Temporomandibular Joint Osteoarthritis Exacerbates with Restored Teeth: A Cadaveric Case Repor

The objective of this case report is to begin to investigate the correlations between gross signs and symptoms of osteoarthritis (OA) on cadaveric temporomandibular joints (TMJs) and the restorative care a patient experienced prior to death. Two cadaveric donors (88-years-old male and 93-years-old female) were investigated by classical dissection for gross symptoms of OA on the mandibular condyle and the mandibular fossa using a validated scale for OA disease severity. A Grade 0-4 disease severity score was awarded to the unilateral condyle and mandibular fossa for each patient. An oral exam was performed to assess restorative changes to the dentition. Both patients demonstrated Grade 4 (severe) OA on the mandibular fossa and condyle. This is a finding documented to only affect 23% (7/31) of a previous research cohort of donors; the mandibular fossa typically presents with more severe disease findings compared to the condyle. These specific donors were selected for TMJ disease assessment as a preliminary oral examination revealed substantial restorative findings. Excluding removal of the third molars, the male donor was charted to have 1 missing tooth and 11 restored teeth whereas the female donor was charted to have 17 missing teeth and 11 restored teeth. The 93-years-old female demonstrated a visibly more profound state of disease on the fossa and condyle of the TMJ compared to any other donor assessed by this protocol to date; the fossa demonstrated complete cartilage loss with a substantial concavity on the articular eminence, the condyle was flattened and the articular disc was effectively absent minus a thin fibrocartilaginous ring. It could be concluded that this substantial degree of TMJ OA disease severity, based on this specific validated scale, may relate to a high quantity of restored teeth and may manifest uniformly between the sexes.