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

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Petra Santander ◽  
Anja Quast ◽  
Carolin Olbrisch ◽  
Marius Rose ◽  
Norman Moser ◽  
...  

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.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
L. de Frutos-Valle ◽  
C. Martin ◽  
J. A. Alarcón ◽  
J. C. Palma-Fernández ◽  
R. Ortega ◽  
...  

Abstract The main aim of this study was to generate an adequate sub-phenotypic clustering model of class III skeletal malocclusion in an adult population of southern European origin. The study design was conducted in two phases, a preliminary cross-sectional study and a subsequent discriminatory evaluation by main component and cluster analysis to identify differentiated skeletal sub-groups with differentiated phenotypic characteristics. Radiometric data from 699 adult patients of southern European origin were analyzed in 212 selected subjects affected by class III skeletal malocclusion. The varimax rotation was used with Kaiser normalization, to prevent variables with more explanatory capacity from affecting the rotation. A total of 21,624 radiographic measurements were obtained as part of the cluster model generation, using a total set of 55 skeletal variables for the subsequent analysis of the major component and cluster analyses. Ten main axes were generated representing 92.7% of the total variation. Three main components represented 58.5%, with particular sagittal and vertical variables acting as major descriptors. Post hoc phenotypic clustering retrieved six clusters: C1:9.9%, C2:18.9%, C3:33%, C4:3.77%, C5:16%, and C6:16%. In conclusion, phenotypic variation was found in the southern European skeletal class III population, demonstrating the existence of phenotypic variations between identified clusters in different ethnic groups.


2018 ◽  
Vol 4 (4) ◽  

Objectives This study aimed at comparing the size and shape of mandibular condyle in mature adult population with different skeletalpatterns.Methods A total of 198 patients within the age range of 15–64 years, including 68 males and 130 females, were allocated into three groupsbased on the ANB angle: skeletal classes I (n = 65), II (n = 69), and III (n = 64). The cone beam computed tomography (CBCT) was used toevaluate right and left temporomandibular joint (TMJ) in each patient. TMJ evaluation was comprised of size of condyle, area of condyle,and morphology index. The Mimics software was used to calculate the size and area of the condyle. The size, area, and morphology indexwere compared between the study groups using parametric tests.Results Based on the results of paired t-test, there was a significant difference between the sizes of right and left condyles, in favor of theright condyle (P = 0.02). In addition, the mean size of the condyle in class III subjects was higher than those of classes I and II; however, thedifference between the classes I and II was insignificant. The size and area of condyle were higher in males compared with females.Conclusion Based on the results of this study, there might be a correlation between the facial skeletal morphology and area of condyle.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Víctor Ravelo ◽  
Gabriela Olate ◽  
Gonzalo Muñoz ◽  
Márcio de Moraes ◽  
Sergio Olate

Objective. The aim of this research was to compare three cephalometric analyses and their correlation with the airway volume in subjects with different skeletal classes using 2D and 3D images. Study Design. Cross-sectional descriptive study. Material and Method. Steiner, McNamara, and Ricketts analyses and the airway volume were compared in 115 subjects who were candidates for orthognathic surgery under diagnosis using cone beam computed tomography (CBCT); 46 males (40%) and 69 females (60%) were included. The sagittal positions of the maxilla and mandible, the angulation of the mandibular plane, the sagittal positions of the upper and lower incisors, measurements of the largest or shortest airway area, and the volume were compared using Spearman’s test considering a p value < 0.05. Results. Differences were observed between the Steiner and McNamara techniques for the sagittal position of the maxilla ( p = 0.01 ). For mandibular angulation, there was a greater difference between values for Steiner and Ricketts techniques ( p = 0.001 ). In the upper incisor, the results for McNamara and Ricketts techniques were significantly different ( p = 0.004 ). Analysing the airway, subjects with a class II skeletal pattern had a smaller volume than those with a class III pattern ( p = 0.034 ). Conclusion. It may be concluded that skeletal class II patients have a significantly smaller airway volume than class III patients. The skeletal parameter does not always relate to the airway volume; however, the high mandibular angle could be related to the airway conditions.


2020 ◽  
Vol 10 (3) ◽  
pp. 40-43
Author(s):  
Farah Saleem ◽  
Zubair H Awiasi

Introduction: Accurate classification and treatment planning relies on correct diagnosis of skeletal and dentalrelationships. Commonly used measurements used to classify sagittal relationship ANB and Wit’s appraisal are not without potential inherent problems which might lead to less accurate classification of sagittal dysplasia. To avoid these problems, a new approach Beta angle was introduced by Baik in 2004. Beta angle as it involves different landmarks of classifying anterior-posterior relationships is said to be devoid of those problems thus more reliable. We conducted a cross sectional study to measure the angle among patients presenting in Nishtar Institute of Dentistry Multan Pakistan. Materials and Method: Ninety pretreatment cephalometric x-rays of patients between ages 12 to 30 years were selected and studied. They were divided into three classes based on ANB angle and Wit’s appraisal. For the measurement of Beta angle, a line was drawn from the center of condyle (C) to point A and other to point B. A third line joining A to B was drawn. A line from point A perpendicular to line C-B was drawn and angle was measured between this perpendicular and line joining A-B. ANOVA was used to compare means of three groups. Pearson correlational coefficient was used to correlate relationship between Beta angle and ANB angle. Result: The results showed Beta angle ranged between 27° and 34° for class I. Subjects having angle less than 27° can be classified as skeletal class II and those with angles larger than 34° as skeletal class III subjects. Conclusion: Beta angle is reliable method for assessing and classifying sagittal skeletal discrepancies 


2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Mohammad Zandi ◽  
Abbas Shokri ◽  
Vahid Mollabashi ◽  
Zahed Eghdami ◽  
Payam Amini

Objetive: This study aimed to compare the anatomical characteristics of the mandible in patients with skeletal class I, II and class III disorders using cone beam computed tomography (CBCT). Material and Methods: CBCT scans of patients between 17 to 40 years taken with NewTom 3G CBCT system with 12-inch field of view (FOV) were selected from the archive. Lateral cephalograms were obtained from CBCT scans of patients, and type of skeletal malocclusion was determined (Class I, II or III). All CBCT scans were evaluated in the sagittal, coronal and axial planes using the N.N.T viewer software. Results: The ramus height and distance from the mandibular foramen to the sigmoid notch in class II patients were significantly different from those in skeletal class I (P < 0.005). Distance from the mandibular canal to the anterior border of ramus in class III individuals was significantly different from that in skeletal class I individuals (P < .005). Conclusion: Length of the body of mandible in skeletal class I was significantly different from that in skeletal class II and III patients. Also, ramus height in skeletal class I was significantly different from that in skeletal class II patients. CBCT had high efficacy for accurate identification of anatomical landmarks.   Keywords Prognathism; Retrognathism; Mandible; Anatomy; Cone beam computed tomography.


2018 ◽  
Vol 56 (3) ◽  
pp. 314-320 ◽  
Author(s):  
Marilia Sayako Yatabe-Ioshida ◽  
Letícia Dominguez Campos ◽  
Renato Yassukata Yaedu ◽  
Ivy Kiemle Trindade-Suedam

Objectives: The purpose of this study was to 3-dimensionally assess the airway characteristics of patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) who underwent orthognathic surgery. Design: This was a retrospective study. Setting: The study took place at a national referral center for cleft lip and palate rehabilitation. Patients and Participants: The sample comprised cone-beam computed tomography (CBCT) scans obtained before and after orthognathic surgery of 15 individuals (30 CBCT scans), divided into 2 groups: UCLP group (n = 9 patients/18 CBCT scans) and BCLP group (n = 6/12 CBCT scans). All patients had a nonsyndromic UCLP or BCLP and a skeletal class III malocclusion at the preoperative period. Interventions: Airway volume, pharyngeal minimal cross-sectional area (mCSA), location of mCSA, sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles, and condylion-A point and condyloid-gnathion linear measurements were assessed in open-source software (ITK-SNAP and SlicerCMF). Main Outcome Measure: Airway dimensions of patients with UCLP and BCLP increase after orthognathic surgery. Results: After orthognathic surgery, UCLP group showed a significant 20% increase in nasopharynx volume. Although not significant, BCLP group also showed an increase of 18% in the same region. Minimal cross-sectional area remained dimensionally stable after surgery and was all located in the oropharynx region, on both groups. Additionally, a positive correlation was observed between volume and mCSA on both groups. Conclusion: Overall, individuals with UCLP and BCLP showed an increase in the upper airway after orthognathic surgery and this might explain the breathing and sleep improvements reported by the patients after the surgery.


2019 ◽  
Vol 24 (4) ◽  
pp. 63-72
Author(s):  
Sonia Patricia Plaza ◽  
Andreina Reimpell ◽  
Jaime Silva ◽  
Diana Montoya

ABSTRACT Objective: The purpose of this study was to establish the association between sagittal and vertical skeletal patterns and assess which cephalometric variables contribute to the possibility of developing skeletal Class II or Class III malocclusion. Methods: Cross-sectional study. The sample included pre-treatment lateral cephalogram radiographs from 548 subjects (325 female, 223 male) aged 18 to 66 years. Sagittal skeletal pattern was established by three different classification parameters (ANB angle, Wits and App-Bpp) and vertical skeletal pattern by SN-Mandibular plane angle. Cephalometric variables were measured using Dolphin software (Imaging and Management Solutions, Chatsworth, Calif, USA) by a previously calibrated operator. The statistical analysis was carried out with Chi-square test, ANOVA/Kruskal-Wallis test, and an ordinal multinomial regression model. Results: Evidence of association (p< 0.05) between sagittal and vertical skeletal patterns was found with a greater proportion of hyperdivergent skeletal pattern in Class II malocclusion using three parameters to assess the vertical pattern, and there was more prevalent hypodivergence in Class III malocclusion, considering ANB and App-Bpp measurements. Subjects with hyperdivergent skeletal pattern (odds ratio [OR]=1.85-3.65), maxillary prognathism (OR=2.67-24.88) and mandibular retrognathism (OR=2.57-22.65) had a significantly (p< 0.05) greater chance of developing skeletal Class II malocclusion. Meanwhile, subjects with maxillary retrognathism (OR=2.76-100.59) and mandibular prognathism (OR=5.92-21.50) had a significantly (p< 0.05) greater chance of developing skeletal Class III malocclusion. Conclusions: A relationship was found between Class II and Class III malocclusion with the vertical skeletal pattern. There is a tendency toward skeletal compensation with both vertical and sagittal malocclusions.


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