Anterior Disc Displacement and Cortication Patterns in the Temporomandibular Joint

BACKGROUND Anterior reduction disc displacement (ARDD) of the temporomandibular joint (TMJ) can present with pain and clicking of the jaw when chewing. This study aimed to evaluate the relationship between articular eminence cortication (AEC) and mandibular condyle cortication (MCC) in 81 patients with ARDD of the TMJ using cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS We examined images of 142 patients who applied to the outpatient clinic between 2022 and 2024 for various reasons and whose radiographic records included CBCT and MRI images. Sixty-one patients who did not meet the inclusion criteria were excluded from the study. MRI images of the remaining 81 patients were analyzed and evaluated for the presence of ARDD. Subsequently, all mandibular condylar processes and articular eminences included in the study were examined by CBCT and the degree of cortication was classified and noted. The relationship between MCC and AEC and ARDD was evaluated with the SPSS 23.0 program (SPSS, Chicago, IL, USA). RESULTS ARDD was observed in 46 (28.4%) of 162 condyles examined. Type 1 cortications were observed in 8 (17.4%), type 2 in 36 (78.3%), and type 3 in 2 (4.3%) of the condyles with disc displacement; 80.0% (8) of type 2 cortications were found in patients with ARDD (P<0.001), and 75.0% of type 3 cortication was observed in intact condyles (P<0.001). CONCLUSIONS This study shows that loss of AEC and MCC may be a significant factor in the diagnosis of ARDD, and decreased AEC and MCC may be a criterion for the diagnosis of ARDD.