Skip to main content
SpringerLink
Log in

Osteochondritis dissecans of the temporomandibular joint: a scoping review

  • Review
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Purpose

To perform a scoping review to identify the available evidence regarding osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ).

Methods

An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: ‘Temporomandibular Joint Disorders’, ‘Osteochondritis Dissecans’, ‘Joint Loose Bodies’ and ‘Temporomandibular Joint’. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria.

Results

Ten articles were included in the analysis — six case reports, one case series, one retrospective study, one comparative study and one correlational study — with a total of 39 patients. The most frequently reported clinical presentation involved TMJ pain, locked jaw and articular noises (clicking and crepitus). The imaging methods used to identify OCD were radiographs, tomography, arthrography and magnetic resonance imaging. The reported imaging findings varied widely, but the most frequent were (single or multiple) calcified intra-articular loose bodies, signs of degenerative osseous changes, disc displacements, widening of the joint space and alterations in condylar morphology. Seven articles reported treatments (surgical or conservative), but the treatment outcome was not reported in all of the articles, which makes it difficult to make comparisons.

Conclusion

OCD of the TMJ may present various non-specific clinical characteristics, and given the heterogeneous imaging findings, multiplanar images are required for an accurate diagnosis. Finally, the results do not allow recommending a standard treatment for OCD of the TMJ.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Schiffman E, Ohrbach R, Truelove E et al (2014) Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network* and orofacial pain special interest group†. J Oral Facial Pain Headache 28:6–27

    Article  PubMed  Google Scholar 

  2. Peck CC, Goulet J-P, Lobbezoo F et al (2014) Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil 41:2–23

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Chau MM, Klimstra MA, Wise KL, Ellermann JM, Tóth F, Carlson CS, Nelson BJ, Tompkins MA (2021) Osteochondritis dissecans: current understanding of epidemiology, Etiology, Management, and Outcomes. J Bone Joint Surg Am 103:1132–1151

    Article  PubMed  Google Scholar 

  4. Bruns J, Werner M, Habermann C (2018) Osteochondritis dissecans: etiology, pathology, and imaging with a special focus on the knee joint. Cartilage 9:346–362

    Article  CAS  PubMed  Google Scholar 

  5. Olley SF, Leopard PJ (1978) Osteochondritis dissecans affecting thetemporo-mandibular joint. British Journal of Oral Surgery 16:21–25

    Article  CAS  PubMed  Google Scholar 

  6. König F (2013) The classic: on loose bodies in the joint. 1887. Clin Orthop Relat Res 471:1107–1115

    Article  PubMed  PubMed Central  Google Scholar 

  7. Andriolo L, Crawford DC, Reale D, Zaffagnini S, Candrian C, Cavicchioli A, Filardo G (2020) Osteochondritis dissecans of the knee: etiology and pathogenetic mechanisms. a systematic review. Cartilage 11:273–290

    Article  PubMed  Google Scholar 

  8. Wang Y-H, Li G, Ma R-H, Zhao Y-P, Zhang H, Meng J-H, Mu C-C, Sun C-K, Ma X-C (2021) Diagnostic efficacy of CBCT, MRI, and CBCT-MRI fused images in distinguishing articular disc calcification from loose body of temporomandibular joint. Clin Oral Investig 25:1907–1914

    Article  PubMed  Google Scholar 

  9. Edmonds EW, Polousky J (2013) A review of knowledge in osteochondritis dissecans: 123 years of minimal evolution from König to the ROCK study group. Clin Orthop Relat Res 471:1118–1126

    Article  PubMed  Google Scholar 

  10. Andriolo L, Candrian C, Papio T, Cavicchioli A, Perdisa F, Filardo G (2019) Osteochondritis dissecans of the knee - conservative treatment strategies: a systematic review. Cartilage 10:267–277

    Article  PubMed  Google Scholar 

  11. Paterno MV, Prokop TR, Schmitt LC (2014) Physical therapy management of patients with osteochondritis dissecans: a comprehensive review. Clin Sports Med 33:353–374

    Article  PubMed  Google Scholar 

  12. Sayani J, Plotkin T, Burchette DT, Phadnis J (2021) Treatment strategies and outcomes for osteochondritis dissecans of the capitellum. Am J Sports Med 49:4018–4029

    Article  PubMed  Google Scholar 

  13. Cohen D, Kay J, Memon M, Slawaska-Eng D, Simunovic N, Ayeni OR (2021) A high rate of children and adolescents return to sport after surgical treatment of osteochondritis dissecans of the elbow: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 29:4041–4066

    Article  PubMed  Google Scholar 

  14. Logli AL, Leland DP, Bernard CD, Sanchez-Sotelo J, Morrey ME, O’Driscoll SW, Krych AJ, Wang Z, Camp CL (2020) Capitellar osteochondritis dissecans lesions of the elbow: a systematic review of osteochondral graft reconstruction options. Arthroscopy 36:1747–1764

    Article  PubMed  Google Scholar 

  15. Tricco AC, Lillie E, Zarin W et al (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169:467–473

    Article  PubMed  Google Scholar 

  16. Umstadt HE, Kusch B (2003) Joint loose bodies in the mandible. Diagnostic criteria and pathways for therapy planning. Mund Kiefer Gesichtschir 7:330–334

    Article  CAS  PubMed  Google Scholar 

  17. Campos PSF, Freitas CE, Pena N, Gonzalez MOD, Almeida SM, Mariz ACR, Lorens FGL (2005) Osteochondritis dissecans of the temporomandibular joint. Dentomaxillofac Radiol 34:193–197

    Article  CAS  PubMed  Google Scholar 

  18. Orhan K, Arslan A, Kocyigit D (2006) Temporomandibular joint osteochondritis dissecans: case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:e41–e46

    Article  PubMed  Google Scholar 

  19. Misirlioglu M, Adisen MZ, Yilmaz S (2014) Radiographic diagnosis of osteochondritis dissecans of the temporomandibular joint: two cases. Med Princ Pract 23:580–583

    Article  PubMed  PubMed Central  Google Scholar 

  20. Smolka W, Sotlar K, Weiss M, Müller-Lisse U (2016) Osteochondrosis dissecans of the temporomandibular joint: a case report and a review of literature. Oral Maxillofac Surg 20:321–325

    Article  PubMed  Google Scholar 

  21. Anderson QN, Katzberg RW (1984) Loose bodies of the temporomandibular joint: arthrographic diagnosis. Skeletal Radiol 11:42–46

    Article  PubMed  Google Scholar 

  22. Schellhas KP, Wilkes CH, Fritts HM, Omlie MR, Lagrotteria LB (1989) MR of osteochondritis dissecans and avascular necrosis of the mandibular condyle. AJR Am J Roentgenol 152:551–560

    Article  CAS  PubMed  Google Scholar 

  23. Carls FR, von Hochstetter A, Engelke W, Sailer HF (1995) Loose bodies in the temporomandibular joint. Journal of Cranio-Maxillofacial Surgery 23:215–221

    Article  CAS  PubMed  Google Scholar 

  24. Adame CG, Monje F, Offnoz M, Martin-Granizo R (1998) Effusion in magnetic resonance imaging of the temporomandibular joint: a study of 123 joints. J Oral Maxillofac Surg 56:314–318

    Article  CAS  PubMed  Google Scholar 

  25. Pu A, Jauregui JJ, Salmons HI, Weir TB, Abzug JM, Gilotra MN (2021) Radiographic evaluation of osteochondritis dissecans of the humeral capitellum: a systematic review. J Orthop 27:114–121

    Article  PubMed  PubMed Central  Google Scholar 

  26. Tan SHS, Tan BSW, Tham WYW, Lim AKS, Hui JH (2021) The incidence and risk factors of osteoarthritis following osteochondritis dissecans of the knees: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 29:3096–3104

    Article  PubMed  Google Scholar 

  27. Hu H, Zhang C, Chen J, Li P, Zhang X-E, Deng Z, Du Y (2019) Clinical value of MRI in assessing the stability of osteochondritis dissecans lesions: a systematic review and meta-analysis. AJR Am J Roentgenol 213:147–154

    Article  PubMed  Google Scholar 

  28. Ross BJ, Hermanns CA, Xu S, Baker J, Vopat B, Miskimin C, Mulcahey MK (2022) Males and females exhibit comparable outcomes following treatment of osteochondritis dissecans lesions of the knee: a systematic review. Arthroscopy. https://doi.org/10.1016/j.arthro.2022.03.015

    Article  PubMed  Google Scholar 

  29. Lu Y, Li YJ, Guo SY, Zhang HL (2018) Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis. Int Orthop 42:601–607

    Article  PubMed  Google Scholar 

  30. Salci L, Ayeni O, Abouassaly M, Farrokhyar F, D’Souza J, Bhandari M, Peterson D (2013) Indications for surgical management of osteochondritis dissecans of the knee in the pediatric population: a systematic review. J Knee Surg 27:147–156

    Article  PubMed  Google Scholar 

  31. Leland DP, Bernard CD, Camp CL, Nakamura N, Saris DBF, Krych AJ (2019) Does internal fixation for unstable osteochondritis dissecans of the skeletally mature knee work? A systematic review. Arthroscopy 35:2512–2522

    Article  PubMed  Google Scholar 

  32. Sacolick DA, Kirven JC, Abouljoud MM, Everhart JS, Flanigan DC (2019) The treatment of adult osteochondritis dissecans with autologous cartilage implantation: a systematic review. J Knee Surg 32:1102–1110

    Article  PubMed  Google Scholar 

  33. McLaughlin RJ, Leland DP, Bernard CD, Sanchez-Sotelo J, Morrey ME, O’Driscoll SW, Camp CL (2021) Both debridement and microfracture produce excellent results for osteochondritis dissecans lesions of the capitellum: a systematic review. Arthrosc Sports Med Rehabil 3:e593–e603

    Article  PubMed  PubMed Central  Google Scholar 

  34. Weiss JM, Shea KG, Jacobs JC Jr, Cannamela PC, Becker I, Portman M, Kessler JI (2018) Incidence of osteochondritis dissecans in adults. Am J Sports Med 46:1592–1595

    Article  PubMed  Google Scholar 

  35. Palconet G, Ludlow JB, Tyndall DA, Lim PF (2012) Correlating cone beam CT results with temporomandibular joint pain of osteoarthritic origin. Dentomaxillofac Radiol 41:126–130

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Chan C, Richmond C, Shea KG, Frick SL (2018) Management of osteochondritis dissecans of the femoral condyle: a critical analysis review. JBJS Rev 6:e5

    Article  PubMed  Google Scholar 

  37. Smet AAD, De Smet AA, Ilahi OA, Graf BK (1996) Reassessment of the MR criteria for stability of osteochondritis dissecans in the knee and ankle. Skeletal Radiol 25:159–163

    Article  PubMed  Google Scholar 

  38. Bruns J, Werner M, Habermann CR (2021) Osteochondritis dissecans of smaller joints: the elbow. Cartilage 12:407–417

    Article  CAS  PubMed  Google Scholar 

  39. de Graaff F, Krijnen MR, Poolman RW, Willems WJ (2011) Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow. Arthroscopy 27:986–993

    Article  PubMed  Google Scholar 

  40. Tamimi D, Hatcher DC (2016) Specialty imaging: temporomandibular joint e-book. Elsevier Health Sciences

  41. Brabyn PJ, Capote A, Muñoz-Guerra MF, Zylberberg I, Rodríguez-Campo FJ, Naval-Gías L (2018) Arthroscopic management of synovial chondromatosis of the temporomandibular joint. case series and systematic review. J Maxillofac Oral Surg 17:401–409

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Universidad Andres Bello, Faculty of Dentistry, Quillota # 980 Torre E, Viña del Mar, Chile

    Diego De Nordenflycht & Héctor Toloza

  2. Private Practice, Viña del Mar, Chile

    Gustavo Matus & Juan Pablo Aravena

Authors
  1. Diego De Nordenflycht
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gustavo Matus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Juan Pablo Aravena
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Héctor Toloza
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection and analysis were performed by Diego De Nordenflycht, Gustavo Matus, Juan Pablo Aravena and Héctor Toloza. The first draft of the manuscript was written by Diego De Nordenflycht, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Diego De Nordenflycht.

Ethics declarations

Ethics approval

This is an evidence synthesis study, no ethical approval is required.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

De Nordenflycht, D., Matus, G., Aravena, J.P. et al. Osteochondritis dissecans of the temporomandibular joint: a scoping review. Oral Maxillofac Surg 28, 29–38 (2024). https://doi.org/10.1007/s10006-022-01134-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-022-01134-2

Keywords

Search

Navigation