A Radiographic Study of Condylar Morphological Abnormalities in Patients at the Dr. René Puig Benz Dental Clinic (UNPHU).
Description
Morphological abnormalities affecting the mandibular condyles are significant in dentistry because of their relationship with dental occlusion and temporomandibular joint (TMJ) function. Panoramic radiography is a widely used imaging method in dentistry thanks to its low cost and availability. It provides a comprehensive view of dental and maxillofacial structures. This type of imaging allows for clear visualization of the anatomical features of the temporomandibular joint (TMJ), including the mandibular condyle and the glenoid cavity, as well as the detection of significant bone abnormalities.This study examines relevant factors, such as sex, age, types of mandibular condyle morphological abnormalities, affected condyle side, and type of edentulism, as well as their evaluation using panoramic radiography. These factors made it possible to identify potential associations between clinical factors and radiographic manifestations of temporomandibular disorder (TMD).This study aimed to determine the prevalence of these abnormalities in patients evaluated via radiographs at the Dr. René Puig Benz Dental Clinic (UNPHU). Of the 2,227 panoramic radiographs evaluated, 937 (42%) showed condylar morphological abnormalities. The most common abnormality was flattening (85%), while other abnormalities occurred less frequently. Female patients were more frequently affected by these abnormalities. The age group with the highest prevalence of condylar abnormalities was 21 to 30 years old. Statistical analysis revealed no direct association between tooth loss and the occurrence of these morphological abnormalities. In conclusion, panoramic radiography is a useful tool for identifying these abnormalities, allowing for early detection.
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The study was conducted in the radiology department of the Dr. René Puig Benz Dental Clinic at the Pedro Henríquez Ureña National University (UNPHU). A total of 2,227 panoramic X-rays were included in the study.The sample size consisted of 937 panoramic radiographs of patients with an identifiable morphological abnormality of the condyle.The information was collected using a data collection form based on the medical records and panoramic X-rays of patients who met the inclusion criteria. Abnormalities of the mandibular condyles, type of condylar morphology, type of abnormality, side of the affected condyle, sex, and age were identified, among other factors. The systematic collection and measurement of the study data were performed exclusively through the visual analysis of digital panoramic radiographs. In the first instance, the sociodemographic variables were obtained directly from the technical data embedded in each radiograph's digital file; sex was recorded using a dichotomous nominal scale (male or female), whereas age was computed in completed years at the time of the examination, subsequently proceeding to its grouping into chronological intervals to optimize the descriptive statistical processing. In the second instance, the diagnosis and characterization of the bone structures were executed through direct observation of the images by a calibrated observer, initially determining the presence or absence of macrostructural changes in the temporomandibular joint to establish the frequency of morphological alterations of the mandibular condyles, the results of which were expressed using absolute frequencies and percentages to define the overall prevalence of the sample. Upon detection of a condylar anomaly, it was qualitatively categorized on a nominal scale according to pre-established radiographic criteria, classifying the type of morphological alteration into flattening, bifid condyle, erosion, osteophytes, or hypertrophy; likewise, the topography of the lesion was identified through the variable affected mandibular condyle side, recording whether the condition presented a unilateral (right or left) or bilateral presentation. Lastly, the patient's dentition status was evaluated directly on the same radiographic image by verifying the presence or absence of teeth to determine if the patient was edentulous, which allowed for the classification of the type of edentulism into three mutually exclusive categories: dentate, partial edentulism, or total edentulism, thereby consolidating a standardized data matrix for subsequent inferential analysis. The data obtained were presented in tables and frequency charts. These were processed using Microsoft Word and Excel to facilitate understanding of the results of the study. The results were organized according to the objectives of the study and presented in tables and graphs with appropriate descriptions.
Institutions
- Universidad Nacional Pedro Henríquez UreñaNacional, Santo Domingo