IDENTIFICATION OF SINGLE NUCLEOTIDE POLYMORPHISM INSULIN-LIKE GROWTH FACTOR TYPE 1 GENE IN VERTICAL MANDIBULAR ASYMMETRY PATIENTS WITH IDIOPATHIC SCOLIOSIS SYMPTOM

Objective:Previous studies reported IGF-1 (Insulin-like Growth factor type-1) gene expression in mandibular condylar cartilage and idiopathic scoliosis development. This paper aims to correlate the Single Nucleotide Polymorphism (SNPs) of IGF-1 gene rs5742632 in vertical mandibular asymmetry patients with idiopathic scoliosis symptom.Methods:TheIGF-1 gene rs5742632 polymorphism of 49 patients (19.38±3.24-year-old) who were treated at orthodontics department Dental Hospital Universitas Sumatera Utara and orthopedics department of Haji Adam Malik Hospital from April-August 2017, were genotyped using polymerase chain reaction-restriction fragment length polymorphism analysis in case-control of idiopathic scoliosis symptom. An enzyme-linked immunochemiluminescent assay measured IGF-1 levels. Analyzing of mandibular asymmetry index based on Kjellberg's technique using the panoramic radiograph.Results:The scoliosis symptom based on clinical judgment of orthopedics by asymmetry trunk posture and adam'sforward bend test movement analysis. This study showed no significant difference (p>0.05) in the genotype distribution (rs5742632) haplotype in vertical mandibular asymmetry based on scoliosis symptom. However, there was a significant difference between early and late adolescent among those subjects in IGF-1 level measurement (p=0.033). dam's forward bend test and a scoliometer measurementConclusion:The result was still not conclusive due to variance in mandibular growth and curve lateral spine in adolescent patients. Further study will requiresubject increment and more specific samples to study the risk factor of vertical mandibular asymmetry

Vertical Mandibular and Trunk Symmetry in Indonesian Orthodontic Patients

Objective: To analyze differences in vertical mandibular and trunk symmetry in orthodontic patients. Material and Methods: This was a cross-sectional study of 129 growing orthodontic patients who sought orthodontic treatment at the Dental Hospital Universitas Sumatera Utara, Indonesia. Mandibular symmetry index was observed with pre-treatment panoramic radiography based on Kjellberg's technique and trunk symmetry was evaluated based on questionnaires and visual observation. Vertical mandibular asymmetry was decided if the index of asymmetry was lower than 93.7%. The bivariate analysis used the chi-squared and Fisher's exact tests, with a significance level of 5%. Results: There was a significant association between vertical mandibular and trunk symmetry (p<0.05). The prevalence odds ratio for the association with vertical mandibular asymmetry was 3.007 (95% CI = 1.016-8.905) for trunk asymmetry. Conclusion: The necessity to consider trunk symmetry could be included in orthodontics treatment of any malocclusion with vertical mandibular asymmetry that might require a multidisciplinary approach in the future

Vertical Mandibular and Trunk Symmetry in Indonesian Orthodontic Patients

Objective: To analyze differences in vertical mandibular and trunk symmetry in orthodontic patients. Material and Methods: This was a cross-sectional study of 129 growing orthodontic patients who sought orthodontic treatment at the Dental Hospital Universitas Sumatera Utara, Indonesia. Mandibular symmetry index was observed with pre-treatment panoramic radiography based on Kjellberg's technique and trunk symmetry was evaluated based on questionnaires and visual observation. Vertical mandibular asymmetry was decided if the index of asymmetry was lower than 93.7%. The bivariate analysis used the chi-squared and Fisher's exact tests, with a significance level of 5%. Results: There was a significant association between vertical mandibular and trunk symmetry (p<0.05). The prevalence odds ratio for the association with vertical mandibular asymmetry was 3.007 (95% CI = 1.016-8.905) for trunk asymmetry. Conclusion: The necessity to consider trunk symmetry could be included in orthodontics treatment of any malocclusion with vertical mandibular asymmetry that might require a multidisciplinary approach in the future

Association between condylar asymmetry and temporo-mandibular disorders using 3D-CT

Objectives: Using reconstructed three-dimensional computed tomography (3D-CT) models, the purpose of this study was to analyze and compare mandibular condyle morphology in patients with and without temporomandibular disorder (TMD). Study Design: Thirty-two patients were divided into two groups: the first comprised those with TMD (n=18), and the second those who did not have TMD (n=14). A CT of each patient was obtained and reconstructed as a 3D model. The 64 resulting 3D condylar models were evaluated for possible TMD-associated length, width and height asymmetries of the condylar process. Descriptive statistics were used to assess the results and student?s t tests applied to compare the two groups. Results: Statistically significant (p<0.05) vertical, mediolateral and sagittal asymmetries of the condylar process were observed between TMD and non-TMD groups. TMD patients showed less condylar height (p<0.05) in comparison with their asymptomatic counterparts. Conclusions: Using 3D-CT, it was shown that condylar width, height and length asymmetries were a common feature of TM

Evaluation of Mandibular Asymmetry in Unilateral and Bilateral Posterior Crossbite Patients

Indexación: Web of Science; ScieloEl objetivo fue determinar la existencia de asimetría vertical mandibular, en pacientes con mordida cruzada posterior uni y bilateral, tanto en dentición mixta primera fase como en permanente completa. Se recolectaron radiografías panorámicas correspondientes a 121 pacientes con dentición mixta primera fase y permanente completa, 57 de los cuales, presentaba mordida cruzada unilateral, 21 mordida cruzada bilateral y 43 individuos con oclusión normal, que sirvieron como grupo control. En las radiografías, se cuantificaron medidas lineales de altura condilar, coronoidea, de rama, cóndilo-más-rama y la diferencia entre las alturas de cóndilo y coronoides. Además, se calcularon los índices de asimetría para cada una de dichas estructuras. Se determinó la existencia de diferencias significativas entre los grupos, mediante el cálculo de los test Mann-Whitney y Kruskal-Wallis, dada la distribución de las variables y un test de chi cuadrado para evaluar asociación entre las mismas, con un intervalo de confianza de 95% (p<,05). Existen diferencias significativas entre los índices de rama y de cóndilo-más-rama, entre el grupo control y el grupo con mordida cruzada unilateral (MCU), al igual que en el índice coronoideo, entre el grupo control y el grupo con mordida cruzada bilateral. El grupo con MCU, presentó un mayor porcentaje de pacientes con asimetría de cóndilo y rama, encontrándose una leve asociación entre la condición de mordida cruzada unilateral y la asimetría de dichas estructuras. Dados los resultados, se puede concluir que existe asimetría en el cóndilo, coronoides y en cóndilo-menos-coronoides y coronoides, tanto en pacientes con mordida cruzada uni como bilateral. Sin embargo, el grupo con MCU presenta un mayor porcentaje de pacientes con asimetría de cóndilo y rama, existiendo una leve asociación entre MCU y asimetría de dichas estructuras.SUMMARY: The aim was to evaluate the mandibular vertical asymmetry, in unilateral and bilateral posterior crossbite patients both in permanent and mixed dentition. One hundred twenty one panoramic radiographs were collected, 57 from patients with unilateral posterior crossbite, 21 patients with bilateral posterior crossbite and 43 with normal occlusion that were used as a control group. Subsequently, reference points and cephalometric traces were drawn manually by a calibrated examiner in order to register the condylar, coronoideal, and ramal heigths. This data was used to calculate an asymmetry index for each structure. According to the distribution of the variables, Mann-Whitney and Kruskal-Wallis test was used to compare the data between groups of patients and chi square was used to evaluate association between them, at the 95% confidence interval (p<.05). Statistically significant differences were found in the ramal and condylar-plus-ramal asymmetry index values, between the control and the unilateral posterior crossbite group, also statistical differences were found in the coronoideal index values, between the control and the bilateral posterior crossbite groups. On the other hand, the bilateral crossbite group, presented a higher percentage of patients with condylar and ramal asymmetry, finding a mild statistically significant association between this condition and those with asymmetry. Condylar and coronoideal asymmetry was found both in the unilateral as in the unilateral posterior crossbite patients. The bilateral crossbite group, presented a major percentage of patients with asymmetry, with a mild association between those conditions. KEY WORDS: Crossbite; Condylar asymmetry; Mandibular asymmetry; Orthopantomograph.http://ref.scielo.org/bzdg5

Polymorphism in 4'-UTR Region of PITX2 in Vertical Mandibular Symmetry

Study on specific genetic pathways of condylar phenotype variation related to vertical mandibular asymmetry remain rare. PITX2, a gene active in the Nodal Pathway that determines the left-right symmetry during embryogenesis, has been reported in expression and regulation of skeletal-muscle development as well as differentiation of satellite cells in adult muscle. The aim of this study is to analyze the phenotypes of expressed PITX2 and its polymorphisms in vertical mandibular asymmetry based on skeletal and dental analysis. Pre-treatment panoramic radiographs from selected 62 orthodontics patients (20.7 ± 3.2 year old) were analyzed using Kjellberg symmetry Index. Subdivision of malocclusions that are limited to Angle’s classification was recorded. DNA material was obtained using buccal swabs, followed by Polymerase Chain Reaction (PCR) and Sanger sequencing with ChromasPro 2.13 software (Technelysium, Queensland, Australia) and then compared to archival data from gene bank number ENSG00000164093 (www.ensembl.org).Genotype analysis showed 3 polymorphisms (rs72554076, rs761511445, rs372257787) in 4'-UTR of 16 subjects (25.8%) with various vertical mandibular asymmetry causing a C>A change at 47-105 in 13 patients, G>A change at 47-9 in 1 patient and G>T change at 46+100 in 2 patients, respectively. The characteristics of vertical mandibular asymmetry and canine subdivision dominated in these subjects. Our findings suggest that complex polygenic trait of vertical mandibular asym metry should consider PITX2 polymorphisms that related to muscular disorder.This work was partially supported by the TALENTA grants from the Universitas Sumatera Utara (5338/UN5.1.R/PPM/ 2017)

Frequência da assimetria mandibular em radiografias panorâmicas na cidade de Cuenca, Equador

Objective: This study aims to determine the frequency of mandibular asymmetries using digital panoramic radiographs that display complete teeth. Material and methods: A descriptive, observational, and retrospective cross-sectional study was conducted. The records of all digital panoramic radiographs from patients aged 18 to 59 years, taken at the Dental Image radiographic center during the period 2016-2020, were reviewed. Panoramic radiographs were evaluated for the presence of mandibular asymmetry using the Habets index. Digital radiographic tracing was employed to assess variables including ascending ramus height (C+R), mandibular ramus height (RH), and condylar height (CH). Symmetrical and asymmetrical radiographs were compared. Results: Out of the total sample of 1000 radiographs analyzed, the predominant age group was 34-41 years, constituting 301 radiographs (30.1%). Additionally, in terms of asymmetry based on gender, males exhibited a predominance, with 33 (6.6%) symmetrical radiographs and 467 (93.4%) asymmetrical radiographs. Conclusions: The study revealed a prevalence of height asymmetry in the right ascending ramus, with greater height observed in males (64.8 mm). These values demonstrated statistical significance in relation to both age and gender.Objetivo: Determinar la frecuencia de asimetrías mandibulares utilizando radiografías panorámicas digitales con presencia de piezas dentales completas. Material y métodos: Se diseñó un estudio de tipo descriptivo, observacional y de corte transversal retrospectivo, donde se revisaron los registros de todas las radiografías panorámicas digitales de pacientes de entre 18 y 59 años de edad del centro radiográfico Dental Image en el período 2016-2020. Se procedió a evaluar las radiografías panorámicas con el porcentaje de asimetría mandibular según el índice de Habets mediante el trazado radiográfico digital, considerando las siguientes variables: altura de la rama ascendente (C+R), altura de la rama mandibular (RH) y altura condilar (CH), comparando las radiografías simétricas y asimétricas. Resultados: Del total de radiografías analizadas de la muestra (1000), se obtuvo que el grupo etario predominante fue el de 34-41 años de edad, con un total de 301 radiografías (30,1 %); asimismo, en cuanto a la asimetría de acuerdo al sexo, predominó el masculino con 33 (6,6%) simétricos y 467 (93,4%) asimétricos. Conclusión: Existió prevalencia en la altura de la rama ascendente derecha, siendo mayor en el sexo masculino (64,8 mm); estos valores tuvieron significancia estadística entre edad y sexo.Objetivo: Determinar a frequência de assimetrias mandibulares utilizando radiografias panorâmicas digitais com todos os dentes presentes. Material e métodos: Foi elaborado um estudo descritivo, observacional, retrospectivo e transversal para analisar registros de todas as radiografias panorâmicas digitais de pacientes com idades entre 18 e 59 anos no centro radiográfico Dental Image, no período de 2016 a 2020. As radiografias panorâmicas foram avaliadas quanto à porcentagem de assimetria mandibular, utilizando o índice de Habets. Traçados radiográficos digitais foram empregados, considerando variáveis como a altura do ramo ascendente (C+R), altura do ramo mandibular (RH) e altura condilar (CH). Foram comparadas radiografias simétricas e assimétricas. Resultados: Das radiografias analisadas na amostra total (1.000), a faixa etária predominante foi de 34 a 41 años, totalizando 301 radiografias (30,1%). Em termos de assimetria por gênero, o sexo masculino apresentou predominância com 33 (6,6%) radiografias simétricas e 467 (93,4%) radiografias assimétricas. Conclusões: Observou-se prevalência na altura do ramo ascendente direito, com valores maiores no sexo masculino (64,8 mm). Esses valores demonstraram significância estatística em relação à idade e ao sexo

Estudio de la asimetría condilar en pacientes infantiles con mordida cruzada posterior.

El objetivo de este estudio fue determinar la presencia de asimetría de cóndilo mandibular en pacientes de ambos sexos de edades comprendidas entre los 7 y 9 años, con mordida cruzada posterior unilateral o bilateral, que acudieron a un Centro Radiográfico en Madrid. Esta investigación se realizó midiendo anchuras condilares derechas e izquierdas de 42 ortopantomogrfías de niños. Se logró determinar que existe una mayor frecuencia de asimetría de cóndilo mandibular en el grupo de pacientes con mordida cruzada posterior unilateral o bilateral. Respecto al género y tipo de dentición no se encontró una diferencia estadísticamente significativa entre los grupos estudiados. Concluimos el estudio afirmando que no existe una mayor asimetría del cóndilo contralateral en pacientes con mordida cruzada posterior uni o bilateral

TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia: a cross-sectional study [version 1; referees: 2 approved]

Background: Temporomandibular joint disorder (TMD) includes symptoms of pain and dysfunction in the muscles of mastication and the temporomandibular joint. Differences in vertical condylar height, observed in the assessment of mandibular asymmetry, is a structural alteration that represents a risk factor for TMD. The study aimed to evaluate the association between TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia.  Methods: The cross-sectional study included 18-25-year-old (mean ± SD, 21.9 ± 2.0 years) old orthodontic patients admitted to the Dental Hospital of Universitas Sumatera Utara, Medan, between June 2016 and March 2017. Vertical mandibular asymmetry was assessed from all 106 subjects using Kjellberg’s technique from pre-treatment panoramic radiographs. The TMD symptoms were assessed by structural interviews using modified questionnaires based on Temporomandibular Disorder Diagnostic Index and Fonseca’s Anamnestic Index. Results: Of the 106 subjects, 26 (24.5% of the total) with vertical mandibular symmetry and 39 (36.8%) with vertical mandibular asymmetry were positive for TMD symptoms. By contrast, 17 patients (16.0% of the total) with vertical condylar symmetry and 24 patients (22.6%) with vertical mandibular asymmetry were regarded negative for TMD symptoms. There was no significant difference (p=0.520) in TMD symptoms based on vertical mandibular symmetry. Conclusion: The results from this studied Sumatran population indicate that there are common TMD symptoms in young adult orthodontic patients, but there is no significant association between vertical mandibular asymmetry and TMD symptoms. Further study on the development of TMD, mandibular asymmetry and treatment planning for growing patients is suggested, using longitudinal and transitional approaches

TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia: a cross-sectional study [version 2; referees: 3 approved]

Background: Temporomandibular joint disorder (TMD) includes symptoms of pain and dysfunction in the muscles of mastication and the temporomandibular joint. Differences in vertical condylar height, observed in the assessment of mandibular asymmetry, is a structural alteration that represents a risk factor for TMD. The study aimed to evaluate the association between TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia.  Methods: The cross-sectional study included 18-25-year-old (mean ± SD, 21.9 ± 2.0 years) old orthodontic patients admitted to the Dental Hospital of Universitas Sumatera Utara, Medan, between June 2016 and March 2017. Vertical mandibular asymmetry was assessed from all 106 subjects using Kjellberg’s technique from pre-treatment panoramic radiographs. The TMD symptoms were assessed by structural interviews using modified questionnaires based on Temporomandibular Disorder Diagnostic Index and Fonseca’s Anamnestic Index. Results: Of the 106 subjects, 26 (24.5% of the total) with vertical mandibular symmetry and 39 (36.8%) with vertical mandibular asymmetry were positive for TMD symptoms. By contrast, 17 patients (16.0% of the total) with vertical condylar symmetry and 24 patients (22.6%) with vertical mandibular asymmetry were regarded negative for TMD symptoms. There was no significant difference (p=0.520) in TMD symptoms based on vertical mandibular symmetry. Conclusion: The results from this studied Sumatran population indicate that there are common TMD symptoms in young adult orthodontic patients, but there is no significant association between vertical mandibular asymmetry and TMD symptoms. Further study on the development of TMD, mandibular asymmetry and treatment planning for growing patients is suggested, using longitudinal and transitional approaches