Mandibular ramus height and condyle distance asymmetries in individuals with different facial growth patterns: a cone-beam computed tomography study

What Features on Routine Panoramic Radiographs Could Help Orthodontists to Estimate the Occurrence of Condylar Hyperplasia from Other Mandibular Asymmetries—Retrospective Analysis Study

“…When assessing routine panoramic radiographs features described herein are quite useful. Nevertheless, increased mandibular basis diameters with visible overgrowth and asymmetry towards the healthy side was the most common syndrome for condylar hyperplasia reported by most authors [1,2,8,10,19,[20][21][22][23]. Rare features might include joint or condylar process/head rare malignant or benign tumors, such as osteochondroma, which always require additional CT/CBCT for better differential diagnostics, as reported by Freidrich et al [24,25].…”

“…Panoramic radiograph is the first choice of imaging modality, due to that its good availability with low costs and good diagnostic performance and low dose is suitable enough for any first step diagnostics. In recent studies by Rizwana et al and Maniskas et al, despite the superiority of CBCT/CT, a panoramic radiograph was still found to be a valuable diagnostic tool [17,[20][21][22]. The evaluation of mandibular asymmetry requires some knowledge of key radiological and anatomical landmarks.…”

“…Because of changes in the facial skeleton, some visible characteristic radiological signs can be easily visible on a routine radiograph. The positions, shapes, sizes, and bone anatomy later influence soft tissue expressions [8,[17][18][19][20]. Some forms of asymmetry might also manifest in facial soft tissues, the overall axial skeletal lack of balance, or even might cause some changes in the detailed facial bone architecture (eye socket or zygomatic bone underdevelopment, or others).…”

“…On the other hand, currently 3D-CT/LDCT evaluation of both skeletal and soft tissue architecture grants more adequate diagnostics [7,9]. A study by Lemes et al highlights the usage of CBCT for total horizontal and vertical measurements of overgrowth of the mandible, which is useful in surgery planning [20]. Condylar position evaluation after a condylectomy is easily evaluated in CT/CBCT and even MRI to assess the lateral pterygoid muscle re-attachment to the new condylar bony stump in cases of condylar head re-shaping procedures [13][14][15][16]25].…”

Three-dimensional analysis of mandible ramus morphology and transverse stability after intraoral vertical ramus osteotomy

“…Patients with mandibular prognathism present with anterior crossbite, which leads to difficulty with mastication. A study showed that the height of the mandibular ramus decreased significantly in individuals with a hyperbranched skeletal pattern [ 7 ].Treatment for patients with mandibular prognathism requires not only mandibular setback to correct the malocclusion and restore the masticatory function but also consideration of the harmony of facial patterns after surgery. Symmetricity in frontal ramal inclination is important, especially in patients with facial asymmetry.…”