Impact of Clinical Features on Radiographic Progression of Degenerative Joint Disease: A Retrospective Cone Beam Computed Tomography Study.

Abstract

Objective: To retrospectively evaluate the association between clinical features and long-term radiographic progression in temporomandibular joint (TMJ) degenerative joint disease (DJD).

Methods: We included 198 TMJs from 104 patients diagnosed with DJD (119 TMJs) or indeterminate DJD (79 TMJs). These patients underwent an initial cone beam computed tomography (CBCT) scan and at least one follow-up CBCT scan at least 1 year later. Demographic information, oral behaviours, chief complaints and clinical examination findings were collected.

Results: Radiographic progression was observed in 33% of DJD and 24% of indeterminate DJD cases during a median follow-up period of 680 days. Teeth clenching (HR = 3.58), disc displacement without reduction (HR = 2.49), limited mouth opening > 3 months (HR = 1.87), and maximum incisal opening < 35 mm (HR = 4.98) appeared to be significant risk factors for DJD progression. Angle Class II malocclusion (HR = 0.49) might be a protective factor for progression of DJD. Time-dependent receiver operating characteristic (ROC) analysis showed area under the curve (AUC) values ranging from 0.74 to 0.88 over 3 years, with a survival tree model predicting DJD progression with 72% accuracy.

Conclusion: Clinical features significantly correlate with DJD progression. The multivariate and survival tree analyses provide moderate predictive accuracy, which could contribute to early identification and management of patients at risk. Further multicentre validation is still required.