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Li X, Shan X, Zhang S, Li Z, Zhang J. The correlation analysis between incisal guidance angle and occlusal plane angles and temporomandibular joint morphology. Clin Oral Investig 2024; 28:455. [PMID: 39078486 DOI: 10.1007/s00784-024-05848-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/18/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVES The correlations between the incisal guidance angle (IGA) and occlusal plane angles and temporomandibular joint (TMJ) morphology were investigated in adults with skeletal Class II division II malocclusion. MATERIALS AND METHODS CBCT images of 37 patients were analyzed. It included 19 cases of skeletal Class II division II malocclusion with low angle (study group) and 18 cases of skeletal Class I average angle (control group). The Invivo Dental 5 software was employed to acquire the data of the incisal guidance angle (IGA), occlusal plane angle (FH-OP), anterior occlusal plane angle (FH-AOP) and the TMJ measurement items. RESULTS The results of IGA, FH-AOP angle and FH-OP angle showed the study group > the control group (P < 0.05). There were statistically difference in the condylar mediolateral diameters, articular eminence inclination and height, and posterior joint spaces between two groups. No differences were revealed in the condylar anteroposterior diameters, the condylar inclination angle, condylar head width and height, condylar length, glenoid fossa depth and width between two groups. In the study group, IGA showed a moderate correlation with FH-AOP, a weak correlation with FH-OP and condylar mediolateral diameters. Meanwhile, there was a correlation between FH-AOP, FH-OP, and TMJ indicators. CONCLUSIONS The IGA was not only related to FH-AOP and FH-OP, but also to the condylar mediolateral diameters. In addition, there was a correlation between the occlusal plane angles and TMJ morphology in skeletal Class II division II low angle malocclusion. CLINICAL RELEVANCE For patients with skeletal Class II division II low angle malocclusion, adjusting the IGA and the occlusal plane angles could improve the esthetic appearance of the anterior teeth, occlusal function, and TMJ morphology.
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Affiliation(s)
- Xiangxin Li
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, 221009, China
| | - Xuelong Shan
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, 221009, China
| | - Shuting Zhang
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, 221009, China
| | - Zhigang Li
- Department of Urology, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, 221009, China.
| | - Jing Zhang
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou Clinical College of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, 221009, China.
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Zheng J, Zhang Y, Wu Q, Xiao H, Li F. Three-dimensional spatial analysis of the temporomandibular joint in adult patients with Class II division 2 malocclusion before and after orthodontic treatment: a retrospective study. BMC Oral Health 2023; 23:477. [PMID: 37438801 DOI: 10.1186/s12903-023-03210-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND To investigate changes in the three-dimensional (3D) spatial morphology of the temporomandibular joint (TMJ) and condyle position in adult patients with Class II division 2 malocclusion using a 3D spatial measurement method and to investigate the similarities and differences in the effects of fixed appliance and clear aligner treatments on the TMJ. METHODS Cone-beam computed tomography (CBCT) data of 47 adult patients with Class II division 2 malocclusion (25, fixed appliance group; 22, clear aligner group) were collected before and after treatment. Mimics 21.0 was used to reconstruct the TMJ 3D model. Fourteen measurement items, such as the anterior, upper, and posterior joint spaces, were measured directly on the 3D model and compared. RESULTS Post-orthodontic treatment, the shape and position of the condyle changed in adult patients with Class II division 2 malocclusion. Reduction in the anterior joint space and increase in the posterior joint space after orthodontic treatment were significant in both fixed appliance and clear aligner treatments; the condyle moved forward to the center of the fossa. The superior joint space and depth of the glenoid fossa increased after clear aligner treatment, but there was no significant change after fixed appliance treatment. CONCLUSIONS The condylar shape and position in patients with Class II division 2 malocclusion changed significantly post-treatment, indicating that the condyle undergoes adaptive reconstruction during orthodontic treatment in these patients. These results provide a reference for diagnosis, design of treatment plan, and monitoring of treatment in orthodontic clinics.
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Affiliation(s)
- Jiajing Zheng
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Yueying Zhang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Qiuyue Wu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Hua Xiao
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Feifei Li
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China.
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Serafim I, Rode S, Lopes S, Oliveira W, Pinho S, Silva E, Winocur E, Meira E Cruz M. Impact of bruxism on craniomandibular morphology: A cone-beam computed tomographic study. Cranio 2022:1-11. [PMID: 36419355 DOI: 10.1080/08869634.2022.2139334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The main goal of this work was to address craniomorphological characteristics of patients with bruxism when compared to those without bruxism using cone beam computed tomography (CBCT) imaging. METHODS Seventy CBCT images of an equal number (n = 35) of orthodontic patients with and without bruxism (age range, 18-44 years) were retrospectively analyzed. Sagittal evaluation, mandibular shape, and skeletal asymmetry were systematically assessed in both groups. RESULTS Significant differences (p < 0.05) were observed between groups for Right Articular Fossa (AF) - Axial Plane (AP) and Left AF - AP (B > NB), Right Gonial Angle (GA), Left GA, Sella-Nasion and Occlusal Plane (B < NB). Age (13%), Condyle-Gonion (18%), AF to AP (67%), and Mental-AP (16%) had the greatest impact on bruxers. CONCLUSION In this study, the CBCT 3D image showed significant differences in craniofacial morphology, particularly in the mandibular structure of bruxers compared with non-bruxers.
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Affiliation(s)
- Irene Serafim
- Department of Biopathology, Institute of Science and Technology, São José dos Campos, São Paulo State University- UNESP, São Paulo, Brazil
| | - Sigmar Rode
- Department of Biopathology, Institute of Science and Technology, São José dos Campos, São Paulo State University- UNESP, São Paulo, Brazil
| | - Sérgio Lopes
- Department of Biopathology, Institute of Science and Technology, São José dos Campos, São Paulo State University- UNESP, São Paulo, Brazil
| | - Wagner Oliveira
- Department of Biopathology, Institute of Science and Technology, São José dos Campos, São Paulo State University- UNESP, São Paulo, Brazil
| | - Sérgio Pinho
- Department of Orthodontics, University of Barcelona, Barcelona, Spain
| | - Ertty Silva
- Department of Biopathology, Institute of Science and Technology, São José dos Campos, São Paulo State University- UNESP, São Paulo, Brazil
| | - Efraim Winocur
- Department of Oral Rehabilitation, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miguel Meira E Cruz
- Sleep Unit, Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal
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Yu LY, Xia K, Sun WT, Huang XQ, Chi JY, Wang LJ, Zhao ZH, Liu J. Orthodontic retreatment of an adult woman with mandibular backward positioning and temporomandibular joint disorder: A case report. World J Clin Cases 2022; 10:691-702. [PMID: 35097096 PMCID: PMC8771383 DOI: 10.12998/wjcc.v10.i2.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/09/2021] [Accepted: 12/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The role of occlusal factors on the occurrence of temporomandibular joint disorders (TMDs) is still unclear and it is tricky for orthodontists to treat malocclusions in patients with TMDs. We report the case of the second orthodontic treatment of an adult female with Class II division 2 malocclusion associated with TMD. With the removal of anterior occlusal interference, TMD symptoms were alleviated and cone beam computed tomography (CBCT) images showed the bilateral condyles shifted forward.
CASE SUMMARY This case report presented an orthodontic retreatment of an adult female with TMD and mandibular backward positioning based on CBCT examination and Joint Space Index (JSI) analysis. The left and right JSI values of -38.5 and -52.6 indicated that the position of bilateral condyles had posterior displacement. Ten years prior to this evaluation, she underwent orthodontic treatment resulting in the extraction of two upper premolars and one lower central incisor. The joint symptoms, including pain and sounds, were alleviated along with verified mandibular forward repositioning by extraction of another lower central incisor.
CONCLUSION Mandibular backward positioning could be associated with TMD. JSI analysis based on CBCT is a convenient way to examine condylar positions quantitatively.
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Affiliation(s)
- Li-Yuan Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Kai Xia
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wen-Tian Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xin-Qi Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jing-Yu Chi
- Department of Stomatology, Strategic Support Force Medical Center of PLA, Beijing 10010, China
| | - Ling-Jie Wang
- Department of Stomatology, Qingyang People's Hospital, Qingyang 745000, Gansu Province, China
| | - Zhi-He Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jun Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
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John ZAS, Shrivastav SS, Kamble R, Jaiswal E, Dhande R. Three-dimensional comparative evaluation of articular disc position and other temporomandibular joint morphology in Class II horizontal and vertical cases with Class I malocclusion. Angle Orthod 2020; 90:707-714. [PMID: 33378480 DOI: 10.2319/121519-801.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 03/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate and compare articular disk position, condylar position, and joint spaces in Class II vertical, Class II horizontal, and Class I cases. The purpose was to assess the potential for development of temporomandibular disorders (TMDs) in the three groups. MATERIALS AND METHODS A sample of 75 cases, 25 cases in each group of Class I, Class II vertical, and Class II horizontal, were selected based on inclusion and exclusion criteria. Magnetic resonance imaging (MRI) assessments were made with a 1.5-Tesla basic system with a closed-mouth technique for evaluating articular disk position in the sagittal and transverse planes, condylar position, and joint spaces in the sagittal plane. Philips 3.0 software was used to analyze the MR images. RESULTS There was evidence of alterations in the temporomandibular joint (TMJ) morphology in both Class II vertical and Class II horizontal cases, with maximum discrepancy in Class II vertical cases. MRI evaluation suggested a tendency for antero-medial disk displacement with anteriorly positioned condyles in Class II vertical cases. The discrepancy was milder in the Class II horizontal group. CONCLUSIONS Class II vertical cases are more susceptible to the development of TMDs and should be subjected to TMJ evaluation before starting any orthodontic treatment to intercept and prevent a mild asymptomatic TMD from developing into a more severe form. Class II vertical cases should be subjected to MRI evaluation before starting any orthodontic treatment.
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Mehraban SH, Jamali S, Azizi A, Nasrabadi N. Evaluating the Effectiveness of Orthognathic Surgery on the Pre-existing Temporomandibular Disorders in Patients with Malocclusion: A Systematic Review and Meta-analysis. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Affiliation(s)
| | | | - Amir Azizi
- Alborz University of Medical Sciences, Iran
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Chane L, Kily JP, Marangelli G, Gebeile-Chauty S. [Somatic dysfunctions of the cervical spine and fixed orthodontic treatment: a 145 subjects-cross sectional study]. Orthod Fr 2019; 90:119-126. [PMID: 31241454 DOI: 10.1051/orthodfr/2019014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 02/10/2019] [Indexed: 06/09/2023]
Abstract
UNLABELLED Objectives : The aim of this blind cross-sectional study is to evaluate the influence of a fixed orthodontic appliance on the cervical spine. MATERIALS AND METHODS Number and severity of somatic dysfunctions (i.e. alteration of the function of an element constituting the somatic system or SD) of the cervical spine have been searched on patients sorted out in three groups: subjects without orthodontic treatment (group 1), subjects wearing fixed orthodontic appliance (group 2) and subjects in a retention period after removal of the fixed orthodontic appliance (group 3) and were compared thanks to khi2 test. RESULTS A total of 145 patients from 6 to 17 years old was included. There are more SD in the second group (p = 0.006) than in the first group. There is no difference between the 1st and the 3rd group (p = 0.2), between the 2nd and the 3rd group (p = 0.4) and between the three groups (p = 0.6) concerning the severity of SD. CONCLUSION Cervical disorders should not be attributed to long-term multi-attachment treatment since once the active orthodontic treatment is finished, the SD are not significantly increased compared to the control group. These results may encourage to make a study to evaluate benefits of cervical osteopathic follow-up for patients at risk after the setting of the fixed appliance.
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Affiliation(s)
- Loïc Chane
- CEESO Lyon, 39 rue Pasteur, Lyon 69007, France
| | - Jean-Pascal Kily
- Maison médicale, 17 impasse Petrus Vitel, 69700 Loire sur Rhone, France
| | | | - Sarah Gebeile-Chauty
- Département d'Orthopédie Dento-Faciale, Faculté d'Odontologie, 11 rue Guillaume Paradin, 69372 Lyon cedex 08, France
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Do patients with malocclusion have a higher prevalence of temporomandibular disorders than controls both before and after orthognathic surgery? A systematic review and meta-analysis. J Craniomaxillofac Surg 2017; 45:1716-1723. [PMID: 28843406 DOI: 10.1016/j.jcms.2017.07.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 06/27/2017] [Accepted: 07/24/2017] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The aim of this study was to identify, through meta-analysis, whether patients who require orthognathic surgery have a higher prevalence of temporomandibular disorders (TMDs) than controls, both before treatment and after. MATERIAL AND METHODS A systematic review and meta-analysis were conducted based on PRISMA guidelines, to address the study purposes. A search of major databases through PubMed, EMBASE, and Cochrane CENTRAL was performed to locate all pertinent articles published from inception to June 2016. Inclusion criteria were controlled clinical studies, either prospective or retrospective, and case-control studies comparing preoperative and postoperative signs and symptoms of TMDs in patients who undergo orthognathic surgery to those of a healthy volunteer population with no dentofacial deformities. The predictor variables were patients with dentofacial deformities who underwent orthognathic surgery and patients with no dentofacial deformities and with good maxillomandibular relations and normal occlusion. The outcomes variables were the weighted, prevalence rate (proportion) in signs and symptoms of TMDs in patients with dentofacial deformities and risk ratio (RR) of signs and symptoms of TMDs before and after orthognathic surgery, compared to the control group. RESULTS A total of 542 patients enrolled in 6 studies were included in this analysis. The overall pooled weighted rate or prevalence of TMDs for orthognathic surgery patients preoperatively was 32.5% (95% CI = 26.7%-38.9%). There was a significant difference between the 2 groups with respect to TMDs before surgery, but no significant difference in TMDs after surgery. The RR for patients who had dentofacial deformities before orthognathic surgery compared with a control group was 1.634 (95% CI = 1.216-2.194; P = 0.001). The RR for patients after orthognathic surgery compared with a control group was 1.262 (0.718; 95% CI = 0.805-1.979; P = 0.311). CONCLUSION The results of this study show that patients who are going to have a correction of their malocclusion by orthodontics and orthognathic surgery have a significant incidence of TMDs when compared to a control population, but that after treatment, the incidence of TMDs does not differ from a control population. The reasons for these findings are not clear.
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