Flattening of the articular eminence is associated with the loss of occlusal support: radiological study

Abstract

Background Degenerative changes in the temporomandibular joint might be associated with ageing and/or with the loss of occlusal support. Objective The aim of the study was to evaluate whether the inclination of the posterior slope of the articular eminence changes in association with: (i) ageing in patients with maintained occlusal support zones (OSZs); and (ii) the loss of OSZs in elders. Methods In this retrospective radiological study, selected orthopantomograms were allocated into the following groups: I—age 18–35, maintained OSZs, II—age 36–60, maintained OSZs, III—age >60, at least one OSZ per side maintained, IV—age >60, loss of all OSZs. The inclination of the articular eminence was measured relative to the Frankfort plane. Results The mean values of the inclination of the slope of the articular eminence amounted 34.05° ± 5.17°, 36.68° ± 5.65°, 34.86° ± 6.26° and 26.31° ± 5.12° for group I, II, III and IV respectively. There were no significant differences between the groups I to III. Group IV differed significantly from each of the previous groups. Conclusions Flattening of the articular eminence is associated with the loss of OSZs rather than ageing.

Factors influencing the articular eminence of the temporomandibular joint (Review)

“…Interestingly enough, it was also published that there could be a correlation between flattening of the AE and a subject's age ( 53 ), but complete edentulism leads to accentuated flattening of the posterior slope of the AE than physiological changes caused by age ( 53 ). Plus, a recent paper reported no statistically significant differences in the angulation values of the posterior slope of the AE between participants of different ages which presented maintained occlusal support zones at the time of the study ( 54 ). After analyzing 170 orthopantomograms, Oruba et al did not confirm a correlation between AEI and age ( 54 ).…”

“…Plus, a recent paper reported no statistically significant differences in the angulation values of the posterior slope of the AE between participants of different ages which presented maintained occlusal support zones at the time of the study ( 54 ). After analyzing 170 orthopantomograms, Oruba et al did not confirm a correlation between AEI and age ( 54 ). As no significant AEI modifications were described in older people with at least one occlusal support zone per side, Oruba et al concluded that ageing seems not to influence AEI when occlusal support zones are present ( 54 ).…”

“…Recently, an analysis of the effects of edentulism on the TMJ determined lower mean AEI in orthopantomograms of edentulous subjects compared to panoramic radiographs of dentate participants in the study (23). As well, results of another 2020 radiological study indicated a major diminution of AEI in the elderly (>60 years of age) with no dental occlusion (54). Important flattening of the AE was observed in older individuals with loss of all occlusal support zones in contrast to elderly in which at least one occlusal support zone per side was still maintained (54).…”

“…After analyzing 170 orthopantomograms, Oruba et al did not confirm a correlation between AEI and age ( 54 ). As no significant AEI modifications were described in older people with at least one occlusal support zone per side, Oruba et al concluded that ageing seems not to influence AEI when occlusal support zones are present ( 54 ). Hence, alterations in the morphology of the AE such as flattening of the posterior slope of the AE have been associated more with missing teeth/loss of occlusal support zones than with the physiological processes of ageing in itself, which is normally taking place in the TMJ of older patients ( 53 , 54 ).…”

“…Edentulism may cause modifications in the masticatory biomechanics, which may lead consequently to changes in the AE ( 23 , 32 , 49 , 53 , 54 ). Several research groups described finding reduced AEI values in edentate patients compared to dentate ones ( 23 , 32 , 49 , 53 , 54 ).…”