Assessment of Degenerative Condylar Bony Change Due to Temporomandibular Joint Disorder in Bangladeshi Population Using Cone Beam Computed Tomography – A Pilot Study

Document Type : Original Article

Authors

1 Oral and Maxillofacial Radiology, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu16150, Malaysia

2 School of Dental Science, Health Campus, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia

3 Dental Research Unit, Center for Transdisciplinary Research (CFTR), Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India

4 Department of Oral and Maxillofacial Surgery, Bangladesh Medical University, Dhaka 1000, Bangladesh

5 Odontology Forensic Science, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Bandung, Indonesia

6 Oral and Maxillofacial Surgery Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia

7 Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia

Abstract

Background: Temporomandibular joint (TMJ) degeneration is a progressive disorder characterised by structural and functional deterioration; however, population-specific epidemiological and morphometric data based on cone-beam computed tomography (CBCT) remain limited for the Bangladeshi population. This study investigated the prevalence of degenerative bony changes in the mandibular condyle and explored their morphometric alterations and demographic (age and gender) correlations in the Bangladeshi population.
Methods: Following predefined inclusion criteria, this descriptive study included 15 patients with temporomandibular disorder (TMD) symptoms in the case group and 15 participants without TMD symptoms in the control group. CBCT was used to evaluate the following bony changes: erosion, flattening, subchondral sclerosis, osteophytes, and subcortical cysts, and their associations with age and gender. Condylar head dimensions were compared between the groups to assess morphometric alterations. Statistical analyses included chi-square tests, t-tests, and Mann-Whitney U tests.
Results: Among the 60 TMJs, erosion (93.3%) was the most common bony change, followed by flattening (53.3%), osteophytes (43.3%), subcortical cysts (43.3%), and sclerosis (40%). The linear measurements of the condylar head and glenoid fossa were found not to differ significantly between the case and control groups or between the left and right sides (P > 0.05). Females showed a higher prevalence of sclerosis. However, no significant correlation was found between bony changes and age groups (P > 0.05).
Conclusion: The study findings indicate that degenerative bony changes of the condyle may occur independently of clinical symptoms and age in the Bangladeshi population, highlighting the need for careful evaluation of every CBCT scan that covers the TMJ. The results may assist Bangladeshi clinicians in refining diagnostic decisions and treatment planning, as well as promoting radiation safety for patients.

Keywords

Main Subjects

References

1. Palla S. Anatomy and pathophysiology of the
temporomandibular joint. In: Klineberg I, Eckert SE,
eds. Functional Occlusion in Restorative Dentistry and
Prosthodontics. Mosby; 2016. p. 67-85. doi:10.1016/b978-0-
7234-3809-0.00006-1
2. Bordoni B, Brizuela M. Anatomy, head and neck,
temporomandibular joint. In: StatPearls. Treasure Island, FL:
StatPearls Publishing; 2025.
3. Medin Ceylan C, Cigdem Karacay B. The relationship between
the oral behavioral checklist and the jaw functional limitation
scale in temporomandibular joint pain. J Oral Health Oral
Epidemiol 2023;12(3):112-7. doi:10.34172/johoe.2023.19
4. Veerappan RR, Gopal M. Comparison of the diagnostic
accuracy of CBCT and conventional CT in detecting
degenerative osseous changes of the TMJ: a systematic
review. J Indian Acad Oral Med Radiol 2015;27(1):81-4.
doi:10.4103/0972-1363.167090
5. Imanimoghaddam M, Madani AS, Bagherpour A, Gharekhani
S, Ebrahimnejad H, Alimohammadi M. Association between
clinical and cone-beam computed tomography findings in
patients with temporomandibular disorders. J Oral Health
Oral Epidemiol 2017;6(4):231-8.
6. Vasegh Z, Safi Y, Sanaei Azar M, Ghazizadeh Ahsaie
M, Arianezhad SM. Assessment of bony changes in
temporomandibular joint in patients using cone beam
computed tomography - a cross sectional study. Head Face
Med 2023;19(1):47. doi:10.1186/s13005-023-00392-z
7. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G,
Goulet JP, et al. Diagnostic criteria for temporomandibular
disorders (DC/TMD) for clinical and research applications:
recommendations of the International RDC/TMD Consortium
Network* and Orofacial Pain Special Interest Group†. J Oral
Facial Pain Headache 2014;28(1):6-27. doi:10.11607/jop.1151
8. Nawaz U, Afzal MW, Siddique K, Ashraf N, Aziz H, Aziz
Khan S, et al. The effectiveness of neck strengthening exercises
on jaw mobility and clicking in anterior disc displacement
with reduction of temporomandibular joint: a randomized
controlled trial. J Oral Health Oral Epidemiol 2024;13(1):1-5.
doi:10.34172/johoe.2107.1362
9. Talmaceanu D, Lenghel LM, Bolog N, Hedesiu M, Buduru
S, Rotar H, et al. Imaging modalities for temporomandibular
joint disorders: an update. Clujul Med 2018;91(3):280-7.
doi:10.15386/cjmed-970
10. Al Amin N, Farook TH, Oscandar F, Abdullah MF, Ibrahim
NB, Eusufzai SZ, et al. The diagnostic accuracy of conebeam
computed tomography for assessing in vitro osseous
alterations of the mandibular condyle: a systematic review and
meta-analysis. Oral Radiol 2025;41(4):449-59. doi:10.1007/
s11282-025-00821-6
11. Browne RH. On the use of a pilot sample for sample size
determination. Stat Med 1995;14(17):1933-40. doi:10.1002/
sim.4780141709
12. Bianchi J, Roberto Gonçalves J, Carlos de Oliveira Ruellas
A, Vieira Pastana Bianchi J, Ashman LM, Yatabe M, et al.
Radiographic interpretation using high-resolution CBCT to
diagnose degenerative temporomandibular joint disease.
PLoS One 2021;16(8):e0255937. doi:10.1371/journal.
pone.0255937
13. Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity
of temporomandibular joint osteoarthritic changes related to
age using cone beam computed tomography. Dentomaxillofac
Radiol 2009;38(3):141-7. doi:10.1259/dmfr/59263880
14. Alrizqi AH, Aleissa BM. Prevalence of temporomandibular
disorders between 2015-2021: a literature review. Cureus
2023;15(4):e37028. doi:10.7759/cureus.37028
15. Nielsen TW, Holte MB, Berg-Beckhoff G, Thorn JJ,
Ingerslev J, Pinholt EM. Three-dimensional assessment
of temporomandibular joint changes following
maxillomandibular advancement surgery: a five-year followup
study. Int J Oral Maxillofac Surg 2025;54(7):617-23.
doi:10.1016/j.ijom.2024.12.002
16. Tsai CM, Wu FY, Chai JW, Chen MH, Kao CT. The advantage
of cone-beam computerized tomography over panoramic
radiography and temporomandibular joint quadruple
radiography in assessing temporomandibular joint osseous
degenerative changes. J Dent Sci 2020;15(2):153-62.
doi:10.1016/j.jds.2020.03.004
17. Marques AP, Perrella A, Arita ES, de Matos Pereira MF, de
Gusmão Paraíso Cavalcanti M. Assessment of simulated
mandibular condyle bone lesions by cone beam computed
tomography. Braz Oral Res 2010;24(4):467-74. doi:10.1590/
s1806-83242010000400016
18. Salemi F, Shokri A, Mortazavi H, Baharvand M. Diagnosis of
simulated condylar bone defects using panoramic radiography,
spiral tomography and cone-beam computed tomography:
a comparison study. J Clin Exp Dent 2015;7(1):e34-9.
doi:10.4317/jced.51736
19. Rehan OM, Saleh HA, Raffat HA, Abu-Taleb NS. Osseous
changes in the temporomandibular joint in rheumatoid
arthritis: a cone-beam computed tomography study. Imaging
Sci Dent 2018;48(1):1-9.
20. Bae S, Park MS, Han JW, Kim YJ. Correlation between
pain and degenerative bony changes on cone-beam
computed tomography images of temporomandibular joints.
Maxillofac Plast Reconstr Surg 2017;39(1):19. doi:10.1186/
s40902-017-0117-1
21. Hafez Maleki F, Shokri A, Hosseini Zarch SH, Bahraniy A,
Ebrahimpour A, Alimohamadi SM. Cone beam CT evaluation
of the bony changes in the temporomandibular joint and the
association with the clinical symptoms of temporomandibular
joint disorders. J Dent Mater Tech 2019;8(1):25-32.
doi:10.22038/jdmt.2018.12123
22. de Almeida Azevedo MQ, de Almeida-Barros RQ, Donato LF,
Youssef MN, Manhães Júnior LR, Panzarella F. Degenerative
bone changes in TMJ assessed by cone beam computed
tomography. RGO Rev Gaúch Odontol 2016;64(2):171-8.
doi:10.1590/1981-863720160002000073191
23. Nah KS. Condylar bony changes in patients with
temporomandibular disorders: a CBCT study. Imaging Sci
Dent 2012;42(4):249-53. doi:10.5624/isd.2012.42.4.249
24. Lau SCX, Lim LZ, Hallinan J, Makmur A. Incidental findings
involving the temporomandibular joint on computed
tomography and magnetic resonance imaging. Singapore
Med J 2023;64(4):262-70. doi:10.4103/singaporemedj.
Smj-2021-068
25. Zieliński G, Pająk-Zielińska B, Ginszt M. A meta-analysis of
the global prevalence of temporomandibular disorders. J Clin
Med 2024;13(5):1365. doi:10.3390/jcm13051365
26. Talaat W, Al Bayatti S, Al Kawas S. CBCT analysis of bony
changes associated with temporomandibular disorders. Cranio
2016;34(2):88-94. doi:10.1179/2151090315y.0000000002
27. Shahidi S, Salehi P, Abedi P, Dehbozorgi M, Hamedani S,
Berahman N. Comparison of the bony changes of TMJ in
patients with and without TMD complaints using CBCT. J Dent
(Shiraz) 2018;19(2):142-9.
28. de Holanda TA, de Almeida RC, Silva AE, Damian MF,
Boscato N. Prevalence of abnormal morphology of the
temporomandibular joint in asymptomatic subjects: a
retrospective cohort study utilizing cone beam computed
tomography. Int J Prosthodont 2018;31(4):321–6.
doi:10.11607/ijp.5623
29. Ahmed J, Sujir N, Shenoy N, Binnal A, Ongole R. Morphological
assessment of TMJ spaces, mandibular condyle, and glenoid
fossa using cone beam computed tomography (CBCT): a
retrospective analysis. Indian J Radiol Imaging 2021;31(1):78-
85. doi:10.1055/s-0041-1729488
30. Alhammadi MS, Almashraqi AA, Thawaba AA, Fayed MMS,
Aboalnaga AA. Dimensional and positional temporomandibular
joint osseous characteristics in normodivergent facial
patterns with and without temporomandibular disorders.
Clin Oral Investig 2023;27(9):5011-20. doi:10.1007/
s00784-023-05120-0
31. Progiante PS, Pattussi MP, Lawrence HP, Goya S, Grossi PK,
Grossi ML. Prevalence of temporomandibular disorders in
an adult Brazilian community population using the research
diagnostic criteria (axes I and II) for temporomandibular
disorders (the Maringá study). Int J Prosthodont 2015;28(6):600-
9. doi:10.11607/ijp.4026
32. dos Anjos Pontual ML, Freire JS, Barbosa JM, Frazão
MA, dos Anjos Pontual A. Evaluation of bone changes
in the temporomandibular joint using cone beam CT.
Dentomaxillofac Radiol 2012;41(1):24-9. doi:10.1259/
dmfr/17815139
33. Koyama J, Nishiyama H, Hayashi T. Follow-up study of
condylar bony changes using helical computed tomography in
patients with temporomandibular disorder. Dentomaxillofac
Radiol 2007;36(8):472-7. doi:10.1259/dmfr/28078357
34. Koç N. Evaluation of osteoarthritic changes in the
temporomandibular joint and their correlations with age: a
retrospective CBCT study. Dent Med Probl 2020;57(1):67-72.
doi:10.17219/dmp/112392
35. Imanimoghaddam M, Madani AS, Talebzadeh MR, Bagherpour
A, Alimohammadi M. The relationship between osseous
changes of the temporomandibular joint and RDC/TMD
groups in CBCT images. J Dent Mater Tech 2014;3(4):151-7.
doi:10.22038/jdmt.2014.3345
Journal of Oral Health and Oral Epidemiology
Volume 15
Pages 1-7

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History

  • Receive Date: 06 May 2025
  • Revise Date: 06 January 2026
  • Accept Date: 01 June 2026

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