Assessment of Condylar Changes in Patients with Temporomandibular Joint Pain Using Digital Volumetric Tomography

Objective. To evaluate the efficiency of DVT in comparison with OPG in the assessment of bony condylar changes in patients of TMJ pain. Methods. 100 temporomandibular joints of 62 patients with the complaint of temporomandibular joint pain were included in the study. DVT and OPG radiographs were taken for all the 100 joints. Three observers interpreted the DVT and OPG radiograph for the bony changes separately for two times with an interval of one week. The bony changes seen in the condyle were given coding from 0 to 6. (0: Normal, 1: Erosion, 2: Flattening, 3: Osteophyte, 4: Sclerosis, 5: Resorption, and 6: other changes). Interobserver and intraobserver variability was assessed with one-way ANOVA statistics. Z test was used to see the significant difference between OPG and DVT. Results. In the present study the interexaminer reliability for OPG and DVT was 0.903 and 0.978, respectively. Intraexaminer reliability for OPG and DVT was 0.908 and 0.980, respectively. The most common condylar bony change seen in OPG and DVT was erosion followed by flattening and osteophyte. There was significant difference between OPG and DVT in detecting erosion and osteophytes. The other changes observed in our study were Ely’s cyst, pointed condyle, and bifid condyle. All the bony changes are more commonly seen in females than males. Conclusion. DVT provides more valid and accurate information on condylar bony changes. The DVT has an added advantage of lesser radiation exposure to the patient and cost effectiveness and could be easily accessible in a dental hospital. 1. Introduction Temporomandibular joint is one of the most fascinating and complex synovial systems in the body. It is the area in which the mandible articulates with the cranium [1]. The masticatory system is extremely complex, which comprises primarily of bones, muscles, ligaments, and teeth, all of which are responsible for activities like mastication, speech, and deglutition. All these movements are regulated by an intricate neurological controlling mechanism, which is important for the system to function normally and efficiently [1]. Lack of such harmony may lead to disruptive muscle behavior or structural damage to any of the components. The function of the TMJ is unique, in that the condyle both rotates within the fossa and translates anteriorly along the articular eminence. Because of the ability of the condyle to translate, the mandible can have a much higher maximal incisal opening than would be possible with rotation alone. Because of all these features, the TMJ is referred to as