Axial Condyle Morphology and Horizontal Condylar Angle in Patients with Internal Derangement Compared to Asymptomatic Volunteers

ABSTRACT

The purpose of this study was to evaluate the possible structural variations of axial condyle morphology and horizontal condylar angle between patients with internal derangement and asymptomatic volunteers. Forty-five symptomatic patients and 31 asymptomatic volunteers (AV) were included in this study. All subjects had bilateral high-resolution magnetic resonance imaging scans. Axial condyle morphology was evaluated using these images and classified into four diagnostic groups: convex, flat, and concave anterior surfaces, and tapered form. The angulation between the condylar long axis and the transversal plane was then measured. A Wilcoxon-Whitney-Mann-U-test demonstrated no significant differences in the horizontal angulation of the patients with disk displacement with reduction (DDR) (24.35 ± 9.31) as compared to patients with displacement without reduction (DDN) (25.61 ± 10.11) and asymptomatic volunteers (25.68 ± 9.31) (AV). Eighty percent of the flat type condyles and 73.3% of the tapered type condyles belonged to the symptomatic patients with disk displacement with reduction (DDR) and without reduction (DDN). Chi-square test demonstrated significant differences between the diagnostic groups of condyle types (p<0.01). A comparison of the angular difference of right and left joints of asymptomatic volunteers and patients using the Wilcoxon-Whitney-Mann-U test showed that the results of the asymptomatic volunteers were significantly lower (p = 0.05). The conclusion that an increase in the horizontal condylar angle is a predisposing factor for the development of internal derangement or that the derangement develops during the prognosis of the disorder could not be clearly stated based on the results of this study. It is proposed that the difference between condyle morphology in patients with disk displacement and asymptomatic volunteers may be a result of the remodeling or degeneration caused by the disorder.

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Notes on contributors

Tonguç Sülün

Dr. Tonguç Sülün received his Dr.Med. Dent. degree at the University of Istanbul in 1999 and is currently a research assistant in the Department of Prosthodontics, Dental Faculty. University of Istanbul. His research interests include predisposing factors of the temporomandibular joint (TMJ) to internal derangement and analysis of TMJ anatomy in magnetic resonance images.

Begüm Akkayan

Dr. Begüm Akkayan received his Dr. Med.Dent. degree in 1997 from the University of Istanbul, Faculty of Dentistry, Department of Fixed Prosthodontics. She is currently a full-time research assistant in the same department. She is a member of the European Prosthodontics Association, International College of Prosthodontics, and she is currently serving as the General Secretary of the Turkish Prosthodontics and Implantology Association. Dr. Akkayan's areas of interest include conical crown retained dentures, occlusion, and all-ceramic systems.

Jean-Marc Pho Duc

Dr. Jean-Marc Pho Due received a D.D.S. degree in 1991 from the University of Regensburg, Germany. He is currently an Associate Professor in the Department of Prosthodontics, University of Munich. Dr. Pho Duc is interested in gnathology and magnetic resonance imaging technique.

Peter Rammelsberg

Dr. Peter Rammelsberg received a D.D.S. degree in 1986 and was an Assistant Professor from 1985–1986 in the Department of Periodontics, University of Würzburg, Germany and an Associate Professor in the Department of Prosthodontics and TMD, University of Regensburg and the University of Munich, Germany from 1986–1994. Dr. Rammelsberg is currently a Professor in the Department of Prosthodontics and TMD, University of Munich, Germany since 1995. His primary research interests are occlusion, magnetic resonance imaging technique, and temporomandibular joint disk displacements.

Necat Tuncer

Dr. Necat Tuncer is currently a Professor at the Department of Prosthodontics, Faculty of Dentistry, University of Istanbul, Turkey. He is also the Director of the Dental Technician Education Program. He has many scientific publications including a book on gnathology. His primary research interests are gnathology and occlusion.

Wolfgang Gernet

Dr. Wolfgang Gernet is the Head of the Department of Prosthodontics and TMD, University of Munich, Germany since 1990. He received a D.D.S. degree in 1974 and attended as an Assistant Professor from 1975–1981 at the University of Freiburg. Following the completion of his Ph.D. degree in 1980 he served as the Head of the Department of Prosthodontics and TMD, University of Regensburg, Germany between 1984–1990. He was elected as the Dean of the Faculty of Medicine, University of Regensberg from 1987–1989 and also served as the Head of the Ethics Committee of the Faculty of Medicine, University of Munich. Dr. Gernet received an honorary degree in 1998 from the University of Istanbul, Turkey. He has published numerous scientific articles, and TMD is his primary research interest.