Comparative assessment of condylar position in patients with temporomandibular disorder (TMD) and asymptomatic patients using cone-beam computed tomography

Background. Temporomandibular disorders (TMD) are the most common reason of non-dental pain in the orofacial region. A clinical examination of the temporomandibular joint (TMJ) with additional imaging is the most recommended procedure for TMD diagnosis. Objectives. The objective of this study was to evaluate the association between TMD and the condylar position in the glenoid fossa by examining a group of patients suffering from TMD compared with a control group of patients without TMD. In this study, we used cone-beam computed tomography (CBCT) images for measurements. Material and methods. Sixty-five symptomatic joints were selected from 48 patients with TMD. Sixty-five joints were selected from a total of 96 asymptomatic joints in the control group. The superior, anterior and posterior area of the joint, and the steepness of the articular eminence were measured on the CBCT images. The data was analyzed using Pearson's chi(2) test. Results. The position of the condyle was significantly more posterior in the joints with TMD, and more anterior and centric in the asymptomatic joints. Statistically, the vertical position of the condyle and the steepness of the articular eminence had no significant relation with the occurrence of TMD. Conclusions. In this study, we observed that the posterior condylar position is more common in TMD patients, but it is not the reason for diagnosing TMD, and the reason of the posterior position of the condyle should be investigated before any decisions pertaining to treatment are made. In future, studies should focus on evaluating how the position of the condyle will change after the treatment of patients with TMD.