Bone Changes in the Temporomandibular Joint: A Retrospective Cone Beam Computed Tomography Study

Objectives: To analyze the prevalence of bone changes in the temporomandibular joint (TMJ) and describe their distribution regarding age and sex using Cone Beam Computed Tomography (CBCT). Methods: This retrospective study analyzed CBCT images of 483 individuals (326 females, 157 males) retrieved from a computer database and assessed using the iCAT Workstation. Right and left condyles were evaluated for the presence of flattening, osteophytes, sclerosis, erosion, and subchondral cysts. Pearson's chi-square test was used to identify potential associations between these alterations and demographic variables (p < 0.05). Results: At least one TMJ alteration was observed in 91.5% of the participants. Flattening was the most frequent finding (76.4%), followed by osteophytes (53%), sclerosis (32.3%), erosion (20.1%), and subchondral cysts (2.7%). No statistically significant association was found between gender and the presence of alterations (p > 0.05), with a high prevalence in both females (91.1%) and males (92.4%). However, specific degenerative changes showed a significant upward trend with age: osteophytes increased from 43.9% in patients under 20 to 68.9% in those over 60, while erosion doubled from 12.2% to 24.4% in the same groups (p < 0.05). Alterations were slightly more frequent on the left side (81.6%) than on the right side (76.6%). Conclusions: Degenerative TMJ changes are highly prevalent in the studied population, with flattening appearing as a widespread finding across all groups. While some specific alterations, such as osteophytes and erosion, show an increased prevalence in older age groups, these associations reflect a descriptive trend of bone remodeling over time rather than a direct causal relationship.