Quantitative Analysis of Temporomandibular Joint Adaptations After One Year of Complete Denture Use: A Cone-Beam Computed Tomography Study.

INTRODUCTION

Alterations in occlusal relationships in individuals with complete edentulism considerably disrupt the equilibrium of the stomatognathic system. Evaluation of the temporomandibular joint (TMJ) is crucial during the edentulous phase, as it influences both aesthetic and functional outcomes. This investigation sought to assess alterations in condylar positioning one year after the placement of complete dentures in edentulous patients, with additional objectives to examine variations based on sex and side.

MATERIALS AND METHODS

This cross-sectional prospective cohort investigation was carried out in the Department of Prosthodontics, involving 15 participants who were systemically healthy, aged between 45 and 60 years, completely edentulous for a minimum duration of one year, and were first-time denture recipients. Following denture insertion, a one-year follow-up evaluation of condylar positioning was conducted using cone-beam computed tomography (CBCT). Analyses were performed on the intercondylar angle, interocclusal gap, and TMJ space (anterior, posterior, superior, and medial). Statistical evaluations were performed using paired and independent t-tests. The significance threshold was set at P < 0.05.

RESULTS

The mean ages of the male and female participants were 55.43 years and 56.38 years, respectively. Significant changes were observed in the TMJ spaces and condylar dynamics at the one-year follow-up. The posterior, superior, and medial joint spaces decreased significantly (p = 0.001), indicating the posterior, superior, and medial displacement of the condyle. The interocclusal gap increased significantly from 1.47 mm in males and 1.51 mm in females at denture insertion to 1.79 mm and 1.80 mm, respectively, at follow-up (p = 0.001). The intercondylar angle significantly decreased (p = 0.001). Sex-based differences were noted in the medial joint space and condylar angle on the left side, with larger mean changes in males (p < 0.05). Side-based differences revealed greater superior space, medial space, and condylar angle on the right side than on the left (p < 0.05).

CONCLUSION

This investigation revealed substantial morphometric alterations in the TMJ spaces and condylar positioning following one-year post-complete denture placement, characterized by pronounced increases in interocclusal gap and reductions in intercondylar angle. Consistent monitoring and prompt repair or replacement of dentures are essential for preserving the TMJ integrity and occlusal equilibrium in edentulous individuals.