Radiographic signs of osteoarthritis in the temporomandibular joint among young adults and associated imaging factors: A cone-beam computed tomography study

Background: This study aims to determine the prevalence of radiographic signs of osteoarthritis in the Temporomandibular Joint (TMJ) among young adults and to identify the associated imaging factors using Cone-Beam Computed Tomography (CBCT) in a population from Arequipa, Peru. Material and Methods: This cross-sectional study involved the analysis of 311 CBCT scans from young adults aged 18 to 40 years. To ensure high image quality and comprehensive clinical data, we applied specific inclusion and exclusion criteria in the study. We evaluated radiographic signs of condylar osteoarthritis, which included flattening, erosion, sclerosis, osteophytes, and subchondral cysts. Additionally, we examined several predictor factors, including sex, age, and two associated imaging factors such as edentulism, and occlusal wear. Furthermore, examiner training and calibration were conducted with the Kappa concordance test. We performed descriptive, bivariate, and multivariate statistical analyses using the chi-square test and binary logistic regression (p<0.05). Results: The prevalence of condylar changes indicative of osteoarthritis was significantly high. Flattening was observed in 30.2% of cases, erosion in 16.1%, and sclerosis in 10.3%. There was a notable association between condylar pathologies and sex; specifically, a significant association was observed between condylar sclerosis and female sex, occurring in 14.1% of women compared to 4.2% of men (p = 0.003). Furthermore, both age (Exp(B) = 1.071; p = 0.001) and edentulism (Exp(B) = 4.353; p < 0.001) significantly influenced the presence of condylar flattening. Similarly, age (Exp(B) = 1.050; p = 0.041) and edentulism (Exp(B) = 2.630; p = 0.024) also affected condylar erosion. Additionally, the occurrence of condylar sclerosis was influenced by age (Exp(B) = 1.067; p = 0.044) and edentulism (Exp(B) = 4.276; p = 0.008). Conclusions: The findings suggest that temporomandibular osteoarthritis can develop moderately in early adulthood, primarily characterized by condylar flattening, erosion, and sclerosis. The data indicate that certain predictor variables, such as sex, reveal that condylar sclerosis is more commonly observed in females. Additionally, age and edentulism are significant factors linked to changes in the condyle, including condylar flattening, erosion, and sclerosis.