Condylar Length Research Articles

Computer-assisted morphometric analysis of the relationship between the coronoid and condylar processes of the mandible

: The mandible is the most durable and only movable bone that constitutes the lower one-third of the face.The mandibular condyle and coronoid processes are two anatomical structures located in the superior portion of the ramus of the mandible. Morphometric understanding of these structures is key to the diagnosis of various disorders associated with the temporomandibular region. It also aids in devising a plan for the management of such disorders.: The purpose of this study is to evaluate the anatomical corelation between the condyle and coronoid of the mandible.: This retrospective study was conducted by obtaining 100 high-resolution computed tomography images from departmental archived records between 2018 and 2024. After acquisition, these images were incorporated into MIMICS Materialize software to create stereolithography models, and morphometric analysis was carried out. Out of 100 HRCT data obtained, 87 were male and 13 were female. There is a statistically significant difference in length and angulation of the coronoid and condyle on both sides. The condyle length for males was (4 ± 5.5 mm) higher than the condyle length of females on both sides. However, the coronoid length of males and females varies in a range of 0.5-2mm on both sides of the mandible. Understanding the morphological variation of mandibular condylar and coronoid processes aids in various fields of medicine like forensics, anthropology, and reconstructive maxillofacial surgery. Our study inference will aid surgeons in planning coronoid grafts for condylar reconstruction as well as other maxillofacial reconstructions. Additionally, it helps in forensic odontology to determine a person's age and gender.

The Feasibility of Condylar Screws for Occipitocervical Fusion in Arabs: Computed Tomography-Based Morphometric Study.

Retrospective, cross-sectional study. Occipitocervical fusion is indicated for various conditions. Some techniques require placement of screws in the occipital condyle. The objective of this study was to analyze the morphometric features of the occipital condyle among Arabs. Computed tomography (CT)-based morphometric analysis of occipital condyles of 200 Arab skeletally mature patients (400 condyles) was done. Axial width of at least 8mm and coronal height of at least 6.5mm are the cutoff values for feasibility of condylar screw placement. The mean age of the patients was 48.0 ± 18.3years. Males were 53.5% (107) of the sample. The mean axial condylar width and length were 8.5 ± 1.5mm and 20.3 ± 2.6mm, respectively, while the mean axial screw angle was 35.9° ± 5.5° from midline. The mean sagittal condylar length and height were 16.1 ± 1.9mm and 8.8 ± 1.5mm, respectively. The mean condylar coronal height was 8.2 ± 1.4mm. Based on axial width and coronal height measurements, 150 (37.5%) condyles could safely fit a 3.5mm condylar screw. One hundred and four (55.9% female condyles) condyles cannot fit a screw in females, while 46 (21.5% male condyles) condyles cannot fit a screw in males. Condylar screw for occipitocervical fusion is feasible for the majority of Arabs in our sample; however, this applies to slightly less than half of the female condyles. Detailed preoperative radiological planning is critical to avoid complications related to occipital condyle screw placement.

The correlation analysis between incisal guidance angle and occlusal plane angles and temporomandibular joint morphology.

The correlations between the incisal guidance angle (IGA) and occlusal plane angles and temporomandibular joint (TMJ) morphology were investigated in adults with skeletal Class II division II malocclusion. CBCT images of 37 patients were analyzed. It included 19 cases of skeletal Class II division II malocclusion with low angle (study group) and 18 cases of skeletal Class I average angle (control group). The Invivo Dental 5 software was employed to acquire the data of the incisal guidance angle (IGA), occlusal plane angle (FH-OP), anterior occlusal plane angle (FH-AOP) and the TMJ measurement items. The results of IGA, FH-AOP angle and FH-OP angle showed the study group > the control group (P < 0.05). There were statistically difference in the condylar mediolateral diameters, articular eminence inclination and height, and posterior joint spaces between two groups. No differences were revealed in the condylar anteroposterior diameters, the condylar inclination angle, condylar head width and height, condylar length, glenoid fossa depth and width between two groups. In the study group, IGA showed a moderate correlation with FH-AOP, a weak correlation with FH-OP and condylar mediolateral diameters. Meanwhile, there was a correlation between FH-AOP, FH-OP, and TMJ indicators. The IGA was not only related to FH-AOP and FH-OP, but also to the condylar mediolateral diameters. In addition, there was a correlation between the occlusal plane angles and TMJ morphology in skeletal Class II division II low angle malocclusion. For patients with skeletal Class II division II low angle malocclusion, adjusting the IGA and the occlusal plane angles could improve the esthetic appearance of the anterior teeth, occlusal function, and TMJ morphology.

Gestational intermittent hypoxia reduces mandibular growth with decreased Sox9 expression and increased Hif1a expression in male offspring rats.

Maternal obstructive sleep apnea (OSA) during pregnancy is the risk factor for impaired fetal growth with low birth weight in the offspring. However, it is unclear whether gestational intermittent hypoxia (IH, a hallmark of maternal OSA) has long-term detrimental consequences on the skeletal development of offspring. This study aimed to investigate postnatal maxillofacial bone growth and cartilage metabolism in male and female offspring that were exposed to gestational IH. Mother rats underwent IH at 20 cycles/h (nadir, 4% O2; peak, 21% O2; 0% CO2) for 8h per day during gestational days (GD) 7-20, and their male and female offspring were analyzed postnatally at 5 and 10weeks of age. All male and female offspring were born and raised under normoxic conditions. There was no significant difference in whole-body weight and tibial length between the IH male/female offspring and their control counterparts. In contrast, the mandibular condylar length was significantly shorter in the IH male offspring than in the control male offspring at 5 and 10weeks of age, while there was no significant difference in the female offspring. Real-time polymerase chain reaction (PCR) showed that gestational IH significantly downregulated the mRNA level of SOX9 (a chondrogenesis marker) and upregulated the mRNA level of HIF-1α (a hypoxia-inducible factor marker) in the mandibular condylar cartilage of male offspring, but not in female offspring. Gestational IH induced underdeveloped mandibular ramus/condyles and reduced mRNA expression of SOX9, while enhancing mRNA expression of HIF-1α in a sex-dependent manner.

Morphological Changes of the Temporomandibular Joint and Masseter Muscle After Mandibular Angle Osteotomy.

Mandibular angle osteotomy with outer cortex grinding is an effective cosmetic procedure for correcting square faces. However, morphological changes in the mandible may also cause temporomandibular joint (TMJ) disorders. This retrospective study aimed to investigate the morphological stabilization of the TMJ and changes in masseter muscle thickness after mandibular angle osteotomy to evaluate the safety of the procedure. Data from patients who underwent mandibular angle osteotomy with outer cortex grinding between January 2016 and January 2019 were retrospectively reviewed. Preoperative and long-term follow-up (~1 y) computed tomography data were collected from these patients, and morphological changes in the TMJ and masseter muscle were analyzed. The results from the computed tomography data showed that the condylar length and condylar height were significantly reduced 1 year after the operation ( P < 0.05). In addition, the morphology of the TMJ was stable, and the distance between the mandibular condyle and the glenoid fossa did not change significantly. No significant difference was observed in masseter muscle thickness before and after the operation. After mandibular angle osteotomy with outer cortex grinding, the length and height of the mandibular condyle were functionally restored without any disorders of the TMJ. Moreover, the masseter muscle exhibited stable function. In conclusion, the procedure is safe for occlusal function and suitable for popularization.

Effect of Different Treatment Modalities for Condylar Fractures in Childhood on Mandibular Symmetry and Temporomandibular Joint Function: A Retrospective Study.

In a retrospective study of the effects of different treatment modalities of condylar fractures in childhood on mandibular symmetry and temporomandibular function, the cases selected for this article were adult patients who had sustained a condylar fracture in childhood. The aim was to investigate the effects of condylar fractures in children on the development and function of the mandible and their specific manifestations after the completion of mandibular development. According to the different treatment modalities, the patients were divided into the conservative treatment group and the open surgical treatment group, and the effects of the 2 treatment modalities on the patients' condylar healing, the difference in growth ability, and the symmetry of the jaws were evaluated. The effects of different treatment modalities of children's condylar fracture on the growth, development, and function of the mandible were investigated using the Ai and Di, the grading of the imaging results, and the 3-dimensional CT fixation measurements from the aspects of both clinical examination and imaging examination. The 2 groups had condylar malalignment and condylar morphology abnormality, and there was one case of joint ankylosis in the surgical treatment group. There was a statistical difference in the evaluation of condylar reconstruction between the 2 groups, and the condylar reconstruction in the surgical treatment group was better than that in the conservative treatment, and there was a statistical difference between the condylar length, condylar width, condylar height, and depth of TMJ fossa between the healthy side and the affected side in the closed treatment group. There was a statistical difference in the height of the mandibular ascending branch between the healthy side and the affected side, and the unilateral condylar fracture was treated conservatively; the difference in the bony chin point deviation between the 2 groups was not statistically significant. In children, after conservative treatment of condylar fracture, the growth of condylar process is poor, and the condylar shape and position are not as good as surgical repositioning, but through the proliferation of temporomandibular joint fossa, it can make up for the insufficient height of condylar process, which has no effect on the symmetry of the mandible, and the surgical treatment can achieve good anatomical repositioning, which has a greater effect on the symmetry of the mandible than the conservative treatment.

Comparison of temporomandibular joints in relation to ages and vertical facial types in skeletal class II female patients: a multiple-cross-sectional study

BackgroundThe temporomandibular joint (TMJ) is closely related to the dynamic balance and stability of mandibular function and orthodontic treatment. Skeletal class II female patients are thought to be at high risk for TMJ disease. The relationship between the TMJ and craniofacial structures is still controversial. This study compared the morphology and position of the TMJ in skeletal class II adolescents and adults with various vertical facial types using cone-beam computed tomography (CBCT).Materials and methodsA total of 117 skeletal class II patients were divided into three groups according to the FH-GoGn angle (hypodivergent, normodivergent and hyperdivergent), with 40 class I normodivergent patients serving as controls. Each group contained two age subgroups (adolescents: 11–14 years old, adults: 18–35 years old). The size (condylar length, height, long and short axis diameter, glenoid fossa width and depth) and shape (condylar neck inclination, condylar head angle and long axis angle, articular eminence inclination) of the condyle and fossa, joint space (anterior, superior, posterior, mesial and lateral), and position of the fossa (vertical, transverse, and anteroposterior distance) and condyle were measured and compared using CBCT.ResultsClass II hypodivergent patients exhibited the greatest condylar length, height, and long- and short-axis diameter; steepest articular eminence; deepest fossa depth; largest superior, mesial and lateral joint spaces; and highest fossa position in both age groups. The manifestations of class II hyperdivergent patients were mostly the opposite. In adults, except for the condylar long axis angle, the measurements of the condyle increased differently among skeletal patterns, while the measurements of the fossa decreased, as the joint spaces and fossa position remained approximately stable compared with those in adolescents.ConclusionThe vertical skeletal pattern, rather than the class II sagittal skeletal pattern, may be the main factor affecting the morphology and position of the TMJ. Attention should be given to the TMJ area in hyperdivergent patients with a relatively poor-fit condyle-fossa relationship. The changes in the TMJ with age were mainly morphological rather than positional and varied with skeletal pattern.

Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders with and without skeletal lateral mandibular asymmetry: a cone beam computed tomographic study

BackgroundTemporomandibular disorders (TMDs) encompass pain and dysfunction in the jaw, muscles, and adjacent structures. This study aimed to explore the quantitative (condylar position, morphology) and qualitative (bone mineral density (BMD)) therapeutic outcomes following a stabilization splint (S.S.) therapy in adult patients diagnosed with TMD (Arthralgia) with/without lateral mandibular asymmetry (MA) using cone beam computed tomography (CBCT).MethodsIn this retrospective clinical study, 60 adult TMD patients who received S.S. therapy were enrolled and allocated into the TMD group (TMDG) and TMD with MA group (TMD + MAG). The diagnosis was made according to the Diagnostic Criteria for TMD (DC/TMD) AXIS I. MA was measured from the mid-sagittal plane to the Menton point. CBCT was used to scan the temporomandibular joints pre- (T0) and post- (T1)-treatment for three-dimensional analysis. Intra- and intergroup statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal‒Wallis test.ResultsFor quantitative comparisons, there was a statistically significant difference between T0 and T1 in the joint spaces of TMD + MAG (anterior, superior, posterior, and coronal lateral on the deviated side as well as in the superior, coronal medial joint space of the contralateral side). Morphologically, the deviated side had a narrower condylar width, reduced condylar height, and a steeper eminence angle. In contrast, the contralateral side tended to have a greater condylar length. For qualitative measurements, BMD also showed statistical significance between T0 and T1 in the majority of the condyle slopes (AS, SS, PS, and LS on the deviated side and in AS and MS on the contralateral side) of TMD + MAG. Additionally, only the AS and PS showed significance in TMDG.ConclusionMultiple joint space widening (AJS and CMS) and narrowing (SJS, PJS, and CLS) could characterize the deviated side in TMD + MA. Factors like narrower condylar width, reduced condylar height, and steeper eminence angle on the deviated side can worsen TMD + MA. Proper alignment of the condyle-disc position is essential for optimal function and load distribution, potentially affecting bone mineral density (BMD). MA plays a prominent role in disturbing bone densities. S.S. therapy shows more evident outcomes in TMD + MAG (on the deviated side compared to the contralateral side) than the TMDG.

Morphological analysis of patellofemoral joint in haemophilic arthropathy: A case-control study.

Knees affected by haemophilic arthropathy exhibit distinct differences in both bone morphology and soft tissue behaviour. This study aims to analyse the morphological characteristics of the distal femur and patellofemoral joint in patients with haemophilia in comparison to normal healthy population. Study was conducted as pair-matched case-control study with 43 individuals in both the haemophilia group and the control group. Patellar luxation, patellar tilt (PT), length of the patella in both axis (pAP, pML), depth and angle of trochlear sulcus (SD, SA), lateral trochlear inclination (LTI), medial and lateral femoral facet length (mFL, LFL), intercondylar depth (ID), transepicondylar axis (TEA) and lateral condyle length (LCL) were assessed on knee MRI. Correlation between Pettersson score and measured variables were also analysed. PT was medial sided in 10 (23.2%) cases in haemophilic group. Mean values of pAP, pML, PT were significantly lower in haemophilia group (p<.001, p: .007, p=.001 respectively). There were no significant changes in SA (p=.628), SD (p=.340), LTI (p=.685), LFL (p=.241) and MFC-LFC (p=.770) whilst mFL was significantly longer in haemophilia group (p=.009). ID (p<.001), TEA (p=.007) and LCL (p=.001) were all shorter in haemophilia group. Pettersson score was inversely correlated with pAP, pML, ID, TEA, LCL, pML/SA and ID/LCL. Morphological changes in haemophilic arthropathy involve a smaller and medially-tilted patella, narrowed lateral condyle and transepicondylar axis, combined with reduced intercondylar depth. These alterations must keep in mind especially in pre- and intraoperative assessments for arthroplasty procedures.

Morphometric Assessment of Condyle and Glenoid Fossa using Cone Beam Computed Tomography in Gujarati Population: A Cross-sectional Study

Introduction: Several morphological alterations and remodelling occur in the mandibular condyle and glenoid fossa to adapt to trauma, malocclusion and other developmental disorders. Understanding these changes will aid healthcare providers in comprehending the pathophysiology of various Temporomandibular Joint (TMJ) problems. Aim: To evaluate the morphometric attributes of the condyle and glenoid fossa in the Gujarati population using Cone Beam Computed Tomography (CBCT). Materials and Methods: This cross-sectional radiographic morphometric investigation was conducted at the Department of Oral Medicine and Radiology at the College of Dental Sciences and Research Centre in Bopal, Gujarat, India using departmental archives from September 2019 to September 2022. A total of 40 CBCT scans (80 TMJs) were performed and analysed using the Papaya 3D and Genoray CBCT machines, along with Triana imaging software. Measurements were taken for condylar length, width, height, joint space (anterior, superior, posterior, medial, lateral) and the thickness of the Roof of the Glenoid Fossa (RGF) (sagittal, coronal) on the CBCT images. The aforementioned parameters were compared between genders, age groups and sides using a paired t-test and statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software package (Chicago, IL, USA), version 21.0 for Microsoft (MS) Windows. Results: The mean age of the study participants was 34±9.6 years. The condylar width between males and females was the only condylar characteristic that differed significantly (p-value 0.001). Apart from the gender analysis, no statistically significant variations (p&gt;0.05) were found in the thickness of the RGF when comparing age or side. However, in the genderwise examination of joint space, males had significantly higher measurements of Superior Joint Space (SJS), Medial Joint Space (MJS) and Lateral Joint Space (LJS) than females. Conclusion: Gujarati males had a significantly larger condylar width compared to females. When considering gender-specific data, males also exhibited greater SJSs, MJSs and LJSs, as well as increased thickness of the RGF. The results of the present study may provide a relevant and comparable reference for the clinical assessment of individuals with healthy, functional, or pathological TMJs.

Femoral Tunnel Length in Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction Is Correlated with Body Size and Knee Morphology.

The purpose of this study was to reveal the correlation between anteromedial (AM) and posterolateral (PL) femoral tunnel lengths in anatomical double-bundle anterior cruciate ligament (ACL) reconstruction and body size and knee morphology. Thirty-four subjects undergoing anatomical double-bundle ACL reconstruction were included in this study. Preoperative body size (height, body weight, and body mass index) was measured. Using preoperative magnetic resonance imaging (MRI), quadriceps tendon thickness and the whole anterior-posterior length of the knee were measured. Using postoperative computed tomography (CT), axial and sagittal views of the femoral condyle were evaluated. The correlation between measured intraoperative AM and PL femoral tunnel lengths, and body size and knee morphology using preoperative MRI and postoperative CT parameters was statistically analyzed. Both AM and PL femoral tunnel lengths were significantly correlated with height, body weight, posterior condylar length, and Blumensaat's line length. These results suggest that the femoral ACL tunnel length created using a transportal technique can be estimated preoperatively by measuring the subject's body size and/or the knee morphology using MRI or CT. For clinical relevance, surgeons should be careful to create femoral tunnel of sufficient length when using a transportal technique, especially in knees of subjects with smaller body size and knee morphology. Level of evidence is III.

A Comparison of the Condyle and Articular Eminence in Asian Juvenile Idiopathic Osteoarthritis Patients with Unilateral and Bilateral TMJ Involvement: A Retrospective Case-Control Study.

This study compared the condylar volume, length, and articular eminence (AE) characteristics of normal individuals to those with unilateral and bilateral juvenile idiopathic osteoarthritis (JOA). The 116 patients were divided into four groups: Control (n = 16), affected condyle of unilateral JOA (Aff-Uni) (n = 36), non-affected condyle of JOA (NonAff-uni) (n = 36), and bilateral JOA (Bilateral) (n = 28). The differences in condyle volume and length and AE were analyzed using ANOVA and Bonferroni post-hoc tests. The results showed that Bilateral had a significantly different condylar volume, especially in the condylar head (p < 0.01), specifically the middle, anterior, and medial parts (p < 0.05). Condylar length also differed among the groups, with differences observed between the control group and the other three groups, as well as between the bilateral group and the other three groups (p < 0.01). AE total volume differed between the control group and Aff-Uni. In the detailed comparison, Aff-Uni and NonAff-Uni were smaller than the control group in the posterior, lateral, and medial sections (p < 0.05). In conclusion, depending on the involvement of unilateral or bilateral JOA, there were differences in condylar volume and AE when compared to the normal control group. Therefore, a prognosis should be evaluated by distinguishing between patients with unilateral and bilateral JOA.

Association Between Femoral Anteversion and Distal Femoral Morphology in Patients With Patellar Dislocation and Trochlear Dysplasia.

Increased femoral anteversion (FA) is reportedly associated with patellar dislocation (PD) and trochlear dysplasia (TD), and the increase in FA may occur at different segments of the femur. In addition, TD is associated with dysplasia of the posterior femoral condyle. Among patients with PD, whether FA is greater with or without TD remains unclear. To explore differences in FA and torsion distribution at different femoral sections among patients with PD and TD, patients with PD and no TD, and sex- and age-matched controls and to investigate the association between FA and distal femoral morphology. Cross-sectional study; Level of evidence, 3. This study involved 132 knees: 44 knees with PD and TD, 44 knees with PD but no TD, and 44 control knees. FA, proximal torsion (PT), middle torsion (MT), distal torsion (DT), and distal femoral morphology were measured. Differences were investigated by 1-way analysis of variance. Pearson correlation analysis was conducted to explore the association between FA and each parameter. FA was significantly larger in the PD with TD group (25.4° ± 4.7°) than in the other groups (controls: 18.9° ± 5.6°; PD without TD: 19.9° ± 4.8°) (P < .01). DT was significantly larger in the PD with TD group (15.8° ± 2.9°) than in the other groups (controls: 9.0° ± 4.3°; PD without TD: 8.8° ± 3.9°) (P < .01). In all 3 groups, FA was strongly positively correlated with DT (control, PD without TD, and PD with TD, respectively: r = 0.76, 0.80, and 0.88; P < .01), strongly positively correlated with the posteromedial condylar length (r = 0.48, 0.48, and 0.70; P < .01) and negatively correlated with the posterolateral condylar length (r = -0.30, -0.35, and -0.78, respectively; P < .05). The increased FA in knees with TD was due mainly to DT rather than PT or MT, which may provide a reference for choosing the optimal position for femoral derotation osteotomy.

Evaluation of skeletal changes in glenoid fossa, condylar head and articular space following fixed functional appliance therapy using cone beam computed tomography – A clinical prospective study

This study was conducted to evaluate skeletal changes in glenoid fossa, condylar head and articular space following Powerscope appliance therapy using CBCT.This study included twenty patients (age group of 11-15 years) having Class II Division 1 skeletal &amp; dental malocclusion. A pre-treatment CBCT scan (T1) of both TMJs was taken. Following leveling &amp; aligning, Powerscope appliance was inserted, which was sequentially activated using crimpable shims until edge-to-edge bite was obtained. After completion of phase 1 of treatment, another CBCT scan (T2) was taken. Condylar position, length, height, glenoid fossa &amp; articular space measurements were obtained from pre- &amp; post-treatment CBCT scans and data obtained were statistically analysed and compared by Paired-t test.Comparison between T1 &amp; T2 data showed that the condyles were shifted anteriorly by 1.08 mm, condylar length and height increased by 0.26 mm and 0.71 mm, respectively. Glenoid fossa and anterior articular space decreased by 1.50⁰ and 0.23 mm, whereas, middle and posterior articular spaces increased linearly by 2.55 mm and 1.85 mm, respectively.Powerscope shifted the condyle anteriorly, increased its length and height, and reduced the glenoid fossa angle. Anterior articular space decreased whereas middle and posterior articular spaces increased.

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.

Retrospective evaluation of the morpometric and morphological anatomy of the occipital condyle, hypoglossal canal and foramen magnum in Turkish populaton with CBCT.

The aim of this study is to morphometrically and morphologically examine the occipital condyle, which is an important anatomical region in terms of surgery and forensic medicine, and its surrounding structures, to evaluate the change in mean values according to gender and age, and to evaluate the correlation of the measurements obtained. 180 (90 men, 90 women) CBCT images selected from the archive of Ankara University Faculty of Dentistry. Occipital Condyle length and width, Hypoglossal Canal-Basion distance, Hypoglossal Canal-Opistion distance, Hypoglossal Canal-Occipital Condyle anterior and posterior border distance, Occipital Condyle thickness, Hypoglossal Canal length, the widest diameter of Hypoglossal Canal, the narrowest diameter of the Hypoglossal Canal, the length of the Jugular Tubercle, the width of the Jugular Tubercle, the anterior intercondylar distance, the posterior intercondylar distance, and the Foramen Magnum index were measured. At the same time, the presence of septum or spicule in the hypoglossal canal and protrusion of the occipital condyle were evaluated. The relationship of age, gender, anterior and posterior intercondylar distance, and foramen magnum index measurements with all measurements were examined. In our study, all measurements were repeated 1month after the first measurements to evaluate the intra-observer agreement, and the agreement between the obtained measurements and the first measurements was evaluated by calculating the intraclass correlation coefficient and 95% confidence intervals. Men's measurements were found to be significantly higher than women's measurements. When the coefficients of concordance in all measurements were examined, it was observed that there was a perfect concordance. When the results of the study are evaluated, it is seen that the values ​​obtained are generally close to the studies related to CT. Considering this, an idea can be gained as to whether CBCT, which has a lower dose and less cost, can be used as an alternative to CT in studies to be conducted with more comprehensive and different methods in skull base surgical planning.

Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders.

This study aimed to explore the quantitative and qualitative condylar changes following stabilization splint (S.S) therapy, including condylar position, morphology, and bone mineral density (BMD) in subjects with temporomandibular disorders (TMD). In this retrospective clinical study, we enrolled 40 TMD subjects (80 joints) aged 18 to 35years, for whom a S.S was used to treat TMD. The 80 TMD consists of 32 masticatory muscle disorders (myalgia) and 48 TMJ disorders (arthralgia). Cone beam computed tomography (CBCT) was used to scan the TMJs of subjects pre- and post-treatment for three-dimensional analysis (3D). Using Mimics software v.21.0, quantitative (3D condylar and joint spaces dimensions parameters were measured using linear measurements in millimeters, according to the Kamelchuk method and Ikeda method, while the assessment of anteroposterior condyle position within the glenoid fossa was based on the method of Pullinger and Hollender), and qualitative (a round bone tissue with an area of 2 mm2 in three representative areas according to the Kamelchuk method to measure condylar BMD) pre- and post-treatment. Intra- and inter-group statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal-Wallis test, respectively. The course of treatment was 6-12months, with an average of 9.1months. For the pre- and post-treatment quantitative comparisons, there was a statistically significant difference in the anterior joint space (AJS) and coronal medial space, as well as the condyle length in the myalgia group and condylar width in the arthralgia group. For qualitative measurements, a significant difference was observed in the posterior slope of the myalgia group and the arthralgia group's anterior, superior, and posterior slopes. The inter-group comparisons revealed significant differences in AJS, condylar length, and anterior slope density. In short-term follow-up, the S.S influenced patients with TMD from different origins; it changes anterior and coronal medial joint space, condyle length in myalgia, and width in arthralgia. Furthermore, it improved the condyle bone density more evidently in arthralgia. This study highlights the influence of S.S on symptomatic populations with TMD of different origins from a qualitative and quantitative perspective.

The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion.

Prospective human anatomical study. Occipitocervical fusion with occipital plate or condyle screws has shown higher failure rates in those with skeletal dysplasia. The modified occipital condyle screw connects the occipital condyle to the pars basilaris of the occipital bone that may achieve fortified bony purchase and serve as a more rigid fixation point. We evaluate anatomical feasibility of a novel cranial fixation technique designed to decrease risk of pseudarthrosis. Occipital condyles were analyzed morphologically using multiplanar three-dimensional reconstructed, ultra-thin section computed tomography. The following parameters were obtained: occipital condyle length, maximal cross section, location of hypoglossal canal, axial and sagittal orientation of the long axis, occipital condyle pedicle (OCP) diameter, maximal length of OCP screw, and entry point. Forty patients with total of 80 occipital condyles were analyzed and the following measurements were obtained: occipital condyle length 24.1 mm (20.5-27.7, standard deviation [SD]: 2.2); condyle maximum axial cross-section 12.6 mm (9-15.8, SD: 1.9); length of OCP screw 38.9 mm (29.3-44, SD: 5.7); diameter of OCP 3.4 mm (3.2-3.6, SD: 0.2); clearance below hypoglossal canal 4.5 mm (3.4-7, SD: 1.1); and distance of screw entry point from condylar foramen 2 mm (range 0-4, SD 1.6). The modified occipital condyle screw connects the condyle with the clivus through the pars basilaris and represents a safe and technically feasible approach to achieve craniocervical fusion in skeletally mature individuals. This cephalad anchor point serves as an alternate fixation point of the occipitocervical junction with increased strength of construct and decreased risk of hardware failure or pseudarthrosis given cortical bone purchase and longer screw instrumentation.

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.

Anthropometric Analysis of Distal Femur Parameters in the Eastern Uttar-Pradesh Population.

Anthropometric measurements of the distal femoral fragment play a crucial role in prosthesis design during arthroplastic knee surgeries and offer valuable clues for stature estimation in forensic investigations. The present study is an attempt to assess various anthropometric parameters of the distal femur in this regard. A total of 96 intact dry femora were anthropometrically assessed using digital Vernier calipers. The femoral length was measured using an osteometric table. The torsion angle was calculated with an analog goniometer. The various parameters studied included: medial condyle length and thickness, lateral condyle length and thickness, bicondylar width, intercondylar width, intercondylar depth, torsional angle, and femoral length. The data obtained were statistically analyzed using SPSS software (IBM Corp., Armonk, NY, USA). Mean medial condyle length was 57.38±4.47mm and thickness was 24.53±2.27mm. Mean lateral condyle length and thickness were found to be 58.49±4.3mm and 25.33±3.15mm respectively. Mean bicondylar width was 71.96±6.73mm, mean intercondylar width 21.86±2.71mm, and the intercondylar depth 27.04±2.59mm respectively. The average femur length was 41.87±3.31mm and the average torsion angle was 20.19°±6.99°. Significant correlations were observed between distal femoral parameters. Lateral condyle length showed maximum correlation with other parameters. Femur length was found to correlate significantly with all parameters except medial condyle thickness. Torsion angle was significantly correlated with lateral condyle length and femur length only. The findings of this study show considerable variation from those of other studies done within India. This proves that distal femoral anthropometry has regional variations. These data can aid sports physicians and orthopedic surgeons with implant designing and forensic experts during investigations.