Comparison of condylar and ramal asymmetries in different temporomandibular joint disorders

AbstractAim: The aim of this study is to compare condylar and ramal asymmetries in different temporomandibular joint disorders.Material and Methods: A total of 91 patients ranging in age from 15 to 79 were included in this study. The study groups were as follows: temporomandibular joint osteoarthritis (OA) group (N=24), disc displacement with reduction (DDWR) group (N=26), disc displacement without reduction (DDWoR) group (N=20), and control group (N=21). All patients’ vertical condylar and ramal heights were measured from panoramic radiographs, and condylar (CAI) ramal (RAI), and total (TAI; condylar + ramal) asymmetry indices were calculated according to Habets el al’s formula.Results: Statistical evaluations were made with the Kruskal–Wallis test using SPSS. Although TAI (p=0.110) and age (p = 0.610) did not differ significantly among the four groups, RAI (p=0.003) and CAI (p = 0.034) did. In intergroup estimates for RAI comparisons, significant differences were observed between the OA and DDWR groups (p=0.004, p=0.033) and between the OA and control groups (p=0.033). Evaluations of CAI among groups showed significant differences only for the OA vs. control group comparison (p=0.022).Conclusion: These results show that OA, a degenerative disease, has greater effects on vertical condylar and ramal asymmetry than on disc displacements and that there are no significant differences between the control and disc displacement groups in terms of CAI.

PDF

___

1. Gencer ZK, Ozkiris¸ M, Okur A, et al. A comparative study on the impact of intra-articular injections of hyaluronic acid, tenoxicam and betametazon on the relief of temporomandibular joint disorder complaints. J Craniomaxillofac Surg 2014;42:1117-21.
2. Sharma S, Gupta D, Pal U, et al. Etiological factors of temporomandibular joint disorders. Natl J Maxillofac Surg 2011;2:116-9.
3. Schokker RP, Hansson TL, Ansink BJ, et al. Craniomandibular asymmetry in headache patients. J Craniomandib Disord 1990;4.
4. Polat ME, Yanik S. Efficiency of arthrocentesis treatment for different temporomandibular joint disorders. Int J Oral Maxillofac Surg 2019.
5. Machon V, Hirjak D, Lukas J. Therapy of the osteoarthritis ofthe temporomandibular joint. J Craniomaxillofac Surg 2011;39:127-30.
6. Scully C. Oral and maxillofacial medicine: the basis of diagnosis and treatment, 2nd edition. Edinburgh: Churchill Livingstone 2008;8,14,30,31,33,101,104,106,291-295,338,339,351.
7. Sezgin OS, Celenk P, Arici S. Mandibular Asymmetry in Different Occlusion Patterns. Angle Orthodontist 2007:77;803-7.
8. Habets LL, Bezuur JN, Naeiji M, et al. The Orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil 1988;15:465-47.
9. Sofyanti E, Boel T, Soegiharto B, et al. TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia: a cross-sectional study. F1000 Res 2018;7: 697.
10. Miller V, Yoeli Z, Barnea E, et al. The effect of parafunction on condylar asymmetry in patients with temporomandibular disorders. J Oral Rehabil 1998;25:721-4.
11. Rodrigues AF, Fraga MR, Vitral RWF. Computed tomography evaluation of the temporomandibular joint in Class II Division 1 and Class III malocclusion pa- tients: condylar symmetry and condyle-fossa relationship. Am J Orthod Dentofacial Orthop 2009;136:199-206.
12. Yanez-Vico RM, Iglesias-Linares A, Torres-Lagares D, et al. Three-dimensional evaluation of craniofacial asymmetry: an analysis using computed tomography. Clin Oral Investig 2011;15:729-36.
13. Bezuur JN, Habets L, Hansson T. The recognition of craniomandibular disordersda comparison between clinical, tomographical, and dental panoramic radiographical findings in thirty-one subjects. J Oral Rehabil 1988;15:549-54.
14. Khojastepour L, Omidi M, Vojdani M, et al. Investigating possible correlation between condylar asymmetry and clinical dysfunction indices in patients with temporomandibular dysfunction using Cone-beam computed tomographic. J Craniomaxillofac Surg 2019;47:438-42.
15. Fuentes R, Engelke W, Bustos L, et al. Reliability of two techniques for measuring condylar asymmetry with x-rays. Int J Morphol 2011;29:694-701.
16. Saglam A. The condylar asymmetry measurements in different skeletal patterns. J Oral Rehabil 2003;30:738-42.
17. Lund TM, Manson-Hing LR. A study of the focal troughs of three panoramic dental x-ray machines. Part I. The area of sharpness. Oral Surg Oral Med Oral Pathol 1975;39:318-28.
18. Kambylafkas P, Murdock E, Gilda E, et al. Validity of panoramic radiographs for measuring mandibular asymmetry. Angle Orthod 2006;76:388-93.
19. Kiki A, Kılıç N, Oktay H. Condylar Asymmetry in Bilateral Posterior Crossbite Patients. Angle Orthodontist 2007:77;77-81.
20. Kurita H, Ohtsuka A, Kobayashi H, et al. Relationship between increased horizontal condylar angle and resorption of the posterosuperior region of the lateral pole of the mandibular condyle in temporomandibular joint internal derangement. Dentomaxillofac Radiol 2003;32:26-9.