Shape Of Condyle Research Articles

MRI observation of condylar location and morphology in the patients with temporomandibular disc displacement

Objective: To evaluate the mandibular condylar location and morphology in the temporomandibular joint disorders. Methods: One hundred thirty-seven TMD patients (age 37.5±16.1 years, male/female=39/98) were performed with MRI scan for temporomandibular joint (TMJ) from November, 2011 to April, 2019 in Department of Radiology,Hainan Hospital of General Hospital of Chinese PLA and General Hospital of Chinese PLA. The patients were classified into 3 groups according the disc displacement: disc without displacement (DWoD) (185 TMJ), disc displacement with reduction (DDWR) (17 TMJ) and disc displacement without reduction (DDWoR) (72 TMJ). The location (anterior position, central position and posterior position) and morphology (oval shape, flat shape and beaklike shape) of the condylar head were observed on the sagittal PDWI, and the long and short axes were measured on the axial T2WI. Another groups were classified into 3 subgroups according to the disc displacement of bilateral TMJ: bilateral normal disc location (biND) (74 cases), unilateral disc displacement (uniDD) (40 cases) and bilateral disc displacement (23 cases). The inter-condyle angle was measured on the axial T2WI. Results: There was no significant difference for the location of condylar head among DWoD, DDWR and DDwoR groups (χ(2)=7.435, P=0.115). The rate for flat condylar shape was significantly higher in DWoD group [83.9%(115/137)] than that in DDWoR group [50.7%(34/67)], and the rate for beaklike condylar shape was significantly lower in DWoD group [16.1%(22/137)] than that in DDWoR group [49.3%(33/67)] (χ(2)=23.521, P<0.001). The length of long axis presented significantly longer in DWoD group [(17.2±2.4) mm] than that in DDWR group [(15.4±2.0) mm] and that in DDWoR group [(14.7±2.7) mm] (P<0.05). The length of short axis presented significantly longer in DWoD group [(7.3±1.2) mm] than that in DDWR group [(6.5±1.3) mm] and that in DDWoR group [(6.1±1.4) mm] (P<0.05). The inter-condyle angle presented significantly larger in biND group (136°±13°) and uniDD group (132°±14°) than that inbiDD group (124°±17°) (P<0.05). Conclusions: The mandibular condylar morphology changes significantly presented in the patients with temporomandibular disc displacement for the temporomandibular disorders.

A simplified relationship between the femoral trochlea and the femoral condyle: A sagittal MRI analysis by an ellipse-fitting approach.

We have introduced an ellipse-fitting approach to express the shapes of trochlea and condyle on magnetic resonance imaging (MRI) and to analyze their relationship. Fifty healthy right knees were sagittal-imaged by MRI at full extension. On the deepest trochlear groove slice, the articular surface was best-fitted by a circle. Based on the center of this circle, both the most prominent slices of the medial and lateral trochleae were best-fitted by ellipses. On the most distal slice of medial condyle, the articular surface was best-fitted by a horizontal ellipse. Based on the center of this ellipse, the lateral condyle was best-fitted by a rotational ellipse. The semimajor and semiminor axes of the trochlear ellipse and the condylar ellipse constituted a rectangle that represented the relationship between the trochlea and the condyle. The anteroposterior dimension (l) of this rectangle was 12.33 ± 1.41 mm, and the superoinferior dimension (w) was 7.21 ± 1.23 mm. The average tangent angle (θ) of the rectangle was 30.1° ± 2.6°. There were significant sex differences in l, w, and θ (all P ≤ 0.006), and all correlated significantly with the height of the subject (all P ≤ 0.001). The relationship between the femoral trochlea and the femoral condyle differed significantly between males and females, but this could have been a consequence of the significant correlation with subject height. Clin. Anat. 33:500-506, 2020. © 2019 Wiley Periodicals, Inc.

Treatment of hearing loss due to temporomandibular joint disorders: Case Report

Introduction : Patients with temporomandibular disorder may have various ear-related symptoms. If an excessive load is applied to the ear area due to the skeletal shape of the mandibular condyle or malposition of the disc, an auditory problems may occur. Case report : The patient was referred to our clinic due to the suspicion of temporomandibular disorder from the local otorhinolaryngology clinic. A few days ago, his right ear could not be heard. MRI showed that the left TMJ disc was anterior displacement with reduction, the right TMJ disc was anteromedial displacement without reduction. Also Right mandibular condyle showed sclerotic bone change, subchondral cyst and was compressing the frontal wall of the ear on MRI view. Right TMJ arthroplasty was done under the diagnosis of right TMJ osteoarthritis and osteochondroma. Postoperative intermaxillary fixation was done with SAS screw and elastics for 2 weeks. One month after the operation, hearing and TMJ discomfort were recovered without any complications. Conclusions As seen in this case, hearing loss due to benign tumor-like lesions of the temporomandibular joint should be treated surgically to restore the TMJ function and hearing.

Evaluation of Mandibular Condylar Morphology By Orthopantomogram In Bangladeshi Population

Background: Orthopantomograph (OPG) is one of the most common radiograph use by dental surgeon for evaluate information about teeth, Maxilla, Mandible and other bony structure. It is also available, low price and low doses of radiation. Mandibular condyle is most important landmarks of mandible, which is changes due to ageing process, developmental abnormalities, distinct diseases, trauma, endocrine shock, radio therapy etc. Panoramic radiographs remain the best screening modality for temporomandibular joint abnormalities today. Objectives: The aims at objective of observing and documentation of shapes of condyle on an orthopantomogram, which were very important for treatment of patient in different branch of dentistry specially in oral and maxillofacial surgery.&#x0D; Materials and Methods: This study composed radiographic evaluation of 500 condylar heads after imaging 250 digitalized OPGs taken for analysis. Then evaluate the mandibular condylar shape in 2D dimensional view (OPG).&#x0D; Results: In our study, an attempt to common prevalent radiographic shapes of the condylar head on the OPG. 200 pairs of condylar heads were evaluated. Out of them 60% were oval in shape, followed by bird beak (29%), diamond (9%) and least being crooked finger (2%). Oval-oval was commonly occurring mix (67%), whereas crooked/ crooked finger was a rarity.&#x0D; Conclusion: Due to low radiation exposer and availability, OPG is common chose of dentist for primary evaluate the tooth, mandible and facial skeleton. Shapes of the mandibular condyle also evaluate by OPG which showing ovaloval being most accepted in both genders.&#x0D; Update Dent. Coll. j: 2019; 9 (1): 29-31

Steep Posterior Tibial Slope, Anterior Tibial Subluxation, Deep Posterior Lateral Femoral Condyle, and Meniscal Deficiency Are Common Findings in Multiple Anterior Cruciate Ligament Failures: An MRI Case-Control Study

Background: Tibiofemoral anatomic parameters, such as tibial slope, femoral condyle shape, and anterior tibial subluxation, have been suggested to increase the risk of anterior cruciate ligament (ACL) reconstruction failure. However, such features have never been assessed among patients experiencing multiple failures of ACL reconstruction. Purpose: To compare the knee anatomic features of patients experiencing a single failure of ACL reconstruction with those experiencing multiple failures or with intact ACL reconstruction. Study: Case-control study; Level of evidence, 3. Methods: Twenty-six patients who experienced failure of revision ACL reconstruction were included in the multiple-failure group. These patients were matched to a group of 25 patients with failure of primary ACL reconstruction and to a control group of 40 patients who underwent primary ACL reconstruction with no failure at a minimum follow-up of 24 months. On magnetic resonance imaging (MRI), the following parameters were evaluated: ratio between the height and depth of the lateral and medial femoral condyles, the lateral and medial tibial plateau slopes, and anterior subluxation of the lateral and medial tibial plateaus with respect to the femoral condyle. The presence of a meniscal lesion during each procedure was evaluated as well. Anatomic, demographic, and surgical characteristics were compared among the 3 groups. Results: The patients in the multiple-failure group had significantly higher values of lateral tibial plateau slope (P < .001), medial tibial plateau slope (P < .001), lateral tibial plateau subluxation (P < .001), medial tibial plateau subluxation (P < .001), and lateral femoral condyle height/depth ratio (P = .038) as compared with the control group and the failed ACL reconstruction group. Moreover, a significant direct correlation was found between posterior tibial slope and anterior tibial subluxation for the lateral (r = 0.325, P = .017) and medial (r = 0.421, P < .001) compartments. An increased anterior tibial subluxation of 2 to 3 mm was present in patients with a meniscal defect at the time of the MRI as compared with patients who had an intact meniscus for both the lateral and the medial compartments. Conclusion: A steep posterior tibial slope and an increased depth of the lateral femoral condyle represent a common finding among patients who experience multiple ACL failures. Moreover, higher values of anterior subluxation were found among patients with repeated failure and those with a medial or lateral meniscal defect.

Reliability of cone-beam computed tomography for temporomandibular joint analysis.

ObjectiveThe aim was to assess the intraobserver and interobserver reliabilities of temporomandibular joint linear measurements and condylar shape classifications performed with cone-beam computed tomography (CBCT).MethodsCBCT images of 30 patients were measured at two different time points by two orthodontists using the Dolphin 3D program (n = 60). Anterior, posterior, and superior joint space measurements and sagittal joint morphology classification in the sagittal view and medial and lateral joint space and mediolateral width measurements and coronal joint morphology classification in the coronal view were recorded. Intraclass-interclass correlation coefficients (ICC) and kappa statistics were used to assess intraobserver and interobserver reliability for the measurements and morphology classifications, respectively.ResultsThe ICC values were good for measurements of the posterior joint space by observer I and for measurements of the posterior, medial, and lateral joint spaces by observer II, while the other intraobserver measurements were excellent. Only the mediolateral width measurements showed excellent interobserver ICC values, while the other measurements showed good interobserver ICC values. Intraobserver agreement for the sagittal morphology classifications was moderate (κ = 0.479) and almost perfect (κ = 0.858) for observers I and II, respectively, while the corresponding agreement for the coronal morphology classifications was substantial for both observers. The interobserver agreement values for sagittal and coronal morphology classifications were slight (κ = 0.181) and fair (κ = 0.265), respectively.ConclusionsLinear temporomandibular joint measurements were reproducible and reliable in both intraobserver and interobserver evaluations. However, interobserver agreement for assessments of condylar shape was low.

Analysis of condylar volume in relation to craniofacial morphology using cone beam computed tomography

Objectives This study aimed at comparing the size and shape of mandibular condyle in mature adult population with different skeletalpatterns.Methods A total of 198 patients within the age range of 15–64 years, including 68 males and 130 females, were allocated into three groupsbased on the ANB angle: skeletal classes I (n = 65), II (n = 69), and III (n = 64). The cone beam computed tomography (CBCT) was used toevaluate right and left temporomandibular joint (TMJ) in each patient. TMJ evaluation was comprised of size of condyle, area of condyle,and morphology index. The Mimics software was used to calculate the size and area of the condyle. The size, area, and morphology indexwere compared between the study groups using parametric tests.Results Based on the results of paired t-test, there was a significant difference between the sizes of right and left condyles, in favor of theright condyle (P = 0.02). In addition, the mean size of the condyle in class III subjects was higher than those of classes I and II; however, thedifference between the classes I and II was insignificant. The size and area of condyle were higher in males compared with females.Conclusion Based on the results of this study, there might be a correlation between the facial skeletal morphology and area of condyle.

Morphology of the Craniovertebral Joint in Psittacosaurus sibiricus (Ornithischia: Ceratopsia)

The joint of the occipital skull region and two first cervical vertebrae of Psittacosaurus sibiricus from the Shestakovo locality (Barremian–Aptian), Kemerovo Region, Russia is described. The morphological differences in the atlas–axis complex between the infraorders Psittacosauria and Neoceratopsia connected with their functional features are revealed. The atlas–axis complex of P. sibiricus consists of two unfused vertebrae. The atlas includes the centrum, neural arch, and intercentrum. The axis consists of fused centrum, neural arch, and intercentrum, which is fused with its centrum. The cranial processes of the neural arch of the atlas are well developed, could have indicated the presence of a proatlas. The shape of the occipital condyle and anterior articular surface of the atlas are evidence that the occiput–atlas joint was only slightly flexible in the vertical plane. The atlas–axis complex and occipital condyle of P. sibiricus are similar in morphology to that of ornithopods.

CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment.

SummaryBackgroundTaking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment.ObjectiveThe aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase.Search methodsMEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently.Selection criteriaThe literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria.Data collection and analysisData were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria.ResultsAs a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs.ConclusionsCBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization.RegistrationNone.Conflict of interestNone to declare.

Effect of joint mimicking loading system on zonal organization into tissue-engineered cartilage.

Cartilage tissue engineering typically involves the combination of a biodegradable polymeric support material with chondrocytes. The culture environment in which cell–material constructs are created and stored is an important factor. The aim of the present study was to investigate the effects of combined stimuli on cartilage zonal organization which is important to maintain cartilage functions such as lubrication and cushion. For that purpose, we developed a joint mimicking loading system which was composed of compression and shear stress. To mimic the joint loading condition, we manufactured a stimuli system that has a device similar to the shape of a femoral condyle in human knee. The fibrin/hyaluronic acid mixture with chondrocytes were dropped into support made of silicon, and placed under the device. The cartilage explants were stimulated with the joint mimicking loading system for 1 hour per day over the course of 4 weeks. The amounts of GAG and collagen in the stimulated tissue were more than that of the static cultured tissue. Cells and collagen were arranged horizontally paralleled to the surface by stimuli, while it did not happen in the control group. The results of this study suggests that mechanical load exerting in the joint play a crucial role in stimulation of extracellular matrix (ECM) production as well as its functional rearrangement.

Anatomic Variations of Mandibular Condyles in Brazilian Specimens

Objective To describe the morphological characteristics and asymmetries between the left and right mandibular condyles in Brazilian cadaveric specimens. Material and Methods Thirty-two jaws were placed on a rigid support for image acquisition of the frontal and lateral views. The shapes of the mandibular condyles were classified, and measurements of the distance between the anatomical landmarks in the lateral and frontal views were performed. Results Mandibular length and width were not different between the right and left sides. Regarding the shapes of the mandibular condyles, the rounded type was the most frequent, followed by marked medial slope; flattened; overhanging lateral and medial slopes; downward flattening of both slopes and their merger in a single, extensive surface; and deformity and marked lateral slope with flaring and flattening. Asymmetry between the left and right mandibular condyles was present in 40% of the specimens. Conclusion The anatomy of mandibular condyles varies greatly, and this knowledge can avoid misdiagnosis by image examination of the anatomic variations.

Comparison of temporomandibular joint shape and size in patients with facial asymmetry.

To examine the morphologic similarities and differences in mandibular condyle and glenoid fossa between the deviated and non-deviated sides in patients with facial asymmetry using statistical analysis. One hundred eighty-four patients (95 men, 89 women; mean age, 22.30 ± 3.87years) with facial asymmetry were examined with cone-beam computed tomography (CBCT). Shape analysis was performed to compare the shapes and sizes of the condyle and fossa between the deviated and non-deviated sides in the frontal and lateral aspects. Ordinary Procrustes analysis (OPA) was used to determine shape variations of the fossa and condyle. Shape variations derived from ordinary sum of squares (OSS) suggested that, in the frontal aspect, there was a difference between the two sides in both the fossa and condyle (P < 0.05). In the lateral aspect, there was no difference in fossa shape between the two sides (P > 0.05); however, the shape of condyle was different between the non-deviated and deviated sides (P < 0.05). Size comparison in OPA matching and centroid size (CS) in the frontal aspect demonstrated that the non-deviated side was larger than the deviated side. In the lateral aspect, fossa showed no difference in CS between the two sides (P > 0.05); however, the non-deviated side was larger than the deviated side for condyle (P < 0.05). Morphometric differences in condyle and fossa between the deviated and non-deviated sides were observed. Structures of the non-deviated side were relatively larger than those of the deviated side, except for fossa in the lateral aspect.

Anatomic Considerations for Temporomandibular Joint Vascularized Composite Allotransplantation.

Concomitant temporomandibular joint (TMJ) transplantation is an obvious advancement in the reconstructive armamentarium for face transplantation in scenarios involving TMJ ankylosis. This study investigates the fidelity of mandibular morphology and explores the feasibility of bilateral mandibular condyle transfer in facial vascularized composite allotransplantation. Geometric analysis was performed on 100 skeletally mature maxillofacial computed tomography scans. Exclusion criteria included mandibular trauma and dentoalveolar disease. Parameters measured were posterior height, ramus tilt, anterior height, intercondylar widths, condyle height, coronoid height, interglenoid distances, symphyseal and gonial angles, condyle and glenoid volumes, and condyle shapes. Parameters were compared by gender and ethnicity using χ, independent sample t tests, and one-way ANOVA. Correlation with age was assessed using Pearson correlation coefficients. Bilateral measurements were compared using paired-sample t tests. Mean intercondylar width was 102.5 mm (SD 7.0 mm), anterior height 21.5 mm (5.5), and posterior height 65.3 mm (7.7), Males demonstrate larger geometric parameters, for example, intercondylar width (4 mm mean difference, P = 0.005), anterior height (2.3 mm, P = 0.032), posterior height (5 mm, P = 0.001). Asians demonstrated statistically larger intercondylar width (8 mm difference to Caucasians, P < 0.001). Increased age was associated with greater anterior height, gonial angle, and symphyseal angle; decreased glenoid height; and change in condyle shape. Despite significant disparity of laterality measurements within individuals, posterior height, glenoid, and condyle volumes are equivalent. Mandibular morphology is highly variable. However, transplantation of a facial allograft including the mandible and bilateral condyles is technically and anatomically feasible in patients with concomitant TMJ pathology.

Developing a reference MRI database for temporomandibular joints in healthy children and adolescents.

Recognition of normal temporomandibular joints (TMJs) is essential to assess arthropathic changes. Few, if any, prior studies have evaluated the morphological appearance of growing TMJs by magnetic resonance (MR) examinations in the pediatric population. This study aimed to determine normative osseous appearance of growing TMJs according to age and gender, both qualitatively and quantitatively, concerning structural and bone marrow changes. From 1,036 MR scans screened, one joint was included from each of 157 patients (76% female; 2-18 years) presenting with at least one normal-appearing TMJ was included. Quantitatively, mandibular condyle was characterized by measuring the following: (i) head-neck angle, (ii) anteversion angle, (iii) condylar dimensions (mediolateral, craniocaudal and anteroposterior [AP]) and (iv) condylar volume. Furthermore, qualitative categorization of condylar shape, into one of three types, and condylar bone marrow type was performed. The head-neck angle significantly correlated with age (bivariable regression β =0.60, P<0.001), indicating an increase of 1.6 degrees per year. Except for AP diameter of condyles, all other mandibular dimensions and condylar volume increased with age (β =0.20-0.59, P≤0.001-0.004). Significant age difference was observed among the different condylar shapes (P<0.001), indicating a change from rounded head without anterior tilt to rectangular head with anterior tilt. Lastly, mandibular condylar size, measured by volume and by AP and mediolateral dimensions, appeared larger in males. The morphology of the mandibular condyles changes with age. During development, the shape of the condyles changes from round to rectangular in contour with the development of the anterior condylar tilt, as measured by the head-neck angle.

Morphological evaluation of temporo-mandibular joint in indian population

The temporomandibular joint (TMJ) is one of the most complex joints in the body and its harmonious functioning is very important to maintain a normal masticatory system. The morphologic alterations and the asymmetrical position of the TMJ structures may lead the various clinicalsigns &amp; symptoms. Morphology of the temporomandibular joint may be influenced by gender of patients, environmental factor and also food habits at various places. Objective: To evaluate the morphology of the temporomandibular joint using computed tomography, in order to determine the condyle shape, joint space and glenoid fossa roof thickness. Material and Methods: One hundred and six healthy patients (212 TMJs) who visited a private hospital (or the University’s Hospital) for CT brain scan were included to this cross-sectional study sample.The patients were aged between 20–50 years with an average age of 35.46 years. All the images were taken by positioning patients in supine position with 120kvp , 50ma,2.33minute exposure with 0.7mm thick slicesby computed topography machine in all three projection that is Axial, Coronal and Saggital view. Results: For all variables, the mean and standard deviation were calculated, based on gender, and TMJ sides. The Paired t-test was used and P&lt;0.05 will be considered to be significant. Conclusion: Present study showed that thereis positive evidence of temporomandibular joint involvement in elderly patients. Change in morphology and position of condylar head with glenoid fossa and roof thickness are one of the most common cause of degenerative diseases.KeywordsTemporomandibular joint; Morphology; Condyle; Joint space.KeywordsTemporomandibular joint; Morphology; Condyle; Joint space

How Does the Remodeling Capacity of Children Affect the Morphologic Changes of Fractured Mandibular Condylar Processes After Conservative Treatment?

Our aim was to explore how the remodeling capacity of children's mandibular condyles affected the morphologic changes of fractured condyles after conservative treatment. A retrospective study was designed and performed in children and adult patients with mandibular condylar fractures. Computed tomographic imaging was reviewed for all patients to analyze the morphologic changes and risk factors for traumatic temporomandibular joint ankylosis. From 2012 to 2017, 81 patients younger than 18years and 10 adult patients accepted treatment in our department. There were 23 young patients (aged <18years) with 41 fractured condyles and 10 adults with 14 fractured condyles who were managed with conservative treatment, and the morphologic changes were analyzed with the aid of Mimics 19.0 software (Materialise, Leuven, Belgium). The fractured condyles with intracapsular fractures completed the remodeling progress within 3 to 4months, and condyles with neck or base fractures took more than 6months. In contrast, we found no remodeling in adults. Of the 81 young patients, 3 had temporomandibular joint ankylosis. Each case was analyzed regarding the risk factors, morphologic changes, and remodeling features. Finally, the common points of these cases were summarized. The shape of fractured condyles can be remodeled after conservative treatment in young patients instead of bony fusion between the fractured fragments compared with adult patients.

Digital diagnosis and treatment of mandibular condylar fractures based on Extensible Neuro imaging Archive Toolkit (XNAT).

ObjectivesThe treatment of condylar fractures has long been controversial. In this paper, we established a database for accurate measurement, storage, management and analysis of patients’ data, in order to help determine the best treatment plan.MethodsFirst of all, the diagnosis and treatment database was established based on XNAT, including 339 cases of condylar fractures and their related information. Then image segmentation, registration and three-dimensional (3D) measurement were used to measure and analyze the condyle shapes. Statistical analysis was used to analyze the anatomical structure changes of condyle and the surrounding tissues at different stages before and after treatment. The processes of condylar fracture reestablishment at different stages were also dynamically monitored. Finally, based on all these information, the digital diagnosis and treatment plans for condylar fractures were developed.ResultsFor the patients less than 18 years old with no significant dislocation, surgical treatment and conservative treatment were equally effective for intracapsular fracture, and had no significant difference for neck and basal fractures. For patients above 18 years old, there was no significant difference between the two treatment methods for intracapsular fractures; but for condylar neck and basal fractures, surgical treatment was better than conservative treatment. When condylar fracture shift angle was greater than 11 degrees, and mandibular ramus height reduction was greater than 4mm, the patients felt the strongest pain, and their mouths opening was severely restricted. There were 170 surgical cases with condylar fracture shift angel greater than 11 degrees, and 118 of them (69.4%) had good prognosis, 52 of them (30.6%) had complications such as limited mouth opening. There were 173 surgical cases with mandibular ramus height reduction more than 4mm, and 112 of them (64.7%) had good prognosis, 61 of them (35.3%) had complications such as limited mouth opening.ConclusionsThe establishment of XNAT condylar fracture database is helpful for establishing a digital diagnosis and treatment workflow for mandibular condylar fractures, providing new theoretical foundation and application basis for diagnosis and treatment of condylar fractures.

Comparison of Occipital Condyle Morphometry in Various Populations with Respect to Skull Base Surgery

Background: The craniovertebral junction is made up of the occiput, upper two cervical vertebrae. Occipital condyle is one the landmarks on the skull base. Morphometric values of these condyles in a specific population is to be known by surgeons to deal with pathologies affecting the cranial base without disturbing the neurovascular structures by doing appropriate condylectomy and to ensure occipito-cervical fusion in case of instability. Methods: The study was performed by comparing the morphometric values of occipital condyles with other populations (Greek, Turkish, Korean, Chinese, American, European and Indian). The data regarding the morphometric values of occipital condyles was taken from our previously published article with a sample of hundred occipital condyles of unsexed dry human skulls of unknown age and compared with the studies of other population. The measurements compared were the length, breadth and thickness of the occipital condyle, intercondylar distance in anterior, middle and posterior parts of the occipital condyles, the angle of the occipital condyle to the sagittal plane and coronal planes and shape of the occipital condyles. Results: Most of the morphometric values of OC in South Indian were lesser than the other populations like breadth, thickness,anterior intercondylar distance, posterior intercondylar distance, angle of the occipital condyle to the sagittal plane. Conclusion: This information has to borne in mind while performing surgical procedures like occipito-cervical screw fixation, condylar drilling in cranial base surgery in South Indian population.

Normal magnetic resonance appearances of the temporomandibular joints in children and young adults aged 2-18years.

Knowledge of normal appearances of the temporomandibular joint (TMJ) is paramount when assessing the joint for disease in juvenile idiopathic arthritis. Reliable features defining normal TMJs in children are limited. To establish reliable normal standards for the TMJ at magnetic resonance imaging (MRI). We included children and young adults aged 2-18years undergoing a head MRI for reasons not believed to affect the TMJs. We assessed TMJ anatomy and contrast enhancement using a high-resolution 3-D T1-weighted sequence. We noted joint fluid and bone marrow oedema based on a T2-weighted sequence. Three experienced radiologists read all examinations twice in consensus and defined intraobserver consensus agreement. We evaluated the TMJs in 101 children and young adults (45 female), mean age 10.7years (range 2-18years). The intraobserver consensus agreement for the assessment of anterior condylar inclination in the sagittal/oblique plane was moderate to good (Cohen κ=0.7 for the right side). Cohen κ for intraobserver consensus agreement for condylar shape in the coronal plane on a 0-2 scale was 0.4 for the right and 0.6 for the left. Intraobserver agreement for measurement of joint space height and assessment of bone marrow oedema was poor. There was a statistically significant increase in anterior inclination by age in the sagittal plane on a 0-2 scale (P<0.0001). Eighty percent of the condyles showed a rounded shape in the coronal plane while 20% showed mild flattening. Thirty-five of 36 right TMJs showed contrast enhancement (mild enhancement in 32 joints, moderate in 3 joints). Subjective assessment of the anterior condylar inclination in the sagittal/oblique plane and condylar flattening in the coronal plane can be considered precise features for describing TMJ anatomy in healthy children. There is an increasing anterior inclination by age. Mild contrast enhancement of the TMJs should be considered a normal finding.

Determination of sex differences of human cadaveric mandibular condyles using statistical shape and trait modeling

The objective of this study was to elucidate sex differences in the anatomy of human temporomandibular joint mandibular condyles using a statistical shape and trait model (SSTM). Mandibles were obtained from 16 human cadavers (79±13years). The condyles were scanned using micro-computed tomography with 27μm resolution. An image processing algorithm was used to segment the bone, determine the border of the entire mandibular condyle and trabecular bone compartments, and create triangulated meshes of the compartments. One subject was chosen as the template and was registered to the other individuals using a coherence point drift algorithm. This process positioned all vertices at corresponding anatomic locations. For the trabecular bone region, around each vertex position, the average bone image intensity, which is proportional to bone density, and microstructural traits, including trabecular bone volume fraction, thickness, separation, connectivity, and connectivity density were calculated. For the entire mandibular condyle mesh, the surface vertices were extracted to represent the overall anatomy of the condyle. Using a SSTM, the shape and trait information was reduced to a small set of independent and uncorrelated variables for each individual. Wilcoxon rank sum tests were used to test for differences in the variables between sexes. A lasso approach was used to determine a set of variables that differentiate between sexes. Male condyles were on average larger than female condyles, with complex differences in the microstructural traits. Two out of 15 principal components were statistically different between males and females (p<0.1). The lasso approach determined a set of 7 principal components that fully described the complex shape and trait differences between males and females. A SSTM was able to determine sex-dependent differences in the shape of the mandibular condyle. These differences may alter the biomechanics of the joint and contribute to the development of temporomandibular joint disease.