الفهرس 
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Abstract
The temporomandibular joint (TMJ) is the most complex joint
in the body due to anatomical and functional considerations that
make it predisposed to different pathological changes that can be
expressed in a range of signs and symptoms. Detailed history taking and thorough clinical examination are
essential in dealing with TMJ problems. Accurate diagnosis of
TMJ dysfunction can’t be based on clinical examination only and
that the clinicians can’t achieve proper and accurate diagnosis
without applying certain radiographic imaging methods.
Therefore, radiographic imaging is mandatory for achieving
accurate diagnosis. Numerous imaging modalities have been used to evaluate the
osseous component of TMJ. CBCT was considered the most
accurate and excellent imaging modality to investigate TMJ
osseous components. It provides two dimension multiplanar
reformatted images with submillimeter spatial resolution and
allows the observer to customize the slices interactively by using
a volumetric data set. It was found that reduction or absence of posterior teeth
support considered an important predisposing factor for TMD.
Moreover, correlation between absence of posterior support and osteoarthrosis of the TMJ was reported in several studies. On the
other hand, it has been concluded that absence of molar support
only is of little importance in the etiology of TMD. Controversies
regarding the effect of inadequately supported occlusion or
missing teeth on TMJ are reported in the literature Consequently, the main issue in the current study was to
evaluate TMJ bony changes in patients with inadequately
supported occlusion (where three or more functional molars were
missing) by CBCT in comparison with sex and age matching
volunteers with adequately supported occlusion and to make
correlation between clinical and radiographic findings among
patient group. Forty TMJs in twenty subjects were included in this study and
divided into two groups; one including ten TMJs of patients with
inadequately supported occlusion (group 1), while the other
group (group 2) comprised another ten TMJs of sex and age
matching volunteers with adequately supported occlusion. Both
groups were subjected to detailed clinical examination and
accurate radiographic examination by CBCT. The two groups
were 10% males with ages ranging between 20-40 years. All subjects were subjected to history taking, clinical
examination and radiographic analysis of TMJs using CBCT. All
images were statistically analyzed to reveal radiographic TMJ bony changes and linear measurements of condyle, glenoid fossaand joint space and to correlate between the clinical and CBCTfindings. There were no significant differences in most of the CBCT
radiographic findings between patients with inadequately
supported occlusion and healthy volunteers with adequately
supported occlusion. Meanwhile, there were significant
differences in condyle position and width between patients and
volunteers as revealed from CBCT images. Also, there was no
statistically significant correlation between clinical findings and
CBCT radiographic findings among patients with inadequately
supported occlusion, except for significant association between
condylar morphology and limited mouth opening. Finally,
according to the present study there was no significant clinical or
radiographic effect of inadequate occlusion on the TMJ except for
condyle width and position.