Evaluation of temporomandibular joint morphology and osteoarthritic changes across different sagittal skeletal patterns using cone-beam computed tomography

To evaluate temporomandibular joint (TMJ) morphology and osteoarthritic findings in individuals with different sagittal skeletal patterns using cone-beam computed tomography (CBCT) and to investigate the relationships among these parameters. This retrospective study included CBCT images of 90 patients equally allocated into skeletal Class I, Class II, and Class III groups according to the ANB angle. Condylar morphology was classified as convex, flat, round, or angled, whereas glenoid fossa morphology was categorized as oval, triangular, trapezoidal, or angled. Condylar mediolateral width and anteroposterior (AP) diameter were measured on axial sections. Osteoarthritic changes, including erosion, osteophyte formation, subchondral sclerosis, generalized sclerosis, and subchondral cysts, were recorded. Statistical analyses were performed using IBM SPSS Statistics version 27.0, with statistical significance set at p < 0.05. Convex was the most common condylar morphology (37.2%), followed by flat (27.8%), round (20.0%), and angled (15.0%) types. The oval glenoid fossa was the predominant morphology (67.8%). A significant association was observed between condylar and glenoid fossa morphologies bilaterally, with convex and round condyles most frequently associated with an oval glenoid fossa and angled condyles with a trapezoidal glenoid fossa ( p < 0.001). Individuals with skeletal Class III exhibited significantly greater condylar mediolateral width than those with skeletal Class II ( p < 0.05). Condylar dimensions showed a weak positive correlation with age and were significantly greater in males than females ( p < 0.05). Radiographic osseous changes were identified in 18.9% of patients and 12.8% of TMJs, with erosion being the most frequent finding No statistically significant associations were detected between the presence of radiographic osseous changes and skeletal class, age, sex, or morphological parameters ( p > 0.05). In the analyzed cohort, CBCT demonstrated that TMJ morphology, particularly condylar mediolateral dimensions, varies according to sagittal skeletal pattern, whereas no statistically significant association was detected between radiographic osseous changes and skeletal class. The clinical implications of these findings require further investigation.