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Objective: To assess the condylar bone metabolic activity in patients with temporomandibular joint health by measuring 99m Tc-MDP uptake using a single-photon emission computed tomography (SPECT) to establish reference values of the uptake difference between condyles and the ratio with respect to the clivus.Setting and sample population: Eighty consecutive patients of both sexes who were admitted to a Nuclear Medicine Centre between 2017 and 2019 were included in the study. Method:This was an observational cross-sectional study in patients with SPECT indications to evaluate pathologies other than those of the temporomandibular joint.The values of the total and normalized counts in a fixed region of interest of five trans-axial slides were obtained to assess the percentage difference between the sides and the uptake ratio. The reference values are expressed as median and 5th and 95th percentiles. Results:The sample included 53 women (66.25%) and 27 men (33.75%) aged 15-55 years. The percentage of uptake difference between condyles was 5.04% (0.46-14.78) for men and 5.17% (0.27-13.21) for women (difference not significant, P = .9). The uptake difference was below 10% in 85% of the subjects (n = 68). The ratio values for total counts in women (0.87, 0.46-1.33) were significantly different (P = .0030) from those in men (1.08, 0.61-2.09). No significant correlation with age was found.Conclusions: These new reference ranges are applicable to the diagnosis of unilateral and bilateral condylar hyperplasia.

Introduction: Facial asymmetry associated with unilateral condylar hyperplasia (UCH) is a complicated clinical condition. Objective: The objective of this study was to describe morphological characteristics of the mandible and the temporomandibular joint in patients with facial asymmetry, using computed tomography and 3D reconstruction. Methods: A retrospective observational study was performed with patients displaying facial asymmetry evaluated by single photon emission computed tomography (SPECT)/CT analysis, for suspected UCH, between 2015 and 2018. The following variables were compared between the affected side (producing the asymmetry) and the contralateral side (side to where the jaw is deflected): condylar length, condylar medial and lateral pole length, mandibular ramus length, intra-articular spaces, articular eminence height and position of the posterior wall of the glenoid fossa. Results: Forty-three patients (21 women, mean age: 20.7 ± 7.25 years) with facial asymmetry were included, 19 patients presented right side deviation and 24 patients had left side deviation. Condylar length, lateral pole length, the sum of maximum values and articular eminence height were greater in the affected side (p< 0.05). A positive correlation was found between the position of the posterior wall of the glenoid fossa and the articular eminence height in the affected side (r = 0.442). Conclusions: In patients with suspected UCH, evaluated through CT, craniofacial measurements showed significantly larger condylar length and the condylar sum of maximum values in the affected side. A positive correlation was found between the increased dimensions of the articular eminence and the more posterior position of the glenoid fossa in the affected side.

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