Skip to main content
NCBI home page
Clinical and Experimental Dental Research logoLink to Clinical and Experimental Dental Research
. 2024 Jan 30;10(1):e845. doi: 10.1002/cre2.845

The effect of tooth loss on the temporomandibular joint space: A CBCT study

Salma Tabatabaei 1, Maryam Paknahad 1,✉, Mahdi Poostforoosh 2
PMCID: PMC10826233  PMID: 38345478

Abstract

Objective

The tooth loss has a significant impact on the positioning of the condyle in the glenoid fossa and joint spaces of the temporomandibular joint (TMJ). The aim of this study was to assess the association between tooth loss and TMJ spaces using cone beam computed tomography (CBCT) images.

Materials and Methods

This retrospective investigation involved the evaluation of CBCT images of the bilateral TMJs in a cohort of 111 individuals, comprising 68 males and 43 women. The dentition of the patients was categorized into three categories, including A (65.4%), B (19.1%), and C (16.4%), based on the Eichner index. Anterior, superior, and posterior joint spaces were then measured in sagittal views. The Kruskal–Wallis test and Mann–Whitney test were employed to identify significant differences among the three Eichner groups.

Results

The findings of the present study suggested that there was no statistically significant variation in the anterior joint space among different Eichner groups within the general population (p = .781). Nevertheless, the superior and posterior joint spaces exhibited statistically significant alterations, as indicated by p‐values of .039 and .010, respectively. It was detected that condyles were positioned inferiorly and posteriorly in group C when compared to groups A and B.

Conclusion

The present study indicated that greater loss of tooth‐supporting zones is associated with posterior and inferior displacement of condyles. Understanding these relationships helps emphasize how crucial it is to replace missing teeth to enhance occlusion support and, in turn, stop the progression and further deterioration of temporomandibular disorders.

Keywords: cone‐beam computed tomography, Eichner index, mandibular condyle, temporomandibular joint spaces

1. INTRODUCTION

The temporomandibular joint (TMJ) is a multifaceted synovial articulation that connects the mandibular condyle to the glenoid fossa and articular eminence of the temporal bone (Whyte et al., 2021). The radiographic joint space refers to the radiolucent region that exists between the mandibular condyle and the temporal bone (Paknahad, Shahidi, Iranpour, et al., 2015). The clinical importance of joint space holds considerable significance since the existence of a proper joint space is essential for facilitating unrestricted movement of the condyle in conjunction with the articular disc (Mallya, 2019). Changes in condylar position over time can lead to structural modifications of the TMJ surfaces, triggering symptoms of temporomandibular joint disorders (TMD), such as discomfort and dysfunction (Ammanna, 2009).

The interrelationship between the anatomical and physiological aspects of the TMJ is closely associated with each constituent of the masticatory apparatus (Ammanna, 2009). The teeth have a crucial role in establishing a secure vertical and distal relationship between the mandible and maxilla. Additionally, they serve as guiding planes for the anterior and lateral movement of the jaw throughout the range of motion where the teeth are in contact (Shehab et al., 2011).

The Eichner index, which was designed by Karl Eichner, is a commonly used dental index that finds application in epidemiological research within the field (Hiltunen et al., 2002; Paknahad, Khojastepour, et al., 2023). This index has been found to be beneficial in establishing intermaxillary connections and extending functional dental invalidity. According to this index, the posterior teeth can be categorized into four support zones, which are determined by the presence or absence of occlusal contact between the premolars and molars (Paknahad, Khojastepour, et al., 2023; Paknahad et al., 2002).

Several studies have shown that tooth loss can greatly affect the TMJ morphology in several ways. The absence of posterior teeth, in particular, and the subsequent loss of the occlusal curve can disrupt the balance between adaptation and functional harmony, leading to impaired functionality (Shehab et al., 2011). Furthermore, the loss of teeth might have an impact on the inclination of the articular eminence through the process of remodeling (Shehab et al., 2011).

Regarding the impact of tooth loss on the TMJ spaces, it has been shown that the reduction in vertical facial height due to tooth wear and tooth loss might lead to the posterior and superior displacement of the condyles inside the joint space (Hongchen et al., 1992). According to a study conducted by Yanikoglu and Guldag (2006), it was found that patients with bilateral loss of posterior tooth‐supporting regions have a reduction in the anterior, superior, and posterior joint spaces, as compared to patients with unilateral posterior tooth‐supporting area. Similarly, a study conducted by Amorim et al. (2003). revealed a significant reduction in the posterior joint space following the loss of posterior teeth. Despite the observed alterations in TMJ joint spaces in previous studies, in a study conducted by Arıkan et al. (2022) evaluating the anterior, superior, and posterior joint spaces in dentate individuals compared to edentulous patients, no statistically significant differences were identified in any of the evaluated joint spaces. The presence of debates in this area presents a challenge in establishing a definitive conclusion regarding the impact of tooth loss on alteration in joint space within the TMJ. Radiographic examination is an integral component of the clinical examination in patients with TMDs. Several imaging modalities have been utilized to visualize the TMJ, such as plain film radiography, conventional tomography (CT), computed tomography, cone‐beam tomography, and magnetic resonance imaging (MRI). Cone beam computed tomography (CBCT) is a developing technique that is being progressively more used in dentomaxillofacial imaging due to its relatively low‐dose, high‐spatial‐resolution characteristics (D'Angeli et al., 2020; Sırlı Yılmazturk et al., 2023). This modality provides accurate and reliable linear measurements for imaging of dental and maxillofacial structures. These measurements are extremely beneficial in clinical practice when treating patients with TMD. Hence, CBCT is the modality of choice for the assessment of temporomandibular osseous structures (Paknahad & Shahidi, 2015; Paknahad et al., 2016).

Due to ongoing controversy as well as the use of two‐dimensional radiography as a main modality of choice for image analysis in the majority of previous studies, the principal objective of this study attempt was to investigate the potential correlation between tooth loss and the TMJ space using CBCT images.

2. MATERIALS AND METHODS

The current investigation received approval from the Institutional Research Committee under the reference number IR.SUMS.DENTAL.REC.1402.004. The CBCT images of 111 patients were analyzed in this study, 68 (61.8%) females and 43 (38.2%). It's worth noting that the images were originally taken for different purposes. The patients' ages ranged from 19 to 83 years old (45.73 ± 16.93). Patients with a history of temporomandibular surgery, acute trauma, severe skeletal malocclusion, congenital abnormalities, musculoskeletal, or neurological disorders, and any systemic diseases that could affect joint morphology, such as rheumatoid arthritis, were all excluded from the study. All participants signed an informed consent that their anemone data may be used in further research.

2.1. Tooth loss recordings

The patient's dentition was categorized into four primary occlusal supporting zones based on the occluding pairs seen in the posterior teeth (two premolars and two molars). In class A, there is contact among all four supporting zones. In class B, one supporting zone is absent, or all four supporting zones are lost, but the anterior region remains intact. Class C is characterized by the absence of occlusal contact between the remaining teeth (Figure 1). This study classified both fully and partially erupted permanent teeth as “present teeth.” Furthermore, it should be noted that the supernumerary teeth, third molars, pontics of bridge prostheses, and implant‐supported superstructures were not counted as present teeth.

Figure 1.

Figure 1

Open in a new tab

Classifications of Eichner index.

2.2. CBCT of TMJs

The bilateral TMJ CBCT images were taken using a New Tom VGi (NewTom) imaging equipment. Imaging settings included 110 KVp voltage peak, 3.05 mA current, and 3.6 s exposure. The images were taken in standard resolution mode (0.3 voxels). The imaging fields were 15 × 15 cm, with patients standing erect; patients were asked to bite down in their maximal intercuspal position. The Frankfort plane maintained parallel alignment with the floor when their heads were positioned. The NewTom Cone Beam 3D imaging system workstation (NNT Software version 6.2) was used to process TMJ images. The evaluation of the CBCT scans was conducted using a high‐resolution Barco‐China monitor in a specialized reporting room with proper viewing conditions, including a dimly illuminated environment.

2.3. Joint space measurement

The focus of the data reconstruction was on the TMJ. The axial view displaying the condylar process with the greatest mediolateral diameter was selected for secondary reconstruction. A line parallel to the longitudinal axis of the condylar process was drawn on this image. Corrected sagittal slices were then reconstructed using a slice interval and thickness of 0.5 mm. On the central sagittal section, the narrowest posterior (P), anterior (A), and superior joint space values were assessed accurately on both the left and right sides. All CBCT images were measured by an oral and maxillofacial radiologist (Figure 2).

Figure 2.

Figure 2

Open in a new tab

Linear measurement of posterior (A), superior (s), and anterior (C) subjective closest joint spaces in a sample patient. (a) Axial view and (b) corrected sagittal view.

2.4. Statistical analyses

Statistical calculations were performed using SPSS (version 25). To assess the presence of significant observer errors during measurement, the same operator remeasured all CBCT images 2 weeks later. The intraclass correlation coefficient (ICC) was utilized to evaluate the congruence between the initial and subsequent assessments. To evaluate the interoperator method error, a random sample comprising roughly 30% of the acquired data was chosen and afterward remeasured by another oral and maxillofacial radiologist. The final data were subsequently subjected to comparison through the utilization of ICCs. The Kruskal−Wallis test and Mann−Whitney test were employed to identify significant differences regarding joint spaces among the three groups. The χ 2 test was used to determine whether there was a significant association between joint spaces and Eichner groups, considering different gender and age groups. The significance level was set at p = .05.

3. RESULTS

The resulting inter‐class correlation coefficient (ICC) value of 0.967 indicates a substantial level of agreement between the initial and subsequent measurements, thereby validating the reliability of the measures. Furthermore, a notable degree of agreement was noted among the operators for all measurements (ICC ≥ 0.90).

The result of this study showed that the anterior joint space was not significantly different between the three groups. However, superior and posterior joint spaces were significantly different between the three groups. It was shown that condyles were posteriorly and inferiorly positioned in group C and compared to group A (Table 1).

Table 1.

Descriptive statistics and comparison of variables among three Eichner classifications.

Eichner groups
Joint space A B C p Value
Anterior 1.9 (1.6 ± 2.5) 2 (1.6 ± 2.65) 1.95 (1.5 ± 2.77) .781
Superior 2.4 (2 ± 2.8)c 2.5 (2.25 ± 3.32) 2.9 (1.9 ± 3.27) .039*
Posterior 2.45 (1.42 ± 3)C 2.1 (1.5 ± 3.2) 1.7 (1.5 ± 2.3) .010*
Open in a new tab

Note: Post hoc: A and C → superior joint space → p = .033, A and C → posterior joint space → p = .026.

*

Significant.

There was a significant association between condylar position and Eichner index in male and female patients. In female patients, the condyles tended to be located more posteriorly and inferiorly in group C than in group A (Table 2).

Table 2.

Descriptive statistics and comparison of variables among three Eichner classifications in female patients.

Eichner groups
Joint space A B C p Value
Anterior 1.7 (1.5 ± 2.1) 1.9 (1.5 ± 2.5) 1.8 (1.5 ± 2.9) .672
Superior 1.8 (1.9 ± 2.8)c 1.9 (1.5 ± 2.57) 2.7 (2.22 ± 3.52) .014*
Posterior 2.7 (1.6 ± 3.77)c 1.7 (1.5 ± 2.3) 1.6 (1.22 ± 2.85) .047*
Open in a new tab

Note: Post hoc: A and C → superior joint space → p = .011, A and C → posterior joint space → p = .043.

*

Significant.

In male patients, the condyles were positioned more posteriorly in group C compared to group A (Table 3).

Table 3.

Descriptive statistics and comparison of variables among three Eichner classifications in male patients.

Eichner groups
Joint space A B C p Value
Anterior 1.7 (1.5 ± 2.27) 2.6 (2.32 ± 3.10) 2 (1.62 ± 2.37) .318
Superior 2.15 (1.72 ± 2.8) 3 (2.22 × 3.30) 1.9 (1.5 ± 2.7) .259
Posterior 2.7 (1.85 ± 3.07)c 2.6 (2.32 ± 3.4) 2.05 (1.22 ± 2.67) .024*
Open in a new tab

Post hoc: A and c → posterior joint space → p = .024.

*

Significant.

Based on different age groups, a significant association was found between Eichner groups and joint space in adult and elderly patients. In adult patients, the condyle tends to be positioned more inferiorly in Eichner group C compared to group A. In elderly patients, the condyle was located more posteriorly in group C than in group B (Table 4).

Table 4.

Descriptive statistics and comparison of variables among three Eichner classifications in different age groups.

Eichner groups
Age group Joint space A B C p Value
Young adult (18−35) Anterior 1.9 (1.52 ± 2.5) 1.3 (1.1 ± 0.00) 0 .079
Superior 2.4 (1.9 ± 2.7) 2.25 (1.9 ± 0.00) 0 .887
Posterior 1.7 (1.35 ± 2.10) 1.5 (0.9 ± 0.00) 0 .645
Adult (35−65) Anterior 1.9 (1.6 ± 2.4) 2 (1.6 ± 2.45) 2.25 (1.42 ± 3.52) .604
Superior 2.1 (2.12 ± 3.00)c 2.20 (1.5 ± 2.7) 3 (2.4 ± 3.43) .029*
Posterior 1.7 (1.52 ± 2.37) 2.15 (1.5 ± 3.2) 2 (1.27 ± 2.35) .344
Elderly (>65) Anterior 1.85 (1.70 ± 3.82) 2.7 (1.47 ± 3.12) 3.10 (2.8 ± 0.00) .0490
Superior 3.75 (3.6 ± 0.00) 2.75 (1.45 ± 3.25) 2.62 (1.97 ± 3.32) .164
Posterior 3 (3.0 ± 3.0)c 2.45 (1.65 ± 3.17) 1.6 (1.5 ± 2.62) .034*
Open in a new tab

Post hoc: A and c (adult group) → superior joint space → p = .031, B and C (elderly group) → anterior joint space p = .04.

*

Significant.

4. DISCUSSION

It is imperative to recognize that the analysis of condylar positioning in clinical settings holds significant importance in identifying factors that may increase the likelihood of TMJ disorders in the future (Abdel‐Fattah, 1989; Crawford 1999; Padmanabhan et al., 2012). The findings of our investigation revealed a correlation between the extent of tooth loss and the displacement of the condylar head within the glenoid fossa. When compared to fully dentate patients, it was discovered that condyles were located more posteriorly and inferiorly in group C in both genders.

Consistent with our findings indicating a reduction in the posterior joint space among edentulous individuals, a study was conducted by Amorim et al. (2003); it revealed that the absence of posterior dental support can lead to a decrease in the posterior joint space. Additionally, it has been postulated that this phenomenon may increase the likelihood of anterior disk displacement and subsequent TMD. This finding is additionally supported by Yanikoglu and Guldag (2006), who have also provided evidence that individuals with Class I Kennedy classification (characterized by bilateral loss of posterior tooth support) exhibit significantly smaller values in the posterior joint space compared to individuals with Class II Kennedy classification (characterized by unilateral loss of posterior tooth support). In contrast to our research, Arikan et al. (2022) conducted a study in which they found no significant impact on the posterior joint space due to the presence or absence of teeth. Despite the utilization of the CBCT technology in their investigation and the similarity in measuring techniques with the current study, the observed dissimilarity can be attributed to morphological changes that may arise from ethnic differences across the studies.

Regarding the inferior displacement of the condyle in edentulous individuals compared to dentate participants, previous studies have yielded conflicting outcomes. According to the research conducted by Yanikoglu and Guldag (2006), it was observed that the superior joint space in individuals with Kennedy Class I is comparatively less than those with Kennedy Class II. This finding was further corroborated in the study conducted by Rokni and Ismail (1979), wherein it was revealed that the superior joint space in edentulous patients is comparatively smaller than that observed in dentate individuals. Yanikoglu and Guldag (2006) have explained that as a result of tooth loss, the condylar head tends to move backward and upward, which would decrease the superior joint space. In contrast to the aforementioned findings, Arikan et al. (2022) have demonstrated that there is no statistically significant disparity in superior joint space between edentulous patients and dentate persons. However, upon evaluating the mean values in the study conducted by Arikan et al. (2022), it was observed that the mean values of the superior joint space were comparatively higher in edentulous patients in comparison to dentate persons. The discrepancy between the findings of the aforementioned research and the current investigation may be ascribed to variations in the duration of tooth loss experienced by the patients. Over an extended duration, there is an increased likelihood of morphological remodeling occurring in the skeletal structures of the TMJ. According to Rosado et al. (2021), there is a notable decrease in bone volume in the glenoid fossa among those who are edentulous. Furthermore, a further investigation conducted by Chen et al. (2022) revealed that the loss of teeth, even unilaterally, can lead to a reduction in condyle bone volume in an in vivo experimental model. Hence, the duration of edentulism may influence the morphological alterations of the condylar process and, consequently, its positioning within the TMJ.

Concerning the impact of age on the measured joint spaces in different Eichner groups, it was found that young adults (18−35) did not exhibit any difference among the Eichner groups when analyzing the joint spaces. It should be pointed out that group C of the Eichner classification did not exist in this age group. On the other hand, the adult patients (35−65) only showed significant changes in the quantities of the superior joint space, which was lowest in group A patients, followed by group B and group C. In the analysis of the elderly patients (<65), it was found that only the posterior joint space values indicated a statistically significant difference between the Eichner groups. Posterior joint space was found to be significantly higher in group C compared to groups A and B. Based on the theoretical speculations, it is hypothesized that the most affected parameters in the elderly (<65) patients are the posterior joint space values due to the higher degree of the loss of vertical dimension in these patients.

In the study by Yanikoglu and Guldag (2006), it was revealed that the age of edentulous patients was only associated with an anteroposterior position of the condyle, which would further impact the anterior and posterior joint spaces. This finding aligns with our research findings about the statistical significance of the posterior joint space in elderly individuals.

To assess various specific variables in the TMJ space, several radiographic modalities have been used, including plain film radiography (Gharge, Ashwinirani, & Sande, 2020; Jalalian & Alaei, 2020), CT (Gupta et al., 2020), computed tomography (Meng et al., 2021; Song et al. 2020), CBCT (Bertram et al., 2018; Shahidi et al., 2018), and MRI (Ertem et al., 2020; Mazza et al., 2020). Since conventional radiography, such as panoramic radiography, has the limitation of converting a 3D space into a 2D image, calculating the exact values of joint space could be really challenging and even unreliable. Besides, the 1−3 mm thickness of slices limits the accuracy of careful examination of condylar morphology. On the other hand, MRI could be a useful approach when assessing soft tissue with limited applicability in hard tissue evaluation. In this regard, CT and CBCT are considered the most effective methods of assessing the joint spaces, while CBCT holds the advantage of submillimeter spatial resolution, which makes it an ideal approach for high spatial resolutions (Paknahad & Shahidi, 2015).

In the present study, the pontics of bridge prostheses and implant‐supported superstructures were not counted as present teeth. The Eichner index classifies the intermaxillary connections of the posterior teeth based on the “naturally existing teeth.” This method of classification has been considered in many previous studies (Esfehani et al., 2022; Paknahad, Barzegar, et al., 2023; Paknahad, Khojastepour, et al., 2023; Yoshino et al., 2012). Few studies considered fixed prostheses in the premolar and molar regions as the constitution for occlusal support (Mathew et al., 2011; Sakakibara et al., 2014). However, the results can be altered by the presence of fixed implant‐supported restorations in the posterior jaws. Therefore, the first method of classification was chosen in this study.

The objective of this study was to investigate the potential correlation between TMJ spaces and the Eichner index. However, it is important to note that certain variables, such as the duration between tooth extraction and imaging, as well as oral habits, were not taken into consideration throughout the evaluation process. Furthermore, increasing the sample size and incorporating the Eichner subclassification of patients could enhance the study's quality and facilitate the identification of potential subtle correlations. To validate or challenge the findings of the current study, it is imperative to undertake more research while considering these criteria.

5. CONCLUSION

The results of this study suggested that the anterior joint space in TMJ is not associated with the degree of patients' tooth loss; nevertheless, posterior and superior joint spaces are directly associated with the degree of posterior tooth loss. These modifications have the potential to cause disturbance in the harmony of TMJ and the stomatognathic system. Hence, by recognizing these impacts, it becomes increasingly viable to preserve the equilibrium in the TMJ and stomatognathic system by prompt restoration of the missing teeth.

AUTHOR CONTRIBUTIONS

Study conception and design: Maryam Paknahad. Data collection: Mahdi Poosforoosh. Analysis and interpretation of results: Maryam Paknahad. Draft manuscript preparation: Maryam Paknahad. All authors reviewed the results and approved the final version of the manuscript.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

ACKNOWLEDGMENTS

The present study was based on the thesis conducted by Mehdi Poostforoosh. The authors thank Dr. Asmari for the statistical analysis. The authors are employed at an academic or research institution where research or education is the primary function of the entity. The authors have no funding to report.

Tabatabaei, S. , Paknahad, M. , & Poostforoosh, M. (2024). The effect of tooth loss on the temporomandibular joint space: A CBCT study. Clinical and Experimental Dental Research, 10, e845. 10.1002/cre2.845

DATA AVAILABILITY STATEMENT

Data that support the findings of this study are available from the corresponding author upon reasonable request.

REFERENCES

  1. Abdel‐Fattah, R. A. (1989). Optimum temporomandibular joint (TMJ) condylar position. Today's FDA: Official Monthly Journal of the Florida Dental Association, 1(3), 1. [PubMed] [Google Scholar]
  2. Ammanna, S. M. (2009). A tomographic study of the mandibular condyle position in partially edentulous population. Rajiv Gandhi University of Health Sciences. [DOI] [PubMed] [Google Scholar]
  3. Amorim, V. C. P. , Laganá, D. C. , Eduardo, J. V. P. , & Zanetti, A. L. (2003). Analysis of the condyle/fossa relationship before and after prosthetic rehabilitation with maxillary complete denture and mandibular removable partial denture. The Journal of Prosthetic Dentistry, 89(5), 508–514. [DOI] [PubMed] [Google Scholar]
  4. Arıkan, B. , Dedeoğlu, N. , & Burak Duman, Ş. (2022). Assessment of the effects of edentulousness on temporomandibular components by using cone beam computed tomography. Journal of Dentistry Indonesia, 29(3), 160–164. [Google Scholar]
  5. Bertram, F. , Hupp, L. , Schnabl, D. , Rudisch, A. , & Emshoff, R. (2018). Association between missing posterior teeth and occurrence of temporomandibular joint condylar erosion: A cone beam computed tomography study. The International Journal of Prosthodontics, 31(1), 9–14. [DOI] [PubMed] [Google Scholar]
  6. Chen, C. P. , Zhang, J. , Zhang, B. , Hassan, M. G. , Hane, K. , Chen, C. C. , Navarro Palacios, A. A. , Kapila, S. , Jheon, A. H. , & Goodwin, A. F. (2022). Unilateral loss of maxillary molars in young mice leads to bilateral condylar adaptation and degenerative disease. JBMR Plus, 6(7), e10638. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Crawford, S. D. (1999). Condylar axis position, as determined by the occlusion and measured by the CPI instrument, and signs and symptoms of temporomandibular dysfunction. The Angle Orthodontist, 69(2), 103–115. [DOI] [PubMed] [Google Scholar]
  8. D'Angeli, G. , Messineo, D. , Riminucci, M. , Corsi, A. , Celli, M. , Vozza, L. , & Sfasciotti, G. L. (2020). The characteristics of adjacent anatomy of mandibular third molar germs: A CBCT pilot study in patients with osteogenesis imperfecta in Healthcare. Healthcare, 8(4), 372. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Ertem, S. Y. , Konarılı, F. N. , & Ercan, K. (2020). Does incidence of temporomandibular disc displacement with and without reduction show similarity according to MRI results? Journal of Maxillofacial and Oral Surgery, 19, 603–608. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Esfehani, M. , Tofangchiha, M. , Poorsayyah, N. , Rahimi, H. , Kholafazadeh, S. , Radfar, S. , Pagnoni, F. , Reda, R. , & Testarelli, L. (2022). Relationship between posterior permanent dentition pattern and radiographic changes of the mandibular condyle. Methods and Protocols, 5(6), 97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gharge, N. R. , Ashwinirani, S. , & Sande, A. (2020). Comparison of temporomandibular changes in edentulous and dentulous patients using digital panoramic imaging. Journal of Oral Research and Review, 12(1), 17–22. [Google Scholar]
  12. Gupta, A. , Jain, D. , & Sampath, S. (2020). Conventional and contemporary diagnostic tools in temporomandibular disorders—An overview. International Journal, 3, 716. [Google Scholar]
  13. Hiltunen, K. , Vehkalahti, M. M. , Peltola, J. S. , & Ainamo, A. (2002). A 5‐year follow‐up of occlusal status and radiographic findings in mandibular condyles of the elderly. The International Journal of Prosthodontics, 15(6), 539–543. [PubMed] [Google Scholar]
  14. Hongchen, L. , Jilin, Z. , & Ning, L. (1992). Edentulous position of the temporomandibular joint. The Journal of Prosthetic Dentistry, 67(3), 401–404. [DOI] [PubMed] [Google Scholar]
  15. Jalalian, E. , & Alaei, M. M. (2020). Evaluation of radiographic changes of mandibular condyle and its relationship with age, joint disorders and eichner's model.
  16. Mallya, L. E. S. (2019). White and Pharoah's oral radiology E‐book: Principles and interpretation: Second South Asia edition E‐book. Elsevier. [Google Scholar]
  17. Mathew, A. L. , Sholapurkar, A. A. , & Pai, K. M. (2011). Condylar changes and its association with age, TMD, and dentition status: A cross‐sectional study. International Journal of Dentistry, 2011, 1–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Mazza, D. , Di Girolamo, M. , Cecchetti, F. , & Baggi, L. (2020). MRI findings of working and non‐working TMJ during unilateral molar clenching on hard bolus. Journal of Biological Regulators and Homeostatic Agents, 34(3 Suppl 1), 1–8. [PubMed] [Google Scholar]
  19. Meng, Q. , Liu, M. , Deng, W. , Chen, K. , Wang, B. , Zhang, X. , & Chen, Z. (2021). Calcium‐suppressed technique in dual‐layer detector computed tomography to evaluate knee articular cartilage. Current Medical Imaging Formerly Current Medical Imaging Reviews, 17(3), 433–438. [DOI] [PubMed] [Google Scholar]
  20. Padmanabhan, S. , Padala, S. , & Chithranjan, A. (2012). Comparative evaluation of condylar position in symptomatic (TMJ dysfunction) and asymptomatic individuals. Indian Journal of Dental Research, 23(1), 122. [DOI] [PubMed] [Google Scholar]
  21. Paknahad, M. , Barzegar, Z. , & Mohaghegh, M. (2023). Evaluation of the relationship between condylar bony changes and condylar bone density in the temporomandibular joint structures: A CBCT study. Oral Surgery, 16(4), 336–341. [Google Scholar]
  22. Paknahad, M. , Khojastepour, L. , Tabatabaei, S. , & Mahjoori‐Ghasrodashti, M. (2023). Association between condylar bone changes and eichner index in patients with temporomandibular dysfunction: A cone beam computed tomography study. Journal of Dentistry, 24(1), 12–18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Paknahad, M. , & Shahidi, S. (2015). Association between mandibular condylar position and clinical dysfunction index. Journal of Cranio‐Maxillofacial Surgery, 43(4), 432–436. [DOI] [PubMed] [Google Scholar]
  24. Paknahad, M. , Shahidi, S. , & Abbaszade, H. (2016). Correlation between condylar position and different sagittal skeletal facial types. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie, 77(5), 350–356. [DOI] [PubMed] [Google Scholar]
  25. Paknahad, M. , Shahidi, S. , Iranpour, S. , Mirhadi, S. , & Paknahad, M. (2015). Cone‐beam computed tomographic assessment of mandibular condylar position in patients with temporomandibular joint dysfunction and in healthy subjects. International Journal of Dentistry, 2015, 1–6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Rokni, A. , & Ismail, Y. H. (1979). Radiographic comparative study of condylar position in centric relation and centric occlusion. The Journal of Prosthetic Dentistry, 41(4), 395. [DOI] [PubMed] [Google Scholar]
  27. Rosado, L. P. L. , Barbosa, I. S. , Junqueira, R. B. , Martins, A. P. V. B. , & Verner, F. S. (2021). Morphometric analysis of the mandibular fossa in dentate and edentulous patients: A cone beam computed tomography study. The Journal of Prosthetic Dentistry, 125(5), 758. e1–758. e7. [DOI] [PubMed] [Google Scholar]
  28. Sakakibara, A. , Hashikawa, K. , Yokoo, S. , Sakakibara, S. , Komori, T. , & Tahara, S. (2014). Risk factors and surgical refinements of postresective mandibular reconstruction: A retrospective study. Plastic Surgery International, 2014, 1–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Shahidi, S. , Salehi, P. , Abedi, P. , Dehbozorgi, M. , Hamedani, S. , & Berahman, N. (2018). Comparison of the bony changes of TMJ in patients with and without TMD complaints using CBCT. Journal of Dentistry, 19(2), 142–149. [PMC free article] [PubMed] [Google Scholar]
  30. Shehab, M. M. , Jameel, N. G. , & Hatim, N. A. (2011). Temporomandibular joint assessment of pre and post prosthetic treatment of par‐tially edentulous patient (radiographic examination). Al‐Rafidain Dental Journal, 11(1), 12–23. [Google Scholar]
  31. Song, H. , Lee, J. Y. , Huh, K. H. , & Park, J. W. (2020). Long‐term changes of temporomandibular joint osteoarthritis on computed tomography. Scientific Reports, 10(1), 6731. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Sırlı Yılmazturk, S. , Bozdemir, E. , Orhan, K. , & Orhan, H. (2023). Evaluation of morphological and morphometric characteristics of the temporomandibular joint in children with different skeletal models in the sagittal and vertical direction. Oral Radiology, 1–10. [DOI] [PubMed] [Google Scholar]
  33. Whyte, A. , Boeddinghaus, R. , Bartley, A. , & Vijeyaendra, R. (2021). Imaging of the temporomandibular joint. Clinical Radiology, 76(1), 76.e21–76.e35. [DOI] [PubMed] [Google Scholar]
  34. Yanikoglu, N. , & Guldag, M. U. (2006). Analysis of the condyle/fossa relationship in Kennedy class I and II partially edentulous subjects. Oral Health and Dental Management, 5, 50–56. [Google Scholar]
  35. Yoshino, K. , Kikukawa, I. , Yoda, Y. , Watanabe, H. , Fukai, K. , Sugihara, N. , & Matsukubo, T. (2012). Relationship between Eichner index and number of present teeth. The Bulletin of Tokyo Dental College, 53(1), 37–40. [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

Data that support the findings of this study are available from the corresponding author upon reasonable request.

Articles from Clinical and Experimental Dental Research are provided here courtesy of Wiley

RESOURCES