| BackgroundMandibular deviation is one of the most frequent malocclusions in adult patients, however, the aetiology of which is not well understood. It is thought that mandibular deviation may have an important effect on face esthetics as well as social-psychological problem. A large of studies had suggested that adult patients with mandibular deviation may also present with dysfunction of occlusion, and malocclusion may consequently result in adaptive remodeling of temporomandibular joint (TMJ). Cephalometric analysis has confirmed that there is correlation between occlusion asymmetry with morphology asymmetry of temporomandibular joint. We proposed that mandibular deviation may result in adaptive remodeling of condyle and glenoid fossa as well as the location change of condyle in glenoid fossa. Previous study mainly evaluated morphology characteristics of temporomandibular joint in patients with mandibular deviation basing on cephalometric analysis, however, cephalometric analysis has its own limitation for it can only offer information in two-dimension. There is still a lack of information in relation to the morphology asymmetry of TMJ in adult patients with mandibular deviation.AimsOur study was designed to evaluate the morphology characteristics of condyle and glenoid fossa in adult patients with mandibular deviation. At the same time, our study was also aimed to explore, compred with control group, whether the morphology asymmetry of condyle and glenoid fossa, and the position of condyle in the flenoid fosa as well as the location of condyle in relative to the craniofacial complex in mandibular deviation group changed.MethodsA total of 20 adult patients with mandibular deviation from 18 to 30 years of age were included (the study group). Twenty subjects without mandibular deviation were selected randomly from all subjects seeking for orthdntic treatment and matched by gender and age to the study group to serve as control group. The helical CT was performed, and the CT images were reconstructed into 3D model by using medical image processing software. Anatomical landmarks were located and reference planes were established on the 3D model. Assessment of tempromandibular joint asymmetry was presented in the form of linear and angular measurements. Statistical analyses were performed with SPSS 13.0.Results(1) In adult patients with mandibular deviation, condylar morphology exhibited some asymmetric characteristics. On the one hand, compared with the ipsilateral side, both the length and the width of the condylar head were larger on the contralateral side in adult patients with mandibular deviation. On the other hand, both the inclination and length of the condylar posterior cant on the contralateral side were smaller than the ipsilateral side. Furthermore, compared with the control group, all those asymmetric change of condylar morphology in the mandibular deviation group is statistically significant.(2) In adult patients with mandibular deviation, asymmetric characteristics of glenoid fossa morphology was not obvious, for only the inner-outer width of glenoid fossa and the inclination of posterior slope on both ipsilateral side and the contralateral side were different significantly. Furthermore, compared with the control group, only the asymmetric change of the inclination of articular posterior slope in the mandibular deviation group is statistically significant.(3) Although the inner gap between condyle and the glenoid fossa was different statistically, the position of condyle in the articular fossa on both sides in adult patients with mandibular deviation was relatively symmetrically. However, in adult patients with mandibular deviation, the location of condyle in relative to the craniofacial complex on both sides presented some incoordinating changes, which can be described as condylar plane in three-dimension rotated counter-clockwise in relative to the mid-sagittal plane, the Frankfort horizontal plane and the coronary plane on the contralateral side. Furthermore, compared with control group, in the mandibular deviation group, the location of condyle in relative to the craniofacial complex on contralateral side rotated forwards, inwards and downwards.ConclusionsOur study demonstrated that mandibular deviation may result in adaptive remodeling of condyle and glenoid fossa as well as the location change of condyle in relative to glenoid fossa. |
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