Abstract
Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress in conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to analysis the difference of dental arch characteristics based on genders in orthodontic patients with suspected CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient’s clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior crossbite and midline deviation), the positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, the distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p<0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form were mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these suspected CH patients. Conclusion: Indeed skeletal asymmetry, the evaluation of the dental arch characteristic symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with suspected CH in the North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.
Highlights
The unilateral non-neoplastic overgrowth of mandibular condyle that leads to occlusal interferences and joint dysfunction or pain, is identified as condylar hyperplasia (CH)
Due to the genetic and enviromental factors influence occlusal development and limitation of radiography evaluation this study aims to analysis the dental arch asymmetry and form in pre-orthodontic patients with suspected Condylar Hyperplasia (CH) based on genders
Participants CH suspected subjects fulfilled the following characteristics: facial asymmetry based on photography, posterior cross bite and midline deviation in plaster casts analysis, and positive temporomandibular joint disorder in functional analysis from the dental records
Summary
The unilateral non-neoplastic overgrowth of mandibular condyle that leads to occlusal interferences and joint dysfunction or pain, is identified as condylar hyperplasia (CH). The elongation of condylar head, neck, and lower arch corpus leads to the development of occlusal disharmony, dental compensation, and asymmetry due to continued abnormal growth that can be unilaterally or bilaterally (Bharathi et al, 2014; Obwegeser & Makek, 1986; Wolford et al, 2014). Sequential assessments (six to twelve month intervals) of CH aim to prevent worsening functional, esthetic, skeletal, and occlusal changes during orthodontic treatment These examinations include clinical examinations, plaster cast analysis, and radiographic evaluations in the abnormal condylar lower arch growth. Results: There was a significant difference (p
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