Three-Dimensional Assessment of the Condylar Position in Different Malocclusions Using Cone-Beam Computed Tomography: A Cross-Sectional Study

利用锥形束计算机断层扫描对不同错颌畸形中髁突位置进行三维评估:一项横断面研究

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Abstract

Introduction The role of the condylar position in the correct functioning of the stomatognathic system has been the center of the study. Using cone-beam computed tomography (CBCT), this study looked at the three-dimensional (3D) position of the condylar bone in patients from Class I, Class II, Division 1, and Division 2. Materials and methods This cross-sectional, retrospective study was conducted using 102 CBCT records, with 34 records allocated to each category of malocclusion classification, such as dentoskeletal Class I, skeletal Class II, and dental Class II, Division 1 and 2. CBCT scans were conducted utilizing a Carestream New Generation CBCT apparatus (Carestream Dental, Atlanta, Georgia) in accordance with a standardized protocol (operating at a voltage of 120 kV, a current of 80 mA, a seven-second scan time, a field of view (FOV) measuring 10 x 10 cm, and a resolution of 0.2 voxels, and 1-mm slice thickness). The condylar position was assessed as the superior, inferior, and medial distance of the condyle from the glenoid fossa, along with the condylar angle. The distance from the most anterior point on the anterior surface of the condyle to the articular eminence was taken as anterior condylar distance; the distance of the superior surface of the condyle from the deepest point of the glenoid fossa was taken as superior condylar distance; the distance of the posterior surface of the condyle from the glenoid fossa was taken as posterior condylar distance; the condylar angle was measured as an angle between the XY line and the FH' line passing through X, where X is the center of the condyle; and the distance of the medial surface of the condyle from the glenoid fossa was taken as medial distance. The data were then subjected to statistical analyses. Results For anterior distance, the highest distance was noted in Class II Division 1 (3.32 ± 0.4 mm), and the lowest was seen in Class I (2.43 ± 0.26 mm). In the posterior distance, Class I exhibited the highest mean distance of 2.05 ± 0.14 mm, while Class II Division 1 showed the lowest distance of 1.83 ± 0.18 mm. For superior distance, the highest mean value was noticed in Class I patients at 2.92 ± 0.22 mm, and the lowest value was seen in Class II Division 1 at 2.61 ± 0.35 mm (p=0.001). For the condylar angle, the highest mean value was observed in Class I (30.96 ± 1.91(0)) and the lowest in Class II Division 1 (26.71 ± 1.48(0)), with p=0.001. Confirmatory factor analysis revealed that the most substantial loading was attributed to the condylar angle at -2.28, signifying its significant contribution to Fc1. Conclusion The condyle was placed anteriorly, superiorly, and medially in Class II Division 1 and posteriorly in Class II Division 2, compared to Class I patients.

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