ABSTRACT
This cross-sectional study aimed to compare, by using Cone-Beam Computed Tomography (CBCT), temporomandibular joint (TMJ) morphology among patients with degenerative joint disease (DJD) with or without arthralgia, as well as a control group. METHODS: Thirty-one patients and their respective CBCT TMJ exams were assessed. These individuals were selected from an Orofacial Pain Service and classified into three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): group 1 (10 patients with TMJ DJD and arthralgia), group 2 (11 patients with TMJ DJD without pain), and group 3 (the control group, consisting of 10 healthy individuals without any signs or symptoms of TMD). A second examiner, who was calibrated and blinded for the patient's diagnosis, evaluated the CBCT images. RESULTS: Group 1 showed a statistically significant association with the variables of erosion (p = 0.003) and osteophyte (p = 0.04) on the condyle surface, as well as concentric condyle position with reduced joint space (p = 0.01). The Kappa concordance index between the clinical diagnosis of DC/TMD and CBCT images was k = 0.134 (p ≤ 0.001). CONCLUSION: The presence of erosion, osteophyte, and concentric condyle position with reduced joint space was statistically associated with DJD and ongoing TMJ joint pain.
ABSTRACT
OBJECTIVES: The aim of this study was to evaluate the interexaminer reliability for tomographic findings in degenerative temporomandibular joint disease and its agreement with clinical diagnosis. METHODS: Women aged 18 and 60 years were invited to participate in this research. All participants were evaluated by a single experienced examiner according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Group 1 was comprised of TMJs with Degenerative Joint Disease (DJD). Group 2 was comprised of healthy TMJs, without any signs and/or symptoms of TMD. All CBCT images were evaluated by 2 calibrated examiners for the image evaluation criteria but blinded for the clinical diagnosis. RESULTS: From the 194 women evaluated, 41 were included, with a mean age of 35.23 (± 14.06) years. Group 1 was comprised of 26 TMJs with DJD and group 2 of 36 asymptomatic TMJs. The interexaminer reliability was κ = 0.706 (p < 0.000), while agreement between clinical and tomographic findings were κ = 0.301 (p = 0.01) and κ = 0.273 (p = 0.02) for each examiner. The use of CBCT as a diagnostic test had shown sensitivity and specificity values of 61.5% and 75%, respectively. CONCLUSIONS: The interexaminer reliability for tomographic findings was strong. However, the agreement between clinical and tomographic findings was reasonable, for both examiners.