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      Spatial analysis of mandibular condyles in patients with temporomandibular disorders and normal controls using cone beam computed tomography

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          Abstract

          Objectives:

          The aim of the study is to investigate the condylar position and its relation to articular eminence and axial condylar angle in temporomandibular joint disorder (TMD) patients and in normal controls using cone beam computed tomography (CBCT).

          Materials and Methods:

          CBCT temporomandibular joint (TMJ) images of 70 participants (38 males and 32 females, mean age 26.4 years) were analyzed. They were divided into control group (including 35 subjects) and study group (including 35 subjects). Linear measurements of joint space and condyle determined the condylar position of each TMJ. Articular eminence height and inclination were also measured with axial condylar angle to determine its relation to condylar position. Independent and paired sample t-test was applied to compare between the groups and TMJ sides of the same group at significance level of 0.05.

          Results:

          Statistical significant differences were found between males and females of both groups regarding superior joint space (SJS), lateral joint space, A-P, and M-L condyle distance ( P < 0.05). SJS, medial joint space (MJS), and eminence angle were greater ( P < 0.01) in male's joints with TMD with flatter axial condylar angle ( P < 0.05), when compared with normal TMJ counterpart. Females TMJs showed significantly higher values of MJS of affected side when compared with normal counterpart with flatter axial condylar angle ( P < 0.05).

          Conclusion:

          Superior and MJS parameters were the ones that showed significant differences between affected and nonaffected joints. The mean axial condylar angle was smaller in joints with abnormal TMJ. This indicates that the condyles of the affected joints may rotate inward.

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          Most cited references27

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          Assessment of optimal condylar position with limited cone-beam computed tomography.

          There are no quantitative standards for the optimal position of the mandibular condyle in the glenoid fossa. Recently developed limited cone-beam computed tomography (LCBCT) allows measurement of this position with high accuracy. LCBCT was used to assess 24 joints in 22 symptom-free subjects (10 male, 12 female; mean age, 18 years) who had no disc displacement as verified by magnetic resonance imaging. Their joints had optimum function with the starting and end points of all functional jaw movements coincident with maximum intercuspation. Linear measurements of anterior space (AS), superior space (SS), and posterior space (PS) were made to determine the position of the condyle for each joint. The mean AS, SS, and PS values were 1.3 mm (SD +/- 0.2 mm), 2.5 mm (SD +/- 0.5 mm), and 2.1 mm (SD +/- 0.3 mm), respectively. The ratio of AS to SS to PS was 1.0 to 1.9 to 1.6. No significant sex difference was noted in joint space distances. The results showed less variability of condylar position in the fossa than previously reported in normal subjects. These data from optimal joints might serve as norms for the clinical assessment of condylar position obtained by LCBCT.
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            Three-dimensional imaging techniques: A literature review

            Imaging is one of the most important tools for orthodontists to evaluate and record size and form of craniofacial structures. Orthodontists routinely use 2-dimensional (2D) static imaging techniques, but deepness of structures cannot be obtained and localized with 2D imaging. Three-dimensional (3D) imaging has been developed in the early of 1990's and has gained a precious place in dentistry, especially in orthodontics. The aims of this literature review are to summarize the current state of the 3D imaging techniques and to evaluate the applications in orthodontics.
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              Imaging of the temporomandibular joint: a position paper of the American Academy of Oral and Maxillofacial Radiology.

              Various imaging techniques for the temporomandibular joint are discussed with respect to uses, strengths, and limitations. An imaging protocol is outlined for evaluating patients with a wide variety of temporomandibular joint related signs and symptoms.
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                Author and article information

                Journal
                Eur J Dent
                Eur J Dent
                EJD
                European Journal of Dentistry
                Medknow Publications & Media Pvt Ltd (India )
                1305-7456
                1305-7464
                Jan-Mar 2017
                : 11
                : 1
                : 99-105
                Affiliations
                [1 ]Department Oral Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
                [2 ]Department of Oral Medicine and Radiology, Gulf Medical University, Ajman, UAE
                [3 ]Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
                Author notes
                Correspondence: Dr. Natheer Hashim Al-Rawi, E-mail: nhabdulla@ 123456sharjah.ac.ae
                Article
                EJD-11-99
                10.4103/ejd.ejd_202_16
                5379844
                28435374
                ca2ecc84-479f-4040-b9d6-faa0491770b1
                Copyright: © 2017 European Journal of Dentistry

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Original Article

                Dentistry
                articular eminence,condylar angle,cone beam computed tomography,joint space,temporomandibular joint

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