Prevalence of degenerative signs of the temporomandibular joint in the Canarian population through the analysis of panoramic radiographs: A pilot study.

Background: Degenerative diseases of the temporomandibular joint (TMJ) represent a frequent subtype of temporomandibular disorders (TMDs), particularly prevalent among individuals over the age of 40. Although cone-beam computed tomography (CBCT) is recognized as the diagnostic gold standard for evaluating bony alterations of the TMJ, panoramic radiography remains widely utilized in clinical practice due to its accessibility and lower radiation exposure. Material and Methods: A retrospective observational pilot study was conducted at the Dental Clinic of the University Fernando Pessoa Canarias. A simple random sample of 60 panoramic radiographs from patients over 40 years of age was selected from a database comprising 323 records collected between April and October 2024. Bilateral assessment of the TMJs was performed by two independent observers according to established diagnostic criteria for degenerative alterations. Inter-observer agreement was measured using Cohen's Kappa statistics. Associations between degenerative and indeterminate findings and demographic variables were evaluated using the Chi-square (χ²) test. Descriptive statistics for age were reported as means and interquartile ranges. Results: Among the 120 TMJs evaluated, osteophyte formation was the only degenerative finding detected (30%). Condylar flattening, considered an indeterminate sign, was observed in 85% of cases. Osteophytes were more frequently identified in males (33.33%); however, no statistically significant association was found between osteophyte presence and sex (p = 0.655). A significant association was observed between the presence of osteophytes and condylar flattening (χ² = 4.73, p = 0.030). Inter-observer agreement was moderate for degenerative signs (κ = 0.68) and minimal for indeterminate signs (κ = 0.37). Conclusions: Osteophyte formation was the sole radiographic indicator of TMJ degeneration identified in this sample, frequently co-occurring with condylar flattening. Although panoramic radiography serves as a valuable screening modality, its diagnostic limitations underscore the need for CBCT in cases with suspected or advanced degenerative joint changes. Key words:Temporomandibular joint, Osteoarthritis, Degenerative joint disease, Panoramic radiography, Osteophyte.