Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (7): 468-473.doi: 10.12016/j.issn.2096-1456.2021.07.006

• Clinical Study • Previous Articles     Next Articles

Evaluation of temporomandibular joint space and condylar morphology in patients with anterior open-bite based on cone-beam CT

LAI Zhanwen1(),HU Ziyang2,PAN Xiao2,HAO Yanqing2,LIN Zitong2()   

  1. 1. Guangxi Institute of Occupational Disease Prevention and Control & Guangxi Workers′ Hospital, Nanning 530000, China
    2. Nanjing Stomatological Hospital, Medical School of Nanjing University, Department of Dentomaxillofacial Radiology Imaging, Nanjing 210008, China
  • Received:2021-01-08 Revised:2021-02-27 Online:2021-07-20 Published:2021-04-19
  • Contact: Zitong LIN E-mail:354889268@qq.com;linzitong_710@163.com
  • Supported by:
    Natural Science Foundation of Jiangsu Province(BK20141083)

Abstract:

Objective To investigate the difference of the temporomandibular joint between patients with anterior open-bite and normal overbite with cone beam CT (CBCT).Methods Fifty-four patients with anterior open bites and 54 patients with normal overbites were selected from the Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University from June 2014 to August 2020. Sagittal and coronal images of the temporomandibular joint were reconstructed with multiplanar reconstruction techique. The Kamelchuk method was used to measure the superior, posterior and anterior space of the temporomandibular joint, and the condylar morphology was divided into two types: normal and abnormal. The joint space and condylar morphology of the anterior open-bite group and the normal overbite group were statistically analyzed. The anterior open-bite group was divided into 3 subgroups: ① Ⅰ° open-bite (open bite distance < 3 mm), ② Ⅱ° open-bite (open bite distance ≥ 3 mm and ≤ 5 mm) and ③ Ⅲ° open-bite (open bite distance > 5 mm). The difference of overbite spaces of the temporomandibular joint was compared among these three subgroups.Results Compared to the normal group, no significant differences were found for the anterior and superior space of the temporomandibular joint in the anterior open-bite group (P > 0.05), but the posterior space increased significantly (P < 0.01). A total of 52.8% of patients in the anterior open-bite group had abnormal condyles, whereas 21.3% of patients in the normal group, overbite significant differences was found between the two groups (P < 0.01). Compared with patients with Ⅰ° and Ⅱ° openbite, the condyle of patients with III° open bites was more forward in the fossa (P < 0.05).Conclusion The position of the condyle in the fossa of patients with anterior open bites is more forward, and abnormal condylar bone is more common found.

Key words: cone-beam CT, temporomandibular joint, anterior space, superior space, posterior space, condylar morphology, anterior open-bite, normal overbite, orthodontic treatment

CLC Number: 

  • R78

Table 1

Comparison of position of condyles in normal over bite group and anterior open-bite group mm,$\bar{x}\pm s$"

Group Anterior space Superior space Posterior space
Normal overbite Left 2.00 ± 0.75 2.75 ± 0.97 2.01 ± 0.58
Right 1.95 ± 0.60 2.68 ± 0.78 2.02 ± 0.56
Bilateral 1.98 ± 0.68 2.72 ± 0.88 2.02 ± 0.57
Anterior open-bite Left 1.98 ± 0.78 2.72 ± 0.79 2.49 ± 1.00
Right 2.07 ± 0.85 2.59 ± 0.90 2.20 ± 0.94
Bilateral 2.02 ± 0.82 2.66 ± 0.85 2.35 ± 0.98
t -0.45 0.53 -3.02
P 0.66 0.60 < 0.01

Table 2

Comparison of morphology of condyles in normal over bite group and anterior open-bite group n(%)"

Group Normal Abnormal
Normal overbite 85(78.7%) 23(21.3%)
Anterior open-bite 51(47.2%) 57(52.8%)
χ2 22.95
P < 0.01

Figure 2

Oblique sagittal reconstruction images of condyle of typical cases in normal overbite and anterior open-bite group a-b: sagittal reconstruction image of condyle of a patient with anterior open-bite; a: the right condyle was beakshaped (as arrow showed); b: the left condyle and it showed cystic absorption (as arrow showed), the bilateral condyles were obviously asymmetrical; c-d: sagittal reconstruction image of condyle of the patient with normal over bite; c: the right condyle; d: the left condyle, the cortical bones were smooth and continuous and the bilateral condyles were approximately symmetrical"

Table 3

Comparison of position of condyles among different anterior open-bite level patients mm,$\bar{x}\pm s$"

Degree of anterior
open-bite
Anterior joint
space
Superior joint
space
Posterior joint
space
Ⅰ° open-bite 2.16 ± 0.94 2.70 ± 0.89 2.27 ± 1.11
Ⅱ° open-bite 1.97 ± 0.56 2.69 ± 0.66 2.35 ± 0.59
Ⅲ° open-bite 1.65 ± 0.47 2.50 ± 0.87 2.58 ± 0.89
Ⅱ° vs. Ⅰ° t 0.924 0.046 0.046
P 0.390 0.960 0.960
Ⅲ° vs. Ⅰ° t 3.198 0.846 -1.116
P < 0.001 0.400 0.270
Ⅲ° vs. Ⅱ° t 2.010 0.784 -0.968
P 0.049 0.440 0.320
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