Evaluation of structural skeletal asymmetry of the glenoid fossa in adult patients with unilateral posterior crossbite using surface-to-surface matching on CBCT images

Abstract

Objectives To compare, using surface-to-surface (StS) matching, any shape differences between the crossbite and noncrossbite side of the glenoid fossa and articular eminence in adult patients affected by posterior unilateral crossbite (PUXB) and compare them with unaffected controls. Materials and Methods 32 cone beam computed tomography (CBCT) scans of patients (mean age: 23.72 ± 3.74 years) undergoing surgical maxillary expansion were analyzed to obtain three-dimensional models of the left and right glenoid fossae that were superimposed using stable anatomical reference points and then compared using StS matching to evaluate the presence of any shape differences. These findings were compared with those obtained from 16 CBCT scans of unaffected controls (mean age: 23.72 ± 3.73 years). Results A mean difference of >11% was found between the study group and controls when comparing the matching percentages of the two sides of the glenoid fossa and articular eminence at all three levels of tolerance selected for this study. These differences were found to be highly statistically significant (P ≤ .0001). Conclusions According to the shape analysis findings, adult PUXB patients exhibit a higher degree of glenoid fossa and articular eminence shape differences compared to unaffected controls.

Three‐dimensional morphological and positional analysis of the temporomandibular joint in adults with posterior crossbite: A cross‐sectional comparative study

“…Although our study described side asymmetry between the control and crossbite groups, it aligns with previous studies regarding the relationship between the symmetric condyle glenoid fossa of the crossbite and non‐crossbite sides in patients with untreated posterior crossbites, which could be explained by skeletal remodelling of the TMJs and/or variation in the thickness of the articular TMJ disc, as described by Muraglie, Hesse, Bishara and Wang 20,25,45,46 . Those studies suggest that the TMJ disc can adapt to any alteration caused by occlusal changes to the space between the condyle and fossa.…”

“…The first method showed that the linear measurements of the crossbite and aligned sides in the UCG and the right and left sides in the other groups were not statistically different except the medial condylar position was significantly greater in the CG and BCG and the CG and UCG on both the right and left sides, likely due to the nearly linear differences (condyle width, height and total volume) between the groups. Muraglie et al 25 found that a higher percentage of glenoid fossa and articular eminence asymmetry was found while comparing the crossbite and non‐crossbite sides of PUXB patients compared with the control sample, with mean percentage differences greater than 11 for each level of tolerance. These findings further corroborate the adaptive nature of the glenoid fossa even in PUXB patients, which is known to occur after changes in the occlusion and positioning of the mandible.…”

“…The impact of posterior crossbite on the morphology of the temporomandibular joint (TMJ) varies from none to major 16‐25 . There are studies 16‐21,25 reporting the uncertainty to the moment of this association, with the presence of other contradictory studies 22‐24,26 . Potential explanations for these contradictory findings include study design, sample size, research approach, imaging technique and whether the assessment was performed in two or three dimensions (2D, 3D); given the anatomical complexity of this region, seemingly innocuous methodological differences can easily produce such disparate outcomes.…”

“…Kecik et al 21 found that the condyles were mispositioned in the glenoid fossa on the crossbite side. Recently, Muraglie et al 25 have shown a higher percentage of glenoid fossa and articular eminence asymmetry while comparing the crossbite and non‐crossbite sides of posterior unilateral crossbite (PUXB) patients compared with the control sample. In contrast, Leonardi et al 23 describe symmetric condylar positioning between the crossbite and aligned sides.…”

How to Obtain an Orthodontic Virtual Patient through Superimposition of Three-Dimensional Data: A Systematic Review

“…The possibility to simulate a virtual patient represents an important step towards a personalized diagnostic and therapeutic approach [44][45][46]. Future investigations would focus on the analysis of the effective clinical advantages that the patient can get from a simplified digital planning.…”