Differences in mandibular condyle and glenoid fossa morphology in relation to vertical and sagittal skeletal patterns: A cone-beam computed tomography study원문보기
Noh, Kyoung Jin
(Private Practice)
,
Baik, Hyoung-Seon
(Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry)
,
Han, Sang-Sun
(Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry)
,
Jang, Woowon
(Private Practice)
,
Choi, Yoon Jeong
(Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry)
Objective: This study aimed to evaluate the following null hypothesis: there are no differences in the morphology of the temporomandibular joint (TMJ) structures in relation to vertical and sagittal cephalometric patterns. Methods: This retrospective study was performed with 131 participants showing...
Objective: This study aimed to evaluate the following null hypothesis: there are no differences in the morphology of the temporomandibular joint (TMJ) structures in relation to vertical and sagittal cephalometric patterns. Methods: This retrospective study was performed with 131 participants showing no TMJ symptoms. The participants were divided into Class I, II, and III groups on the basis of their sagittal cephalometric relationships and into hyperdivergent, normodivergent, and hypodivergent groups on the basis of their vertical cephalometric relationships. The following measurements were performed using cone-beam computed tomography images and compared among the groups: condylar volume, condylar size (width, length, and height), fossa size (length and height), and condyle-to-fossa joint spaces at the anterior, superior, and posterior condylar poles. Results: The null hypothesis was rejected. The Class III group showed larger values for condylar width, condylar height, and fossa height than the Class II group (p < 0.05). Condylar volume and superior joint space in the hyperdivergent group were significantly smaller than those in the other two vertical groups (p < 0.001), whereas fossa length and height were significantly larger in the hyperdivergent group than in the other groups (p < 0.01). The hypodivergent group showed a greater condylar width than the hyperdivergent group (p < 0.01). The sagittal and vertical cephalometric patterns showed statistically significant interactions for fossa length and height. Conclusions: TMJ morphology differed across diverse skeletal cephalometric patterns. The fossa length and height were affected by the interactions of the vertical and sagittal skeletal patterns.
Objective: This study aimed to evaluate the following null hypothesis: there are no differences in the morphology of the temporomandibular joint (TMJ) structures in relation to vertical and sagittal cephalometric patterns. Methods: This retrospective study was performed with 131 participants showing no TMJ symptoms. The participants were divided into Class I, II, and III groups on the basis of their sagittal cephalometric relationships and into hyperdivergent, normodivergent, and hypodivergent groups on the basis of their vertical cephalometric relationships. The following measurements were performed using cone-beam computed tomography images and compared among the groups: condylar volume, condylar size (width, length, and height), fossa size (length and height), and condyle-to-fossa joint spaces at the anterior, superior, and posterior condylar poles. Results: The null hypothesis was rejected. The Class III group showed larger values for condylar width, condylar height, and fossa height than the Class II group (p < 0.05). Condylar volume and superior joint space in the hyperdivergent group were significantly smaller than those in the other two vertical groups (p < 0.001), whereas fossa length and height were significantly larger in the hyperdivergent group than in the other groups (p < 0.01). The hypodivergent group showed a greater condylar width than the hyperdivergent group (p < 0.01). The sagittal and vertical cephalometric patterns showed statistically significant interactions for fossa length and height. Conclusions: TMJ morphology differed across diverse skeletal cephalometric patterns. The fossa length and height were affected by the interactions of the vertical and sagittal skeletal patterns.
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문제 정의
2 The differences of TMJ morphology based on the interactive effects of the sagittal and vertical cephalometric relationships were barely investigated using 3D images. Therefore, this study aimed to evaluate the following null hypothesis: there are no differences in morphology of the TMJ structures in relation to vertical and sagittal cephalometric patterns.
가설 설정
2. The fossa length and height were affected by the interaction of the vertical and sagittal skeletal patterns.
제안 방법
The field of view was 154 × 154 mm2. The images were transformed to the Digital Imaging and Communications in Medicine format, reconstructed, and analyzed with OnDemand software (Cybermed Inc., Seoul, Korea). The CBCT images were reoriented with the Frankfort horizontal (FH) plane parallel to the ground.
6 years) selected from 449 patients who had visited Yonsei University Dental Hospital between January 2012 and June 2016 and had undergone both lateral cephalography and CBCT including the TMJ structure. The participants had undergone CBCT for the following reasons: orthodontic diagnosis for orthognathic surgery; presence of impacted teeth; and evaluation of the available amount of al.,eolar bone for orthodontic tooth movement. The inclusion criteria were absence of signs and symptoms of TMD based on research diagnostic criteria for TMD; availability of lateral cephalography and CBCT images; and age over 18 years.
One-way analysis of vari- ance (ANOVA) and Scheffe post-hoc test were used to compare Class I, Ⅱ, and Ⅲ groups according to the sag- ittal skeletal patterns. The same tests were performed to compare hypodivergent, normodivergent, and hyper- divergent groups according to the vertical skeletal pat- terns. The nine subgroups were compared by two-way ANOVA and Bonferroni post-hoc test to evaluate the interactions between the sagittal and vertical cephalo- metric patterns.
This study aimed to compare the morphology of TMJ structures and the spatial relationships between the condyle and fossa in relation to vertical and sagittal cephalometric patterns, and the findings suggested that the Class Ⅲ group showed higher values for condylar width, condylar height, and fossa height than the Class II group. Condylar volume, condylar width, and superior joint space in the hyperdivergent group were significantly smaller than those in the hypodivergent group, while fossa length and height were significantly larger in the hyperdivergent group than the hypodivergent group.
This study was designed to analyze condylar volume, condylar size (width, length, and height), fossa size (length and height), and condyle-to-fossa joint spaces at the anterior, superior, and posterior condylar poles (Figure 1). For measurements, we identified 10 anatomical landmarks (Cd-med, Cd-lat, Cd-sup, Cd-ant, Cd- post, Sig-inf, Sig-post, Fs-sup, At-inf, and Am-inf), as defined in Table 2.
Using cephalometric analysis, the participants were classified on the basis of their vertical and sagittal skeletal relationships. The sella-nasion to mandibular plane (SN-MP) angle was used to divide the participants into hypodivergent (SN-MP < 30°), normodivergent (30° < SN-MP < 38°), and hyperdivergent (SN-MP > 38°) groups, 22 while the A point-nasion-B point (ANB) angle was used to divide them into Class I (1° < ANB < 4°), Class II (ANB > 4°), and Class Ⅲ (ANB < 1°) groups.
대상 데이터
This retrospective study included 131 participants with no TMJ symptoms (48 men and 83 women; mean age, 23.5 years; range, 18.0–39.6 years) selected from 449 patients who had visited Yonsei University Dental Hospital between January 2012 and June 2016 and had undergone both lateral cephalography and CBCT including the TMJ structure. The participants had undergone CBCT for the following reasons: orthodontic diagnosis for orthognathic surgery; presence of impacted teeth; and evaluation of the available amount of al.
Three-dimensional images were acquired with a CBCT device (Alphard VEGA; ASAHI Roentgen IND, Kyoto, Japan) set at 5.0–8.0 mA and 80 kV, and images were captured for 17 seconds with a 0.30-mm voxel size. The field of view was 154 × 154 mm2.
데이터처리
The same tests were performed to compare hypodivergent, normodivergent, and hyper- divergent groups according to the vertical skeletal pat- terns. The nine subgroups were compared by two-way ANOVA and Bonferroni post-hoc test to evaluate the interactions between the sagittal and vertical cephalo- metric patterns. All measurements were analyzed by us- ing IBM SPSS Statistics software (ver.
이론/모형
Normal distribution of the data was confirmed by the Kolmogorov-Smirnov test. One-way analysis of vari- ance (ANOVA) and Scheffe post-hoc test were used to compare Class I, Ⅱ, and Ⅲ groups according to the sag- ittal skeletal patterns.
성능/효과
1. TMJ morphology differed according to diverse skeletal patterns: the findings showed significant differences in condylar width, condylar height, and fossa height among the three sagittal groups, while condylar volume, condylar width, fossa height and length, and superior joint space were significantly different among the three vertical groups.
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