A Systematic Review on the Association Between Clinical Symptoms and CBCT Findings in Symptomatic TMJ Degenerative Joint Disease. 2021

Michael Wu, and Fabiana T Almeida, and Reid Friesen

OBJECTIVE To evaluate the association between clinical signs/symptoms and bone changes on CBCT images in patients with degenerative joint disease (DJD) of the temporomandibular joint (TMJ). METHODS An electronic literature search of the MEDLINE, PubMed, EMBASE, Scopus, and Web of Science databases, as well as Google Scholar for gray literature, was conducted to identify relevant articles on February 26, 2021. Risk of bias was evaluated using the Joanna Briggs Institute critical appraisal tools. The GRADEpro (Recommendation, Assessment, Development, and Evaluation) system instrument was applied to assess the level of evidence across studies. RESULTS Nine papers assessing clinical signs/symptoms and CBCT findings were included. TMJ pain (arthralgia) and TMJ noises carried the strongest associations with various CBCT findings, each of which were supported by four studies with significant associations. Only one study found significant associations between masticatory myalgia (muscle pain) and CBCT findings. Range of motion carried no significant associations with CBCT findings in the included studies. Based on the GRADEpro system, the certainty of evidence is low for said associations. CONCLUSIONS The results suggest that TMD patients with TMJ arthralgia and joint noises may benefit from CBCT imaging. There would be less benefit in TMD patients exhibiting primarily myalgia or limited range of motion, and therefore these patients should not be prescribed routine CBCT radiographs unless indicated by other clinical findings. The heterogeneity of reporting in the included studies suggests that embracing universal clinical (DC/TMD) and radiographic diagnostic criteria for TMJ-DJD would benefit both research and clinical outcomes.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013704 Temporomandibular Joint An articulation between the condyle of the mandible and the articular tubercle of the temporal bone. TMJ,Joint, Temporomandibular,Joints, Temporomandibular,Temporomandibular Joints
D013705 Temporomandibular Joint Disorders A variety of conditions affecting the anatomic and functional characteristics of the temporomandibular joint. Factors contributing to the complexity of temporomandibular diseases are its relation to dentition and mastication and the symptomatic effects in other areas which account for referred pain to the joint and the difficulties in applying traditional diagnostic procedures to temporomandibular joint pathology where tissue is rarely obtained and x-rays are often inadequate or nonspecific. Common diseases are developmental abnormalities, trauma, subluxation, luxation, arthritis, and neoplasia. (From Thoma's Oral Pathology, 6th ed, pp577-600) TMJ Disorders,TMJ Diseases,Temporomandibular Disorders,Temporomandibular Joint Diseases,Disease, TMJ,Disease, Temporomandibular Joint,Diseases, TMJ,Diseases, Temporomandibular Joint,Disorder, TMJ,Disorder, Temporomandibular,Disorder, Temporomandibular Joint,Disorders, TMJ,Disorders, Temporomandibular,Disorders, Temporomandibular Joint,Joint Disease, Temporomandibular,Joint Diseases, Temporomandibular,Joint Disorder, Temporomandibular,Joint Disorders, Temporomandibular,TMJ Disease,TMJ Disorder,Temporomandibular Disorder,Temporomandibular Joint Disease,Temporomandibular Joint Disorder
D016059 Range of Motion, Articular The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES. Passive Range of Motion,Joint Flexibility,Joint Range of Motion,Range of Motion,Flexibility, Joint
D054894 Spiral Cone-Beam Computed Tomography Modality of computed tomography in which the patient is irradiated in a spiral path around the body with a cone or pyramid-shaped beam. CAT Scan, Spiral Cone-Beam,CT Scan, Spiral Cone-Beam,Spiral Volumetric CT,Tomography, Spiral Volumetric Computed,Helical Cone-Beam CT,Spiral Cone-Beam CAT Scan,Spiral Cone-Beam CT,Spiral Cone-Beam CT Scan,Spiral Cone-Beam Computer-Assisted Tomography,Spiral Cone-Beam Computerized Tomography,Spiral Volume CT,CAT Scan, Spiral Cone Beam,CT Scan, Spiral Cone Beam,CT, Helical Cone-Beam,CT, Spiral Cone-Beam,CT, Spiral Volume,CT, Spiral Volumetric,CTs, Spiral Volume,Cone-Beam CT, Helical,Cone-Beam CT, Spiral,Cone-Beam CTs, Helical,Helical Cone Beam CT,Spiral Cone Beam CAT Scan,Spiral Cone Beam CT,Spiral Cone Beam CT Scan,Spiral Cone Beam Computed Tomography,Spiral Cone Beam Computer Assisted Tomography,Spiral Cone Beam Computerized Tomography,Volume CT, Spiral,Volumetric CT, Spiral
D018771 Arthralgia Pain in the joint. Joint Pain,Polyarthralgia,Arthralgias,Joint Pains,Pain, Joint,Pains, Joint,Polyarthralgias

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