X-ray and anatomical features of the temporomandibular joint disorders; [Рентгеноанатомические особенности при заболеваниях височно-нижнечелюстного сустава]

Cone-beam computed tomography (CBCT) is one of the most informative methods of X—ray diagnostics in dentistry, which allows to assess the features of the structure, position, shape of the temporomandibular joints (TMJ), as well as to analyze the size of the articular space. The aim of study was to investigate the X-ray and anatomical features of the TMJ disorders. Materials and methods. 104 patients with TMJ dysfunction (temporomandibular joint-pain-dysfunction syndrome [Costen] (K07.60), clicking (snapping) jaws (K07.61), recurrent dislocation and subluxation of temporomandibular joint (K07.62), arthrosis of temporomandibular joint (M19.0X) were examined. CBCT was used to study X-ray changes in patient with TMJ disorders. Results. In the sagittal plane the posterior position of the lower jaw heads was found in 55.8% of cases, anterior — in 38.4% of people, central — in 5.8% of patients. In the frontal plane in 93.5% of patients we discovered a bilateral decrease of the articular space in the medial part of TMJ and a bilateral increase in the lateral part (the difference between the results and normal indices was: −33.6% for the medial part on the right, and −31.7% on the left, for the lateral part on the right — 47.8%, on the left — 38.3%. The analysis of morphological disturbances of the mandibular heads showed various manifestations of degenerative-dystrophic processes in the joint: crater-like erosion, pitted surface of the mandibular heads, thinning of their surfaces, subchondral cysts, sclerosis. Discussion. We associate disturbances in the topography of the mandibular heads with the adaptation of the TMJ to functional overload caused by masticatory muscles hypertension, tooth wear, loss of lateral teeth. Morphological changes are secondary and arise as a result of degenerative processes in the bone tissue of the mandibular head, articular cartilage and disc. Conclusions. The results of X-ray examination (obtained using cone-beam computed tomography) are very informative and necessary in the treatment of patients with TMJ disorders. © 2023 The Author(s).