Evaluation of condyle-fossa relationships in adolescents with various skeletal patterns using cone-beam computed tomography

Abstract

Objectives: To evaluate the condyle-fossa relationship in adolescents with various skeletal patterns using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images obtained in 120 adolescent patients were used for this study. The patients were divided into 3 groups according to 3 criteria: (1) age (early, middle, and late adolescence); (2) facial height ratio or Jarabak quotient (hyperdivergent, normodivergent, and hypodivergent); and (3) ANB classification (Class I, Class II, and Class III). Temporomandibular joint space (TMJS: AS, anterior space; SS, superior space; PS, posterior space; MS, medial space; LS, lateral space), width and depth of the condyle (MLT, mediolateral thickness; APT, anteroposterior thickness), articular slope (ArS) and vertical height of the fossa (VHF) were measured and compared using CBCT. Results: Differences in condyle-fossa relationships were not significantly different between male and female adolescents, but were significantly different (P < .05) between left and right sides. The mean values showed no statistical differences according to age and skeletal pattern. Most measurements in the sagittal view showed that SS was the greatest, and the mean ratio of AS to SS to PS was 1.00 to 1.27 to 1.19, respectively. The mean values of coronal MS and LS were not significantly different. Conclusions: There were almost no statistical differences in the TMJS in adolescents across various factors except between left and right sides.

Assessment of the Morphology and Degenerative Changes in the Temporomandibular Joint Using CBCT according to the Orthodontic Approach: A Scoping Review

“…All of the possible spatial combinations of condyle positioning in the joint had been observed in hypodivergent patients. Both narrowing of the anterior [56], anterior and superior combined, [22,34], and posterior [49], as well as widening of the upper articular talar space, had been demonstrated [24,54].…”

“…In another study, the authors did not find an optimal condyle position in any of the patients presenting with a class III malocclusion [58]. A significant number of the articles included in the review did not prove a statistically significant correlation between mandibular head position and articular joint space morphology and anterior malocclusions [25,47,50,52,54,55]. Only one study, but based on a large study group (120 patients), evaluated the effect of the extent of chin deviation in skeletal and dental class III malocclusion on the position of the condyle in the joint space.…”

“…In hyperdivergent patients, narrowing of the posterior [22,56] and upper [24,54,55] joint space was most commonly observed. Also, Alhammadi et al [56] demonstrated widening of the upper joint space in addition to narrowing of the posterior joint space.…”

“…The association of joint space features and condylar positions with maxillofacial morphology and malocclusion was addressed in 19 articles included in the systematic review. These studies were published between 2012 and 2021 and involved patient populations from China [22,46], Brazil [35,44,47], India [48,49], Peru [34], Iran [25], Nepal [50], Turkey [51,52], South Korea [24,[53][54][55], Egypt [56,57], and Ukraine [58]. Sample sizes ranged from 20 [50] to 180 [35] patients.…”

“…This resulted in an anterior, superior, or anterosuperior position of the condylar heads, respectively, as compared with the other groups. Some papers did not find a statistically significant association between altered joint space morphology and condyle position and skeletal or dental class II malocclusion [44,47,52,54,55]. Only two articles reported a retrusive position of the mandibular condyles, which resulted in a wider dimension of the anterior articular joint space [48,57].…”