Marie Mansour

Abstract

The purpose of this research was to determine a prevalence of degenerative joint disease in our pre-orthodontic adolescent patients age ten through seventeen. The prevalence was assessed according to gender. Severity of DJD was established for each patient and a "red flag" for diagnosis was identified. The purpose was also to establish norms for joint space for patients with and without degenerative joint disease. Correlations to distal condyle position and angle classification were described. 123 consecutive patients, 77 female and 46 male T1 NewTom records were reviewed. Severity of DJD was classified according to none, mild, moderate, and severe. Sagittal anterior, middle, and posterior measurements, and coronal medial pole, middle, and lateral pole measurements of joint space were made to establish norms. Distal condyle was assessed from sagittal sections and Angle classification was assessed from models.

A Chi-square analysis revealed there was no significant difference in prevalence between males and females. The prevalence of DJD was 15.6% for females and 13% for males. Norms for mean joint space were established for coronal sections in non-DJD subjects and were 2.5 for anterior, 1.8 for middle, and 2.2 for posterior. Mean joint space in patients with DJD for coronal sections was 2.7 for medial pole, 2.1 for middle, and 2.4 for lateral pole. Mean joint space for sagittal sections for non-DJD subjects was 1.8 for medial pole, 1.7 for middle, and 1.8 for lateral pole. Mean joint space for sagittal sections for patients with DJD was 2.2 for anterior, 1.8 for middle, and 2.0 for posterior. A t-test revealed a significant difference between DJD patients and non-DJD patients for mean sagittal anterior joint space. A chi-square analysis showed in the patients positive for signs of DJD, they were more likely to have a distal condyle than not, and if patients did not have DJD, they were more likely to not have a distal condyle. The chi-square value was large and significant (p < .001). 44.4% of DJD versus 12.4% of non-DJD subjects had a distal condyle. Angle classification and prevalence of patients with signs of DJD were described. 17.5% of all Class I,15.2% of all Class II div 1, 0% of all Class II div 2, and 10% of all Class III displayed radiographic signs of DJD. Lastly, frequency of the severity of the signs of DJD was determined to establish a "red flag" for the clinician to diagnose radiographic signs of DJD, which was flattening of the condyle, and there was no difference according to gender for this sign. Radiographic signs of DJD were prevalent in our pre-orthodontic adolescent sample and norms were established for joint space. A distal condyle relationship and the relationship of Angle Classification to signs of DJD were described, and a red flag was established. This increased prevalence will make clinicians aware of the greater potential for our adolescent orthodontic patients to have signs of degenerative joint disease.

LLU Discipline

Orthodontics and Dentofacial Orthopedics

Department

Orthodontics and Dentofacial Orthopedics

School

Graduate School

First Advisor

Joseph M. Caruso

Second Advisor

Ruel C. Bench

Third Advisor

James Farrage

Fourth Advisor

Ross H. Tallents

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

2004

Date (Title Page)

9-2004

Language

English

Library of Congress/MESH Subject Headings

Temporomandibular Joint Disorders; Osteoarthritis; Joint Diseases; Adolescent

Type

Thesis

Page Count

viii; 110

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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