and Upper Cervical Vertebrae in Degenerative Joint Disease: A Cone-Beam Computed Tomography-Based Analytical Study

Ajay G Nayak  1 , Sunanda Bhatnagar  2 , Atrey J Pai Khot  3
Affiliations

Correlation Between Radiological Changes of the Temporomandibular Joint and Upper Cervical Vertebrae in Degenerative Joint Disease: A Cone-Beam Computed Tomography-Based Analytical Study

Ajay G Nayak et al. Cureus. .

Abstract

Objectives This study was conducted to assess the radiological changes of the temporomandibular joint (TMJ) and cervical vertebrae individually and their correlation in degenerative joint disease (DJD) using a cone-beam computed tomography (CBCT)-based approach. Methodology The study employed a cross-sectional, analytical retrospective design, analyzing one-year data. CBCT scans of 60 patients (120 TMJs) were assessed for degenerative changes using standardized imaging parameters. Eligibility criteria included full field-of-view CBCT scans, excluding those with craniofacial anomalies or prior orthodontic treatment. Radiological assessments of TMJs and cervical vertebrae were conducted by experienced radiologists using the Anjos Pontual method and novel grading system (TMJ Spine Degenerative Severity Index). Results The study included 60 CBCT scans (120 joints), with 31.7% males and 68.3% females. Participants were predominantly aged 31-60 years (58.3%). DJD findings for the right TMJ showed grade 1 changes in 55.0% and grade 2 in 31.7%, while the left TMJ had 46.7% grade 1 and 35.0% grade 2 changes. A strong positive correlation (0.704) was found between bilateral TMJ and cervical vertebrae changes. Age correlated significantly with TMJ alterations but not with cervical vertebrae changes. Conclusion This study demonstrated that there exists a positive association between the radiological changes of TMJ and cervical vertebrae in DJD with age, which can be detected in mild stage of severity on CBCT and can be of use in clinical correlation and application of optimal interventions ensuring better prognosis.

Keywords: cone-beam computed tomography (cbct); degenerative joint disease; diagnostic ct imaging; severity of disease; temporomandibular joint (tmj); upper cervical spine.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee, Terna Dental College issued approval TDC/EC/22/2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Intellectual property info: The novel classification system, "CBCT-Based Grading System for Severity in Degenerative Joint Disease of TMJ and Upper Cervical Spine" is granted approval and registered with Ref. No. L-152146/2024 under the Copyright Office, Intellectual Property Rights, Government of India. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. CBCT imaging showing TMJ grade 1.
A: Mild flattening of contours. B: Mild thinning of cortical outline. CBCT: cone-beam computed tomography; TMJ: temporomandibular joint.
Figure 2
Figure 2. CBCT imaging showing TMJ grade 2.
A: Moderate flattening of contours. B: Less than three erosions. C: Small osteophyte. CBCT: cone-beam computed tomography; TMJ: temporomandibular joint.
Figure 3
Figure 3. CBCT imaging showing TMJ Grade 3
A: Severe flattening of contours. B: Severe or multiple erosions (more than three). C: Large pseudocyst formation. D: Large osteophyte. E: Severe sclerosis of cortical outline. CBCT: cone-beam computed tomography; TMJ: temporomandibular joint.
Figure 4
Figure 4. CBCT imaging showing upper cervical vertebrae grade 1.
A: Mild thinning of cortical outline. B: Mild rarefaction of the trabecular pattern. CBCT: cone-beam computed tomography.
Figure 5
Figure 5. CBCT imaging showing upper cervical vertebrae grade 2.
Less than three erosions and small osteophytes. CBCT: cone-beam computed tomography.
Figure 6
Figure 6. CBCT imaging showing upper cervical vertebrae grade 3.
A: Large osteophyte, severe sclerosis of cortical outline, and severe narrowing of intervertebral joint spaces. B: Presence of C1-C2 rotation. CBCT: cone-beam computed tomography.
Figure 7
Figure 7. Demographic characteristics of the participants.
See this image and copyright information in PMC

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