[Clinical and cone-beam CT analysis of 368 patients with temporomandibular joint disc perforation in different age groups].

PURPOSE

The aim of this study was to investigate the clinical characteristics of disc perforation (DP) of temporomandibular joint (TMJ) at different ages. METHODS：Patients with TMJ disc perforation admitted to the Department of Trauma and Temporomandibular Joint Surgery Stomatological Hospital of Wuhan University, from April 2012 to May 2021 were included in this study. They were divided into 6 groups according to different ages. Clinical and CBCT radiographic features were analyzed. Clinical features included maximal interincisal opening, pain, clicking，and occlusal changes. Imaging features included condylar absorption flattening, hyperplasia or osteophyte formation, sclerosis, subchondral cysts, depression defects, and blurred anterior slope. The clinical and imaging characteristics of patients in different age groups were statistically analyzed. SPSS 26.0 software was used for statistical analysis, and Chi-square test was used to compare the distribution of clinical symptoms and imaging features in patients of different ages.

RESULTS

A total of 368 patients were collected, including 24 males, with an average age of 27.63±15.90 years. There were 344 females with an average age of 32.61±15.61 years. The incidence of pain was 21.31%, occlusal change was 50.82%, and condylar absorption flat was 50.82% in the 10-19 age group. The incidence of pain in 20-29 age group was 31.06%, occlusal change was 53.42%, and condylar absorption flattening was 45.34%. In 50-59 age group, the incidence of pain was 83.33%, occlusal changes were 2.38%, and hyperplasia or osteophyte formation was 47.62%. In age group ≥60 years old, the incidence of pain was 82.86%, occlusal changes were 2.86%, and hyperplasia or osteophyte formation was 60%.

CONCLUSIONS

In terms of clinical features, patients under 40 years old are more likely to have occlusal changes, while patients over 40 years old are most likely to have joint pain. Radiographically, patients under 40 years old are mainly characterized by bone loss in the condyle, while patients over 40 years old are mainly characterized by condylar hyperplasia.