Evaluation of the mandibular condyles trabecular structure in patients with severe class III pattern: a computed tomography (CT) fractal analysis study

Abstract

Class III malocclusion is a combination of dental and skeletal disorders that causes discrepancies in occlusion. Malocclusion can affect the structure of the Temporomandibular joint (TMJ) resulting in many problems, one of which is affecting the internal structure of the bone. This study aimed to examine the morphological features of class III patients’ trabecular structure of the mandibular condyle in comparison with normal class I individuals using fractal analysis (FA). To study the internal structure of the mandibular condyle bone, Computed Tomography (CT) scans of 45 severe class III patients (age: 16–46) who were the candidates for orthognathic surgery were selected and matched by age and sex with 45 normal class I individuals. The trabecular bone structure of the left and right mandibular condyles in three CT planes of the study group and control group were evaluated employing the FA. The result of the present study indicated that the fractal dimensions (FD) values of class III patients were lower than those of the normal class I individuals in axial (class I: 1.31 ± 0.02, class III: 1.28 ± 0.02), sagittal (class I: 1.25 ± 0.03, class III: 1.19 ± 0.08), and coronal (class I: 1.5 ± 0.06, class III: 1.45 ± 0.07) planes (P < 0.001). There were no significant differences between the FD values of the males and females. The intra-group evaluation revealed that there was no correlation between age and FD values. No evidence of laterality was found regarding the FD values of the right and left condyles. Given the noticeable differences between the FD values, it can be implied that severe class III malocclusion may affect the trabecular pattern of the cancellous bone of the mandibular condyle compared to class I individuals. Therefore, due to the altered trabecular structure, clinicians should be cautious when planning treatments for these patients.

Evaluation of Trabecular Changes Using Fractal Analysis After Orthodontic Treatment for Congenital Maxillary Lateral Incisor Missing with Space Opening and Closure Methods

“…The literature in orthodontics shows that FD analysis has been performed in many studies to explore the impact of functional appliance treatment and malocclusion on mandibular condyles and to evaluate the effect of orthodontic treatment on the mandibular bone (15,28,(35)(36)(37)(38). In addition, Ok and Kaya, in their study investigating the connection between dental effects of RME (rapid maxillary expansion) treatment and the patency of the midpalatal suture suggested that fractal analysis can also applied to determine the modifications of midpalatal suture and alveolar bone following RME treatment (15).…”

Fractal analysis of the mandibular ramus in class II and III patients undergoing orthognathic surgery: Retrospective study trough Cone-beam Computed Tomography

“…Since then, it has been a method used to assess changes in trabecular bone. Fractal dimension (FD), obtained from radiographs or tomographs [11], is a measure that allows interpretation of the microstructure of trabecular bone [12]. Higher FD values are associated with a complex bone structure, characterized by denser and less porous trabecular architecture [13].…”