Evaluation of temporomandibular joint spaces and condylar position: A CBCT study
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Temporomandibular joint (TMJ) is a unique joint. The dimension joint space is determined by the optimal Condylar position. Conventional radiographs cannot exactly show the relationship hence MRI and CT are being used frequently for imaging of TMJ. CBCT has recent advancement into technology especially in this field as helped to analyse the TMJ in more comphrehensive manner. The aim of this study is to assess the position of condyle in TMJ with patients of TMDs. The importance of relationship between condyle and glenoid fossa remains controversial. The CBCT utilizes less radiation and as higher resolution than normal CT. The position of condyle in the glenoid fossa is measured with high accuracy using CBCT technique for reconstruction and imaging of the TMJ. It provides reliable and accurate images. The study was designed to compare the condylar morphology in symptomatic and asymptomatic patients with TMD s.Keywords:
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In recent years, temporomandibular disorder (TMD) is occasionally found among orthodontic patients and has become a great concern in orthodontics. From this point of view, a certain technique has been hopefully anticipated for diagnosis and treatment planning. The purpose of this study was to develop a new method for evaluating three-dimensional position of the mandibular condyle relative to the glenoid fossa and also to investigate its clinical application. Seven-layered tomograms were taken and contours of the condyle and glenoid fossa were traced on an acetate paper. These contours were entered into a personal computer by use of a digitizer and were equally divided into 9 parts for the condyle and 15 parts for the glenoid fossa, consisting of 10 and 16 points on the contours of condyle and glenoid fossa. Three-dimensional configuration of the TMJ was thus constructed by 108 triangles for the condyle and 180 triangles for the glenoid fossa. The shortest distance between the condyle and the glenoid fossa (CGFD) was then calculated along a perpendicular line to center of gravity of a triangle on the condyle. For evaluating the position of the condyle to the glenoid fossa easily in a three dimensional space, surface of the condyle was divided into five areas, i.e. anterior, posterior, middle, lateral and medial areas. In order to investigate whether or not the CGFD is accurate enough to identify the distance between surface of the condyle and glenoid fossa, a model of hemi-spherical solid shell was made, of which the thickness is 3.0 mm. Tomograms of the model were taken to analyze the thickness. Direct measurement of the same area was also made by calipers. Two means were approximately 3.0 mm, which is the thickness itself and no significant differences were indicated at 5% level of confidence. The present technique was applied to diagnosis of an orthodontic patient with painful clicking as TMD. The analyzed CGFDs were coincident with clinical symptom. It is shown that the present approach provides an availability and a possibility to evaluate positional relationship between the mandibular condyle and the glenoid fossa of patients with TMDs.
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Abstract Objectives The purpose of this study was to investigate the condylar morphology and position of Koreans using cone-beam computed tomography (CBCT) images. Analyzing the mean values of this study with reference to left and right sides, gender, and age will help to understand the size of the condyle and glenoid fossa, condylar morphology, and temporomandibular joint (TMJ) symmetry for establishing the standard temporomandibular joint structures of Koreans and then design the standard temporomandibular joint prosthesis for Koreans. Results There was no significant result in the condyle size, condyle axis angle, joint space, fossa depth, and mandibular body size between the left and right sides ( p > 0.05). On the other hand, the mediolateral width of the condyle and mandibular body size show significantly different with the gender ( P < 0.05). Also, significant differences were found in condyle size, joint space, fossa depth, and mandibular body size according to age groups ( p < 0.05). Conclusions Condylar position and morphology vary according to side, age, and gender. The results of this study are expected to help in customizing a treatment for the patients who need TMJ reconstruction by predicting the TMJ morphology according to age and gender and design the standard temporomandibular joint prosthesis for the Koreans.
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266 sagittal tomographs corresponding to the left and right temporo-mandibular joints of 133 patients were divided into 7 groups according to the absence or presence of functional disturbances or of organic lesions. The statistical analysis of the values obtained from a "triangular study" of the surface of the glenoid fossa and of the mandibular condyle showed the following: - the average surface area of the glenoid fossa does not significantly differ from one to the other of the 7 groups examined - the average surface of the mandibular condyle did not significantly vary between groups - in no group studied, except the F/P group (function disturbances/small displacement), was there any relationship between the surface of the glenoid fossa and that of the condyle. It can, however, be stated that the relationship between the surface of the glenoid fossa and the mandibular condyle would seem to play a role in the degree of displacement of the condyle during full opening of the mouth.
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The aim of the present study was to investigate morphology of temporomandibular joint using cone beam computer tomography. Study included 45 adults (32 females and 13 males). Articular eminence inclination, glenoid fossa width, glenoid fossa depth, condylar mediolateral distance, condylar anteroposterior distance and condylar type were determined for each temporomandibular joint. Since independent samples t-test did not show significant differences between left and right sides for all of observed parameters (p≥0.05), left and right side values were treated as one sample. The determined glenoid fossa depth was 7.11±2.23, glenoid fossa width 19.22±2.58, condylar anteroposterior distance 7.54±1.59, condylar mediolateral distance 17.95±2.81 and articular eminence inclination was 34.59±7.35 degrees. Most of condyles were classified as convex type (32.5%), followed by flattened (23.8%), rounded (11.3%) and angled (10%). Undefined (other type) were classified 22.5% of condyles. Cone beam computer tomography measurements of temporomandibular joint bone structures in present study showed similarities to most of previous research (with different populations studied). Still, the prevalence of different condylar types differs from those obtained by most of previous studies. Interindividual differences in temporomandibular joint morphology are expected.
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Gas in the joint space was observed in three patients with condylar fracture who were referred for CT examinations of the mandible. CT showed that the condylar fractures were non-open fractures. The gas was only observed in the intrajoint capsule of the temporomandibular joint (TMJ). Follow-up CT, 4 days after the initial CT, showed that the gas in the joint space was absorbed in one of three cases. In the non-open condylar fractures, the gas collection in the TMJ was considered to be a vacuum phenomenon due to the intact joint capsule of the TMJ on CT.
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Introduction: Conditions of the temporomandibular joint (TMJ) are affected by changes in movement and load during the joint’s function, which can cause morphological changes in hard tissues, such as the condyle. Panoramic radiographs can provide an indication of changes in hard tissues in TMJ. Objectives: The aim of this study was to determine whether there was any correlation between mandibular condyle shapes as seen on panoramic radiographs and TMJ conditions in adult female participants. Methods: The participants of this study were 75 adult female patients who underwent a panoramic radiograph examination conducted at the Maranatha Dental Hospital Radiology Unit. The patients were clinically examined based on the Research Diagnostic Criteria for Clinical Temporomandibular Disorder (RDC/TMD) questionnaire and also their panoramic radiographs. The data from the patients were categorized into four groups according to the RDC/TMD: normal, muscle disorders, disc displacement, and other joint diseases. Next, the radiographs were analyzed by two observers to determine the condyle shapes. Condyle shapes were classified into four groups: ovoid, flat, erosion, and osteophyte. Result: This study showed that of 75 patients, the right TMJ was normal in 34 patients, 2 patients had muscle disorders, 24 demonstrated disc displacement, and 15 had other joint diseases. For the left side of the TMJ, 22 radiographs were normal, 2 revealed muscle disorders, 35 identified disc displacement, and 16 showed other joint diseases. There was a strong agreement between the two observers in determining the right (κ=0.681) and left condyle shapes (κ=0.652). All participants’ findings indicated that condyle shapes and TMJ conditions are highly correlated for both the right (η2=0.889) and left condyle (η2=0.762). Conclusion: This study concluded that mandibular condyle shapes seen on panoramic radiographs and TMJ conditions in adult female participants were highly correlated.
TMJ disorders
Panoramic radiograph
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Temporomandibular joint (TMJ) is a unique joint. The dimension joint space is determined by the optimal Condylar position. Conventional radiographs cannot exactly show the relationship hence MRI and CT are being used frequently for imaging of TMJ. CBCT has recent advancement into technology especially in this field as helped to analyse the TMJ in more comphrehensive manner. The aim of this study is to assess the position of condyle in TMJ with patients of TMDs. The importance of relationship between condyle and glenoid fossa remains controversial. The CBCT utilizes less radiation and as higher resolution than normal CT. The position of condyle in the glenoid fossa is measured with high accuracy using CBCT technique for reconstruction and imaging of the TMJ. It provides reliable and accurate images. The study was designed to compare the condylar morphology in symptomatic and asymptomatic patients with TMD s.
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The aim of this study was to investigate the possible relationship between disc displacement and the presence of reduction by comparing condyle anteroposterior (AP) diameter, condyle height, mandibular fossa AP diameter, and mandibular fossa depth.A total of 588 joints of 294 patients were included in the study for evaluation. Disc displacement and the presence of reduction, condyle AP diameter, condyle height, mandibular fossa AP diameter, and mandibular fossa depth were evaluated.Of the 588 temporomandibular joint examined in the study, there was disc displacement in 141 (24%) and no disc displacement in 447 (76%). Of the joints with disc displacement, reduction was observed in 53 (9%) and not in 88 (15%).A statistically significant correlation was determined between condyle AP diameter and disc displacement (P = 0.00); in the cases with disc displacement, the condyle AP diameter was measured smaller. A statistically significant correlation was determined with condyle height, mandibular fossa AP diameter, and fossa depth. In the patients with disc displacement, the condyle height value was lower and the measured values of the mandibular fossa AP diameter and mandibular fossa depth were higher (P = 0.00). A statistically significant relationship was determined between the presence of reduction and age, condyle AP diameter, condyle height, and articular eminence depth.In conclusion, a deep and wide mandibular fossa, and a short and small condyle lay the ground for disc displacement in the temporomandibular joint.
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