Comprehensive 3D analysis of condylar morphology in adults with different skeletal patterns – a cross-sectional study

Abstract

Background The correlation between individuals’ condylar morphology and their skeletal pattern is of great interest for treatment strategies ranging from orthodontic orthopaedics to orthognathic surgery. The objective of the present study was to investigate this relationship three-dimensionally. Methods A total of 111 adult patients (mean age = 27.0 ± 10.2 years) who underwent head computed tomography or cone beam computed tomography scans were included. Based on these data, 3D models of the skull and the condyles were calculated. The craniofacial skeleton was evaluated (1) transversally regarding skeletal symmetry (menton deviation), (2) sagittally regarding skeletal classes (Wits appraisal) and vertically regarding the inclination of the jaws (maxillomandibular plane angle). The condylar morphology was assessed (a) linearly by the condylar width, height and depth; (b) angularly by the antero-posterior and medio-lateral condylar inclination; and (c) volumetrically by the ratio of the condylar volume/mandibular volume (C/Mand). Results (1) Transversal: Asymmetric patients showed significantly higher discrepancies in the volumetric ratio C/Mand on the deviation and non-deviation side compared to symmetric patients. (2) Sagittal: Class III subjects demonstrated longer, more voluminous condyles with higher antero-posterior and medio-lateral inclination angles compared to Class II participants. (3) Vertical: Hyperdivergent subjects had smaller condyles with higher antero-posterior inclination angles than those of hypodivergent subjects. No interactions of skeletal class and vertical relationships regarding condylar morphology were observed. Conclusions This study demonstrates a clear correlation between pronounced skeletal patterns and condylar morphology in an adult population. The description of radiographic condyle characteristics in relation to the craniofacial morphology improves orthodontic treatment planning and could be helpful in the diagnosis of temporomandibular joint pathologies.

Analysis of the Volumetric Asymmetry of the Mandibular Condyles Using CBCT

“… 20 Few other researchers have used a plane parallel to the Frankfurt horizontal passing through the most caudal point of the mandibular notch. 21 , 22 It noteworthy that the volume of the condyle is approximately 3 to 4 times greater with the former method when compared to the latter method because of the difference in the boundaries of segmentation.…”

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

“…The literature showed that, during mandibular dynamics, there is a functional remodeling response [31]. In particular, the head of the mandibular condyle may react directly or indirectly to the load exerted by the chewing muscles [32]; it varies in thickness and mineralization in relation to different vertical facial models [33,34].…”

TMJ Position in Symmetric Dentofacial Deformity

“…In our sample, the results were in the same direction because the subjects with skeletal class III showed a lower mandibular plane and a posterior condylar position. Some authors [21][22][23][24] observed a relation between the skeletal class and the sagittal and coronal position of the condyle, indicating that this morphology could explain the differences in the adaptive biomechanical patterns of the TMJ for different facial morphologies.…”