Τρίτη 1 Ιανουαρίου 2019

Osteoarthritis of the TMJ and increase of the horizontal condylar angle. A longitudinal study

Publication date: Available online 31 December 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Peggy P. Lee, Alexander R. Stanton, Austin E Schumacher, Edmond Truelove, Lars G. Hollender

Abstract
Objective

Our previous study of patients with unilateral TMJ osteoarthritis (OA) showed that the affected joints had greater horizontal condylar angle (HCA) than contralateral unaffected joints. However, it was unclear whether the HCA changes preceded or were the result of OA changes. The aim of this study was to investigate the relationship between HCA and OA progression in a longitudinal study.

Study Design

127 subjects (with and without TMJ disorders) completed baseline and follow up examinations (average time to follow-up 7.9 years). Generalized Estimating Equation models were used to account for correlation of observations within the same patients.

Results

(1) HCA was greater in OA-affected than in unaffected joints (p=0.04). (2) Increased HCA at follow up was associated with change in joint status from no OA to OA. (p=0.001). (3) Baseline HCA value alone did not predict future OA diagnosis. (4) All OA changes in fossa/articular eminence morphology, and some combinations of condylar changes, were associated with a greater HCA. (5) OA diagnosis was associated with pain during maximum opening (p=0.005) and pain history (p=0.002). (6) Aging alone was not correlated with increased HCA.

Conclusions

Clinical progression of OA preceded increases in HCA. HCA alone did not predict OA development.



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