Diagnóstico tomográfico e manifestações clínicas das desordens degenerativas da articulação temporomandibular
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Publicado
May 9, 2024
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Resumo
Objetivo: Avaliar indivíduos com alterações degenerativas na ATM previamente visualizadas através de imagens de tomografia computadorizada de feixe cônico (TCFC), relacionando tais alterações com os diagnósticos clínicos e sinais de DTM articular. Métodos: Foram avaliados 38 pacientes que haviam realizado previamente o exame de TCFC na Faculdade de Odontologia da Universidade Federal de Juiz de Fora. Os indivíduos foram agrupados de acordo com o diagnóstico clínico através do RDC/TMD. Considerou-se a presença de limitação bucal durante a abertura ativa máxima, lateralidade e protrusão, além da presença de crepitação grosseira. Resultados: Dentre os diagnósticos exclusivamente clínicos, apenas 10,5% foram conclusivos, classificando os pacientes como portadores de osteoartrite. Não houve diferença estatística entre a presença de limitação de abertura bucal (p=0.63) e dos movimentos excursivos de lateralidade (p=0.55) e protrusão (p=0.58) e este diagnóstico. A presença de esclerose na região de tubérculo articular foi significante (p=0.08) em indivíduos com limitação de abertura bucal. Conclusão: A presença de esclerose na região da eminência articular foi significante em indivíduos com limitação de abertura bucal. A crepitação grosseira apresentou-se apenas no grupo com alterações degenerativas (10,5%) sendo que todos os pacientes possuíam alterações ao exame de imagem. 89,5% das alterações degenerativas foram clinicamente subdiagnosticadas.
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Como Citar
PintoR. de A. S., SilvaB. M. da, BonatoL. L., FerreiraL. A., WerneckC. de S., VernerF. S., & LeiteF. P. P. (2024). Diagnóstico tomográfico e manifestações clínicas das desordens degenerativas da articulação temporomandibular. Revista Eletrônica Acervo Saúde, 24(5), e16372. https://doi.org/10.25248/reas.e16372.2024
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Referências
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2. ALEXIOU KE, et al. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol., 2009; 38(3):141-7.
3. AL-ANI Z. Temporomandibular Joint osteoarthrosis: a review of clinical aspects and management. Prim Dent J., 2021; 10(1): 132-140.
4. ARAYASANTIPARB R, et al. Association of radiographic and clinical findings in patients with temporomandibular joints osseous alteration. Clinical Oral Investigations. 2020; 24(1):221-227.
5. BAKKE M, et al. Bony deviations revealed by cone beam computed tomography of the temporomandibular joint in subjects without ongoing pain. Journal of oral & facial pain and headache, 2014; 28(4): 331-7.
6. BONATO LL, et al. Desordem temporomandibular e a influência do polimorfismo genético. Faculdade de Odontologia de Lins/Unimep, 2013; 23(2): 61-68.
7. CARDONEANU A, et al. Temporomandibular Joint Osteoarthritis: Pathogenic Mechanisms Involving the Cartilage and Subchondral Bone, and Potential Therapeutic Strategies for Joint Regeneration. Int. J. Mol. Sci., 2023; 24(1): 171.
8. CHUNG MK, et al. The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models. Front. Pain Res., 2023; 9:4:1038808.
9. DAGAR SR et al. Modified sthetoscope for auscultation of temporomandibular joint sounds. J Int Oral Health. 2014; 6(2):40-4.
10. DELPACHITRA SN, DIMITROULIS G. Osteoarthritis of the temporomandibular joint: a review of aetiology and pathogenesis. British Journal of Oral and Maxillofacial Surgery, 2022; 60(4): 387-396.
11. DERWICH M, et al. Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature. Medicina (Kaunas), 2020; 56(5): 225.
12. DIAS IM, et al. Evaluation of the correlation between disc displacements and degenerative bone changes of the temporomandibular joint by means of magnetic resonance images. International journal of oral and maxillofacial surgery, 2012; 41(9): 1051-7.
13. DWORKIN SF e LERESCHE L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomand Disord., 1992; 6(4): 301-55.
14. FERREIRA LA, et al. Indication Criteria of Imaging Exams for Diagnosing of Temporomandibular Joint Disorders. J Clin Exp Pathol., 2014, Vol 4(5): 190.
15. GÖRÜRGÖZ C, et al. Degenerative changes of the mandibular condyle in relation to the temporomandibular joint space, gender and age: A multicenter CBCT study. Dent Med Probl., 2023; 60(1): 127-135.
16. HELKIMO M. Studies on function and occlusal state 11. lndex for anamnesic and clinicai dysfunction and oclusal state. Swed Dent J., 1974; 67(2): 101-21.
17. HONDA K, et al. Correlation between MRI evidence of degenerative condylar surface changes, induction of articular disc displacement and pathological joint sounds in the temporomandibular joint. Gerodontology, 2008; 25(4): 251-7.
18. HUSSAIN AM, et al. Role of different imaging modalities in assessment of temporomandibular joint erosions and osteophytes: a systematic review. Dentomaxillofac Radiol., 2008; 37(2): 63-71.
19. JUAN AZ, et al. Potential pathological and molecular mechanisms of temporomandibular joint osteoarthritis. Journal of Dental Sciences, 2023; 18(3): 959-971.
20. KIM TH, et al. Assessment of Morphologic Change of Mandibular Condyle in Temporomandibular Joint Osteoarthritis Patients with Stabilization Splint Therapy: A Pilot Study. Healthcare (Basel), 2022; 10(10): 1939.
21. KRISJANE Z, et al. The prevalence of TMJ osteoarthritis in asymptomatic patients with dentofacial deformities: a cone-beam CT study. Int. J. Oral Maxillofac. Surg., 2012; 41(6): 690-5.
22. LASCALA CA, et al. Analysis of the accuracy of linear measurement obtained by cone beam computed tomography (CBCT-NewTom). Dentomaxillofac Radiol., 2004; 33(5): 291-4.
23. LEE JY, et al. A longitudinal study on the osteoarthritic change of the temporomandibular joint based on 1-year follow-up computed tomography. Journal of Cranio-Maxillo-Facial Surgery, 2012; 40(8): e223-8.
24. LI C, et al. Osteoarthritic Changes After Superior and Inferior Joint Space Injection of Hyaluronic Acid for the Treatment of Temporomandibular Joint Osteoarthritis with Anterior Disc Displacement Without Reduction: A Cone-Beam Computed Tomographic Evaluation. Journal of Oral and Maxillofacial Surgery, 2015; 73(2): 232-44.
25. LIMCHAICHANA N, et al. The efficacy of magnetic resonance imaging in the diagnosis of degenerative and inflammatory temporomandibular joint disorders: a systematic literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod., 2006; 102(4): 521-36.
26. LOOK JO, et al. Reliability and validity of Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC⁄TMD) with proposed revisions. Journal of Oral Rehabilitation, 2010; 37(10): 744-59.
27. MALLYA SM et al. Recommendations for Imaging of the Temporomandibular Joint. Position Statement from the American Academy of Oral and Maxillofacial Radiology and the American Academy of Orofacial Pain. J Oral Facial Pain Headache. 2023;37(1):7-15
28. OK, SM. et al. Anterior condylar remodeling observed in stabilization splint therapy for temporomandibular joint osteoarthritis. Oral surgery, oral medicine, oral pathology and oral radiology, 2014; 118(3): 363-70.
29. PANTOJA LLQ, et al. Prevalence of degenerative joint disease of the temporomandibular joint: a systematic review. Clinical Oral Investigations, 2019; 23(5): 2475-2488.
30. SCHIFFMAN E e OHRBACH R. Executive summary of the Diagnostic Criteria for Temporomandibular Disorders for clinical and research applications. J Am Dent Assoc. 2016; 147(6): 438-45.
31. VALESAN LF, et al. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clinical Oral Investigations, 2021; 25(2): 441-453.
32. VÎRLAN MJR, et al. Degenerative bony changes in the temporal component of the temporomandibular joint – review of the literature. Rom J Morphol Embryol., 2022; 63(1): 61-69.
33. WANG XD, et al. Current Understanding of Pathogenesis and Treatment of TMJ Osteoarthritis. Journal of dental research, 2015; 94(5): 666-73.
34. WIESE 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; 106(2): e52-63.
35. WIESE M, et al. Association between TMJ symptoms, signs and clinical diagnosis using RDC/TMD and radiographic findings in TMJ tomograms. J Orofac Pain, 2008; 22(3): 239-51.
36. XIAO JL, et al. Association of GDF5, SMAD3 and RUNX2 polymorphisms with temporomandibular joint osteoarthritis in female Han Chinese. Journal of oral rehabilitation, 2015; 42(7): 529-36.
37. XIANG W, et al. Correlation between craniocervical posture and upper airway dimension in patients with bilateral anterior disc displacement. J Stomatol Oral Maxillofac Surg. 2024; 125(6):101785.
38. YADAV S, et al. Diagnostic accuracy of 2 cone-beam computed tomography protocols for detecting arthritic changes in temporomandibular joints. American Journal of Orthodontics and Dentofacial Orthopedics, 2015; 147(3): 339-44.
39. YILDIZER E e ODABAŞI O. Differences in clinical and radiographic features between bilateral and unilateral adult degenerative temporomandibular joint disease: A retrospective cross-sectional study. International Orthodontics, 2023; 21(2): 100731.
2. ALEXIOU KE, et al. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol., 2009; 38(3):141-7.
3. AL-ANI Z. Temporomandibular Joint osteoarthrosis: a review of clinical aspects and management. Prim Dent J., 2021; 10(1): 132-140.
4. ARAYASANTIPARB R, et al. Association of radiographic and clinical findings in patients with temporomandibular joints osseous alteration. Clinical Oral Investigations. 2020; 24(1):221-227.
5. BAKKE M, et al. Bony deviations revealed by cone beam computed tomography of the temporomandibular joint in subjects without ongoing pain. Journal of oral & facial pain and headache, 2014; 28(4): 331-7.
6. BONATO LL, et al. Desordem temporomandibular e a influência do polimorfismo genético. Faculdade de Odontologia de Lins/Unimep, 2013; 23(2): 61-68.
7. CARDONEANU A, et al. Temporomandibular Joint Osteoarthritis: Pathogenic Mechanisms Involving the Cartilage and Subchondral Bone, and Potential Therapeutic Strategies for Joint Regeneration. Int. J. Mol. Sci., 2023; 24(1): 171.
8. CHUNG MK, et al. The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models. Front. Pain Res., 2023; 9:4:1038808.
9. DAGAR SR et al. Modified sthetoscope for auscultation of temporomandibular joint sounds. J Int Oral Health. 2014; 6(2):40-4.
10. DELPACHITRA SN, DIMITROULIS G. Osteoarthritis of the temporomandibular joint: a review of aetiology and pathogenesis. British Journal of Oral and Maxillofacial Surgery, 2022; 60(4): 387-396.
11. DERWICH M, et al. Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature. Medicina (Kaunas), 2020; 56(5): 225.
12. DIAS IM, et al. Evaluation of the correlation between disc displacements and degenerative bone changes of the temporomandibular joint by means of magnetic resonance images. International journal of oral and maxillofacial surgery, 2012; 41(9): 1051-7.
13. DWORKIN SF e LERESCHE L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomand Disord., 1992; 6(4): 301-55.
14. FERREIRA LA, et al. Indication Criteria of Imaging Exams for Diagnosing of Temporomandibular Joint Disorders. J Clin Exp Pathol., 2014, Vol 4(5): 190.
15. GÖRÜRGÖZ C, et al. Degenerative changes of the mandibular condyle in relation to the temporomandibular joint space, gender and age: A multicenter CBCT study. Dent Med Probl., 2023; 60(1): 127-135.
16. HELKIMO M. Studies on function and occlusal state 11. lndex for anamnesic and clinicai dysfunction and oclusal state. Swed Dent J., 1974; 67(2): 101-21.
17. HONDA K, et al. Correlation between MRI evidence of degenerative condylar surface changes, induction of articular disc displacement and pathological joint sounds in the temporomandibular joint. Gerodontology, 2008; 25(4): 251-7.
18. HUSSAIN AM, et al. Role of different imaging modalities in assessment of temporomandibular joint erosions and osteophytes: a systematic review. Dentomaxillofac Radiol., 2008; 37(2): 63-71.
19. JUAN AZ, et al. Potential pathological and molecular mechanisms of temporomandibular joint osteoarthritis. Journal of Dental Sciences, 2023; 18(3): 959-971.
20. KIM TH, et al. Assessment of Morphologic Change of Mandibular Condyle in Temporomandibular Joint Osteoarthritis Patients with Stabilization Splint Therapy: A Pilot Study. Healthcare (Basel), 2022; 10(10): 1939.
21. KRISJANE Z, et al. The prevalence of TMJ osteoarthritis in asymptomatic patients with dentofacial deformities: a cone-beam CT study. Int. J. Oral Maxillofac. Surg., 2012; 41(6): 690-5.
22. LASCALA CA, et al. Analysis of the accuracy of linear measurement obtained by cone beam computed tomography (CBCT-NewTom). Dentomaxillofac Radiol., 2004; 33(5): 291-4.
23. LEE JY, et al. A longitudinal study on the osteoarthritic change of the temporomandibular joint based on 1-year follow-up computed tomography. Journal of Cranio-Maxillo-Facial Surgery, 2012; 40(8): e223-8.
24. LI C, et al. Osteoarthritic Changes After Superior and Inferior Joint Space Injection of Hyaluronic Acid for the Treatment of Temporomandibular Joint Osteoarthritis with Anterior Disc Displacement Without Reduction: A Cone-Beam Computed Tomographic Evaluation. Journal of Oral and Maxillofacial Surgery, 2015; 73(2): 232-44.
25. LIMCHAICHANA N, et al. The efficacy of magnetic resonance imaging in the diagnosis of degenerative and inflammatory temporomandibular joint disorders: a systematic literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod., 2006; 102(4): 521-36.
26. LOOK JO, et al. Reliability and validity of Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC⁄TMD) with proposed revisions. Journal of Oral Rehabilitation, 2010; 37(10): 744-59.
27. MALLYA SM et al. Recommendations for Imaging of the Temporomandibular Joint. Position Statement from the American Academy of Oral and Maxillofacial Radiology and the American Academy of Orofacial Pain. J Oral Facial Pain Headache. 2023;37(1):7-15
28. OK, SM. et al. Anterior condylar remodeling observed in stabilization splint therapy for temporomandibular joint osteoarthritis. Oral surgery, oral medicine, oral pathology and oral radiology, 2014; 118(3): 363-70.
29. PANTOJA LLQ, et al. Prevalence of degenerative joint disease of the temporomandibular joint: a systematic review. Clinical Oral Investigations, 2019; 23(5): 2475-2488.
30. SCHIFFMAN E e OHRBACH R. Executive summary of the Diagnostic Criteria for Temporomandibular Disorders for clinical and research applications. J Am Dent Assoc. 2016; 147(6): 438-45.
31. VALESAN LF, et al. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clinical Oral Investigations, 2021; 25(2): 441-453.
32. VÎRLAN MJR, et al. Degenerative bony changes in the temporal component of the temporomandibular joint – review of the literature. Rom J Morphol Embryol., 2022; 63(1): 61-69.
33. WANG XD, et al. Current Understanding of Pathogenesis and Treatment of TMJ Osteoarthritis. Journal of dental research, 2015; 94(5): 666-73.
34. WIESE 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; 106(2): e52-63.
35. WIESE M, et al. Association between TMJ symptoms, signs and clinical diagnosis using RDC/TMD and radiographic findings in TMJ tomograms. J Orofac Pain, 2008; 22(3): 239-51.
36. XIAO JL, et al. Association of GDF5, SMAD3 and RUNX2 polymorphisms with temporomandibular joint osteoarthritis in female Han Chinese. Journal of oral rehabilitation, 2015; 42(7): 529-36.
37. XIANG W, et al. Correlation between craniocervical posture and upper airway dimension in patients with bilateral anterior disc displacement. J Stomatol Oral Maxillofac Surg. 2024; 125(6):101785.
38. YADAV S, et al. Diagnostic accuracy of 2 cone-beam computed tomography protocols for detecting arthritic changes in temporomandibular joints. American Journal of Orthodontics and Dentofacial Orthopedics, 2015; 147(3): 339-44.
39. YILDIZER E e ODABAŞI O. Differences in clinical and radiographic features between bilateral and unilateral adult degenerative temporomandibular joint disease: A retrospective cross-sectional study. International Orthodontics, 2023; 21(2): 100731.