Three-dimensional Cone-beam Computed Tomography Analysis of Temporomandibular Joint Morphology in Complete Denture versus Implant-supported Prosthesis Patients

Introduction: Edentulism can lead to adverse alterations in temporomandibular joint (TMJ) morphology and condylar position due to the loss of occlusal support. This observational study aimed to evaluate three-dimensional TMJ morphological characteristics in edentulous patients rehabilitated with conventional complete dentures compared to implant-supported fixed prostheses using cone-beam computed tomography (CBCT) over a 2-year period. Materials and Methods: Sixty edentulous patients (aged 45–75 years) were divided equally into two groups: Group A (30 patients wearing conventional complete dentures for ≥ 6 months) and Group B (30 patients using implant-supported fixed prostheses for ≥ 6 months). Standardised bilateral CBCT scans were performed in maximum intercuspation to measure condylar volume, joint space dimensions (anterior, superior, and posterior), sagittal condylar angulation, condylar morphology, and joint space asymmetry. Data were statistically analysed using independent t-tests, Mann–Whitney U-tests, and Chi-square tests with significance set at P < 0.05. Result: Patients with implant-supported prostheses showed significantly higher mean condylar volume (1.87 ± 0.21cm 3 vs 1.63 ± 0.19 cm 3 ) and superior joint space (2.92 ± 0.31 mm vs. 2.65 ± 0.28 mm) compared to complete denture patients ( P < 0.05$). Normal condylar shape was preserved in 80% of implant patients compared to 57% of denture wearers ( P < 0.05). Complete denture patients exhibited significantly greater joint space asymmetry >0.5 m (40% vs. 13%) and increased sagittal condylar angulation (14.6° ± 2.4° vs. $12.8° ± 2.1°, P < 0.05). Conclusion: Implant-supported prostheses significantly better preserve anatomical TMJ morphology, joint space dimensions, condylar volume, and structural symmetry over 2 years. In contrast, conventional complete dentures are associated with higher condylar remodelling, dimensional loss, and joint asymmetry.