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Could Crepitus Be an Indication for Early Temporomandibular Joint Osteoarthritis?
J Oral Med Pain 2019;44:45-53
Published online June 30, 2019;  https://doi.org/10.14476/jomp.2019.44.2.45
© 2019 Korean Academy of Orofacial Pain and Oral Medicine

Hye-Min Ju1, Sun-Hee Lee1, Hye-Mi Jeon2, Kyung-Hee Kim3, Yong-Woo Ahn4, Soo-Min Ok4, Sung-Hee Jeong4

1Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea, 2Department of Oral Medicine, Pusan National University Hospital, Busan, Korea, 3Department of Oral Medicine, Inje University Busan Paik Hospital, Busan, Korea, 4Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University, Yangsan, Korea
Correspondence to: Sung-Hee Jeong Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea Tel: +82-55-360-5242 Fax: +82-55-360-5238 E-mail: drcookie@pusan.ac.kr https://orcid.org/0000-0002-6296-4775
Received March 25, 2019; Revised April 8, 2019; Accepted April 8, 2019.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: To determine whether crepitus may be a clinical indication for early temporomandibular joint (TMJ) osteoarthritis (OA) and to investigate the correlation between crepitus and the occurrence of TMJ OA with respect to factors, such as patient sex, age, chewing habits, and diagnosis.
Methods: This is retrospective analysis of clinical data for 162 TMJs. The criteria for a joint to be included in this study was a minimum of two cone-beam computed tomography (CBCT) scans performed with no OA observed during the initial scan. The Diagnostic Criteria for Temporomandibular Disorders was used for OA diagnosis. Crepitus was recorded when it was objectively palpated during the follow-up period. Correlations between various patient factors and progression to TMJ OA were calculated using the Pearson’s chi-square test. A linear-by-linear association was used to analyze trends of OA progression with increasing age.
Results: Among the 162 joints, 101 progressed to OA and 61 did not. In the joints where crepitus had been present before OA was confirmed at next or last CBCT, OA progressed at a high rate, and especially higher in female and older patients (p<0.01). Patients in the painrelated disorder group with crepitus were observed to have higher rates of OA progression compared to patients in the intra-articular disorder group (p<0.01).
Conclusions: If a patient experiences pain in the TMJs and crepitus, close monitoring through regular CBCT scans is necessary even if there is no evidence of radiologically confirmed OA after the first CBCT.
Keywords : Crepitus; Early osteoarthritis; Temporomandibular joint; The Diagnostic Criteria for Temporomandibular Disorders


June 2019, 44 (2)