Condylar Height Research Articles

Evaluation of six radiomorphometric indices


 
 
 
 
 
 
 
 
 
 
 
 Purpose: Aging is accompanied by the gradual loss of teeth, which can cause several orofacial changes. This study aimed to compare panoramic radiomorphometric indices between dentate and totally edentulous patients.
 Materials and Methods: One hundred panoramic radiographs were analyzed to measure six indices using Clinview 9.3 software: the gonial angle (GA), antegonial angle (AGA), condylar height (CH), ramus height (RH), mental index (MI), and mandibular cortical index (MCI). An independent sample t-test and Chi-square was used to compare the means of the measured data between dentate and edentate subjects and genders.
 Results: In both genders, dentate people had greater left CH (p=0.05) and left GA (p=0.03). Men had greater RH in the dentate and edentate groups (p<0.001). No correlation was found between groups and genders in MCI scores. 
 Conclusion: CH index assessment as the function of the masticatory muscles and GA as residual ridge resorption were decreased in edentulous people. The findings highlight the importance of oral hygiene education and prosthetic rehabilitation of the edentulous.
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Investigation of Morphometric Factors Associated With Adolescent ACL Rupture.

There are no definitive anatomic morphometric risk factors for adolescent anterior cruciate ligament (ACL) injury. To compare the parameters used to define the tibial and femoral morphometric structure of the knee between adolescent patients with and without ACL rupture. Cross-sectional study; Level of evidence, 3. Included were magnetic resonance imaging (MRI) scans and radiographs of 115 patients aged 10 to 17 years who were evaluated for ACL rupture at a single institution between February 1, 2019, and January 31, 2022. Images from 115 patients with intact MRI scans were included as controls. We investigated the following imaging parameters: tibial slope (on lateral radiograph), lateral condylar height, tibial sulcus height, medial condylar height, condylar width, intercondylar notch with, intercondylar notch angle, notch index, eminence width, tibial plateau width, eminence width/tibial plateau width, medial/lateral/overall eminence height, medial plateau depth, and 2 different eminence angles. Parameters were compared between groups using the chi-square, Fisher exact, Student t, or Mann-Whitney U test, as appropriate. Receiver operating characteristic analysis was conducted for cutoff values of significant parameters. There were no significant differences in age, sex, or side affected between groups. Only the medial plateau depth was found to be statistically significant between the ACL rupture and ACL intact groups (2.6 vs 2.2 mm; P = .015). A statistically significant cutoff value could not be obtained for the medial plateau depth. Medial plateau depth was found to be significantly greater in adolescent patients with ACL rupture compared with ACL-intact controls.

Patients with trochlear dysplasia have dysplastic medial femoral epiphyseal plates.

To investigate the growth of the epiphyseal plate in patients with trochlea dysplasia using a 3D computed tomography (CT)-based reconstruction of the bony structure of the distal femur. The epiphysis plate was divided into a medial part and a lateral part to compare their differences in patients with trochlear dysplasia. This retrospective study included 50 patients with trochlea dysplasia in the study group and 50 age- and sex-matched patients in the control group. Based on the CT images, MIMICS was used to reconstruct the bony structure of the distal femur. Measurements included the surface area and volume of the growth plate (both medial and lateral), the surface area and capacity of the proximal trochlea, trochlea-physis distance (TPD) (both medial and lateral), and height of the medial and lateral condyle. The surface area of the medial epiphyseal plate (1339.8 ± 202.4mm2 vs. 1596.6 ± 171.8mm2), medial TPD (4.9 ± 2.8mm vs. 10.6 ± 3.0mm), height of the medial condyle (1.1 ± 2.5mm vs. 4.9 ± 1.3mm), and capacity of the proximal trochlear groove (821.7 ± 230.9mm3 vs. 1520.0 ± 498.0mm3) was significantly smaller in the study group than in the control group. A significant positive correlation was found among the area of the medial epiphyseal plate, the medial TPD, the height of the medial condyle and the capacity of the proximal trochlear groove (r = 0.502-0.638). The medial epiphyseal plate was dysplastic in patients with trochlea dysplasia. There is a significant positive correlation between the surface area of the medial epiphyseal plate, medial TPD, height of the medial condyle and capacity of the proximal trochlear groove, which can be used to evaluate the developmental stage of the trochlea in clinical practice and to guide targeted treatment of trochlear dysplasia. III.

Efficacy of Arthroscopic Diskopexy on Condylar Growth in Temporomandibular Joint Anterior Disk Displacement: A Randomized Clinical Trial.

Adolescents with temporomandibular joint (TMJ) anterior disk displacement (ADD) frequently develop dentofacial deformities. It is unknown whether adjunctive arthroscopic diskopexy compared with orthodontic treatment alone increases condylar growth and then improves dentofacial deformity. This study aimed to determine whether arthroscopic diskopexy before functional appliance (joint-occlusal treatment) or single functional appliance (occlusal treatment) increases condylar growth and improves dentofacial deformity among adolescents with TMJ ADD. A multicenter, randomized, parallel, controlled trial was conducted in 3 centers in China. Adolescents diagnosed with TMJ ADD and dentofacial deformity were enrolled. Eligible participants were randomly assigned to a joint-occlusal group or occlusal group at a ratio of 2:1. Magnetic resonance imaging scans and cephalometric radiographs were evaluated at baseline, at 8 months, and at 14 months. The primary outcome was changes in condylar height from 14 months to baseline. Secondary outcomes were changes in skeletal position. A total of 240 patients (14.65 ± 1.88 years of age) were randomized (joint-occlusal group, 160; occlusal group, 80). The overall difference in condylar height between groups was 3.65 mm (95% CI, 3.10 to 4.19 mm; P < 0.001). The between-group differences in condylar height on the left and right sides were 3.60 mm (95% CI, 2.92 to 4.28 mm; P < 0.001) and 3.69 mm (95% CI, 3.06 to 4.32 mm; P < 0.001), respectively. Significant between-group differences were noted in skeletal position (all P < 0.001). Joint-occlusal treatment can promote condylar growth and improve dentofacial deformity in adolescents after 14 months when compared with single occlusal treatment. Therapeutic, I.

Relationship between condylar surface CT value in coronal plane and condylar morphology in jaw deformity patients

Objectives. This study aimed to examine the relationship between condylar surface computed tomography (CT) values in the coronal plane and condylar morphology in patients with jaw deformities classes II and III before and after orthognathic surgery. Materials and MethodsThe maximum CT values (pixel values) at three points on the condylar surface, height, and joint space were measured on the coronal plane. The condylar width, thickness, and angle were measured on the horizontal plane preoperatively and at 1 year postoperatively. ResultsA total of 112 temporomandibular joints of 56 female patients were divided into two groups according to skeletal class (56 joints each in class II and class III). The maximum CT values of class II were higher than those of class III at the medial, central, and lateral sites on the condylar surface, preoperatively and at 1 year postoperatively (P < 0.05). CT values of the condylar surface were significantly negatively correlated with the condylar heights at the center and lateral sites preoperatively and at 1 year postoperatively (P < 0.05). ConclusionsCondylar surface CT values in the coronal plane are associated with condylar morphology, including condylar height.

TMJ anterior disc displacement anchorage surgery: a retrospective study based on a suture-free titanium screw strategy.

To evaluate the feasibility and effectiveness of using a suture-free titanium screw in repositioning anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ). A consecutive sample of twelve patients (fifteen joints) was included in this study. All patients were diagnosed with ADDwoR and showed limited mouth opening or temporomandibular joint pain symptoms. Suture-free titanium screw was placed in the condyle directly following the disc repositioning. Pre- and postoperative evaluation parameters include operation time, the visual analogue scale for pain (VAS), lateral excursion movements (LEM), maximum interincisal opening (MIO), and disc length and position on MRI. In addition, the mandibular condyle height was also measured. Statistical significance was considered when p < 0.05. The unilateral operation time was 58.54 ± 5.43min; during the 6-month period after the operation, the VAS values decreased from 87 ± 6.34 to 14.08 ± 6.65. The MIO increased from 30.07 ± 4.73 to 39.89 ± 1.69mm (p = 0.01). The TMJ disc length was prolonged from 8.23 ± 1.12 to 11.51 ± 1.29mm. The condyles showed significant remodeling, and the height of the condyle increased from 18.24 ± 4.12 increase to 19.6 ± 4.31mm. The LEM was increased from 5.27 ± 0.51 to 6.36 ± 0.62mm. The MRI images showed the stability of the disc in position during the opening and closing of the mouth. The TMJ disc position was stable during the follow-up period. Anteriorly displaced articular disc can be repositioned by a suture-free titanium screw strategy. This technique is an alternative method to address ADDwoR.

Effect of arthroscopic discopexy on condylar growth in adolescents with temporomandibular joint disc displacement without reduction: A retrospective self-controlled case series study

This study was a retrospective self-controlled study that aimed to evaluate the effect of arthroscopic discopexy on condylar height and mandibular position in adolescents with temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDwoR).Patients between 10 and 20 years of age and diagnosed with bilateral TMJ ADDwoR by magnetic resonance image (MRI) were included in this study. All patients underwent a period of natural course before arthroscopic surgery and then a follow-up period postoperatively. Changes in condylar height and mandibular position were measured by MRI and X-ray radiographs. Data were analyzed by paired t-test, Pearson correlation analysis, and generalized estimating equations.This study comprised a total of 40 patients with a mean age of 14.80 years. Pearson correlation analysis showed correlations between condylar height and mandibular position changes. The condylar height change during the post-operative period was significantly higher than that during natural course period (3.57 mm, p < 0.001). The changes in mandibular position (including ANB angle, SNB angle, and Pog-Np) were significant different (all p < 0.05) between the two periods.This study found that arthroscopic discopexy can promote condylar growth and correct dentofacial deformity in adolescents with bilateral TMJ ADDwoR.

Dimensional and positional temporomandibular joint osseous characteristics in normodivergent facial patterns with and without temporomandibular disorders

ObjectiveThis study evaluated the dimensional and positional osseous temporomandibular joint features in normodivergent facial patterns with and without temporomandibular disorders.MethodsA total of 165 adult patients were divided into two groups: group 1 (n = 79 patients; 158 joints): temporomandibular disorders patients and group 2 (n = 86 patients; 172 joints): non-temporomandibular disorders patients. Three-dimensional positional and dimensional temporomandibular joint characteristics, including glenoid fossa, mandibular condyles, and joint spaces, were assessed by cone beam computed tomography.ResultsThe glenoid fossa positions in the three orthogonal planes and height showed statistical significance between the two studied groups. The temporomandibular disorders patients showed higher horizontal and vertical condyle inclinations while anteroposterior inclination was less, and the condyle was positioned more superior, anterior, and lateral in the glenoid fossa. The condyle width and length showed no significance between the two groups, while condyle height was smaller in temporomandibular disorders patients. Anterior and medial joint spaces increased while the superior and posterior joint spaces reduced in temporomandibular disorders patients.ConclusionThere were significant differences between the patients with and without temporomandibular joint disorders in terms of mandibular fossa positions and height as well as condylar positions and inclinations in horizontal and vertical planes together with reduced condylar height and reduced posterior and superior joint spaces in the temporomandibular disorders patients.Clinical relevanceThe temporomandibular disorder is a multifactorial disorder in which one of these factors is the dimensional and positional characteristics of the temporomandibular joints; including or excluding this factor requires a comprehensive three-dimensional investigation of patients with TMD compared to the normal group under the condition that the facial pattern is average as a confounding factor.

Effect of occlusal stabilisation splint with or without arthroscopic disc repositioning on condylar bone remodelling in adolescent patients

The aim of this study was to investigate the treatment effects of a stabilisation splint (SS) with and without arthroscopic disc repositioning (ADR) on condylar bone remodelling in adolescent patients with anterior disc displacement without reduction (ADDwoR). Cone beam computed tomography and magnetic resonance imaging were used to analyse condylar bone remodelling, condyle position, and disc position. Twenty-two temporomandibular joints of 14 patients who underwent ADR (age range 12–20 years; mean follow-up 12.5 ± 7.8 months) and 21 temporomandibular joints of 14 patients who did not undergo ADR (age range 13–20 years; mean follow-up 11.1 ± 5.1 months) were included. The change in bone volume (P < 0.001), rate of bone volume change (P < 0.001), and change in condyle height (P = 0.031) were significantly greater in patients with ADR than in those without ADR. The changes in posterior joint space (P = 0.013), superior joint space (P = 0.020), and ratio of condyle sagittal position (P = 0.013) were significantly greater in patients with ADR than in those without ADR. All discs in patients who underwent ADR and one disc in those who did not undergo ADR were backward repositioned. In conclusion, in adolescent patients with ADDwoR, ADR with SS therapy achieved better condyle and disc position than SS therapy alone, and also induced bone generation.

Gender Determination by Radiographic Evaluation of Condylar Length, Coronoid Height and Gonial Angle

Introduction: Forensic dentistry plays an important role in the identification of the gender of an individual in situations like natural disasters (eg. earthquakes, floods, etc.) or man-made disasters (such as accidents and bombings). Among all the bones in the human body, the pelvis and the skull show the maximum sexual dimorphism. But in cases where an intact skull is not found, the mandible becomes our first choice for gender determination, as it is covered with dense, compact bone, which makes it very durable and well-preserved. Aims and Objectives: To determine the effectiveness of condylar height, coronoid height and gonial angle of the mandible for sex determination using orthopantomography and to compare and determine the most reliable parameter for gender determination. Materials and Method: This study was conducted using digital panoramic images of 25 patients of each gender. The images captured were viewed on AutoCAD 2014 software and were subjected to measurements of the condylar, coronoid heights and gonial angles both on the left and right side using AutoCAD 2014 imaging software. The data was entered into a Microsoft Excel sheet and statistical analysis was done. Results: The Student t-test showed significant (P &lt; 0.05) differences and higher values for both condylar height and coronoid height on both the right and left sides of males as compared to females. However, the difference in the mean gonial angle on both the right and left sides did not differ (P &gt; 0.05) between the two genders. All three variables were higher in males as compared to females. Conclusion: The parameters such as condylar height, coronoid height and gonial angle using orthopantomographs are reliable in gender determination and the condylar height of the left side is the best parameter in gender determination.

3D analysis of maxillomandibular morphology in hyperdivergent and hypodivergent individuals: A cross-sectional study.

The aim of this cross-sectional study was to investigate maxillomandibular morphology in hyperdivergent and hypodivergent individuals, using 3D surface models generated by cone-beam computed tomography (CBCT). The sample consisted of 60 CBCTs (30 males, 30 females) patients aged 12-30 years, divided into two groups comprising hyperdivergent (≥35°) and hypodivergent (≤30°) individuals, according to the mandibular plane (MP) angle. Multiplanar reconstructions were used to mark the landmarks, and 3D surface models were created to evaluate structures of the maxillomandibular complex, including condyle, ramus, symphysis and palatal height. Intergroup comparisons were performed by independent t-test. Pearson's correlation test was used (P < .05) to evaluate the correlation of the MP angle with the angles and linear measurements of other structures. Significant differences were found between the groups regarding condylar width, ramus height, condylar plus ramus height, mandibular length, gonial angle, palatal plane angle and palatal-mandibular angle. No differences (P > .05) were found for the condylar height, symphysis inclination angle or palatal height. Correlations (P < .05) were found between the MP angle and structures of the maxillomandibular complex. Hyperdivergent (MP ≥ 35°) and hypodivergent (MP ≤ 30°) individuals present different skeletal morphology regarding condylar width, ramus height, condylar plus ramus height, mandibular length, gonial angle, palatal plane angle and palatal-mandibular angle. There is a significant correlation between MP angle and morphological structures such as condyle, ramus, symphysis, palatal plane angle and palatal-mandibular angle.

THREE-DIMENSIONAL EVALUATION AND COMPARISON OF CONDYLE-FOSSA RELATIONSHIP, THEIR POSITION AND SYMMETRY USING CBCT IN VARIOUS SAGITTAL SKELETAL MALOCCLUSIONS

Introduction: Three-dimensional evaluation and comparison of condyle-fossa relationship, their position and symmetry using CBCT in various sagittal skeletal malocclusions. Aims and Objectives: To evaluate and compare the size and morphology of right and left fossa and condyle, condyle-fossa relationship, position and symmetry in various malocclusions. Materials and Methods: Sixty eight subjects with a mean age of 18.2±3.5 years, were divided into three sagittal Skeletal malocclusion (Class I,Class II. Class III) groups. 15 Linear and 2 Angular variables were evaluated from the CBCT images obtained from Carestream CS 9300C 3D system. The digitization and measurements were carried out using Trophy Dicom CS 3D software. Statistical Analysis: Independent t test and Karl Pearsons coefficient of correlation. Results: On comparison between the Right and Left sides, Angle Md.Co.Pro-MS Plane in Group I (p=0.007**)and C.Co-MS Planein Group II (p=0.047*)was significant. On Comparison of Concentric positioning of condyles, the mean differences in Group II on the Right side (p =0.039 *) and on the Left side (p =0.004**) were significant. Conclusion: In Skeletal Class I malocclusion, width and height of condyle was increased on the left side. Anterior joint space was decreased significantly in Skeletal Class II malocclusion. Superior joint space was significantly decreased and width of mandibular fossa was increased on both the sides in Skeletal Class III malocclusion. The condyles were anteriorly placed in all skeletal malocclusions but greatest difference was present in Class II.

Differences of temporomandibular joint symmetry in patients with unilateral complete cleft lip and palate at different developmental stages.

Currently, the research results regarding the bilateral temporomandibular joint symmetry in patients at different ages with unilateral complete cleft lip and palate (UCLP) are still controversial. In this study, the position of condyle in the articular fossa and morphology of condyle in UCLP patients at different developmental stages was measured and analyzed to explore the asymmetry difference, which can provide a new theoretical basis for the sequential therapy. A total of 90 patients with UCLP were divided into a mixed dentition group (31 cases), a young permanent dentition group (31 cases) and an old permanent dentition group (28 cases) according to age and dentition development. Cone beam computed tomography (CBCT) images were imported into Invivo5 software for 3D reconstruction, and the joint space, anteroposterior diameter, medio-lateral diameter, and height of condylar were measured, and its asymmetry index was calculated. The asymmetry index of condylar height and anteroposterior diameter among the 3 groups, from small to large, was the mixed dentition group<the young permanent dentition group<the old permanent dentition group (both P<0.05). There was no significant difference in condylar anteroposterior diameter and asymmetry index between the mixed dentition group and the young permanent dentition group (both P>0.05), all of them were lower than those in the old permanent dentition group (both P<0.05). Compared with the normal side, the height of fracture condyle was smaller among the 3 groups (all P<0.05), and the anterior joint space was smaller (P<0.05) and the posterior joint space was larger (P<0.05) in the mixed dentition group. In patients with UCLP, the asymmetry of condylar morphology increases with age, but the condylar position tends to normal. These results suggest that early treatment has important clinical significance for the morphologic development of temporomandibular joint in UCLP patients.

Cone-beam computed tomography study of mandibular morphology and tooth compensation in asymmetrical patients

This study evaluated mandibular morphology and transverse dental compensation between symmetrical and asymmetrical subjects, allocated according to sagittal skeletal patterns. In addition, the hypothesis that mandibular morphology and dental compensations differed between symmetrical/asymmetrical groups and also among the different types of sagittal skeletal patterns was tested. Cone-beam computed tomography images of 96 patients were included in this study and were divided into 2 groups according to the degree of menton deviation: a symmetrical group with deviation up to 2.0 mm (n= 48; mean age, 15 ± 6 years), and an asymmetrical group with deviation from 3.5 mm (n= 48; mean age, 16 ± 8 years). The 2 groups were divided in accordance with the ANB angle: Class I, II, and III. Skeletal and dental measurements were performed. Intergroup and intragroup analyses were carried out, using a 2-way analysis of variance to assess the interaction of factors: symmetry and sagittal skeletal pattern; and the Student t test for differences between deviated (Dv) and nondeviated (NDv) sides. Symmetrical/asymmetrical groups and Class I, II, and III groups were similar in relation to demographic aspects (P= 0.412 and P= 0.357 for sex and age, respectively). Asymmetrical patients had higher values for body length and mandibular ramus and condyle height on the NDv side (P= 0.011, P= 0.024, and P= 0.001, respectively). When comparing the different skeletal patterns, patients with a Class III relationship demonstrated higher values for mandibular ramus height. Intergroup analysis showed no differences in dental parameters. In the comparison between the sides, the asymmetrical group showed a significant difference in canine inclination (P= 0.008), mandibular ramus height (P= 0.004), condyle height (P= 0.010) and gonion to midsagittal plane distance (P= 0.018). Asymmetrical subjects showed higher values for canine inclination and mandibular body, ramus and condylar height on the NDv side. The hypothesis was partially confirmed that mandibular morphology and dental compensations are different between symmetrical/asymmetrical groups and among different sagittal skeletal patterns.

Bone Density of the Condyle of Children with Craniofacial Microsomia and its Correlation with Condylar Resorption After Mandible Distraction Osteogenesis.

To investigate condylar bone density (BD) in children with craniofacial microsomia (CFM) and identify factors that contribute to early stage condylar resorption (CR) after mandibular distraction osteogenesis (MDO). Retrospective study. Craniofacial department of a plastic surgery hospital. Fifty-one children with CFM classified as Pruzansky IIa based on complete pre-(T0) and post-MDO (T1) computed tomography (CT) data. Mimic 21.0 (Materialise Inc., Belgium) was used to measure bilateral BD and condylar height (CH) and volume (CV) of affected side. Children were split into groups based on either affected side BD or the distraction length (DL,25 mm as cutoff) .Bilateral BD was compared using a paired t-test in each group. The CH and CV of affected side at T0 and T1 were compared. The relative values of the CH and CV (CH ratio) and the volume (CV ratio) of the affected side were compared across the groups. The BD was lower on affected side than on unaffected side. Regarding BD, CH and CV decreased after MDO in group I, while the CH ratio and CV ratio of group I was lower than that of groups II and III. Regarding DL, the CV ratio was lower in Group L than Group S. The condylar bone quality on affected side is compromised in type IIa CFM. A low BD in combination with a larger distraction distance may increase the risk of CR; therefore, MDO in patients with such characteristics should be postponed.

"Grand-piano sign" as a femoral rotational indicator in both varus and valgus knees: a simulation study of anterior resection surface in total knee arthroplasty.

The "Grand-piano sign" is a popular indicator of the appropriate rotational alignment of the femoral component during total knee arthroplasty (TKA). The aim of the study was to investigate the shape of the anterior femoral resection surface of varus and valgus knees. A cohort of 80 varus knees and 40 valgus knees (hip-knee-ankle angle > 2° for varus and < -2° for valgus knees) matched for age, sex, height, body weight, and KL grade was made using propensity score matching. Virtual TKA was performed using 3 patterns of components (anterior flange flexion angles of 3°, 5°, and 7°). The anterior femoral resection surface was evaluated for 3 patterns of rotational alignments: parallel to the surgical epicondylar axis (NR, neutral rotation), 3° internal rotation (IR), and 3°external rotation (ER) relative to the surgical epicondylar axis. In each anterior femoral resection surface, the vertical height of medial and lateral condyles was measured, and the ratio of the medial to the lateral height (M/L ratio) was evaluated. The M/L ratio in NR for both varus and valgus knees was 0.57 to 0.64, with no significant difference between the cohorts (p value > 0.05). The M/L ratio showed a similar pattern of increasing at IR and decreasing at ER in both varus and valgus knees. The variation in the M/L ratio with malrotation in valgus knees was smaller than in varus knees. During TKA, the anterior femoral resection surface was similar in varus and valgus knees; however, the variation with malrotation was smaller in valgus knees than in varus knees. TKA for valgus knees requires precise surgical technique and careful intraoperative assessment. IV, Case series.

Is lateral femoral condyle hypoplasia a feature of genu valgum? A morphological computed tomography study of 200 knees

BackgroundYoung surgeons are taught that genu valgum deformity is associated with hypoplasia of the lateral femoral condyle, despite the absence of supporting evidence. The objective of this study was to determine whether the lateral condyle was hypoplastic in genu valgum, by assessing the morphological features of the distal femur and their variations according to the severity of the coronal deformity. HypothesisThe lateral femoral condyle is not hypoplastic in genu valgum deformity. Material and methodsThe 200 included patients treated by unilateral total knee arthroplasty were divided into five groups based on their preoperative hip-knee-ankle (HKA) angle. The HKA angle, valgus cut angle (VCA), and anatomical lateral distal femoral angle (aLDFA) were measured on long-leg radiographs. Computed tomography images were then used to measure the medial and lateral anterior-posterior condylar lengths (mAPCL and lAPCL) and condylar thicknesses (mCT and lCT), distal femoral torsion (DFT), medial and lateral posterior condylar heights (mPCH and lPCH), and medial and lateral condylar volumes (mCV and lCV). ResultsNo significant differences were demonstrated across the five mechanical-axis groups for mAPCL, lAPCL, mCT, lCT, mPCH, or lPCH. The groups differed significantly regarding the VCA (p<0.0001), aLDFA (p<0.0001), DFT (p<0.0001), and mCV/lCV ratio (p<0.0001). VCA and aLDFA were smaller when the valgus exceeded 10°. DFT was similar in all varus knees (2.2°–2.6°) but significantly greater for knees with moderate (4.0°) or severe (6.2°) valgus. Finally, lCV was greater than mCV in valgus knees compared to varus knees. ConclusionThe presence of lateral condyle hypoplasia in knees with genu valgum seems open to question. Apparent hypoplasia noted during the standard physical examination may be chiefly ascribable to distal valgus of the femoral epiphysis in the coronal plane and, with the knee flexed, to distal epiphyseal torsion, whose severity increases with the degree of valgus deformity. These considerations should be taken into account when performing distal femoral cuts for TKA, to ensure the restoration of normal anatomy in patients with genu valgus. Level of evidenceIV.

Paper 15: Is Asymmetry of the Medial and Lateral Posterior Femoral Condyles Associated with ACL Rupture: A Case Control Study of Pediatric Patients

Objectives: Rates of anterior cruciate ligament (ACL) injury in the pediatric population have increased in the last 20 years. While many risk factors have been investigated, to the authors knowledge no study has analyzed the difference in the posterior femoral condyles in patients who have sustained ACL rupture. Therefore, this case control study sought to understand the relationship between the medial and lateral posterior condyles, as well as examining distal femoral version. The authors hypothesized that pediatric patients who suffered ACL rupture will have a relatively larger medial posterior femoral condyle leading to increase structural valgus in flexion. Methods: Pediatric patients with a pre-operative knee MRI who underwent ACL reconstruction between February 2016 and June 2020 at a tertiary orthopedic hospital were collected. Cases were matched to controls based on sex, laterality of injury, and age at imaging within 1.5 years. Medial and lateral posterior condylar height was measured for each participant. Condylar difference was calculated as medial posterior condylar height minus lateral posterior condylar height. The distal femoral version was calculated as the angle between the femoral posterior cortical axis and the posterior condylar axis. Mann-Whitney U tests were used to compare continuous variables. Significance was set as a p≤0.05. Results: A total of 72 participants were included in this analysis - 36 cases and 36 controls. Median age was 13.5 ± 3.3 years for all participants. Condylar difference was noted to be 1.8 mm greater in cases than controls (p=0.038), while distal femoral version was noted to be 2.0° greater in cases than controls (p=0.025). Conclusions: This study demonstrated a significantly greater posterior condylar height difference and distal femoral version among pediatric patients who suffered ACL rupture compared to a matched control group. We speculate that this morphology leads to a relative increase in knee valgus in flexion. [Figure: see text][Table: see text][Figure: see text]

Normal variation of mandibular asymmetry in children.

To explore the normal variation of asymmetry in mandibles of children in the age group of 1 to 12 years. The study group consisted of 92 cadaveric mandibles of children with a dental age of 1 to 12 years old in possession of ACTA (Academic Centre for Dentistry Amsterdam), Faculty of Dentistry, the Netherlands. 3D models of the mandibles were obtained from CT-scans and hemimandibular volumes of all mandibles were calculated. The condylar height, ramus height, mandibular body length and the gonial angle were bilaterally determined using a novel landmark-based method, and the degree of asymmetry was calculated. No relationship was found between dental age and asymmetry of the studied parameters (P < .05). The highest degree of asymmetry was found in the ramus height, whereas the gonial angle presented the lowest degree of asymmetry. A positive correlation was found between the asymmetry of the hemimandibular volume vs the height of the ramus (P < .05) and the length of the mandibular body (P < .05). An inverse correlation was found between the asymmetry of the ramus height vs the condylar height (P < .05), mandibular body length (P < .05) and gonial angle (P < .05). Mandibular asymmetries in children did occur (9.8% of the included mandibles presented with a relevant overall asymmetry of ≥3%) and were unrelated to age. The different segments of the mandible seem to compensate for each other, in order to maintain a functional equilibrium.

Three-dimensional evaluation of the mandibular condyle in adults with various skeletal patterns.

Morphometric and morphological evaluation of the mandibular condyle in adults and to identify its correlation with skeletal malocclusion patterns. Cone-beam computed tomography scans of 135 adult patients were used in this study and classified into groups according to four criteria: (1) sex (male and female); (2) sagittal skeletal discrepancy (Class I, Class II, and Class III); (3) vertical skeletal discrepancy (hyperdivergent, normodivergent, and hypodivergent); and age (group 1 ≤ 20 years, 21 ≤ group 2 < 30, and group 3 ≥ 30 years). The morphometrical variables were mandibular condyle height and width, and the morphological variable was the mandibular condyle shape in coronal and sagittal sections. Three-dimensional standard tessellation language files were created using itk-snap (open-source software), and measurements were performed using Meshmixer (open-source software). The mandibular condyle height was significantly greater (p < 0.05) in patients with class III malocclusion than in those with class I or II malocclusion; the mandibular condyle width was not significantly different among different sexes, age groups, and sagittal and vertical malocclusions. There were no statistical associations between various mandibular condyle shapes and the sexes, age groups, and skeletal malocclusions. The condylar height was greatest in patients with class III malocclusion. The condylar height and width were greater among males than in females. The mandibular condyle shapes observed in sagittal and coronal sections did not affect the skeletal malocclusion patterns.