Korean J Orthod.  2013 Oct;43(5):209-217. 10.4041/kjod.2013.43.5.209.

Comparison of the condyle-fossa relationship between skeletal class III malocclusion patients with and without asymmetry: a retrospective three-dimensional cone-beam computed tomograpy study

• Kim HO
• Lee W
• Kook YA
• Kim Y

• KMID: 2273412
• DOI: http://doi.org/10.4041/kjod.2013.43.5.209

Abstract

OBJECTIVE
This study investigated whether temporomandibular joint (TMJ) condyle-fossa relationships are bilaterally symmetric in class III malocclusion patients with and without asymmetry and compared to those with normal occlusion. The hypothesis was a difference in condyle-fossa relationships exists in asymmetric patients.
METHODS
Group 1 comprised 40 Korean normal occlusion subjects. Groups 2 and 3 comprised patients diagnosed with skeletal class III malocclusion, who were grouped according to the presence of mandibular asymmetry: Group 2 included symmetric mandibles, while group 3 included asymmetric mandibles. Pretreatment three-dimensional cone-beam computed tomography (3D CBCT) images were obtained. Right- and left-sided TMJ spaces in groups 1 and 2 or deviated and non-deviated sides in group 3 were evaluated, and the axial condylar angle was compared.
RESULTS
The TMJ spaces demonstrated no significant bilateral differences in any group. Only group 3 had slightly narrower superior spaces (p < 0.001). The axial condylar angles between group 1 and 2 were not significant. However, group 3 showed a statistically significant bilateral difference (p < 0.001); toward the deviated side, the axial condylar angle was steeper.
CONCLUSIONS
Even in the asymmetric group, the TMJ spaces were similar between deviated and non-deviated sides, indicating a bilateral condyle-fossa relationship in patients with asymmetry that may be as symmetrical as that in patients with symmetry. However, the axial condylar angle had bilateral differences only in asymmetric groups. The mean TMJ space value and the bilateral difference may be used for evaluating condyle-fossa relationships with CBCT.

Keyword

TMJ; Facial asymmetry; Class III diagnosis; Three-dimensional cone-beam computed tomography; Condyle-fossa relationship

MeSH Terms

Cone-Beam Computed Tomography
Facial Asymmetry
Humans
Malocclusion*
Mandible
Retrospective Studies*
Temporomandibular Joint

Figure

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  Figure 1 The 3 views of the condyle in the cone-beam computed tomography (CBCT) image: A, axial view; B, coronal view; C, sagittal view. The CBCT images were reoriented with the horizontal reference plane connecting the bilateral orbitales and Frankfurt horizontal plane,17,18 and the vertical midline and horizontal reference planes were set accordingly. The sagittal slice (C) was evaluated at the point where the mediolateral diameter of the right or left condyles was greatest (A) in the axial view.

• 

  Figure 2 Measurement of the joint space in the sagittal view. Anterior joint space (AS), superior joint space (SS), and posterior joint space (PS) were measured from the most prominent anterior, posterior, and superior condylar points to that of the glenoid fossa with the methods previously reported.7 The plane parallel to the Frankfurt horizontal (FH) plane was used as the reference plane.

• 

  Figure 3 Measurement of the axial condylar angle of the condylar process (A). It was defined as the angle between the long axis of the mandibular condylar process and a perpendicular line to the midsagittal plane.7

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  Figure 4 Cone-beam computed tomography image of a sample case showing the largest axial condylar angle difference between the deviated and non-deviated sides.

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