Introduction Some clinicians believed that mandibular deviation leads to facial asymmetry and it also had a correlation with temporomandibular disorders (TMDs). Posteroanterior (PA) cephalogram was widely reported as a regular record in treating facial asymmetry and craniofacial anomalies. The objective of this study was to analyze the relationship of menton deviation in PA cephalogram with temporomandibular disorders (TMDs) symptoms. Materials and Methods TMJ function was initially screened based on TMD-DI questionnaire. PA cephalogram of volunteer subjects with TMDs (n = 37) and without TMDs (n = 33) with mean age of 21.61 ± 2.08 years was taken. The menton deviation was measured by the distance (mm) from menton point to midsagittal reference (MSR) horizontally, using software digitized measurement, and categorized as asymmetric if the value is greater than 3 mm. The prevalence and difference of menton deviation in both groups were evaluated by unpaired t-test. Result The prevalence of symmetry group showed that 65.9% had no TMDs with mean of 1,815 ± 0,71 mm; in contrast, the prevalence of asymmetry group showed that 95.5% reported TMDs with mean of 3,159 ± 1,053 mm. There was a significant difference of menton deviation to TMDs (p = 0.000) in subjects with and without TMDs. Conclusion There was a significant relationship of menton deviation in PA cephalogram with TMDs based on TMD-DI index.

Temporomandibular joint disorder (TMD) includes symptoms of Background: 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.The cross-sectional study included 18-25-year-old (mean ± SD, 21.9 Methods: ± 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.Of the 106 subjects, 26 (24.5% of the total) with vertical mandibular Results: 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.The results from this studied Sumatran population indicate that Conclusion: 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.

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Objective: Previous studies reported insulin-like growth factor type 1 (IGF-1) gene expression in mandibular condylar cartilage and idiopathic scoliosis development. This paper aims to correlate the single nucleotide polymorphisms (SNPs) of IGF-1 gene rs5742632 in vertical mandibular asymmetry patients with idiopathic scoliosis symptom.

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress in conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to analysis the difference of dental arch characteristics  based on genders in orthodontic patients with suspected CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient’s clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior crossbite and midline deviation), the positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, the distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p<0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form were mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these suspected CH patients. Conclusion: Indeed skeletal asymmetry, the evaluation of the dental arch characteristic symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with suspected  CH in the North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

Background: The mandible constitutes part of the craniofacial bone that plays an important role in determining an individual’s facial profile. The mandible grows and develops throughout life from the prenatal phase up to old age when it becomes and edentulous. Changes in the mandible can be measured using radiographs. These establish several parameters of mandibular morphology, including: ramus height, condylion height, body length, condylion angle, symphysis height, symphysis width and symphysis angle. Purpose: This study aimed to determine differences in the mandibular morphology of members of the mongoloid racial group in Medan according to age as measured by cephalometric radiography. Methods: This investigation constituted analytical research using cross-sectional study with a total sample of 150 individuals divided according to age: group 1 (aged 4-12 years), group 2 (aged 13-24 years, group 3 (aged 25-34 years), group 4 (aged 35-60 years) and group of 5 (aged > 60 years). The parameters were computerized by means of a digital cephalometric radiograph, the resulting data being analized with Oneway ANOVA and LSD. Results: The mean value of the highest to the lowest ramus height, and symphysis height from the five age groups, sequentially, were in group 3, group 4, group 5, group 2, and group 1. The mean value from the highest to the lowest of body length, condylion height, condylion angle, and symphysis width, sequentially, were in group 3, group 4, group 2, group 5, and group 1. The mean value from the highest to the lowest of symphysis angle, sequentially, were in group 1, group 3, group 4, group 2, and  group 5. Conclusion: The mandibular morphology of each age group differs in Mongoloid races in Medan based on lateral cephalometric radiography in which changes are may be affected by the state of teeth and age.

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.

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