Condylar and Ramal Vertical Asymmetry of Temporomandibular Disorders in Panoramic

파노라마 방사선사진을 이용한 측두하악관절장애 환자의 하악과두와 하악지 비대칭에 관한 연구

  • Jong, Ji-Woong (Dept. of Oral Medicine, School of Dentistry, Chonnam National University) ;
  • Kim, Byung-Gook (Dept. of Oral Medicine, School of Dentistry, Chonnam National University) ;
  • Kim, Jae-Hyung (Dept. of Oral Medicine, School of Dentistry, Chonnam National University)
  • 정지웅 (전남대학교 치과대학 구강내과학교실) ;
  • 김병국 (전남대학교 치과대학 구강내과학교실) ;
  • 김재형 (전남대학교 치과대학 구강내과학교실)
  • Published : 2005.06.30

Abstract

The purpose of this study was to examine the difference of condylar and ramal vertical asymmetric indices on paonramic radiographs between temporomandibular disorder patients and normal group and according to classification of temporomandibular disorders. One hundred and twenty temporomandibular disorder patients and thirty normal individuals were selected. After tracing the panoramic radiographs, measurements for asymmetric indices were identified. The means and standard deviations of the measurement of each group were calculated and compared between two groups. Through the comparison of the measurement between two groups, following results were obtained 1. As a result of comparing condylar and ramal vertical asymmetry indices of the temporomandibular disorder patients with that of normal group, there was significant difference in condylar vertical asymmetry index between two groups and no significant difference in ramal vertical asymmetry index between two groups. 2. Condylar and ramal vertical asymmetry indices of temporomandibular joint disorder and muscle disorder patients showed greater value than normal group, but there was no significant difference between temporomandibular joint disorder patients and muscle disorder patients. 3. Among temporomandibular joint disorder patients, muscle disorder patients, and normal group, there was only significant difference in condylar vertical asymmetry index between temporomandibular joint disorder patients and normal group. 4. Among disc displacement, disc dislocation with reduction, and disc dislocation without reduction, there were no significant difference in condylar and ramal vertical asymmetry indices. 5. There were no correlation between aging and condylar and ramal vertical asymmetry indices. The results of the present study showed that condylar vertical asymmetry index of temporomandibular disorder patients showed greater values than normal group, and this difference could be considered as the features of temporomandibular disorders. Thus measuring the condylar vertical asymmetry index on panoramic radiographs is considered as the important factor for diagnosis and treatment of temporomandibular disorders.

References

  1. Okeson JP. Management of Tempomandibular Disorders and Occlusion. 5th ed., St. Louis, 2003, Mosby
  2. Mohl ND, Lund JP, Widmer CG, McCall WD Jr. Devices for the diagnosis and treatment of temporomandibular disorders. Part II: Electromyography and sonography. J Prosthet Dent 1990;63:332-336 https://doi.org/10.1016/0022-3913(90)90207-S
  3. Tronje G. Image distortion in rotational panoramic radiography. Dentomaxillofac Radiol 1982; Suppl 3
  4. Welander U. A mathematical model of narrow beam rotation radiography. Acta Radiol 1974;15:307-315
  5. Larheim TA, Svanses DB. Reproducibility of rotational panoramic radiography: mandibular linear dimensions and angles. Am J Orthod Dentofac Orthop 1986;90:45-41
  6. Lund JP, Widmer CG. An evaluation of the use of surface electromyography in the diagnosis, documentation, and treatment of dental patients. J Craniomandib Disord 1988;3:125-137
  7. Schiffman EL, Friction JR, Haley D. The relationship of occlusion, parafunctional habits, and recent life events to mandibular dysfunction in a non-patient population. J Oral Rehabil 1992;19:201
  8. Mongini, F. The importance of radiotraphy in the diagnosis of TMJ dysfunction, A comparative evaluation of transcranial radiographs and serial tomography. J Prosthe Dent 1981;45:186 https://doi.org/10.1016/0022-3913(81)90339-5
  9. Costa. RL. Asymmetry of the mandibular condyle in Haida Indians. Am J Phy anthropol 1986;70;119 https://doi.org/10.1002/ajpa.1330700116
  10. Bezuur J. The recognition of craniomandibular disorders. Thesis. Academic Center for Dentistry, University of Amsterdam, The Netherlands
  11. Hansson TL, Nordstrom B. Thickness of the soft tissue layers and articular disk in temporomandibular joints with deviation in form. Acta Odontol Scand 1977;35:281-2888 https://doi.org/10.3109/00016357709064126
  12. Habets LLMH, Bezuur JN, Van Ooij SP, Hansson TL. The Orthopantomogram, an aid in diagnosis of temporomandibular joint problems. I. The factor of vertical magnification. J Oral Rehabil 1987:14:475-480 https://doi.org/10.1111/j.1365-2842.1987.tb00742.x
  13. Athanasiou EA, Melsen B, Mavreas D, Kimmel FP. Stomatognathic function of patients who seek orthognathic surgery to correct denotfacial deformities. Int J Adult Orthod Orthognath Surg 1989;4:239-254
  14. Ramstad T, Hensten-Pettersen O, Mohn E, Ibrahim SI. A methodological study of errors in vertical measurements of edentulous ridge height on orthopantomographic radiograms. J Oral Rehabil 1978;5:403-412 https://doi.org/10.1111/j.1365-2842.1978.tb01259.x
  15. Kjellberg H, Ekestubbe A, Kiliaridis S, Thilander B. Condylar height on panoramic radiographs. A methodologic study with a clinical application. Acta Odontol Scand 1994;52:43-53
  16. McDavid WD, Tronje G, Welander U, Morris CR. Mummikoski P. Imaging characteristics of seven panoramic x-ray units. Chapter 4. Horizontal and vertical magnification. Dentomaxillofac Radiol 1985;Suppl 8:29-34
  17. Smith SR, Matteson SR, Phillips C, Tyndall DA. Quantitative and subjective analysis of temporomandibular joint radiographs. J Prosthet Dent 1989;62:456-463 https://doi.org/10.1016/0022-3913(89)90181-9
  18. Petersson A. Radiography of the temporomandibular joint. A comparison of information obtained from different radiographic techinques. Malo, Sweden, 1976, University of Malmo, pp. 500
  19. Habets LLMH, Bezuur JN, Naeiji M, Hansson TL. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil 1988;15:465-471 https://doi.org/10.1111/j.1365-2842.1988.tb00182.x
  20. Zach GA, Langland OE, Sippy FH. The use of the orthopantomogram in longitudinal studies. Angle Orthod 1969;39:42-50
  21. Lund TM, Manson-Hing LR. A study of focal troughs of three panoramic dental x-ray machines II. Image dimensions. Oral Surg Oral Med Oral Pathol 1984;58:736-741 https://doi.org/10.1016/0030-4220(84)90045-8
  22. Haber JD, Moss RA, Kuczmierczk AR, Garrett JC. Assessment and treatment of stress in myofacial pain dysfunction syndrome: a model for analysis. J Oral Rehabil 1983;10:187
  23. Larheim TA, Svanaes DB. Johannessen S. Reproducibility of rotational panoramic radiographs with the orthopanotomograph 5: tooth length assessment. Oral Surg Oral Med Oral Pathol 1984;58:736-41 https://doi.org/10.1016/0030-4220(84)90045-8
  24. Christensen LV. Jaw muscle fatigue and pains induced by experimental tooth clenching: a review. J Oral Rehabil 1981;8:26-27
  25. Miller VJ, Myers SL, Yoeli Z, Zeltser C. Condylar asymmetry and its relation to age in a group of patients with a craniomandibular disorder of mygenous origin. J Oral Rehab 1994;21:707 https://doi.org/10.1111/j.1365-2842.1994.tb01186.x
  26. Isbeg-Holm AM, Westesson P. Movement of the disc and condyle in temporomandibular joints with clicking: An arthrographic and cineradiographic study on autopsy specimen. Acta Odontol Scand 1982;40:151-164 https://doi.org/10.3109/00016358209012724
  27. Miller VJ. Condylar asymmetry and handness in patients wity temporomandibular disorders. J Oral rehabil 1997;24:247 https://doi.org/10.1111/j.1365-2842.1997.tb00322.x
  28. Pullinger A, Hollender L. Assessment of mandibular condyle position: a comparison of transcranial radiographs and linear tomograms. Oral Surg Oral Med Oral Pathol 1985;60:329-334 https://doi.org/10.1016/0030-4220(85)90319-6
  29. Farr WB, McCarty WL Jr. A Clinical Outline of Tempomandibular Joint, Diagnosis and Treatment. 7th ed., Chicago, Quintessence Pub. Co., 1993