Identifying Idiopathic Osteoarthritis of the TMJs

Idiopathic Osteoarthritis of the TMJ's occurs in about 20% of adolescent orthodontic patients. Most of these patients are asymptomatic! In about 50% of patients demonstrating hard tissue changes of the TMJ's, growth of the facial skeleton will also be affected. As practicing orthodontists we need to be aware of which patients are at risk and what are the signs that may indicate that a problem may exist that would preclude normal orthodontic treatment results. This lecture will highlight the signs of IOA of the TMJ's using routine orthodontic records as well as 3D imaging (CBCT). It will also help to identify when the orthodontist should delay the initiation of orthodontic treatment until the TMJ's become more stable.

Learning Objectives:

• Identify possible growth changes to the facial skeleton secondary to IOA of the TMJ's using routine 2D radiographs.
• Identify and distinguish the different stages of IOA of the TMJ's on CBCT scans.
• Differentiate between stable vs unstable TMJ's in order to manage the timing orthodontic treatment.