{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T23:34:54Z","timestamp":1780356894530,"version":"3.54.1"},"reference-count":35,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: The aim of this study is to evaluate pretreatment osseous changes in the temporomandibular joint (TMJ) in orthognathic surgery patients using cone-beam computed tomography (CBCT) and to determine the distribution of the findings according to sagittal skeletal malocclusion groups. Methods: CBCT images of 103 patients (206 condyles) were retrospectively analyzed. Patients were classified as Class I, II, and III based on ANB angles. Condylar morphology was assessed for flattening, sclerosis, erosion, osteophyte formation, and subchondral bone cysts. All evaluations were performed by a single investigator (\u03ba = 0.87). Group differences were analyzed using the chi-square test with Bonferroni correction (p &lt; 0.05). Results: The most frequent alteration was flattening (29.6%), followed by sclerosis (11.2%), erosion (10.7%), osteophyte formation (8.3%), and subchondral bone cysts (4.4%). No significant sex-related differences were found (p &gt; 0.05). A significant difference was observed only in sclerosis (p = 0.049), which was more prevalent in Class I than Class III. Flattening predominated in all groups, while erosion and osteophytes were more common in Class II, and sclerosis was more frequent in Class I. Conclusions: This study demonstrated that condylar flattening was the most common morphological alteration in orthognathic patients across all skeletal malocclusion groups. The higher prevalence of sclerosis in Class I compared with Class III suggests that mandibular positioning may influence adaptive and degenerative remodeling processes of the TMJ. This study emphasizes the importance of CBCT evaluation for detecting osseous changes in TMJ before orthognathic surgery and demonstrates that pre-existing alterations may impact surgical stability and postoperative functional outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics16010101","type":"journal-article","created":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T23:54:36Z","timestamp":1766966076000},"page":"101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cone-Beam CT-Based Analysis of Temporomandibular Joint Osseous Changes in Orthognathic Surgery Patients: A Retrospective Cross-Sectional Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7005-6179","authenticated-orcid":false,"given":"Merve Berika","family":"Kad\u0131o\u011flu","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry, Ankara University, Ankara 06560, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9796-5738","authenticated-orcid":false,"given":"Mehmet Emre","family":"Yurttutan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Ankara 06560, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0516-9245","authenticated-orcid":false,"given":"Mehmet Alp","family":"Eri\u015f","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Ankara 06560, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8486-875X","authenticated-orcid":false,"given":"Meyra","family":"Durmaz","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry, Ankara University, Ankara 06560, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Abbass, M.M.S., Rady, D., El Moshy, S., Ahmed Radwan, I., Wadan, A.H.S., D\u00f6rfer, C.E., and El-Sayed, K.M.F. (2024). The Temporomandibular Joint and the Human Body: A New Perspective on Cross Talk. Dent. J., 12.","DOI":"10.3390\/dj12110357"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Gharavi, S.M., Qiao, Y., Faghihimehr, A., and Vossen, J. (2022). Imaging of the Temporomandibular Joint. Diagnostics, 12.","DOI":"10.3390\/diagnostics12041006"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Warzocha, J., Gadomska-Krasny, J., and Mrowiec, J. (2024). Etiologic Factors of Temporomandibular Disorders: A Systematic Review of Literature Containing Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC\/TMD) from 2018 to 2022. Healthcare, 12.","DOI":"10.3390\/healthcare12050575"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.sdentj.2024.03.005","article-title":"Comparative Analysis of Temporomandibular Joint Morphology in Degenerative Joint Disease: A Cone-Beam CT Study in Patients with and without Arthralgia","volume":"36","author":"Zanlorenzi","year":"2024","journal-title":"Saudi Dent. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/j.ijom.2015.06.023","article-title":"Temporomandibular Joint Osteoarthritis: Cone Beam Computed Tomography Findings, Clinical Features, and Correlations","volume":"44","year":"2015","journal-title":"Int. J. Oral. Maxillofac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"7083","DOI":"10.1007\/s00784-022-04668-7","article-title":"Mandibular Stability and Condylar Changes Following Orthognathic Surgery in Mandibular Hypoplasia Patients Associated with Preoperative Condylar Resorption","volume":"26","author":"Wang","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_7","first-page":"22","article-title":"Changes in the Condylar Volume and Skeletal Relapse Following Orthognathic Surgery in Patients with Dentofacial Deformity: A Retrospective Study","volume":"43","author":"Takahara","year":"2025","journal-title":"Cranio\u2014J. Craniomandib. Sleep Pract."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1080\/00016357.2023.2215317","article-title":"TMJ Degenerative Joint Disease: Relationships between CBCT Findings, Clinical Symptoms, and Signs","volume":"81","author":"Yap","year":"2023","journal-title":"Acta Odontol. Scand."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Dygas, S., Szarmach, I., Radej, I., and Chaqu\u00e9s-Asensi, J. (2025). Influence of Maxillofacial Morphology on Temporomandibular Joint Degenerative Alterations and Condyle Position Assessed by CBCT in Class II Malocclusion Adult Patients\u2014A Cross-Sectional Study. J. Clin. Med., 14.","DOI":"10.3390\/jcm14134499"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Chen, Y., Li, L., Li, Y., Luo, N., Dai, H., and Zhou, J. (2023). Comprehensive Positional and Morphological Assessments of the Temporomandibular Joint in Adolescents with Skeletal Class III Malocclusion: A Retrospective CBCT Study. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-02788-4"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Abubakr, N.H., Al-Talib, T., Bahar, N., Badani, A., Nelson, S., and Mago, J. (2025). Correlation Between Condylar Shape and Malocclusion: CBCT Analysis. Diagnostics, 15.","DOI":"10.3390\/diagnostics15060768"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"\u00c2ngelo, D.F., Faria-Teixeira, M.C., Maffia, F., Sanz, D., Sarkis, M., Marques, R., Mota, B., Jo\u00e3o, R.S., and Cardoso, H.J. (2024). Association of Malocclusion with Temporomandibular Disorders: A Cross-Sectional Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13164909"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1007\/s12663-024-02277-3","article-title":"Evaluation of the Relationship Between Osteoarthritis and Morphological Changes in the Joint Structures in Temporomandibular Disorders By Cone Beam Computed Tomography","volume":"24","author":"Paknahad","year":"2024","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s00784-025-06541-9","article-title":"Prevalence of Degenerative Alterations of Osseous Temporomandibular Joint Structures in Cone Beam Computed Tomograms in a Consecutive Sample of Young Adults. A Retrospective Study","volume":"29","author":"Schnabl","year":"2025","journal-title":"Clin. Oral Investig."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S0889-5406(96)70081-1","article-title":"Progressive Mandibular Retrusion--Idiopathic Condylar Resorption. Part I","volume":"110","author":"Arnett","year":"1996","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.ijom.2024.12.002","article-title":"Three-Dimensional Assessment of Temporomandibular Joint Changes Following Maxillomandibular Advancement Surgery: A Five-Year Follow-up Study","volume":"54","author":"Nielsen","year":"2025","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Xiao, M., and Ni, S. (2025). Different Effects of Abnormal Mechanical Stress on Temporomandibular Joint Cartilage, Subchondral Bone, and Discs. Front. Physiol., 16.","DOI":"10.3389\/fphys.2025.1539342"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1259\/dmfr\/17815139","article-title":"Evaluation of Bone Changes in the Temporomandibular Joint Using Cone Beam CT","volume":"41","author":"Freire","year":"2012","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1259\/dmfr\/59263880","article-title":"Evaluation of the Severity of Temporomandibular Joint Osteoarthritic Changes Related to Age Using Cone Beam Computed Tomography","volume":"38","author":"Alexiou","year":"2009","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1016\/j.ijom.2017.06.012","article-title":"Is Oestrogen Associated with Mandibular Condylar Resorption? A Systematic Review","volume":"46","author":"Nicolielo","year":"2017","journal-title":"Int. J. Oral. Maxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1590\/S1517-74912003000200015","article-title":"Evaluation of the Relation between the Horizontal Condylar Angle and the Internal Derangement of the TMJ\u2014A Magnetic Resonance Imaging Study","volume":"17","author":"Campos","year":"2003","journal-title":"Pesqui. Odontol. Bras."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S1079-2104(98)90004-X","article-title":"The Effect of Age and Gender on the Onset of Symptomatic Temporomandibular Joint Disk Displacement","volume":"85","author":"Isberg","year":"1998","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"20140235","DOI":"10.1259\/dmfr.20140235","article-title":"Temporomandibular Joint Diagnostics Using CBCT","volume":"44","author":"Larheim","year":"2015","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Emshoff, R., Rudisch, A., and Bertram, S. (2025). Clinical Factors Associated with Radiographic Severity of Progressive Temporomandibular Joint Osteoarthritis: A Retrospective CBCT Study. BMC Musculoskelet. Disord., 26.","DOI":"10.1186\/s12891-025-09149-y"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.oooo.2019.01.072","article-title":"Cone Beam Computed Tomography Study of Osteoarthritic Alterations in the Osseous Components of Temporomandibular Joints in Asymptomatic Patients According to Skeletal Pattern, Gender, and Age","volume":"128","author":"Walewski","year":"2019","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.ijom.2012.03.006","article-title":"The Prevalence of TMJ Osteoarthritis in Asymptomatic Patients with Dentofacial Deformities: A Cone-Beam CT Study","volume":"41","author":"Krisjane","year":"2012","journal-title":"Int. J. Oral. Maxillofac. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"6731","DOI":"10.1038\/s41598-020-63493-8","article-title":"Long-Term Changes of Temporomandibular Joint Osteoarthritis on Computed Tomography","volume":"10","author":"Song","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"6863014","DOI":"10.1155\/2022\/6863014","article-title":"Assessment of the Morphology and Degenerative Changes in the Temporomandibular Joint Using CBCT According to the Orthodontic Approach: A Scoping Review","volume":"2022","author":"Dygas","year":"2022","journal-title":"Biomed Res. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e060","DOI":"10.1590\/1807-3107bor-2024.vol38.0060","article-title":"Prevalence of Condylar Morphological Changes in Individuals with Class II Malocclusion","volume":"38","author":"Oliveira","year":"2024","journal-title":"Braz. Oral. Res."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Chen, S., Lei, J., Fu, K.-Y., Wang, X., and Yi, B. (2015). Cephalometric Analysis of the Facial Skeletal Morphology of Female Patients Exhibiting Skeletal Class II Deformity with and without Temporomandibular Joint Osteoarthrosis. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0139743"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/j.joms.2020.03.019","article-title":"Are Signs of Degenerative Joint Disease Associated With Chin Deviation?","volume":"78","author":"Jinnavanich","year":"2020","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"249","DOI":"10.5624\/isd.2012.42.4.249","article-title":"Condylar Bony Changes in Patients with Temporomandibular Disorders: A CBCT Study","volume":"42","author":"Nah","year":"2012","journal-title":"Imaging Sci. Dent."},{"key":"ref_33","first-page":"142","article-title":"Comparison of the Bony Changes of TMJ in Patients With and Without TMD Complaints Using CBCT","volume":"19","author":"Shahidi","year":"2018","journal-title":"J. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"218\u2013229; discussion 230\u2013232","DOI":"10.1097\/00006534-199290020-00009","article-title":"Mandibular Retrusion, Temporomandibular Joint Derangement, and Orthognathic Surgery Planning","volume":"90","author":"Schellhas","year":"1992","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"903","DOI":"10.12659\/MSM.889528","article-title":"Anteroposterior Condylar Position: A Comparative Study between Subjects with Normal Occlusion and Patients with Class I, Class II Division 1, and Class III Malocclusions","volume":"19","author":"Fraga","year":"2013","journal-title":"Med. Sci. Monit."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/1\/101\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:06:27Z","timestamp":1766966787000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/1\/101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,28]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["diagnostics16010101"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16010101","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,28]]}}}