Three-dimensional assessment of condylar morphology, position, and joint spaces in different jaw base divergences: A cone-beam computed tomography study

Abstract

The mandibular condyle being part of the temporomandibular joint complex, its volume, and shape play a pivotal role in treatment stability and outcomes in orthodontic and orthognathic patients over the long term. Different loading patterns would result in different morphology of the TMJ. The association with different facial types and understanding of the relationship between condylar morphology and jaw base divergence is limited. The objective of this study was to assess the condylar morphology, which includes condylar height, length, width, axis angulation, joint spaces, height of the fossa, and volume in different jaw base divergences. A cross-sectional study was conducted in which 90 patients undergoing orthodontic treatment were selected and allocated into three groups of 30 each, namely, hypodivergent, normodivergent, and hyperdivergent based on Frankfort mandibular plane angle. Patients satisfying the inclusion criteria were subjected to lateral cephalogram and cone-beam computed tomography under standard resolution and field of view of 8 × 8 cm2 with the teeth in maximum intercuspation. On the obtained digital imaging and communications in medicine image, ten anatomical landmarks were marked and analyzed using Carestream imaging software. The condylar volume was assessed using three-dimensional Slicer software. Results were statistically analysed using analysis of variance and post hoc Bonferroni test. The average values of the condylar width and volume showed statistically significant values in the hypodivergent whereas axis angulation and superior joint spaces in the hyperdivergent groups, respectively. Hypodivergent individuals have condyles that are larger in size and volume, whereas hyperdivergent individuals have larger axis angulation and more superiorly positioned condyles.