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Zhang N, Tang R, Zhao P, Xu N, Meng F, Wang Z, Zhang T, Zhang Z, Yin H, Ding H, Qiu X, Dai C, Huang Y, Yang Z, Huang X, Wang Z. Potential of ultra-high-resolution CT in detecting osseous changes of temporomandibular joint: experiences in temporomandibular disorders. BMC Oral Health 2023; 23:737. [PMID: 37814269 PMCID: PMC10563235 DOI: 10.1186/s12903-023-03449-2] [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: 07/10/2023] [Accepted: 09/24/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Osseous changes of the temporomandibular joint (TMJ) are related to the progression of temporomandibular disorders (TMD), and computed tomography (CT) plays a vital role in disease evaluation. OBJECTIVE The aims of this study were to evaluate the image quality and diagnostic value of ultra-high-resolution CT (U-HRCT) in TMD compared to cone-beam CT (CBCT). METHODS TMD patients who underwent both CBCT and U-HRCT between November 2021 and September 2022 were retrospectively included. Image quality scores were assigned for four osseous structures (the cortical and trabecular bones of the condyle, articular eminence, and glenoid fossa) by two independent observers from Score 1 (unacceptable) to Score 5 (excellent). Diagnostic classification of TMD was categorized as follows: Class A (no evident lesion), Class B (indeterminate condition) and Class C (definitive lesion). Image quality scores and diagnostic classifications were compared between CBCT and U-HRCT. The Cohen's Kappa test, Wilcoxon signed-rank test, Chi-square test and Fisher's exact test were conducted for statistical analysis. RESULTS Thirty TMD patients (median age, 30 years; interquartile range, 26-43 years; 25 females) with 60 TMJs were enrolled. Image quality scores were higher for U-HRCT than for CBCT by both observers (all Ps < 0.001). Definitive diagnoses (Class A and C) were achieved in more cases with U-HRCT than with CBCT (93.3% vs. 65.0%, Fisher's exact value = 7.959, P = 0.012). Among the 21 cases which were ambiguously diagnosed (Class B) by CBCT, definitive diagnosis was achieved for 17 cases (81.0%) using U-HRCT. CONCLUSIONS U-HRCT can identify osseous changes in TMD, providing improved image quality and a more definitive diagnosis, which makes it a feasible diagnostic imaging method for TMD.
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Affiliation(s)
- Ning Zhang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ruowei Tang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ning Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fanhao Meng
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhen Wang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Tingting Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhengyu Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hongxia Yin
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Heyu Ding
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiaoyu Qiu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chihang Dai
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yan Huang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiaofeng Huang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Chen Y, Li L, Li Y, Luo N, Dai H, Zhou J. Comprehensive positional and morphological assessments of the temporomandibular joint in adolescents with skeletal Class III malocclusion: a retrospective CBCT study. BMC Oral Health 2023; 23:78. [PMID: 36750919 PMCID: PMC9903422 DOI: 10.1186/s12903-023-02788-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Condyle-fossa relationships in adolescents with skeletal Class III malocclusion remain unclear. Therefore, this study used cone-beam computed tomography (CBCT) to evaluate the position and morphology of the temporomandibular joint (TMJ) in adolescents with skeletal Class III malocclusion. METHODS In this cross-sectional retrospective study, CBCT images from 90 adolescents with skeletal Class III malocclusion and 30 controls were analysed. Adolescents with skeletal Class III malocclusion were divided into different groups based on (1) sex (male and female), (2) sides (right and left), (3) age (early, middle, and late adolescence), and (4) vertical skeletal patterns (hyperdivergent, normodivergent, and hypodivergent). Morphology of the condyle and fossa as well as condylar position, was compared among groups. Data were collected and submitted for statistical analysis. This study adheres to STROBE guidelines. RESULTS Regarding the intergroup comparisons, there were significant differences in TMJ position and morphology between the skeletal Class III malocclusion with different vertical skeletal patterns and control groups (P < 0.05). Within groups, condyle-fossa relationships differed significantly according to sex, age, and vertical skeletal patterns (P < 0.05); however, the mean values were not statistically different between left and right sides in adolescents with skeletal Class III malocclusion. CONCLUSIONS Our findings can be used clinically and radiographically to evaluate the condyle and glenoid fossa features in adolescents with skeletal Class III malocclusion, providing a basis for better TMD diagnosis and orthodontic treatment.
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Affiliation(s)
- Yanxi Chen
- grid.459985.cStomatological Hospital of Chongqing Medical University, 426, Songshi North Road, Chongqing, China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Lingfeng Li
- grid.459985.cStomatological Hospital of Chongqing Medical University, 426, Songshi North Road, Chongqing, China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Ying Li
- grid.459985.cStomatological Hospital of Chongqing Medical University, 426, Songshi North Road, Chongqing, China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Nan Luo
- grid.459985.cStomatological Hospital of Chongqing Medical University, 426, Songshi North Road, Chongqing, China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Hongwei Dai
- grid.459985.cStomatological Hospital of Chongqing Medical University, 426, Songshi North Road, Chongqing, China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China ,grid.203458.80000 0000 8653 0555Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jianping Zhou
- Stomatological Hospital of Chongqing Medical University, 426, Songshi North Road, Chongqing, China. .,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Chen S, Zhang C, Zhang K, Tan X, Xi X, Zhao Y, Liu D. Condylar morphology and position changes after miniscrew-assisted rapid palatal expansion in skeletal Class III malocclusion adult patients with mandibular deviation and unilateral posterior crossbite. Prog Orthod 2022; 23:30. [PMID: 36045260 PMCID: PMC9433628 DOI: 10.1186/s40510-022-00425-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the morphological and positional changes of mandibular condyle after miniscrew-assisted rapid palatal expansion (MARPE) in skeletal Class III malocclusion adult patients with horizontal mandibular deviation (MD). METHODS The sample consisted of 15 patients with MD (6 males and 9 females, mean age 21.58 ± 3.12 years). The CBCT scans were taken before and after MARPE immediately. The pre- and post-registered images of the cranial base and mandible were measured, respectively, by Mimics. RESULTS After expansion, the distance between superior condylar point and the Frankfort horizontal plane on the deviated side and the non-deviated side increased by 0.96 ± 0.60 mm (P = 0.011) and 0.70 ± 0.65 mm (P = 0.046); coronal condylar angle of the deviated side increased by 0.39° ± 0.34 (P = 0.028) and 0.06° ± 0.49 (P = 0.917) on the non-deviated side. No statistically significant differences were found when comparing the condylar position on both sides before and after treatment. The degree of mandibular deviation decreased 0.43 mm (P = 0.270). CONCLUSIONS This study suggested that for skeletal Class III malocclusion adult patients with horizontal MD, the condyle on the deviated side rotated toward the non-deviated side in the coronal direction; the condylar remodeling occurred mainly on the deviated side after MARPE in the vertical direction.
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Affiliation(s)
- Shuai Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Chunxi Zhang
- The Center of Stomatology, Qingdao Municipal Hospital Affiliated to Qingdao University, #5 Donghai Middle Road, Qingdao, 266000, China
| | - Kaili Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Xiaoming Tan
- Department of Stomatology, Linyi Third People's Hospital, Linyi, 276023, China
| | - Xun Xi
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Yi Zhao
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China
| | - Dongxu Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, 250012, China.
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Arif CA, Randy C, Matthew S, Serhat S, Brian K, Peter W, Jue W, Viet V, Linh T, How KC. Comparison of the condyle-fossa relationship and resorption between patients with and without Juvenile Idiopathic Arthritis (JIA). J Oral Maxillofac Surg 2021; 80:422-430. [PMID: 34627744 DOI: 10.1016/j.joms.2021.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 09/04/2021] [Accepted: 09/06/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The most common disease in pediatric rheumatology is juvenile idiopathic arthritis (JIA). JIA is considered to be an autoimmune disease with an onset before the age of 16. The temporal mandibular joint (TMJ) has been reported to be involved in up to 87% of patients with JIA. Even though substantial research has been conducted on JIA, limited research has studied to understand its effect on the condyle-fossa relationship and to evaluate resorption amount on condyle by using a scoring system. AIM The purpose of this study was 1) to compare condyle - fossa relationships in the temporomandibular joint (TMJ), 2) was to score condylar resorption by using a TMJ indexing system in patients with JIA and without JIA. METHODS The present retrospective cross-sectional study included cone-beam computed tomography (CBCT) images obtained from the sagittal, coronal, and axial slices. In the multidisciplinary Pediatric Rheumatology Outpatient Clinic at The University of Alabama at Birmingham (UAB) children with JIA are also examined by a group of orthodontists working in the same institute from October 2018 to July 2019. The predictor variable consists of patients with JIA and without JIA. The primary outcome variables are the depth of the mandibular fossa, joint spaces, axial angles, medio-lateral width, and condyle resorption. Other study variables were age and sex. In this study, the measurements obtained from 2 different groups (with JIA and without JIA) are compared using a t-test, where Tukey is utilized to adjust for multiple comparisons. The left and right joints are analyzed separately as the paired t test conducted showed a significant difference between the 2 joints (P < .05). RESULTS The study was comprised of 34 patients diagnosed with JIA and 34 healthy subjects. The depth of the mandibular fossa, the anterior joint spaces, the axial angles, and the resorption index showed statistically significant differences between the JIA and healthy groups in both left and right sides (P < .05). However, there was no statistically significant difference in the posterior joint spaces and mediolateral width between JIA and healthy groups in both sides (P > .05). CONCLUSIONS The results of our study presented the destructive potential of juvenile idiopathic arthritis by using CBCT. CBCT scanning is a helpful tool in the evaluation of the radiographic result of TMJ.
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Affiliation(s)
- Celebi Ahmet Arif
- Department of Orthodontics, School of Dentistry, University of Alabama Birmingham, Birmingham
| | - Cron Randy
- Department of Pediatric Rheumatology, University of Alabama Birmingham, Birmingham
| | - Stoll Matthew
- Department of Pediatric Rheumatology, University of Alabama Birmingham, Birmingham
| | - Simsek Serhat
- Feliciano School of Business, Montclair State University, New Jersey
| | - Kinard Brian
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Alabama, Birmingham
| | - Waite Peter
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Alabama, Birmingham
| | - Wang Jue
- Department of Orthodontics, School of Dentistry, University of Alabama Birmingham, Birmingham
| | - Vo Viet
- School of Dentistry, University of Alabama, Birmingham
| | - Tran Linh
- School of Dentistry, University of Alabama, Birmingham
| | - Kau Chung How
- Department of Orthodontics, School of Dentistry, University of Alabama Birmingham, Birmingham.
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Loiola MEDA, Fuziy A, Higa RH, Fuziy CHF, Gandini Júnior LG, Costa ALF. In vivo three-dimensional cephalometric landmarks using CBCT for assessment of condylar volume and surface in individuals with Class I, II, and III malocclusions. Cranio 2020:1-6. [DOI: 10.1080/08869634.2020.1857616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Acácio Fuziy
- Department of Orthodontics, School of Dentistry, State University of Northern Paraná (UENP), Jacarezinho, Brazil
| | - Rodrigo Hitoshi Higa
- Department of Orthodontics, School of Dentistry, State University of Northern Paraná (UENP), Jacarezinho, Brazil
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Abdelkarim A. Cone-Beam Computed Tomography in Orthodontics. Dent J (Basel) 2019; 7:E89. [PMID: 31480667 PMCID: PMC6784482 DOI: 10.3390/dj7030089] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/05/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
Abstract
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.
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Affiliation(s)
- Ahmad Abdelkarim
- Department of Orthodontics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
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