Purpose: This study had a twofold aim: first, to gather knowledge about the prevalence of radiologic signs of temporomandibular joint osteoarthritis (TMJ-OA) and possible risk factors in patients who had worn an implant prosthesis for between 2.5 and 10 years; and second, to investigate the diagnostic value of radiologic TMJ-OA signs for orofacial pain in a non-temporomandibular disorders group. Materials and Methods: Two hundred thirty patients (134 women, 96 men) answered a questionnaire regarding orofacial pain. In mean, they were 64 years old and wore 98 fixed and 132 removable implant dentures. The effect of age, gender, state of the dentition, time span after prosthesis placement, parafunction, and TMJ sounds on radiologic TMJ-OA signs was estimated through multiple logistic regression. The predictive values were calculated to assess the diagnostic value of severe TMJ-OA signs to predict orofacial pain. Results: Prevalence of TMJ-OA signs was 70% for flattening, 23% for osteophytes, and 24% for erosion. Some effect on radiologic TMJ-OA signs of gender and state of the dentition was found. The predictive values for orofacial pain from radiologic TMJ-OA ranged from 0.22 to 0.81. Conclusion: Radiologic signs of TMJ-OA were common findings. The study gave no indication that long-term wearing of an implant prosthesis has a negative effect on TMJ-OA. It was not possible to predict orofacial pain from radiologic TMJ-OA signs.