Subchondral bone alterations in temporomandibulat joint arthralgia negatively affect the functional results of stabilization appliance therapy. A retrospective exploratory cohort study

Temporomandibular disorders (TMDs) are a major public health issue because it affects general health, and social and economic well-being. Some studies have suggested that occlusal splint therapy can be helpful for a group of patients with TMD pain. The purpose of this exploratory study was to evaluate the impact of condylar subchondral bone alterations (SBAs) on the 6-month functional results of temporomandibular joint (TMJ) arthralgia patients who were managed with a 3 mm resilient splint therapy. In total, 109 consecutive patients with a unilateral Diagnostic Criteria for TMD (CD/TMD) diagnosis of arthralgia were included in this retrospective cohort study. Following clinical examination, each patient underwent cone beam computed tomography to assess the degree of condylar osteoarthritic changes. Pretherapeutic functional results were compared with the 6-month follow-up results when the Jaw Functional Limitation Scale-20 (JFLS-20) was applied. According to all 3 JFLS domains, age, sex, pain intensity and duration had no effect on functional outcome. Compared with patients with mild (grade 1) condylar SBAs, patients with severe (grade 3-4) condylar SBAs had significantly worse outcomes as measured by the JFLS-mastication scores (p = 0.005). The results indicate that baseline condylar SBA grade potentially plays a role in the prediction of which arthralgia patients would show less pronounced improvement during a 6-month follow-up. Ongoing research is warranted to assess the proposed CBCT-based scoring metric for application in clinical trials and medical practice for patients with TMJ arthralgia.