Cephalometric evaluation of condylar and mandibular growth modification: a review

Abstract

Based on a wealth of orthodontic archives, this work aims to review the cephalometric analysis systems that can identify the changes in condylar and mandibular position as well as growth direction in response to bite jumping therapy. Numerous cephalometric approaches were screened to testify their feasibility and reliability in accurately depicting the growth modification of the condyle and the mandible. The critical assessment of the working mechanisms of these cephalometric methods was elaborated to help build up the rationale and justification for their clinical use. 1) The changes in condylar and mandibular size, position and growth direction can be identified by using lateral cephalograms with closed-mouth or open-mouth posture. 2) With superimposition methods where the anatomical structures for superimposition registration must be stable and reproducible, the growth modification of the condyle and the mandible between two time-points is qualitatively demonstrated in a diagram if reference lines are not constructed. The growth modification can be quantitatively identified if the reference lines are created. 3) With non-superimposition methods, the size and position of the condyle and the mandible are separately identified for each time-pint by relating them to the stable reference structures. The growth modification between two time-pints is evaluated by comparing the two separate measurements. The application of a standardized and well designed cephalometric evaluation system may reduce the bias that attribute to the arbitrariness of the clinical effects of bite jumping functional appliances.