Condylar volume and surface in Caucasian young adult subjects

<p>Abstract</p> <p>Background</p> <p>There have been no quantitative standards for volumetric and surface measurements of the mandibular condyle in Caucasian population. However, the recently developed cone-beam computed tomography (CBCT) system allows measurement of these parameters with high accuracy.</p> <p>Methods</p> <p>CBCT was used to measure the condylar volume, surface and the volume to surface ratio, called the Morphometric Index (MI), of 300 temporo-mandibular joints (TMJ) in 150 Caucasian young adult subjects, with varied malocclusions, without pain or dysfunction of TMJs.</p> <p>Results</p> <p>The condylar volume was 691.26 ± 54.52 mm³in males and 669.65 ± 58.80 mm³in, and was significantly higher (<it>p</it>< 0.001) in the males. The same was observed for the condylar surface, although without statistical significance (406.02 ± 55.22 mm²in males and 394.77 ± 60.73 mm²in females).</p> <p>Furthermore, the condylar volume (693.61 ± 62.82 mm³) in the right TMJ was significantly higher than in the left (666.99 ± 48.67 mm³, <it>p </it>< 0.001) as was the condylar surface (411.24 ± 57.99 mm²in the right TMJ and 389.41 ± 56.63 mm²in the left TMJ; <it>t </it>= 3.29; <it>p </it>< 0.01). The MI is 1.72 ± 0.17 for the whole sample, with no significant difference between males and females or the right and left sides.</p> <p>Conclusion</p> <p>These data from temporomandibular joints of patients without pain or clinical dysfunction might serve as examples of normal TMJ's in the general population not seeking orthodontic care.</p

Cone-Beam Computed Tomographic Assessment of the Mandibular Condylar Volume in Different Skeletal Patterns: A Retrospective Study in Adult Patients

The aim of this study was to assess the condylar volume in adult patients with different skeletal classes and vertical patterns using cone‐beam computed tomography (CBCT). CBCT scans of 146 condyles from 73 patients (mean age 30   12 years old; 49 female, 24 male) were selected from the archive of the Department of Dentistry and Maxillofacial Surgery of Fondazione IRCCS Ca’ Granda, Milan, Italy, and retrospectively analyzed. The following inclusion criteria were used: adult patients; CBCT performed with the same protocol (0.4 mm slice thickness, 16   22 cm field of view, 20 s scan time); no systemic diseases; and no previous orthodontic treatments. Three‐dimensional cephalometric tracings were performed for each patient, the mandibular condyles were segmented and the relevant volumes calculated using Mimics Materialize 20.0  software (Materialise, Leuven, Belgium). Right and left variables were analyzed together using random‐intercept linear regression models. No significant association between condylar volumes and skeletal class was found. On the other hand, in relation to vertical patterns, the mean values of the mandibular condyle volumes in hyperdivergent subjects (688 mm3) with a post‐rotation growth pattern (625 mm3) were smaller than in hypodivergent patients (812 mm3) with a horizontal growth pattern (900 mm3). Patients with an increased divergence angle had smaller condylar volumes than subjects with normal or decreased mandibular plane divergence. This relationship may help the clinician when planning orthodontic treatment

Cone-Beam Computed Tomography Accuracy for Morphological and Morphometric Evaluation of Mandibular Condyles Using Small FOV and Small Voxel Size

&nbsp; The objective of this study is to evaluate the accuracy of cone beam computed tomography (CBCT) in determining and visualizing the morphology and morphometry of the mandibular condyle. Narrative reviews with article searches were carried out through NCBI's PubMed database and Scopus from September 2021–October 2021, with the inclusion criteria articles published in 2011–2021.&nbsp; The temporomandibular joint (TMJ) has a crucial role and is closely related to the masticatory system. The diagnosis of temporomandibular disorder (TMD) is not easy and is complex enough to require a comprehensive clinical and radiographic examination. Pathological changes such as erosion of the condyle, fracture, ankylosis, dislocation, and osteophyte can be well seen using CBCT imaging. CBCT images obtained with smaller field of view (FOV) have smaller a voxel size and a higher image resolution. FOV or scan volume refers to the anatomical area that will be included in the data volume or the area of the patient that will be irradiated. The dimension of FOV depends on the detector size and shape, the beam projection geometry, and the ability to collimate the beam. Voxel size is an important component of image quality, related to both the pixel size and the image matrix. Selection of small FOV and small voxel size is recommended because they provide better visualization and detail for the evaluation of morphology and morphometry of the condyle, especially the detection of erosion and defects on the condyle surface

CORRELATION OF MONSON’S SPHERE AND SOME OTHER DENTOFACIAL VARIABLES TO TEMPOROMANDIBULAR JOINTS (TMJs) IN THE CHINESE POPULATION

Purpose: The purpose of this study was to investigate the correlation of Monson’s Sphere along with several dentofacial variables to the morphologic changes of condyles (condylar height in this case), as well as the possible mechanism that may govern this correlation. These variables are: the discrepancy of the mandibular and maxillary spheres, ANB (anterior-posterior relationship of the maxilla with the mandible), Bonwill’s Angle, Overbite, Overjet, the angle of mediolateral axes of two condyles and the distance between the two condyles. Materials and methods: CT (Computed Tomography) DICOM (Digital Imaging and Communications in Medicine) data of 54 Chinese patients were collected, including 43 females and 11 males aged from 11 to 49 years old. The coordinates of the dental, craniofacial and temporomandibular landmarks were measured through a DICOM viewer. A linear regression model was used to fit the sphere to the coordinates of the dental and temporomandibular landmarks. As well, condylar height and other variables were calculated from the coordinates of the landmarks. Pearson Correlation was performed to illustrate the bivariate correlation of the variables in couples. The difference among the groups categorized by the fixed factors including gender, age, ANB and so on, was tested by ANOVA, and the influence of multiple independent variables on dependent variables was examined. Results: From the data analysis, the mean radius of Monson’s Sphere in the maxilla is 92.42 mm and the mean radius in the mandible is 85.69 mm. Condylar height is correlated to the angle of the mediolateral axes of two condyles positively, and to Overjet, ANB and Bonwill’s angle in a negative way. The discrepancy of the two Monson’s spheres seems to have a linear correlation with both Overjet and Overbite, and the group with the lower values of condylar height are more likely to obtain a portfolio of the greater values of Overjet, Overbite and the discrepancy of the two spheres. Conclusion: The average radius of the mandible Monson’s Sphere is less than 100mm and the radii of only 3 out of 54 subjects are around 100 mm; however, the average distance between two submits of condyles is 100.87 mm. The group of Angle Classification Class II Division I seem to be the high-risk population with the feature of lower condylar height. This finding may pave the way for further research on the relationship between occlusion and temporomandibular joints. Note that since all the results and conclusions herein come from a specific set of populations (Chinese in particular), generalization to other populations may need to be applied with careful and informed consideration

Mandibular repositioning in adult patients - an alternative to surgery?: A two-year follow-up

Abstract Background Adult patients presenting with skeletal discrepancies may refuse surgical intervention. Materials and methods Thirty-two patients who declined orthognathic correction of their maxillo-mandibular dysplasia and who were without signs of temporomandibular dysfunction (TMD) were offered mandibular repositioning as a non-invasive alternative. Simulating a skeletal correction, it was explained that the approach was based on results described in case reports. Before commencing treatment, initial records, lateral and frontal head films, study casts and photos were obtained (T0) and the mandible was repositioned to camouflage a retrognathic skeletal discrepancy or a mandibular transverse asymmetry by means of an occlusal build-up using Triad™ gel. Results Three months later (T1), 23 patients had adapted to the new occlusion reflected by an absence of functional disturbance and without fracture of the composite occlusal build-up. Mandibular position in these patients was maintained by additional orthodontic treatment and an adjustment of the occlusion to the built-up postured position (T1). The skeletal changes occurring during repositioning were assessed on sagittal and frontal head films while intra-articular changes occurring during a two-year follow-up period (T2) were evaluated on images constructed from CBCT scans. No significant change, either in the direction of relapse or in the direction of further normalisation of condylar position, were observed during the two-year observation period. Conclusion Mandibular repositioning is a non-invasive intervention that may be considered a valid alternative to surgery in selected patients. Morphological variables from the radiographs taken at T0 and the results of the initial clinical evaluation of dysfunction yielded only vague and insignificant indicators regarding the predictability of the adaptation. A CBCT scan at T0 might have contributed to the identification of the patients who would likely accept the repositioning

Effects Of Inhaled Corticosteroids On Condylar Head Of Mandible In Asthmatic Patients

Background : “Inhaled corticosteroids” are widely used and more efficient in management of asthma and chronic obstructive pulmonary disease. There are undesirable consequences on human bones associated to long-term treatment of corticosteroids. Several studies observed many variations that may affect the human condyles but little studies monitored effect of “inhaled corticosteroids” on these bones. Aim of study : To observe if long-term use of inhaled corticosteroids influence mandibular condylar head in patients with asthma on CBCT image. Materials and Methods : A study undertaken on “70 individuals” between ages 25-40 years who referred to Dental centers in Iraqi Capital for taking CBCT images of jaws between 5/2014 to 10/2016. Selected patients (35 case) have “mild to severe asthma and treated with inhaled corticosteroids used at least two times per day and for period of at least two years”. Other selected individuals (35 case) have a good health status. Linear measurements of mandibular condylar head carried out on CBCT images. Measurements included condylar head width and length on both of left and right condyle. Conclusion : There was no influence on condylar head of mandible in patients after using long-term inhaled corticosteroids.Keywords : Corticosteroids, Inhaled-corticosteroids, Asthma, mandibular condylar hea

Variation of normal condyle shape based on gender in panoramic radiographs

Objectives: To find out information about variations in the normal shape of the condyles based on gender using panoramic radiographic observations and to find out the frequency data for variations in the normal shape of the condyles. Materials and Methods: This is a descriptive observational research using 122 panoramic radiographs as secondary data. The panoramic image consisted of 61 male samples and 61 female samples. The condyles were observed by describing the condyle shapes on the right and left sides. Observation of the shape of the condyle was carried out by three observers. Then, the data were tested for reliability by using the Intraclass Correlation Coefficient to equalize the perceptions of the three observers. Results: The reliability test using ICC obtained a score &gt; 0.9 which means very good reliability. The most commonly found condyles shape is round and there are differences in shape between the right and left condyles in both males and females. Conclusion: The most common variation of the normal shape of the condyle found in both males and females is round on the right and left sides