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Case 214618

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Referral category

Temporomandibular joints (TMJ)

Region of interest

TMJ

Referral reason

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Canaray 214618

Degenerative joint disease in the left TMJ

The superior surface of the left condylar head exhibits remodelling and is flattened. An osteophyte may be forming on the anterior surface of the left condylar head. Erosions are also visible at the superior posterior aspect of the left condylar head. This appearance is suggestive of the presence of mild degenerative joint disease in the left temporomandibular joint. The right condylar head does not exhibit any signs of osseous degeneration, but appears to be slightly posteriorly positioned within the glenoid fossa in the mandibular closed position, which may be a sign of an anteriorly displaced articular disc.

No significant changes to condylar head position with bite registration

In the bite registration position, the right condylar head remains slightly posteriorly positioned within the glenoid fossa. The left condylar head is slightly anteriorly positioned relative to its position in maximum intercuspation.

Hypermobility of joints in mandibular open position

In the mandibular open position, both condylar heads translated to positions anterior and superior to the crests of the articular eminences. This is representative of joint hypermobility, and there may be increased risk of an open lock developing.

Overlays of all three scans demonstrating right TMJ positions

All three scans were overlaid. Maximum intercuspation is shown in greyscale. The bite registration shown in greenscale. The maximal open position is shown in redscale.

Overlays of all three scans demonstrating left TMJ positions

All three scans were overlaid. Maximum intercuspation is shown in greyscale. The bite registration shown in greenscale. The maximal open position is shown in redscale.

1. Widened PDL space on tooth 15

The periapical periodontal ligament space on the endodontically-treated tooth 15 is widened. The tooth appears adequately obturated. This may represent a healed post-treatment appearance with an apical scar or persistent low-grade endodontic pathology. Endodontic sealer has been extruded through the apical foramen of the tooth and is retained within the alveolar process. This represents a non-significant incidental finding. The remaining periradicular bone appears normal. There are no signs of a root fracture.

2. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.

3. Mild cervical degenerative joint disease

Small osteophytes and mild subchondral sclerosis are present in the articular regions of the Atlas and dens of the cervical vertebrae. This is a common incidental finding with no clinical significance that is suggestive of mild cervical degenerative joint disease.

4. Physiologic intracranial calcification

A midline physiologic calcification is present intracranially. This is an incidental finding with no significance.