OSTEOARTRITIČNE PROMJENE TEMPOROMANDIBULARNOG ZGLOBA POTVRĐENE MAGNETSKOM REZONANCIJOM

Tomislav Badel, Ivana Savić Pavičin, Dijana Zadravec, Ladislav Krapac, Josipa Kern

Clinical and radiological findings were compared between the patients with osteoarthritis (OA) of temporomandibular joint (TMJ) with or without disc displacement (DD), and asymptomatic volunteers. This study included 30 patients with OA of TMJs (mean age 52.6). All the patients were examined clinically by manual functional analysis and using magnetic resonance imaging. The inclusion criteria for patients comprised: pain referred to the TMJ and/or crepitation in the TMJ. A second group consisted of 20 asymptomatic dental school students (mean age 23.5). There is a statistically significant difference between degenerative changes of the condyle of TMJs with and without clinical signs of OA of patients (p=0.009). In 28% of osteoarthritic joints, flattening of condylar joint surfaces was observed and 17.4% of the joints were without clinical signs of OA. Osteophyte formations were found in 8% of asymptomatic and 25.7% of osteoarthritic patients’ joints. There is a statistically significant difference between patients’ TMJs with and without OA (p=0.0003): pronounced shape loss and severe sclerosation of the articular eminence were found in 12% of the joints without OA, and 42.9% of joints with OA. There is no difference between students’ joints and patients’ TMJs without OA (p=0.804). The most common imaging findings of osteoarthritic TMJs were sclerosis of the condyle and osteophyte formation.

Uspoređeni su klinički i radiološki nalazi bolesnika s osteoartritisom temporomandularnog zgloba s ili bez pomaka diska te asimptomatskih dobrovoljaca. Istraživanje je obuhvatilo 30 bolesnika s osteoartritisom temporomandibularnog zgloba (prosječne dobi 52,6 godina). Svi bolesnici pregledani su klinički manualnom funkcijskom analizom i uporabom magnetske rezonancije. Kriterij kojim su obuhvaćeni bolesnici bili su: bol vezan za temporomandibularni zglob i/ili krepitacija u istom zglobu. Drugu skupinu činilo je 20 asimptomatskih studenata dentalne medicine (prosjek dobi 23,5 godina). Postojala je statistički značajna razlika između degenerativnih promjena kondila zglobova bolesnika s i bez znakova osteoartritisa (p=0,009). U 28% osteoartritičnih zglobova bila je deplanacije zglobnih površina kondila, kao i u 17,4% zglobova bez kliničkih znakova osteoartritisa. Osteofitične tvorbe pronađene su u 8% asimptomatskih i 25,7% osteoartritičnih zglobova bolesnika. Postojala je statistički značajna razlika među zglobovima bolesnika s i bez osteoartritisa (p=0,0003): izraženi gubitak kontura i izražena sklerozacija zglobne kvržice nađeni su u 12% zglobova bez osteoartritisa i 42,9% zglobova s osteoartritisom. Nije bilo razlike između zglobova studenata i zglobova bolesnika bez osteoartritisa (p=0,804). Najčešći nalaz na snimkama osteoartritičnih zglobova bile su skleroza kondila i osteofitične tvorbe.