Abstract
The aim of this study was to assess the condylar volume in adult patients with different skeletal classes and vertical patterns using cone-beam computed tomography (CBCT). CBCT scans of 146 condyles from 73 patients (mean age 30 ± 12 years old; 49 female, 24 male) were selected from the archive of the Department of Dentistry and Maxillofacial Surgery of Fondazione IRCCS Ca’ Granda, Milan, Italy, and retrospectively analyzed. The following inclusion criteria were used: adult patients; CBCT performed with the same protocol (0.4 mm slice thickness, 16 × 22 cm field of view, 20 s scan time); no systemic diseases; and no previous orthodontic treatments. Three-dimensional cephalometric tracings were performed for each patient, the mandibular condyles were segmented and the relevant volumes calculated using Mimics Materialize 20.0® software (Materialise, Leuven, Belgium). Right and left variables were analyzed together using random-intercept linear regression models. No significant association between condylar volumes and skeletal class was found. On the other hand, in relation to vertical patterns, the mean values of the mandibular condyle volumes in hyperdivergent subjects (688 mm3) with a post-rotation growth pattern (625 mm3) were smaller than in hypodivergent patients (812 mm3) with a horizontal growth pattern (900 mm3). Patients with an increased divergence angle had smaller condylar volumes than subjects with normal or decreased mandibular plane divergence. This relationship may help the clinician when planning orthodontic treatment.
Highlights
The mandibular condyle morphology represents an important anatomic region for the skeletal and occlusal relationship as it plays an important role in orthopaedic-orthodontic treatment, both in shape and volume variables [1,2]
The condyle can constantly reshape itself when exposed to various stimuli as it represents a growth site, and the morphology it assumes has a fundamental role in the development and correction of the different types of malocclusions [3,4]
To assess the absence of temporomandibular joint (TMJ) pathologies, the following adjunct parameters were taken into account regarding TMJ range of motion: maximum mouth opening (MMO) within normal ranges (MMO ≥ 40 mm) and no deviation from the midline in the opening movement [17]
Summary
The mandibular condyle morphology represents an important anatomic region for the skeletal and occlusal relationship as it plays an important role in orthopaedic-orthodontic treatment, both in shape and volume variables [1,2]. The condyle can constantly reshape itself when exposed to various stimuli as it represents a growth site, and the morphology it assumes has a fundamental role in the development and correction of the different types of malocclusions [3,4]. Condyle anatomy should be considered when proposing an orthodontic treatment plan, as a correlation with vertical facial morphology has been hypothesized [3]. The mandibular condyle, as part of the temporomandibular joint (TMJ), is believed to have a key role in the long-term stability of the occlusion after orthodontic and orthognathic treatments. The 2D assessment of the TMJ is complex due to its articulated anatomy, magnification errors and the overlapping of adjacent anatomical structures [7,8]. 3D technology allows for a more detailed analysis of the mandibular condyles, their morphology and, above all, their volumes [9]
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