Objective: This retrospective cone-beam computed tomography (CBCT) study examined whether temporomandibular joint (TMJ) space asymmetry is associated with upper cervical (C0-C1-C2) position in unilateral TMJ osteoarthritis (TMJOA).Methods: Seventy-nine patients (40 controls without definite OA in either TMJ, 39 unilateral), classified using RDC/TMD criteria, had the joint spaces, a condylar ratio, and craniovertebral parameters measured and expressed as side-to-side and affected-versus-unaffected asymmetries.Results: Within the unilateral group, superior joint-space asymmetry correlated moderately with occipital condyle-atlas-axis (OCAA) asymmetry (rho = 0.50, p = .001), surviving false-discovery-rate correction; the whole-sample correlation was weaker (rho = 0.24).Conclusion: Superior joint-space asymmetry may represent an imaging correlate of craniovertebral position, not a diagnostic marker. These findings are preliminary and require replication; interpretation is limited by the retrospective design, an approximately six-year age difference between groups, and the absence of clinical or symptom data.
