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Tun Oo L, Miyamoto JJ, Takada JI, Cheng SWE, Yoshizawa H, Moriyama K. Three-dimensional characteristics of temporomandibular joint morphology and condylar movement in patients with mandibular asymmetry. Prog Orthod 2022; 23:50. [PMID: 36577877 PMCID: PMC9797632 DOI: 10.1186/s40510-022-00445-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/20/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Investigating the morphological and functional effects on mandibular asymmetry (MA) is important not only to understand the developmental process of masticatory dysfunction, but also to provide suggestions for evidence-based occlusal treatment. AIM To evaluate three-dimensional temporomandibular joint (TMJ) morphology and its relationship to asymmetrical condylar movement in MA patients. MATERIALS AND METHODS Fifty subjects were divided into MA and control groups (n = 25 each) according to a menton deviation of 4 mm from the mid-sagittal plane. TMJ morphology (condyle, glenoid fossa and TMJ spaces) were evaluated using a three-dimensional analysis programme. Three-dimensional condylar movements (from the sagittal and horizontal planes) were recorded and measured by computerized axiography on protrusion. Side-to-side asymmetry was measured for each parameter. The asymmetry index value was calculated to assess the correlation between TMJ morphology and condylar movement. For the statistical analysis, Wilcoxon's signed-ranked test, the Mann-Whitney U test, and Spearman's rank correlation were used. RESULTS Glenoid fossa volume, surface area, anteroposterior length, and condylar volume were significantly smaller, and articular eminence angle, glenoid fossa, and condylar axial angle were significantly larger, on the shifted side of the MA group when compared with those on the non-shifted side and the mean values of the control group (P < 0.05). The TMJ spaces of the MA group showed no bilateral difference but were significantly narrower in the medial, superior, and anterior joint spaces when compared with the control group (P < 0.05). Condylar path length and sagittal condylar inclination were significantly asymmetrical. The asymmetry index of the condyle volume was significantly correlated with that of the condylar path length (P = 0.005). The asymmetry index of the glenoid fossa volume and the articular eminence angle were significantly correlated with that of the sagittal condylar inclination (P = 0.009 and P = 0.002, respectively), and the asymmetry index of glenoid fossa volume was significantly correlated with the bilateral transverse condylar inclination (P = 0.006 and P = 0.016, respectively). CONCLUSIONS Morphological asymmetry of the TMJ is significantly different between the shifted and non-shifted sides and is closely related to functional asymmetry of condylar movement in MA patients. (350/350).
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Affiliation(s)
- Lin Tun Oo
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Jun J. Miyamoto
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Jun-Ichi Takada
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Shih-Wei Eric Cheng
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Hideyuki Yoshizawa
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Keiji Moriyama
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
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Tun Oo L, Miyamoto JJ, Takada JI, Moriyama K. Correlation between the position of the glenoid fossa and condylar translational movement in skeletal Class III mandibular asymmetry patients. Eur J Orthod 2022; 44:294-302. [PMID: 34546345 PMCID: PMC9127719 DOI: 10.1093/ejo/cjab060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Understanding the mechanism of mandibular asymmetry (MA) is important to provide suggestions for occlusal treatment and to know the developmental process of masticatory dysfunction. To investigate the morphological and functional effects on MA, we evaluated the three-dimensional position of the glenoid fossa and its relationship to asymmetrical condylar translational movement. METHODS In this retrospective study, 50 subjects who previously underwent computed tomography for surgical purposes were divided into MA and control groups according to a menton deviation of at least 4 mm from the mid-sagittal plane. The glenoid fossae positions were evaluated using a three-dimensional analysis program. Condylar translational movements were recorded and measured by computerized axiography on protrusion. Side-to-side asymmetry was measured for each parameter. Asymmetry index value was calculated to assess the correlation between glenoid fossa position and condylar movement. Wilcoxon's signed-ranked test, Mann-Whitney U-test, and Spearman's rank correlation were used for the statistical analysis. RESULTS In the MA group, glenoid fossa position on the shifted side was significantly inferior and posterior as compared to that on the non-shifted side and of the control group. Condylar path length and sagittal condylar inclination were significantly greater on the shifted side versus non-shifted side, while no significant difference was found in transverse condylar inclination. The asymmetry index of the anterior-posterior glenoid fossa position was significantly correlated with that of condylar path length and bilateral transverse condylar inclination. In the control group, there were no significant correlations among the morphological and functional parameters. LIMITATIONS This study did not consider muscle activity and disc position, which may affect condylar movement. CONCLUSIONS Functional asymmetry of condylar translational movements is closely related to asymmetry of glenoid fossa position in MA patients.
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Affiliation(s)
- Lin Tun Oo
- Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Jun J Miyamoto
- Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Jun-Ichi Takada
- Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Keiji Moriyama
- Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
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Lee WJ, Park KH, Kang YG, Kim SJ. Automated Real-Time Evaluation of Condylar Movement in Relation to Three-Dimensional Craniofacial and Temporomandibular Morphometry in Patients with Facial Asymmetry. SENSORS 2021; 21:s21082591. [PMID: 33917213 PMCID: PMC8068048 DOI: 10.3390/s21082591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/29/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the correlation between craniofacial morphology, temporomandibular joint (TMJ) characteristics, and condylar functional movement in patients with facial asymmetry using an up-to-date automated real-time jaw-tracking system. A total of 30 patients with mandibular asymmetry and prognathism were included. Three-dimensional (3D) craniofacial and TMJ morphometric variables were analyzed in images captured using cone-beam computed tomography. Three-dimensional condylar movements were recorded during the opening, protrusion, and laterotrusion of the jaw and divided into those for deviated and non-deviated sides. Overall functional and morphometric variables were compared between the sides by a paired t-test. Pearson’s correlation analysis and factor analysis were also performed. As a result, significant differences were found between the sides in morphometric and functional variables. The condylar path length was significantly longer and steeper on the deviated side during protrusion and lateral excursion. TMJ morphometric asymmetry, more so than the craniofacial morphologic asymmetry, seemed to be reflected in the functional asymmetry, representing different correlations between the sides, as supported by factor analysis. This study provides evidence explaining why the asymmetric condylar path remained unchanged even after orthognathic surgery for the correction of craniofacial asymmetry.
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Lee JY, Lee SM, Kim SH, Kim YI. Long-term follow-up of intersegmental displacement after orthognathic surgery using cone-beam computed tomographic superimposition. Angle Orthod 2021; 90:548-555. [PMID: 33378504 DOI: 10.2319/061119-398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 12/01/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate intersegmental displacement during long-term follow-up after bilateral sagittal split osteotomy (BSSO) by mandibular body area superimposition. MATERIALS AND METHODS Cone-beam computed tomography (CBCT) images of 23 patients ages 18-37 years with class III malocclusion before orthognathic surgery were obtained. A three-dimensional (3D) CBCT examination was performed at four stages: surgery (T0), 6 months after surgery (T1), 1 year after surgery (T2), and long-term follow-up (6.1 ± 2.1 years, T3). The CBCT datasets were superimposed on the symphyseal area and the lower part of the distal segment of the mandible between T0 and the other time points (T1, T2, and T3). The reference points (both condyle, coronoid, and sigmoid) were estimated by the CBCT analyzed program. RESULTS The coronoid, condylion, and sigmoid showed changes within 6 months after surgery, but there was no significant change in the intersegmental displacement between 6 months and 6 years after surgery. The distances between the left and right coronoid, condylion, and sigmoid from T0 to T3 were noted. CONCLUSIONS The change in intersegmental displacement between T0 and T3 affecting relapse after orthognathic surgery was not significantly different. This suggests that the mandible itself may have a stable morphology during the follow-up period.
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Ortún-Terrazas J, Cegoñino J, Illipronti-Filho E, Pérez del Palomar A. Analysis of temporomandibular joint dysfunction in paediatric patients with unilateral crossbite using automatically generated finite element models. Comput Methods Biomech Biomed Engin 2020; 23:627-641. [DOI: 10.1080/10255842.2020.1755275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - José Cegoñino
- Department of Mechanical Engineering, University of Zaragoza, Zaragoza, Spain
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Association between 3-dimensional mandibular morphology and condylar movement in subjects with mandibular asymmetry. Am J Orthod Dentofacial Orthop 2017; 151:324-334. [PMID: 28153162 DOI: 10.1016/j.ajodo.2016.06.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the hypothesis that 3-dimensional mandibular morphology is correlated with condylar movement in patients with mandibular asymmetry. METHODS Subjects were classified into 2 groups (n = 25 each): mandibular asymmetry with a menton deviation greater than 4 mm and no mandibular asymmetry with a menton deviation less than 4 mm. Linear and volumetric measurements of 3-dimensional mandibular morphology were recorded using computed tomography. Mandibular functional movement was recorded by computerized axiography (CADIAX; Gamma Dental, Klosterneuburg, Austria), and condylar path length, sagittal condylar inclination, and transverse condylar inclination on protrusion were measured. We calculated side-to-side asymmetry (shifted side vs nonshifted side) in mandibular morphology and assessed condylar movement by using an asymmetry ratio (nonshifted side/shifted side). RESULTS Significant differences in mandibular morphology and condylar movement were found between the 2 groups. In the group with menton deviation greater than 4 mm, significant correlations were found between the asymmetry ratio of mandibular morphology and condylar movement: ie, condylar path length and transverse condylar inclination. No significant correlations were found between any of these measurements in the group with menton deviation less than 4 mm. CONCLUSIONS In support of our hypothesis, the results suggested that 3-dimensional mandibular morphologic asymmetry is associated with condylar movement in subjects with mandibular asymmetry.
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Kanomi R, Hidaka O, Yamada C, Takada K. Asymmetry in the Condylar Long Axis and First Molar Rotation. J Dent Res 2016; 83:109-14. [PMID: 14742646 DOI: 10.1177/154405910408300205] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Asymmetric growth occurs frequently in the mandibulofacial region, but little attention has been given to asymmetry in the temporomandibular joint. The purpose of this study was to clarify the feature of asymmetry in the condylar long axis and its relation to upper first molar rotation. Records of 148 pre-orthodontic patients were used. The angle of the condylar long axis and that of the molar rotation were both larger on the left side than on the right side. Positive correlations were found between the corresponding bilateral measurements of condylar long axes and also between those of molar rotations, whereas no correlation was found between the condylar long axis and molar rotation. These findings were found in most subgroups classified by dental age, skeletal pattern, bite force balance, or gender. These results suggest that consistent left-right differences in the condylar long axis and first molar rotation are common.
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Affiliation(s)
- R Kanomi
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
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Ugolini A, Mapelli A, Segù M, Galante D, Sidequersky FV, Sforza C. Kinematic analysis of mandibular motion before and after orthognathic surgery for skeletal Class III malocclusion: A pilot study. Cranio 2016; 35:94-100. [DOI: 10.1080/08869634.2016.1154681] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Alessandro Ugolini
- Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico (LAFAS), Facoltà di Medicina e Chirurgia, Dipartimento di Scienze Biomediche per la Salute, Functional Anatomy Research Center (FARC), Università degli Studi di Milano, via Mangiagalli 31, I-20133 Milano, Italy
| | - Andrea Mapelli
- Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico (LAFAS), Facoltà di Medicina e Chirurgia, Dipartimento di Scienze Biomediche per la Salute, Functional Anatomy Research Center (FARC), Università degli Studi di Milano, via Mangiagalli 31, I-20133 Milano, Italy
| | - Marzia Segù
- Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico (LAFAS), Facoltà di Medicina e Chirurgia, Dipartimento di Scienze Biomediche per la Salute, Functional Anatomy Research Center (FARC), Università degli Studi di Milano, via Mangiagalli 31, I-20133 Milano, Italy
| | - Domenico Galante
- Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico (LAFAS), Facoltà di Medicina e Chirurgia, Dipartimento di Scienze Biomediche per la Salute, Functional Anatomy Research Center (FARC), Università degli Studi di Milano, via Mangiagalli 31, I-20133 Milano, Italy
| | - Fernanda V. Sidequersky
- Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico (LAFAS), Facoltà di Medicina e Chirurgia, Dipartimento di Scienze Biomediche per la Salute, Functional Anatomy Research Center (FARC), Università degli Studi di Milano, via Mangiagalli 31, I-20133 Milano, Italy
| | - Chiarella Sforza
- Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico (LAFAS), Facoltà di Medicina e Chirurgia, Dipartimento di Scienze Biomediche per la Salute, Functional Anatomy Research Center (FARC), Università degli Studi di Milano, via Mangiagalli 31, I-20133 Milano, Italy
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The relationship between the changes in three-dimensional facial morphology and mandibular movement after orthognathic surgery. J Craniomaxillofac Surg 2013; 41:686-93. [PMID: 23465640 DOI: 10.1016/j.jcms.2013.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 01/03/2013] [Accepted: 01/03/2013] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the relationship between changes in three-dimensional (3D) facial morphology and mandibular movement after orthognathic surgery. We hypothesized that facial morphology changes after orthognathic surgery exert effects on 3D mandibular movement. MATERIALS AND METHODS We conducted a prospective follow-up study of patients who had undergone orthognathic surgical procedures. Three-dimensional facial morphological values were measured from facial CT images before and three months after orthognathic surgery. Three-dimensional maximum mandibular opening (MMO) values of four points (bilateral condylions, infradentale, and pogonion) were also measured using a mandibular movement tracking and simulation system. The predictor variables were changes in morphological parameters divided into two groups (deviated side (DS) or contralateral side (CS) groups), and the outcome variables were changes in the MMO at four points. RESULTS We evaluated 21 subjects who had undergone orthognathic surgical procedures. Alterations in the TFH (total facial height), LFH (lower facial height), CS MBL (mandibular body length), and DS RL (ramus length) were negatively correlated with changes in bilateral condylar movement. The UFH, DS MBL and CS ML (mandibular length) showed correlations with infradentale movement. The CS ML, DS ML, MBL, UFH, and SNB were correlated with pogonion movement. CONCLUSION The height of the face is most likely to affect post-operative mandibular movement, and is negatively correlated with movement changes in the condyles, infradentale and pogonion. The changes in CS morphological parameters are more correlated with mandibular movement changes than the DS. The changes in CS MBL and bilateral RL were negatively correlated with condylar movement changes, while the bilateral MBL and CS ML were positively correlated with changes in infradentale and pogonion.
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Ueki K, Moroi A, Sotobori M, Ishihara Y, Marukawa K, Takatsuka S, Yoshizawa K, Kato K, Kawashiri S. A hypothesis on the desired postoperative position of the condyle in orthognathic surgery: a review. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:567-76. [DOI: 10.1016/j.oooo.2011.12.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 12/08/2011] [Indexed: 10/28/2022]
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The relationship between three-dimensional principal rotations and mandibular deviation. ACTA ACUST UNITED AC 2010; 110:e52-60. [DOI: 10.1016/j.tripleo.2010.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Revised: 07/09/2010] [Accepted: 07/15/2010] [Indexed: 11/18/2022]
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Changes in the Duration of the Chewing Cycle in Patients With Skeletal Class III With and Without Asymmetry Before and After Orthognathic Surgery. J Oral Maxillofac Surg 2009; 67:67-72. [DOI: 10.1016/j.joms.2008.06.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 02/20/2008] [Accepted: 06/16/2008] [Indexed: 11/22/2022]
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Correlation Between Craniofacial and Condylar Path Asymmetry. J Oral Maxillofac Surg 2008; 66:2020-7. [DOI: 10.1016/j.joms.2008.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Revised: 01/18/2008] [Accepted: 06/10/2008] [Indexed: 11/22/2022]
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Midline shift and lateral guidance angle in adults with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop 2008; 133:804-8. [DOI: 10.1016/j.ajodo.2006.05.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Revised: 05/01/2006] [Accepted: 05/01/2006] [Indexed: 11/21/2022]
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Ueki K, Marukawa K, Shimada M, Nakagawa K, Yamamoto E, Niizawa S. Changes in the chewing path of patients in skeletal class III with and without asymmetry before and after orthognathic surgery. J Oral Maxillofac Surg 2005; 63:442-8. [PMID: 15789314 DOI: 10.1016/j.joms.2004.06.059] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of this study was to examine the relation between changes in the condylar long axis and the chewing path before and after mandibular ramus osteotomy for patients with prognathism with and without asymmetry. PATIENTS AND METHODS Eleven men and 16 women with mandibular prognathism were divided into groups on the basis of symmetry and osteotomy procedure. Preoperative and postoperative frontal chewing paths were recorded. The chewing path consisted of 4 components: deviated side range, undeviated side range, vertical range, and incisal path angle. The angle of the condylar long axis and the 4 components of the chewing path were compared between groups and the differences were analyzed statistically. RESULTS No significant differences in each of the 4 chewing path components were found between groups on the basis of symmetry or osteotomy procedure. A positive correlation was found between the changes in incisal path angle when chewing on the undeviated side and condylar long axis angle on the undeviated side (P < .05). A positive correlation was also found between the changes in undeviated side range when chewing on the deviated side and condylar long axis angle on the deviated side (P < .05). CONCLUSION This study suggests that surgically induced increase in the condylar long axis is correlated with increase in side range and incisor path angle, although surgical orthodontic treatment does not significantly change the chewing pattern.
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Affiliation(s)
- Koichiro Ueki
- Department of Oral and Maxillofacial Surery, Kanazawa University, Kanazawa 920-8641, Japan.
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Abstract
Normal asymmetry in the area of the craniofacial skeleton can be directional or fluctuating in nature. Directionality can in principle be found in three dimensions: anteroposterior, cranio-caudal, and asymmetries in the left-right dimension. When it comes to directional left right differences, an explanation has been difficult to find, although expressions of this type are obvious. Recent findings made in molecular genetics strongly support the genetic inheritance pattern of laterality. When functionally increased asymmetries of facial structures are concerned, it is often difficult to determine the exact contribution of each factor involved. In the light of recent experimental data, however, it seems that the influence of occlusion on the development of balanced facial structures is highly important during the early periods of life. A review of these factors is given in this article.
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Affiliation(s)
- P Pirttiniemi
- Department of Oral Development and Orthodontics, Institute of Dentistry, University of Oulu, Finland
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