Abstract
Temporomandibular joint osteoarthrosis (TMJ-OA) frequently causes mild, moderate,
or severe condylar morphological changes. A novel condylar remodelling scoring system
(CRSS) based on three-dimensional cone beam computed tomography images is proposed,
which is used to grade condylar morphological changes. In the CRSS, the condyle is
divided into 10 regions by 11 reference points. For each increase in the number of
regions involved in TMJ-OA, one point is subtracted from the full score of 10. The
intra-class correlation coefficients for intra- and inter-observer agreement (range
0.656–0.898 and 0.841–0.906, respectively) indicated that the CRSS had good reliability.
Cephalometric analysis showed that the condyles with severe morphological changes
were prone to present with a retrognathic and clockwise rotating mandible, shorter
ramus height, reduced mandibular length, larger mandibular angle, and maxillary retrusion.
Qualitative CRSS evaluation and quantitative volumetric analysis were performed to
evaluate the stability of severe TMJ-OA in its natural course (343 condyles). The
continuous cortex group showed no remarkable changes with an average follow-up of
2 years. In the discontinuous cortex group, most (74.4%) converted into a continuous
cortex during follow-up (mean 2 years).
Keywords
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Article info
Publication history
Published online: August 13, 2022
Accepted:
August 2,
2022
Identification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
