The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT

Bo-Ram Lee; Dae-Keun Kang; Woo-Sung Son; Soo-Byung Park; Seong-Sik Kim; Yong-Il Kim; Kyung-Min Lee

doi:10.4041/kjod.2011.41.2.87

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Lee, Kang, Son, Park, Kim, Kim, and Lee: The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT

Original Article

Korean Journal of Orthodontics

Korean Journal of Orthodontics 2011; 41(2): 87-97.

Published online: 30 April 2011

DOI: https://doi.org/10.4041/kjod.2011.41.2.87

The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT

Bo-Ram Lee, DDS^a, Dae-Keun Kang, DDS^a, Woo-Sung Son, DDS, MSD, PhD^b, Soo-Byung Park, DDS, MSD, PhD^b, Seong-Sik Kim, DDS, MSD, PhD^c, Yong-Il Kim, DDS, MSD^d, Kyung-Min Lee, DDS, MSD^e

^aGraduate Student, Department of Orthodontics, School of Dentistry, Pusan National University, Korea.

^bProfessor, Department of Orthodontics, School of Dentistry, Pusan National University, Korea.

^cAssociate Professor, Department of Orthodontics, School of Dentistry, Pusan National University, Korea.

^dClinical Assistant Professor, Department of Orthodontics, School of Dentistry, Pusan National University, Korea.

^eFellow, Department of Orthodontics, School of Dentistry, Pusan National University, Korea.

Corresponding author: Woo-Sung Son. Department of Orthodontics, Pusan National University Hospital, Beomeo-ri, Mulgeum-eup, Yangsan 626-770, Korea. +82 55 360 5150; wsson@pusan.ac.kr

Received 17 January 2011 Revised 28 February 2011 Accepted 4 March 2011

Abstract

Objective

Facial asymmetry is usually evaluated from the difference in length and angulation of the maxilla and mandible. However, asymmetric position or shape of the condyle can also affect the expression of asymmetry. The purpose of this study was to evaluate the correlation between condylar asymmetry and chin point deviation in facial asymmetry.

Methods

Cone-beam CT images of fifty adult skeletal Class III patients were studied. Thirty patients who had more than 4 mm menton deviation were categorized in the asymmetric group. Twenty patients with less than 4 mm menton deviation were assigned to the symmetric group. Anteroposterior and transverse condyle positions were evaluated from the cranial base. The greatest mediolateral diameter (GMD) of the condyle in the axial plane and angulation to the coronal plane were measured. The height and volume of the condyles were evaluated.

Results

The symmetric group had no statistical difference between both condyles in position, angulation, GMD, height and volume. In the asymmetric group, the non-deviated side condyle was larger in GMD, height and volume than the deviated side. There was no statistical difference in condyle position and angulation. The GMD, height difference and condylar volume ratio (non-deviated/deviated) were positively correlated with chin deviation. From the linear regression analysis, condylar volume ratio was a significant factor affecting chin deviation.

Conclusions

These findings suggests that the non-deviated side condyle is larger than the deviated side. In addition, condylar asymmetry can affect the expression of facial asymmetry.

Keywords: Facial asymmetry, Cone-beam computed tomography, Mandibular condyle, Menton deviation

Figures and Tables

Fig. 1

Reference planes and chin point deviation. A, Constructed reference planes; B, chin point deviation measured from MSR plane to menton point (inferior).

Fig. 2

Measurement of GMD, angulation to coronal plane. The geometric center defined as the center of GMD. The anteroposterior position to coronal plane and mediolateral position to midsagittal reference plane of geometric center were measured. GMD, Greateast mediolateral diameter; AP, anteroposterior; ML, mediolateral; MSR plane, midsagittal reference plane.

Fig. 3

Measurement of condylar height. A, Center of ramus. This line bisects the axial plane of ramus; B, ramal plane was constructed by a line perpendicular to the center of ramus and tangent to the posterior ramus. PR (Perpendicular to ramal) plane, a line passing through the deepest point of sigmoid notch and tagent to the ramal plane. Condylar height was measured from the PR plane to the highest point of the condyle (parallel to ramal plane).

Fig. 4

Condyle segmentation was done for condylar volume measurement.

Table 1

Reference planes and measurements used in the study

Table 2

Comparison of mean and standard deviation of the deviated/non-deviated side difference in both groups

Differences are using (non-deviated side (ndev.) - deviated side (dev.)). SD, Standard deviation; GMD, greatest mediolateral diameter; AP, anteroposterior; ML, mediolateral. ^†p < 0.001; ^†p < 0.01.

Table 3

Comparison of condylar characteristics of the deviated/non-deviated side in asymmetric group

SD, Standard deviation; GMD, greatest mediolateral diameter; AP, anteroposterior; ML, mediolateral. ^*p < 0.001; ^†p < 0.01.

Table 4

Comparison of condylar characteristics of the deviated/non-deviated side in symmetric group

SD, Standard deviation; GMD, greatest mediolateral diameter; AP, anteroposterior; ML, mediolateral.

Table 5

Pearson correlation analysis between chin deviation and condylar characteristics (deviated/non-deviated side difference) in both groups

Sig, Significance; ndev, non-deviated side; dev, deviated side; GMD, greatest mediolateral diameter; AP, anteroposterior; ML, mediolateral. ^*p < 0.01; ^†p < 0.05.

Table 6

Factors affecting chin deviation

Sig, Significance; GMD, greatest mediolateral diameter; AP, anteroposterior; ML, mediolateral. ^*p < 0.001; ^†p < 0.01.

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