Purpose: This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Materials and Methods: Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using 3D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. Results: The mean of the average point-to-point distances on condylar surface was $0.11{\pm}0.03mm$. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. Conclusion: This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.8
no.1
/
pp.43-47
/
1978
The purpose of this study was to investigate the normal range of condylar movement of normal adults. The author has observed roentgenographic images of four serial positions of condylar head taken by modified transcranail lateral oblique projection. The serial positions are centric occlusion, rest position, 1 inch open position and maximal open position. The results were obtained as follow; 1. Inter-incisal distance was 46.85㎜ in maximal open position. 2. The length between the deepest point of glenoid fossa and summit of condylar head in rest position was wider than that in centric occlusion by 0.8㎜. 3. In 1 inch open position, condylar head moved forward from the standard line in 12.64㎜ of horizontal direction and moved downwards from the standard line in 1.84㎜ of vertical direction. 4. In maximal open position, condylar head moved forward from the standard line in 19.06㎜ of horizontal direction and moved downwards from thestanard line in 0.4㎜ of vertical direction. 5. In centric occlusion, the width between glenoid fossa and margin of condylar head was greater in the posterior portion than in the anterior portion by 0.4㎜. 6. Except for the estimated figures of 1 inch open position, all of the estimated figures was greater in male than in female.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.13
no.1
/
pp.7-15
/
1983
The purpose of this study was to investigate the radiographic images of the condylar head in clinically normal subjects and the TMJ patients using standardized projection technique. 45 subjects who have not clinical evidence of TMJ problems and 96 patients who have the clinical evidence of TMJ problems were evaluated, but the patients who had fracture, trauma and tumor on TMJ area were discluded in this study. For the evaluation of radiographic images, the author has observed the condylar head positions in closed mouth and 2.54㎝ open mouth position taken by the standardized transcranial oblique lateral projection technique. The results were as follows: 1. In closed mouth position, the crest of condylar head took relatively posterior position to the deepest point of the glenoid fossa in 8.9 % of the normals and in 26.6% of TMJ patients. 2. In 2.54㎝ open mouth position, condylar head took relatively posterior position to the articular eminence in 2.2% of TMJ patients and 39.6% of the normals. 3. In open mouth position, the horizontal distance from the deepest point of the glenoid fossa to the condyla head was 13.96㎜ in the normals and 10.68㎜ in TMJ patients. 4. The distance of true movement of condyalr head was 13.49㎜ in the normals and l0.27㎜ in TMJ patients. 5. The deviation of mandible in TMJ patients was slightly greater than that of the normals.
The objective of this study was to compare the condylar path and the anterior angle of articular fossa and to analyze the pattern of condylar path in edentulus patients. Nineteen male and female edentulous patients with normal masticatory system ranging in age 42 to 78, without present symptoms and any history of TMJ disturbance were selected for this study. On the computer analysis on the transcranial radiographs of the TMJ, the angle of slope of articular eminance and condylar path to the Frankfort Horizontal Plane and the height of glenoid fossa was measured respectively, and stuied their interrelationship comparatively. Obtained results were asfollows. 1. The angle of the slope of articular eminence averaged 37.28 degree. and there was no significant difference between the right and left side. 2. The condylar path angle averaged 29.05 degree and there was no significant difference between the right and left side. 3. The height of the glenoid fossa averaged 8.11 mm and there was no significant difference between the right and left side. 4. The sequence of the frequence of condylar movement patterns were concavex curve(39.5% ), 'S' shape curve(34.2%), reverse 'S' shape(15.8%) and convex curve(10.5%). 5. The horizontal distance of the point of the changed curve of the condylar path averaged 2.91 mm. 6. The height of glenoid fossa was highly correlated to the slope of articular eminence and relatively highly correlated to tile condylar path and the condylar path was closely correlated to the slop of articular eminence.
The purpose of this study was to compare the sagittal condylar guidance obtained by the graphic method(pantographic tracing) with that produced by the positional method(check-bite). Ten adults who had normal occlusion and were free of TMJ dysfunction were selected, and the clutches were constructed. At first pantographic survey was performed and the articulator was adjusted with each pantographic recording. And then three protrusive check-bite were taken on the subjects using the polyether$(Lamitec^{(R)})$ on the buccal side of the posterior teeth without the interocclusal record method and the vericheck method was performed with each protrusive check-bite. Sagittal condylar guidances obtained by using the pantograph and Vericheck were compared and analyzed statistically. The results were as follows: 1. The average condylar guidance ankle at 4mm and 7mm from centric relation point on the pantograph $(35.9{\pm}1.10^{\circ},\;32.4{\pm}1.55^{\circ})$ was statisccally significant(P<0.01). 2. The average condylar guidance angle of the Vericheck was $27.0{\pm}3.43^{\circ}$. 3. The comparison of the right and left was not statistically significant in all group(P>0.05). 4. The comparison of pantograph and Vericheck was statistically significant in the right and left(P<0.001).
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.9
no.1
/
pp.13-18
/
1979
The purpose of this study was to investigate the radiographic images of Temporomandibular joint trouble patients. This study included 186 patients with the chief complaints of TMJ pain and dysfunction. Their age ranged from 17 to 68 years. All patients were identified in the department of Dental mary of College of Dentistry, Seoul National University, Apr. 1978 to Jun. 1979. The author has observed the radiographic variations of two positions of condylar head taken by modified transcranial oblique-lateral projection, which are one in centric occlusion and the other in 1 inch(2.54㎝) mouth open. The results were obtained as follows; 1. In centric occlusion, the distances and positional relationship between the summit of condylar head and the deepest point of articular fossa revealed more or less large variations; Normal range is of 37.9%, anterior displacement of 37.3% and posterior displacement of 22.6%. 2. In the horizontal movement of condylar heads when on 1 inch mouth open, it was revealed that normalrange was of 46.5%, anterior displacement of 12.3%, posterior displacement of 41. 1 %. 3. In the positional interrelationship of both condylar heads when on 1 inch mouth open, it was revealed that symmetry(71. 5%) occurred approximately 2.5 times as many as asymmetry. 4. In both centric occlusion and 1 inch mouth open, it was showed that almost all estimated figures were greater in male than in female, and in the horizontal movement of condylar head when on 1 inch open, it was showed that hypermobility was dominant in male and hypomobility in female.
Kim, Bum-Joon;Cha, Yong-Hoon;Lim, Jae-Hyung;Park, Kwang-Ho;Huh, Jong-Ki
Maxillofacial Plastic and Reconstructive Surgery
/
v.32
no.6
/
pp.521-528
/
2010
Purpose: Anatomical reduction of the fractured condylar process is an important prerequisite for re-establishing function. The authors reported about effectiveness of transoral approach for mandibular subcondyle fracture using trochar device in cases that the fracture line is below the reference line, the perpendicular line of the longitudinal axis of condylar process passing the lowest point of sigmoid notch. As a serial study, we report the open reduction via preauricular approach for mandibular condyle fracture, in cases that the fracture line is above the reference line. Patients and Methods: Sixteen condylar fractures of 15 adult patients were divided two groups and treated by open reduction via preauricular approach (8 cases) or by closed reduction (8 cases). The degree of maximal mouth opening, occlusion, anatomical reduction, condylar resorption and complications were assessed and evaluated for the two groups. Results: The open reduction of condyle via preauricular approach leads to good results without permanent complications. Anatomical reduction of open reduction group and maximal mouth opening range of the closed reduction group is significantly better than the other group. No significant differences were found in the condylar resorption and the occlusion. Conclusion: The preauricular approach was useful to reduce and fix the condylar fragment, in cases that the fracture line is above the reference line.
This investigation was to analyse normal protrusive and lateral condylar pantographic records written on the sagittal plane and to study components of Fisher's angle and their interrelations. The purpose of this study was limited to (1) discussing the significance of sagittal pantographic record in diagnosis of occlusal disease and(2) basing for reasoning validity of measuring Fisher's angle which has been reported so far. As a result followings were concluded. 1. In each protrusive and lateral condylar movement path, five complicate factors such as initial straightness, distributed simple sigmoid type, simple curvature, initial tiny protruding convexity and tiny repeated sigmoid patterns were noted. Generally each condylar movement path was composed of two to three of these factors. 2. The distribution of positional interrelations of protrusive and lateral condylar paths could be divided into five categories; (a) protrusive-upper, (b) completely coinciding, (c) partially initial coinciding, (d) partially inverted crossing, and (e) completely inverting. Among these, protrusive path-upper positioned condyles were prevailed (79.2%). 3. The distribution of interrelations of protrusive and lateral condylar paths could be devided into five categories according to their distances in the course of movement. Among these, opening (95.8%) and paralleling (66.7%) were prevailing. 4. The involved number of characteristic heterogenous patterns of five categories in protrusive and lateral condylar movement recording relations at one simultaneous recordings was limited to three. However, in case of homogeneous patterns were repeated, usually three to four were included. 5. The maximum distance between protrusive and lateral condylar paths was 1.45mm at the location of 4mm advanced position from centric relation point and 3.90mm at the location of protrusive movement terminal. 6. It seemed to be that ,pantographic records should be consulted other clinical symptoms in order to make certain occlusion diagnosis. 7. At the present moment of investigation, expressing Fisher's angle as a degree revealed a lack due to inherent complexity of protrusive and lateral condylar movement paths. 8. The typical pattern of protrusive and lateral condylar paths written on a pantographic sagittal plate might be described as follows; (a) protrusive condylar path should be positioned upwardly, (b) both mainly be simple curvature, (c) interrelations mainly be opening or paralleling. 9. The mean amounts of separation between protrusive and lateral condylar movement path were $0.75{\pm}0.46$ at 4mm advanced location from centric relation and $1.74{\pm}0.64mm$ at the location of protrusive path terminal.
PURPOSE. The study was conducted to compare the radiographic and clinical methods of measuring the horizontal condylar guidance (HCG) values. MATERIALS AND METHODS. The condylar guidance was measured using the radiographic (CT scan) and three clinical methods i.e. the wax protrusive records, Lucia jig record and intraoral central bearing device in 12 patients aged between 20-40 years irrespective of sex. The records were taken and transferred on the semi-adjustable articulator to record the HCG values. The CT scan was taken for 3D reconstruction of the mid facial region. Frankfort horizontal plane (FHP) and a line extending from the superior anterior most point on the glenoid fossa to the most convex point on the apex of articular eminence (AE) was marked on the CT scan. An angle between these two lines was measured on both right and left sides to obtain condylar inclination angle. Three interocclusal protrusive wax and jig records were taken and transferred to the semi adjustable articulator. Three readings were recorded on each side. Similarly the records were taken and transferred to the same articulator using the intra oral central bearing device to record the readings. RESULTS. The statistical analysis showed insignificant differences in the HCG values between the right and left sides [(P=.589 (CT), P=.928 (wax), P=.625 (jig), P=.886 (tracer)]. The clinical methods provided low Pearsons correlation values [(R = 0.423 (wax), R = 0.354 (jig), R = 0.265 (tracer)] for the right as well as the left sides when compared with the CT values. Among the clinical methods, jig and wax method showed strong level of association which is statistically significant while the intra-oral tracer showed weak association with the other two methods. CONCLUSION. The right and left HCG values were almost similar. The CT scan showed higher HCG values than the clinical methods and among the clinical methods, values obtained from all the methods were comparable.
PURPOSE. When performing an occlusal procedure, it is recommended that the patient should be sitting straight with the head in a natural position. An inappropriate mandibular position caused by an incorrect occlusal record registration or occlusal adjustment can result in damaged teeth and cause functional disorders in muscles and temporomandibular joints. The purpose of this study was to clarify the influence of horizontal cephalic rotation on mandibular position by investigating the three-dimensional positions of condylar and incisal points. MATERIALS AND METHODS. A three-dimensional jaw movement measurement device with six degrees of freedom (the WinJaw System) was used to measure condylar and incisal points. The subjects were asked to sit straight with the head in a natural position. The subjects were then instructed to rotate their head horizontally $0^{\circ}$, $10^{\circ}$, $20^{\circ}$, $30^{\circ}$, $40^{\circ}$, $50^{\circ}$and $60^{\circ}$ in the right or left direction. RESULTS. The results indicated that horizontal cephalic rotation made the condyle on the rotating side shift forward, downward, and toward the inside, and the condyle on the counter rotating side shift backward, upward, and toward the outside. Significant differences in deviations were found for angles of rotation higher than $20^{\circ}$. The incisal point shifted in the forward and counterrotating directions, and significant differences were found for angles of rotation higher than $20^{\circ}$. CONCLUSION. The mandibular position was altered by horizontal cephalic rotations of more than $20^{\circ}$. It is essential to consider the possibility of deviation of the mandibular position during occlusal procedures.
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