Clinical evaluation of the temporomandibular joint anatomy using hologram models: a retrospective study

Objectives: Temporomandibular joint (TMJ) is the only synovial joint in head region and is exposed to very strong pressure, especially during chewing. Disorders of this joint are quite common and occur with severe pain. Recent studies focused on the ideal surgical procedures to manage disorders and pathologies of TMJ. The number of studies on prosthesis implantations for the condylar process is also increasing; therefore, the three-dimensional anatomical organization of the TMJ becomes important. Methods: Computed tomography images of 160 healthy individuals (82 women, 78 men) submitted to the Radiology Department of Bal›kesir University Hospital from 2016 and to the first three months of 2018 were evaluated retrospectively to describe the detailed three-dimensional anatomical organization of this joint. The anterior, posterior and superior articular spaces between the condylar process and the temporal bone were measured. Anteroposterior condyle diameter and condyle height were also evaluated. Data were compared for age and gender. Results: The mean value of superior articular distance was measured as 2.39 mm, anterior articular distance 1.83 mm, posterior articular distance 1.99 mm and diameter of the condylar process 10.38 mm. Statistical results indicated that there were gender differences among the parameters. Conclusion: The results of the present study point out to the importance of the gross anatomy of the TMJ and revealed the differences between genders and individuals. These data may guide surgeons for planning the ideal surgical protocols during managing of joint disorders.


1. Nascimento Falcao I, Cal Alonso MBC, da Silva LH, Lopes S, Comar LP, Costa ALF. 3D morphology analysis of TMJ articular eminence in magnetic resonance imaging. Int J Dent 2017;2017: 5130241.

2. Kim DG, Haghighi A, Kwon HJ, Coogan JS, Nicolella DP, Johnson TB, Kim HD, Kim N, Agnew AM. Sex dependent mechanical properties of the human mandibular condyle. J Mech Behav Biomed Mater 2017;71:184–91.

3. Paglio AE, Bradley AP, Tubbs RS, Loukas M, Kozlowski PB, Dilandro AC, Sakamoto Y, Iwanaga J, Schmidt C, D’Antoni AV. Morphometric analysis of temporomandibular joint elements. J Craniomaxillofac Surg 2018;46:63–6.

4. Coogan JS, Kim DG, Bredbenner TL, Nicolella DP. Determination of sex differences of human cadaveric mandibular condyles using statistical shape and trait modeling. Bone 2018;106:35–41.

5. Saccucci M, D’Attilio M, Rodolfino D, Festa F, Polimeni A, Tecco S. Condylar volume and condylar area in class I, class II and class III young adult subjects. Head Face Med 2012;8:34.

6. Zhang YL, Song JL, Xu XC, Zheng LL, Wang QY, Fan YB, Liu Z. Morphologic analysis of the temporomandibular Joint between patients with facial asymmetry and asymptomatic subjects by 2D and 3D evaluation: a preliminary study. Medicine (Baltimore) 2016;95: e3052.

7. Kanavakis G, Mehta N. The role of occlusal curvatures and maxillary arch dimensions in patients with signs and symptoms of temporomandibular disorders. Angle Orthod 2014;84:96–101.

8. Al-Saleh MA, Alsufyani N, Flores-Mir C, Nebbe B, Major PW. Changes in temporomandibular joint morphology in class II patients treated with fixed mandibular repositioning and evaluated through 3D imaging: a systematic review. Orthod Craniofac Res 2015;18:185–201.

9. Iguchi R, Yoshizawa K, Moroi A, Tsutsui T, Hotta A, Hiraide R, Takayama A, Tsunoda T, Saito Y, Sato M, Baba N, Ueki K. Comparison of temporomandibular joint and ramus morphology between class II and class III cases before and after bi-maxillary osteotomy. J Craniomaxillofac Surg 2017;45:2002–9.

10. Obamiyi S, Malik S, Wang Z, Singh S, Rossouw EP, Fishman L, Feng C, Michelogiannakis D, Tallents RH. Radiographic features associated with temporomandibular joint disorders among African, White, Chinese, Hispanic, and Indian racial groups. Niger J Clin Pract 2018;21:1495–500.

11. Borahan MO, Mayil M, Pekiner FN. Using cone beam computed tomography to examine the prevalence of condylar bony changes in a Turkish subpopulation. Niger J Clin Pract 2016;19:259–66.

12. Halpern LR, Levine M, Dodson TB. Sexual dimorphism and temporomandibular disorders (TMD). Oral Maxillofac Surg Clin North Am 2007;19:267–77.

13. Caruso S, Storti E, Nota A, Ehsani S, Gatto R. Temporomandibular joint anatomy assessed by CBCT images. Biomed Res Int 2017;2017:2916953.

14. Kobayashi K. Efficacy of Image diagnosis on temporomandibular joint disorders. Oral Radiol 2003;19:70–1.

15. Chiarini L, Albanese M, Anesi A, Galzignato PF, Mortellaro C, Nocini P, Bertossi D. Surgical treatment of unilateral condylar hyperplasia with piezosurgery. J Craniofac Surg 2014;25:808–10.

16. Koide D, Yamada K, Yamaguchi A, Kageyama T, Taguchi A. Morphological changes in the temporomandibular joint after orthodontic treatment for Angle Class II malocclusion. Cranio 2018;36:35–43.

17. Ma X, Fang B, Dai Q, Xia Y, Mao L, Jiang L. Temporomandibular joint changes after activator appliance therapy: a prospective magnetic resonance imaging study. J Craniofac Surg 2013;24:1184–9.

18. Yang ZJ, Song DH, Dong LL, Li B, Tong DD, Li Q, Zhang FH. Magnetic resonance imaging of temporomandibular joint: morphometric study of asymptomatic volunteers. J Craniofac Surg 2015;26:425–9.

19. Aiken A, Bouloux G, Hudgins P. MR imaging of the temporomandibular joint. Magn Reson Imaging Clin N Am 2012;20:397– 412.

20. Safi AF, Kauke M, Grandoch A, Nickenig HJ, Zoller JE, Kreppel M. Volumetric analysis of 700 mandibular condyles based upon cone beam computed tomography. J Craniofac Surg 2017;29:506–9.

21. Ganugapanta VR, Ponnada SR, Gaddam KP, Perumalla K, Khan I, Mohammed NA. Computed tomographic evaluation of condylar symmetry and condyle-fossa relationship of the temporomandibular joint in subjects with normal occlusion and malocclusion: a comparative study. J Clin Diagn Res 2017;11: ZC29–33.

22. Karagoz H, Eren F, Sever C, Ulkur E, Acikel C, Celikoz B, Aysal BK. Mandibular reconstruction after hemimandibulectomy. J Craniofac Surg 2012;23:1373–4.

23. Man QW, Jia J, Liu K, Chen G, Liu B. Secondary reconstruction for mandibular osteoradionecrosis defect with fibula osteomyocutaneous flap flowthrough from radial forearm flap using stereolithographic 3- dimensional printing modeling technology. J Craniofac Surg 2015;26:e190–3.

24. Gravvanis A, Anterriotis D, Kakagia D. Mandibular Condyle reconstruction with fibula free-tissue transfer: the role of the masseter muscle. J Craniofac Surg 2017;28:1955–9.

25. Han S, Shin SM, Choi YS, Kim KB, Yamaguchi T, Maki K, Chung CJ, Kim YI. Comparison of temporomandibular joint shape and size in patients with facial asymmetry. Oral Radiol 2018; doi: 10.1007/s11282-018-0344-x.

26. Al-Saleh MAQ, Punithakumar K, Lagravere M, Boulanger P, Jaremko JL, Major PW. Three-dimensional assessment of temporomandibular joint using MRI-CBCT image registration. Plos One 2017;12:e0169555.

27. Otonari-Yamamoto M, Sano T, Okano T, Wakoh M. Association between osseous changes of the condyle and temporomandibular joint (TMJ) fluid in osteoarthritis. Oral Radiol 2015;31:41–8.

28. Yasa Y, Akgul HM. Comparative cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals. Oral Radiol 2018;34:31–9.

29. Bork F, Stratmann L, Enssle S, Eck U, Navab N, Waschke J, Kugelmann D. The benefits of an augmented reality magic mirror system for integrated radiology teaching in gross anatomy. Anat Sci Educ 2019. doi:10.1002/ase.1864.

Kaynak Göster

417 225

Sayıdaki Diğer Makaleler

Effects of chronic unpredictable stress on intestinal morphology in Wistar rats


Impact of a gynecologic oncology cadaveric dissection course for surgical training


Sutural bones: a literature review


Radiographic evaluation of bone maturations in children and adolescents living in Erzurum using Greulich-Pyle method


Clinical evaluation of the temporomandibular joint anatomy using hologram models: a retrospective study


Variation of the brachial plexus roots in the interscalene groove: relevance in interscalene blocks

Kerri KEET, Graham LOUW

Cadavers in anatomy classes: opinions of the students of Bursa Uluda¤ University School of Medicine

Nilgün ÇİNİ, Serdar BABACAN, İlker KAFA, Sezer KAFA

Morphological features of the ventral tegmental area: a brainstem structure related to attention deficit hyperactivity disorder


Radiological hip indices correlate with GMFCS level I and GMFM-66 scores in cerebral pasy


Effects of alcohol and tramadol co-treatment on cognitive functions and neuro-inflammatory responses in the medial prefrontal cortex of juvenile male rats

Damilare ADEKOMI, Adebiyi ADEGOKE, Olayinka OLANIYAN, Adepeju OGUNRINDE, Olayemi IJOMONE