Condylar osseous changes following conservative therapies: A cone-beam computed tomography longitudinal study on adult patients with degenerative temporomandibular joint disease

Abstract

This retrospective study aimed to comprehensively investigate the impact of non-surgical treatments on condylar osseous changes in adult patients with degenerative joint disease (DJD). Radiographic and clinical data were collected for analysis. Cone-beam computed tomography (CBCT) was used to diagnose DJD, including flattening, erosion, osteophytes, sclerosis and cysts. Condylar osseous changes were divided into three classifications: progression, stability and remission. Kaplan-Meier analyses were performed to evaluate progression-free probability. Hazard ratios (HRs) of overall and specific DJD progression were calculated with multivariate Cox analysis. Hyaluronic acid (HA) injection significantly reduced the progression-free probability (P = 0.0312). HRs of progression after stabilization splint (SS) treatment within one year, glucosamine treatment within six months and HA injection was 3.41 (95% CI: 1.70–6.84; P = 0.0005), 0.35 (95% CI: 0.14–0.86; P = 0.0226), and 1.84 (95% CI: 1.06–3.20; P = 0.0313), respectively. HRs of progression of flattening, erosion, osteophyte, and sclerosis adjusted for gender and age after HA injection were 2.77 (95% CI: 1.32–5.81; P = 0.0071), 2.12 (95% CI: 1.09–4.10; P = 0.0264), 3.38 (95% CI: 1.08–10.54; P = 0.0361) and 2.78 (95% CI: 1.02–7.52; P = 0.0447) respectively. HA injection and SS treatment were possible risk factors for TMJ deterioration, while glucosamine treatment was possible protective factor against TMJ deterioration.