Evaluation of condylar morphology using panoramic radiography

Abstract

Background: Orthopantomograph (OPG) is a routine imaging modality utilized by most dental surgeons for obtaining general information about the teeth, mandible, and adjacent regions of the jaw. It also yields a favorable cost-benefit relationship and exposes patients to relatively low doses of radiation. Human mandibular condyle may be categorized into five basic types: Flattened, convex, angled, rounded, and concave. Morphologic changes of condyle occur due to developmental variations, remodeling, various diseases, trauma, endocrine disturbances, and radiation therapy. Among various imaging modalities used for temporomandibular joint (TMJ) imaging panoramic radiographs still remain the main screening modality for TMJ abnormalities. Aims and Objectives: This study, aims at observing and recording the variation in the shapes of condyle on an OPG and thereby evaluates whether dentate or non-dentate oral cavity shows any peculiarities in Indian population and whether it could have a deterministic value in forensic science. Materials and Methods: This study comprised radiographic evaluation of 400 condylar heads after visualizing 200 digitalised OPGs taken for routine investigation. The radiographs were evaluated by two oral radiologists for the formulation of operational definitions. Condylar morphology of four types was identified according to a particular classification. Trends occurring in the shapes were evaluated, and combinations of the condylar shapes present in population were identified. Results: The present study is an attempt to scout the prevalent radiographic shapes of the condylar head on the OPG. Of the 200 pairs of condylar heads evaluated, 60% were oval in shape, followed by bird beak (29%), diamond (9%) and least being crooked finger (2%). This raised a curiosity whether the TMJ followed any typical feature of symmetry. Oval-oval was commonly occurring combination (67%), whereas crooked/ crooked finger was a rarity. Conclusion: Low exposure dose and ease of prescription makes OPG a common choice of imaging prescription. Evaluation of condyle on OPG seems to attract clinicians to make fine observations. Oval-oval being most common in both genders. More sample size and evaluation of other parameters may aid in giving more information about the population and thereby generating interest in forensics.