Temporomandibular Disfonksiyonlu Hastalarda Temporomandibular Eklem Yüzeylerindeki Morfolojik Değişikliklerin Değerlendirilmesi

Amaç: Çalışmanın amacı, temporomandibular eklem (TME) bozukluğu olan hastalarda kondil ve artiküler fossa şekillerinin dağılımını ve birbiriyle ilişkisini konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleriyle incelemektir. Gereç ve Yöntemler: Bu çalışmada, TME bozukluğu olan 134 hastanın (268 eklem) KIBT görüntüleri geriye dönük olarak değerlendirildi. Koronal ve sagittal kondil şekillerinde kullanılan sınıflandırma yuvarlak, oval, düz ve üçgen şeklindeydi. Artiküler fossa şekilleri oval, üçgen, açılı, trapezoid şeklinde sınıflandırıldı. Artiküler fossa ve mandibular kondilin en net görüldüğü sagittal ve koronal kesitlerde değerlendirme yapıldı. Veriler ki-kare testi kullanılarak değerlendirildi. Bulgular: Sagittal kesitlerde oval ve koronal kesitlerde düz şekil diğer şekillere göre daha sık görüldü. Sadece 83 eklemde (%30,97) sagittal ve koronal kondil şeklinin aynı olduğu tespit edildi. Sagittal kesitlerde eklem fossa şekilleri 128’inde (%47,8) oval, 68’inde (%25,4) açılı, 50’sinde (%18,7) trapezoid ve 22’sinde (%8,2) üçgen şeklindeydi. Sagittal ve koronal kesitlerde her kondil şekli grubunda en yaygın fossa şekli ovaldi. Cinsiyet veya yaş grupları ile artiküler fossa ve kondil şekilleri arasında anlamlı ilişki saptanmadı. Sonuç: Kondil ve artiküler fossa şekillerinin bilinmesi, klinisyenlerin TME bozukluğu olan hastalardaki morfolojik kemik değişikliklerini anlamalarına yardımcı olabilir. KIBT, TME kemik yüzeylerinin üç boyutlu muayenesi gerektiğinde doğru tanı aracı olarak kullanılabilir.

Assessment of Morphological Alterations of Temporomandibular Joint Articular Surfaces in Patients with Temporomandibular Dysfunction

Objective: This study aimed to examine the distribution of condyle and articular fossa shapes in patients with temporomandibular joint dysfunction (TMD) and their relationship with each other using cone-beam computed tomography (CBCT) images. Materials and Methods: CBCT scans of 134 patients (268 joints) with TMD were evaluated retrospectively. In the coronal and sagittal views, condyles were classified based on the following basic shapes: round, oval, flattened, and triangular. Shapes of the articular fossa were classified as oval, triangular, angled, and trapezoidal. The evaluation was made in the sagittal and coronal sections where the articular fossa and mandibular condyle were most clearly seen. Data were analyzed using the chi-square test. Results: Sagittal-oval and coronal-flattened condyles were seen more frequently than other shapes. Identical sagittal and coronal condyles were observed in 83 joints (30.97%). In sagittal sections, the shapes of the articular fossa were oval in 128 (47.8%), angular in 68 (25.4%), trapezoid in 50 (18.7%), and triangular in 22 (8.2%) patients. The most common fossa shape was oval in each shape of the condyles in sagittal and coronal sections. No relationship was found between gender or age groups and shapes of the articular fossa and condyle in all sections. Conclusion: Knowledge of condyle and fossa shapes may help clinicians understand morphological bone changes in patients with TMD. CBCT can be used as an accurate diagnostic tool when three-dimensional examinations of TMJ bone surfaces are necessary.

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