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Could Crepitus Be an Indication for Early Temporomandibular Joint Osteoarthritis?

Ju, Hye-Min;Lee, Sun-Hee;Jeon, Hye-Mi;Kim, Kyung-Hee;Ahn, Yong-Woo;Ok, Soo-Min;Jeong, Sung-Hee

  • Received : 2019.03.25
  • Accepted : 2019.04.08
  • Published : 2019.07.01

Abstract

Purpose: To determine whether crepitus may be a clinical indication for early temporomandibular joint (TMJ) osteoarthritis (OA) and to investigate the correlation between crepitus and the occurrence of TMJ OA with respect to factors, such as patient sex, age, chewing habits, and diagnosis. Methods: This is retrospective analysis of clinical data for 162 TMJs. The criteria for a joint to be included in this study was a minimum of two cone-beam computed tomography (CBCT) scans performed with no OA observed during the initial scan. The Diagnostic Criteria for Temporomandibular Disorders was used for OA diagnosis. Crepitus was recorded when it was objectively palpated during the follow-up period. Correlations between various patient factors and progression to TMJ OA were calculated using the Pearson's chi-square test. A linear-by-linear association was used to analyze trends of OA progression with increasing age. Results: Among the 162 joints, 101 progressed to OA and 61 did not. In the joints where crepitus had been present before OA was confirmed at next or last CBCT, OA progressed at a high rate, and especially higher in female and older patients (p<0.01). Patients in the pain-related disorder group with crepitus were observed to have higher rates of OA progression compared to patients in the intra-articular disorder group (p<0.01). Conclusions: If a patient experiences pain in the TMJs and crepitus, close monitoring through regular CBCT scans is necessary even if there is no evidence of radiologically confirmed OA after the first CBCT.

Keywords

Crepitus;Early osteoarthritis;Temporomandibular joint;The Diagnostic Criteria for Temporomandibular Disorders

Acknowledgement

Supported by : Pusan National University Dental Hospital