Korean J Orthod.  2017 Sep;47(5):277-288. 10.4041/kjod.2017.47.5.277.

Cone-beam computed tomographic evaluation of the temporomandibular joint and dental characteristics of patients with Class II subdivision malocclusion and asymmetry

• Huang M
• Hu Y
• Yu J
• Sun J
• Ming Y
• Zheng L

• KMID: 2389143
• DOI: http://doi.org/10.4041/kjod.2017.47.5.277

Abstract

OBJECTIVE
Treating Class II subdivision malocclusion with asymmetry has been a challenge for orthodontists because of the complicated characteristics of asymmetry. This study aimed to explore the characteristics of dental and skeletal asymmetry in Class II subdivision malocclusion, and to assess the relationship between the condyle-glenoid fossa and first molar.
METHODS
Cone-beam computed tomographic images of 32 patients with Class II subdivision malocclusion were three-dimensionally reconstructed using the Mimics software. Forty-five anatomic landmarks on the reconstructed structures were selected and 27 linear and angular measurements were performed. Paired-samples t-tests were used to compare the average differences between the Class I and Class II sides; Pearson correlation coefficient (r) was used for analyzing the linear association.
RESULTS
The faciolingual crown angulation of the mandibular first molar (p < 0.05), sagittal position of the maxillary and mandibular first molars (p < 0.01), condylar head height (p < 0.01), condylar process height (p < 0.05), and angle of the posterior wall of the articular tubercle and coronal position of the glenoid fossa (p < 0.01) were significantly different between the two sides. The morphology and position of the condyle-glenoid fossa significantly correlated with the three-dimensional changes in the first molar.
CONCLUSIONS
Asymmetry in the sagittal position of the maxillary and mandibular first molars between the two sides and significant lingual inclination of the mandibular first molar on the Class II side were the dental characteristics of Class II subdivision malocclusion. Condylar morphology and glenoid fossa position asymmetries were the major components of skeletal asymmetry and were well correlated with the three-dimensional position of the first molar.

Keyword

Cone-beam computed tomography; TMJ; Asymmetry; Class II subdivision

MeSH Terms

Anatomic Landmarks
Cone-Beam Computed Tomography
Crowns
Head
Humans
Malocclusion*
Molar
Orthodontists
Temporomandibular Joint*

Figure

• 

  Figure 1 Reference planes and landmarks used in the study. A, Frontal view of the craniofacial bone. B, Lateral view of the craniofacial bone. C, D, Setting of the three perpendicular reference planes. The red plane represents the sagittal plane (sag), the blue one represents the axial plane (axi), and the green one represents the coronal plane (cor). Terms and definitions are listed in Table 1.

• 

  Figure 2 The measurements of the teeth and mandibular bone (Table 1 and Table 2). A and D, Right perspective view of the mandibular bone: mesiodistal crown angulation of the first molar (a); B and E, frontal perspective view of the mandibular bone: faciolingual crown angulation of the first molar (b); C and F, right perspective view of the mandibular bone: sagittal position of the first molar (c); G, left view of the mandibular bone; H, frontal view of the mandibular bone; I, right view of the mandibular bone: the length of the mandibular body (d), height of the ramus (e), and length of the entire mandibular bone (f).

• 

  Figure 3 The measurements of the condyle and glenoid fossa (Table 1 and Table 2). A, Mediolateral cut surface of the condyle: the height of the condylar head (g); B, anteroposterior cut surface of the condyle: the height of the condylar process (h); C, condylar process reconstructed by cutting the condyle along the wp plane: condylar area and volume; D and E, top view of the mandible: the angle between the mediolateral plane of the condyle and the sagittal plane (i); the vertical distance from the geometric centers of the condyles to the coronal plane (j); F, the condyle and glenoid fossa in a cone-beam computed tomography image: the width of the glenoid fossa (k), depth of the glenoid fossa (l), and angle of the posterior wall of the articular tubercle (m).

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