Comparative Analysis of the Temporomandibular Joints in Patients with Chronic Periodontitis Using Cone-Beam Computed Tomography (CBCT)

Introduction: Chronic periodontitis is a common disorder in adults causing periodontal destruction and loss of teeth. These clinical presentations may lead to temporomandibular joint disorders (TMDs). This study aimed to examine the anatomic structures of the temporomandibular joints (TMJs) using cone-beam computed tomography (CBCT) in patients with chronic periodontitis. Methods: Fifty patients with chronic periodontitis were enrolled in the study. Based on the severity of chronic periodontitis, these patients were divided into the mild, moderate, and severe groups. CBCT images of TMJs were acquired and reconstructed. Several indices on the reconstructed CBCT images were collected and analyzed, such as the oblique joint space parallel to the long axis of the condyle, the long axis diameter of the condyle, the vertical angle of the condyle, the inclination of the articular eminence vertical to the long axis of condyle at the oblique and sagittal positions, the depth of the fossa, and the horizontal angle of the cross-sections. The measurements between right and left sides of each patient were compared. Statistical analysis (paired samples t test) was performed. Results: The differences of the joint space vertical to the bilateral condyles were statistically significant (P < 0.05). Additionally, in the severe periodontitis group, the distances between the inner and outer poles of the condyles were statistically different (P < 0.05). Conclusion: In patients with chronic periodontitis, TMJ space vertical to the condyles and the distances between the outer and inner poles of the condyle may change over time. These two indices can potentially be used as indicators for diagnosis and further comparative analyses.