A Study to Assess the Temporomandibular Joint Variations in Digital Computed Tomography–A Cross-Sectional Study

Abstract Background: The temporomandibular joint (TMJ) is a complex synovial articulation facilitating mastication, phonation, and deglutition. Understanding TMJ morphology and morphometry is essential to differentiate physiological remodeling from pathological changes. Cone Beam Computed Tomography (CBCT) provides precise three-dimensional evaluation of osseous structures with minimal distortion and radiation exposure. Aim: This study aimed to assess age- and gender-related morphological and morphometric variations of the TMJ using CBCT in an Indian population, establishing normative reference data. Materials and Methods: A cross-sectional observational study was conducted on CBCT scans of participants divided into three age groups: 20–39, 40–59, and ≥60 years. Morphological features—condylar flattening, cortical sclerosis, erosion, and osteophyte formation—were recorded. Morphometric measurements included condylar height, width, volume, and anterior, superior, and posterior joint spaces bilaterally. Data were analyzed using descriptive and inferential statistics. Pearson correlation assessed age-morphometry relationships, while intra- and inter-observer reliability was evaluated using intraclass correlation coefficient (ICC). Results: Condylar flattening (23%) and sclerosis (17.3%) were the most common morphological changes. Condylar height, width, and volume decreased significantly with age (p < 0.05). Superior and posterior joint spaces narrowed with age, while anterior space remained stable. Condylar height showed the strongest negative correlation with age (r = –0.372, p < 0.001). Males had significantly larger condylar dimensions and fossa depth than females (p < 0.05), with no significant gender difference in joint space. Intra- and inter-observer reliability was excellent (ICC > 0.90). Conclusion: TMJ morphology and morphometry vary with age and gender. CBCT provides reliable quantitative assessment, aiding in distinguishing adaptive remodeling from early pathology and offering essential normative data for clinical reference in diagnosis and treatment planning.