Cephalometric characteristics of open-bite cases with degenerative joint disease(DJD) of TMJ

Kim, Tae Woo

Abstract

The purpose of this study is to investigate the cephalometric characteristics of the open-bite patients with DJD of TMJ. The DJD open-bite cases were compared with normal samples and Class II open-bite cases with normal TMJ respectively. Twenty three open-bite patients with bilateral DJD of TMJ(13.9~35.3 years old, Group I) were selected from the Department of Orthodontics, SNUDH. Group II consisted of thirteen Class II open-bite cases(13.2-27.4 years old) with no TMD signs/symtoms and good condylar shapes. Group III samples were the forty eight healthy dental students who have Class I molar relationships with no history of orthodontic treatment, good facial balance and no TMD symptoms(20.0-26.8 years old). First, sixty measurements in the lateral cephalometric radiographs and analysis of variance(p<0.05, Scheffe) were used to compare these three groups. The seven measurements showed significant difference(P<0.05) between Group I and Group II. After analysis of variance, six of them were used for the discriminant analysis(Wilks', stepwise analysis) and the discrminant function for Group I/Group II was obtained. The results and conclusions were as follows: In most of the measurements, Group I and Group II showed the same skeletal and dental characteristics. But seven of the sixty measurements(FH-PP angle, SNB, FH-ArGo angle, articulare angle, gonial angle, upper gonial angle and Ar-Go length) were significantly different(p<0.05) between Group I and Group II. These differences may be explained by the fact that in DJD cases the mandible rotated backward due to the shortening of the ramus following the degenerative destruction of condylar head and its surrounding structures. The resulting discriminant function was: D = -0.l20X1 + 0.066X2 + 0.144X3 - 0.058X4 + 2,000, where X1=ArGo length(mm), X2=SArGo angle(degree), X3=FH-PP angle(degree), X4=Gonial angle(degree), Mean of the group centroids was -0.555 and percent of the "grouped" cases correctly classified was 88.89%.