Korean J Orthod.  2015 May;45(3):121-129. 10.4041/kjod.2015.45.3.121.

Three-dimensional assessment of the temporomandibular joint and mandibular dimensions after early correction of the maxillary arch form in patients with Class II division 1 or division 2 malocclusion

• Coskuner H
• Ciger S

• KMID: 1974803
• DOI: http://doi.org/10.4041/kjod.2015.45.3.121

Abstract

OBJECTIVE
This study aimed to assess three-dimensional changes in the temporomandibular joint positions and mandibular dimensions after correction of dental factors restricting mandibular growth in patients with Class II division 1 or division 2 malocclusion in the pubertal growth period.
METHODS
This prospective clinical study included 14 patients each with Class II division 1 (group I) and Class II division 2 (group II) malocclusions. The quad-helix was used for maxillary expansion, while utility arches were used for intrusion (group I) or protrusion and intrusion (group II) of the maxillary incisors. After approximately 2 months of treatment, an adequate maxillary arch width and acceptable maxillary incisor inclination were obtained. The patients were followed for an average of 6 months. Intraoral and extraoral photographs, plaster models, and cone-beam computed tomography (CBCT) images were obtained before and after treatment. Lateral cephalometric and temporomandibular joint measurements were made from the CBCT images.
RESULTS
The mandibular dimensions increased in both groups, although mandibular positional changes were also found in group II. There were no differences in the condylar position within the mandibular fossa or the condylar dimensions. The mandibular fossa depth and condylar positions were symmetrical at treatment initiation and completion.
CONCLUSIONS
Class II malocclusion can be partially corrected by achieving an ideal maxillary arch form, particularly in patients with Class II division 2 malocclusion. Restrictions of the mandible in the transverse or sagittal plane do not affect the temporomandibular joint positions in these patients because of the high adaptability of this joint.

Keyword

Computed tomography; Early treatment; Temporomandibular joint; Class II

MeSH Terms

Cone-Beam Computed Tomography
Humans
Incisor
Joints
Malocclusion*
Mandible
Palatal Expansion Technique
Prospective Studies
Temporomandibular Joint*

Figure

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  Figure 1 Anterior (1), superior (2), and posterior (3) joint spaces and the mandibular fossa depth (4) on a sagittal image of the right temporomandibular joint.

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  Figure 2 The greatest anteroposterior (1) and mediolateral (2) diameters of the mandibular condyle, vertical distance from the geometric centers of the condyles to the midsagittal plane (4), and the angle between the long axis of the mandibular condyle and the midsagittal plane (3) on an axial image of the temporomandibular joint.

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