The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT

Lee, Boram; Kang, Dae-Keun; Son, Woo‐Sung; Park, Soo‐Byung; Kim, Seong-Sik; Kim, Yong‐Il; Lee, Kyung-Min

doi:10.4041/kjod.2011.41.2.87

Cited by 16 publications

(14 citation statements)

References 24 publications

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“…Then the surface size and volume were calculated by numerically integrating the size of all triangles attributed to the condyle based on the 3-D reconstructed separated TMJ (Figure 1 ). Both the surface size and volume were significantly bigger on deviated side than on the non-deviated side, consistent with the variety law that the deviated condyle is larger than the non-deviated one found by the previous researchers [ 23 , 24 ]. Habib et al .…”

Section: Discussionsupporting

confidence: 90%

Mandibular asymmetry: a three-dimensional quantification of bilateral condyles

et al. 2013

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IntroductionThe shape and volume of the condyle is considered to play an important role in the pathogenesis of the mandibular deviation. Curvature analysis is informative for objectively assess whether the shape of the condyles matches that of the glenoid fossa. In this study, a three-dimensional (3-D) quantification of bilateral asymmetrical condyles was firstly conducted to identify the specific role of 3-D condylar configuration for mandibular asymmetry.Methods55 adult patients, 26 males (26 ± 5 yrs) and 29 females (26 ± 5 yrs), diagnosed with mandibular asymmetry were included. The examination of deviation of chin point, deviation of dental midlines, inclination of occlusal plane, and depth of the mandibular occlusal plane were conducted. After the clinical investigation, computed tomography images from the patients were used to reconstruct the 3-D mandibular models. Then the condylar volume, surface size, surface curvature and bone mineral density were evaluated independently for each patient on non-deviated and deviated sides of temporomandibular joint.ResultsBoth the condylar surface size and volume were significantly larger on deviated side (surface size: 1666.14 ± 318.3 mm2, volume: 1981.5 ± 418.3 mm3). The anterior slope of the condyle was flatter (0.12 ± 0.06) and the posterior slope (0.39 ± 0.08) was prominently convex on the deviated side. The corresponding bone mineral density values were 523.01 ±118.1 HU and 549.07 ±120. 6 HU on anterior and posterior slopes.ConclusionsThe incongruence presented on the deviated side resulted in a reduction in contact areas and, thus, an increase in contact stresses and changes of bone density. All aforementioned results suggest that the difference existing between deviated and non-deviated condyles correlates with facial asymmetrical development. In mandibular asymmetry patients, the 3-D morphology of condyle on deviated side differ from the non-deviated side, which indicates the association between asymmetrical jaw function and joint remodeling.

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Section: Discussionsupporting

confidence: 90%

Mandibular asymmetry: a three-dimensional quantification of bilateral condyles

et al. 2013

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“…Stepwise linear regression analysis selected only menton deviation (Me-S) as a valid parameter for the asymmetry index of hypopharyngeal volume and cross-sectional area. Several previous studies mentioned that Menton deviation correlates with several skeletal abnormalities of mandible, including elongated mandibular body, discrepant hemi-ramal and condylar volume, and asymmetric ramal inclination between the non-deviated and deviated sides 49 , 50 . It is one of the most prominent features in skeletal Class III patients with mandibular deviation which usually determines the degree of facial asymmetry 51 .…”

Section: Discussionmentioning

confidence: 99%

Upper airway asymmetry in skeletal Class III malocclusions with mandibular deviation

Zheng

Wang

et al. 2017

Sci Rep

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The purpose of this study was to investigate the relationship between bilateral differences of upper airway and mandibular morphologic patterns in subjects with skeletal Class III mandibular deviation. 47 skeletal Class III (ANB < 0°) adult patients with and without mandibular deviation were divided into 2 groups. Bilateral differences of minimum cross-sectional area, mean cross-sectional area, volume of subdivisions (nasopharynx, palatopharynx, glossopharynx, hypopharynx) were assessed paired t test. Stepwise linear regression analysis and Pearson correlation coefficients were computed between a significant pair of upper airway variables and a pair of mandibular deviation variables to examine the quantitative relationship between the upper airway asymmetry and mandibular deviation. The mean cross-sectional area and the volume of palatopharynx on the deviated side in mandibular deviated group was significantly smaller than non-deviated side. The asymmetry index of the palatopharyngeal volume showed significant correlations with CRA asymmetry (r = 0.49) and Ramus asymmetry (r = 0.54). However, in the glossopharyngeal and hypopharyngeal segment, the mandibular deviated group showed significant asymmetry, characterized by larger mean cross-sectional area and volume in deviated side. The asymmetry index of the glossopharyngeal volume and hypopharyngeal volume showed significant correlations with CRA asymmetry (r = 0.42), Me-s (r = 0.72) and Me-s (r = 0.67) respectively.

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“…However, many researchers and clinicians have used Me for the evaluation of mandibular asymmetry on CBCT images,1314151723 even though some studies, including the above-mentioned study, reported lower reliability of identification of the Me on 3D CT or CBCT images than on 2D radiographs 1011. This may be because most orthodontists are accustomed to conventional landmarks, such as Me, which have been used for more than half a century in 2D cephalometric analysis.…”

Section: Discussionmentioning

confidence: 99%

The genial tubercle: A prospective novel landmark for the diagnosis of mandibular asymmetry

et al. 2017

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IntroductionIdentifying menton (Me) on posteroanterior cephalograms and three-dimensional (3D) cone-beam computed tomography (CBCT) images is difficult, because the midpoint of the symphyseal area is not identifiable after the mandibular symphysis fuses at an early age. The aim of this study was to evaluate the reliability of the identification of the genial tubercle (GT) in patients with mandibular asymmetry and to compare it with that of the traditional landmark, Me.MethodsThe samples comprised 20 CBCT images of adults with mandibular asymmetry. Two examiners performed the identifications and measurements. Me and GT were marked, and the anteroposterior, vertical, and transverse distances to the three reference planes were measured on 3D-reconstructed CBCT images. The intra- and inter-examiner reliability of landmark identification of Me and GT were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots.ResultsThe Me and GT landmarks showed excellent reliability (ICC ≥ 0.993) three-dimensionally. In the transverse evaluation, the ICC values of the GT (range, 0.997–0.999) tended to be slightly higher than those of Me (range, 0.993–0.996). In the Bland-Altman plots for the two separate assessments, Me showed a maximum error of 1.76 mm in the transverse direction, whereas the GT showed a maximum error of 0.96 mm in the 95% limit.ConclusionsOur results suggest that both Me and GT are clinically reliable and equally useful landmarks for the evaluation of mandibular asymmetry on CBCT images.

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The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT

Cited by 16 publications

References 24 publications

Mandibular asymmetry: a three-dimensional quantification of bilateral condyles

Mandibular asymmetry: a three-dimensional quantification of bilateral condyles

Upper airway asymmetry in skeletal Class III malocclusions with mandibular deviation

The genial tubercle: A prospective novel landmark for the diagnosis of mandibular asymmetry

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