| Background:mandibular asymmetry orthodontic patients is a common phenomenon, have a certain impact on the appearance and function of the patient. Studies have shown that patients with mandibular deviation and mandibular condylar asymmetry are closely related. Learn mandibular deviation patients condylar structural and functional changes of clinical mandibular asymmetry have some significance, so this has been a hot topic of orthodontics. Previous studies indicate that there are significant differences in adult patients with mandibular deviation skew side condyle and non skewed side condyle in morphology and size, but on the reconstruction of mandibular condylar asymmetry caused by deflection, or due to differences in the patients themselves condylar morphology cause mandibular asymmetry, academia is still controversial. In this study, patients with mandibular deviation were measured in adult and child patients with bilateral mandibular condylar skew data to understand the mandibular condyle deviation and volume difference of causality.Traditional mandibular asymmetry checks typically used X-ray detector, although relatively easy to detect, but it has some limitations, especially the performance of the mandibular condyle, because the structure of the overlap of the two-dimensional imaging and other reasons, the distortion is large.Objective:In this study, cone-beam CT (CBCT) for patients with mandibular deviation craniofacial scan radiography, the resulting data using computer imaging technology, obtaining a three-dimensional model of the structure of the mandibular condyle in three-dimensional model of the jaw in patients with mandibular deviation condylar signs point mark and measure bilateral condylar height, anteroposterior diameter, inner and outer diameter and volume of bilateral condylar comparison. Mandibular deviation were measured in adult patients and children with bilateral mandibular condylar skew data to understand the mandibular condyle deviation and volume difference of causality.Methods:Patients seek treatment from2009-2014Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Department of Orthodontics, select adult patients with mandibular deviation19(3males,16females, age range18-32years, mean age21.5years) As a control group.7patients with mandibular deviation minors (2males and5females, age range8-17years, mean age12.6years). All of the subjects were taken craniofacial CBCT, all subjects informed consent. The study according to the following selection criteria:(1) measurement of anteroposterior skull skull chin deviation from the median sagittal plane≥2mm.(2) When the cusp of the mandibular midline deviation from the midline staggered bit≥2mm.(3) no history of trauma and maxillofacial, mandibular osteomyelitis no history, no history of temporomandibular joint tumors.(4) the basic integrity of the dentition, dental tissue without obvious morphological abnormalities.(5) when illuminated front chin chin to one side, bilateral facial asymmetry apparent.The resulting data into mimics15CBCT image processing software, select the condylar organization, generating a three-dimensional model and measure the volume, and then the three-dimensional model into3-matic7.0for processing and measuring the height of the condyle on the model, the anteroposterior diameter, inside and outside diameter, were bilateral comparison in order to understand the condylar shape and volume differences.Using GraphPad Prism5statistical software measurement results normality test, adult patients with mandibular deviation skewed data and non-data skew side lateral condylar condyle paired t-test analysis of bilateral condylar whether there are differences. Using independent sample t test to analyze whether adult patients with mandibular deviation patients with mandibular deviation minors condylar data differences. Using a paired t-test analysis of patients with mandibular deviation minor deviation side condyle and lateral condyle of the non-skewed data whether there are differences.Results:Adult patients with mandibular deviation lateral condylar volume deviation1188.41±214.32mm3significantly less than non-deflected side condylar volume of1568.25±279.59mm3(P<0.01); oblique lateral condyle within the outer diameter of16.91±1.64mm non-skewed side outside diameter of17.27±1.81mm within condylar no significant difference (P>0.05); oblique lateral condylar around9.02±1.00mm diameter significantly less than before the non-deflected side condylar path11.28±1.71mm (P<0.01); partial Xiece condylar height of13.11±1.70mm significantly less than non-deflected side condyle of15.83±2.46mm (P<0.01).Minor deviation in patients with mandibular deviation side condylar volume782.42±131.97mm3with non-skewed side condylar volume824.63±144.67mm3no significant difference (P>0.05); oblique lateral condyle within the outer diameter of12.74±1.16mm and non-outside diameter of13.03±1.44mm was no significant difference (P>0.05) in the skewed side condyle; diameter7.37±0.51mm diameter7.71±0.99mm was no significant difference between the front and rear side of the non-skewed skewed front side condylar condyle (P>0.05); oblique lateral condyle11.05±0.87mm and non-skewed side condyle11.49±1.22mm was no significant difference (P>0.05) height.The volume of adult patients with a minor deviation in patients with mandibular deviation of lateral condyle, height, inner and outer diameter and anteroposterior diameter were significantly different (P<0.01), the volume of non-deflected side condyle, height, inner and outer diameter and the anteroposterior diameter were significantly different (P<0.01).Conclusions:Adult patients with bilateral mandibular condylar deviation form the obvious differences; underage patients with bilateral mandibular condylar deviation there is no significant difference in morphology; mandibular deviation patients condyle during growth and development in the emergence of asymmetry alterations; minor mandibular deviation patients early diagnosis and treatment can prevent its occurrence condylar asymmetry alterations. |
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