Abstract
BACKGROUND: Temporomandibular joint (TMJ) degenerative joint disease (DJD) involves progressive osseous changes and is commonly associated with temporomandibular disorders (TMD). Cone-beam computed tomography (CBCT) is a valuable diagnostic tool for evaluating these changes. However, the relationship between clinical signs and symptoms, such as TMJ clicking or pain and radiographic findings remains poorly understood. Clarifying these associations can refine imaging prescribing practices and improve patient-specific diagnostic strategies. OBJECTIVE: This study aimed to investigate the association between clinical signs and symptoms of TMD and radiographic features of TMJ DJD detected on CBCT, emphasising its diagnostic value and limitations. METHODS: A retrospective chart review of 98 patients (196 TMJs) was conducted at a university-based oral medicine clinic. Clinical signs, including TMJ clicking, muscle pain and joint pain, were documented and CBCT findings, such as osteophytes and erosions, were analysed. Logistic regression was used to assess associations. RESULTS: A significant association was identified between TMJ clicking and the presence of osteophytes (p < 0.05). No significant associations were observed between other clinical features, including muscle and joint pain and CBCT findings. CONCLUSION: The findings support an indication-driven approach to CBCT imaging, highlighting its diagnostic value in patients with specific clinical presentations, such as TMJ clicking, combined with additional clinical indicators. Routine CBCT imaging for all patients with TMD is not justified and future research should focus on refining imaging guidelines to ensure judicious use in TMJ diagnostics.