Is There an Association between Temporomandibular Disorders and Articular Eminence Inclination? A Systematic Review

Abstract

(1) Background: In order to determine the correlation between the inclination of articular eminence (AEI) and the development of temporomandibular disorders (TMDs), a systematic review was performed. (2) Methods: A systematic literature research was conducted between 1946 and January 2020, based on the following electronic databases: PubMed, Cochrane Library, Embase, Medline, Scope, SciELO, and Lilacs. Observational studies, analytical case-control studies, and cohort studies written in English were identified. The articles were selected and analyzed by two authors independently. The PICO format was used to analyze the studies and the Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. (3) Results: Sixteen articles were included in this review, ten case-control studies and six cohort studies. Eight articles (50%) established a positive relation between AEI and TMDs and eight (50%) did not. The scientific quality was medium-low, mainly influenced by the exposure to the risk of bias and the lack of clinical methods with adequate consistency and sensitivity on the diagnosis of TMDs. (4) Conclusions: It is controversial to establish a causal relationship between the TMDs and the AEI in the field of stomatology, due to limited and inconclusive evidence. However, it is suggested that the AEI defined by some specific methods may be associated with some special pathological stages of TMDs. High-quality prospective studies are required to draw any definitive conclusions.

Temporomandibular Joint Osseous Morphology of Class I and Class II Malocclusions in the Normal Skeletal Pattern: A Cone-Beam Computed Tomography Study

“…This may lead the mandible to move more vertically during the functional movement [6]. It is reported that a patient with steeper articular eminence is more likely to develop internal dysfunctions, such as anterior disk displacements, than a patient with a flatter articular eminence [7,8].…”

Evaluation of Articular Eminence Morphology in Patients with Spontaneous Temporomandibular Joint Dislocation Using Cone Beam Computed Tomography

“…However, not all patients with dislocation possess a steep AE slope. There have been many studies on the treatment of dislocation [7,8,10] or the relationship between the morphology of AE and disc displacement [11][12][13][14][15][16][17][18][19][20], but almost no studies have been found on the relationship between the morphology of AE and dislocation except for the study of Cohen et al [21]. In their study [21], the morphology of AE did not affect the anterior dislocation of the TMJ.…”

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

“…Two slopes have been described for the AE: the anterior slope (the non-articular slope) and the posterior slope (the articular slope, also known as the articular surface), the latter being covered by fibrocartilage. Of uttermost importance is the fact that the condylar process slides forward and downward along the posterior slope of the AE as the mandible moves anteriorly (7,13,14). The inclination of the path traversed by the condyle in relation to the AE during a protrusive or a contralateral mandibular movement is known as the condylar path/condylar guidance (15)(16)(17)(18).…”

“…In terms of function, the TMJ allows maximal free motion (it is a diarthrosis) ( 2 , 6 ), but also permits both hinging and gliding movements of the mandible within the three planes of space ( 7 ). Therefore, as the TMJ is considered a bicondylar diarthrosis, the two articular surfaces are represented by the condyle of the mandible and the bony eminence on the temporal bone (the articular tubercle or the articular eminence (AE) of the temporal bone) ( 2 , 6 ).…”

“…Widman even described an inverse relationship between the angle of the AE and the occlusal and mandibular planes and stated that the Frankfort horizontal plane-AE angle may be useful in orthodontic treatment ( 20 ). As the inclination of the AE dictates the trajectory of the condyle ( 13 ), modifications in the AE angulation might result in biomechanical variations of the TMJ ( 7 , 21 ). The particular morphological patterns encountered at bone levels may predispose to affections or complications ( 22 ).…”