Radiological study on mandibular ramus asymmetry in young population
Abstract
Background: The aim of this study was to estimate the prevalence of ramus asymmetries related to age and gender in a young population and the influence of growth spurt on ramus asymmetry.
Materials and methods: The study consisted of 776 panoramic radiographs of individuals aged 9 to 21 years (335 males and 441 females). Individuals were divided into two groups with respect of linear growth spurt as age 12 in females and age 14 in males. The first group consisted of females aged between 9 and 11 and males between 9 and 13. The second group consisted of females aged between 12 and 21 and males between 14 and 21. Bilateral ramus heights on each radiograph were measured. A panoramic software programme was used to measure the ramus heights. Quantitative data was tested by Student’s t test. Qualitative data was tested by χ2 test. The intraclass correlation coefficient was calculated for the magnitude error of the measurement.
Results: The mean of ramus asymmetry was found to be 2.90% ± 2.58%. Significant differences between the right and left ramus height ratios were observed (p < 0.01). There was a high prevalence (10.8%) of ramus asymmetry, which did not correlate with the age and gender of the patients.
Conclusions: This study revealed a high prevalence of ramus asymmetry in 9–21- -year-old population. Within the limitations of this study, it can be concluded that ramus asymmetry should be carefully evaluated in all ages for the potential relation with temporomandibular dysfunctions and also for orthodontic anomalies.
Keywords: asymmetrymandibleramusskullanthropologypanoramic radiographs
References
- Arieta-Miranda JM, Silva-Valencia M, Flores-Mir C, et al. Spatial analysis of condyle position according to sagittal skeletal relationship, assessed by cone beam computed tomography. Prog Orthod. 2013; 14: 36.
- Blakemore SJ, Burnett S, Dahl RE. The role of puberty in the developing adolescent brain. Hum Brain Mapp. 2010; 31(6): 926–933.
- Cho BH, Ahn YW, Jung YH. Comparison of mandibular morphology between patients with temporomandibular joint osteoarthritis and asymptomatic normal subjects. Quintessence Int. 2009; 40(8): e49–e54.
- el-Mofty S. Surgical correction of mandibular underdevelopment. Egypt Dent J. 1978; 24(3): 219–234.
- Gidarakou IK, Tallents RH, Kyrkanides S, et al. Comparison of skeletal and dental morphology in asymptomatic volunteers and symptomatic patients with bilateral disk displacement with reduction. Angle Orthod. 2002; 72(6): 541–546.
- Habets LL, Bezuur JN, Naeiji M, et al. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil. 1988; 15(5): 465–471.
- Kjellberg H, Ekestubbe A, Kiliaridis S, et al. Condylar height on panoramic radiographs. A methodologic study with a clinical application. Acta Odontol Scand. 1994; 52(1): 43–50.
- Kurt G, Uysal T, Sisman Y, et al. Mandibular asymmetry in class II subdivision malocclusion. Angle Orthod. 2008; 78(1): 32–37.
- Leversha J, McKeough G, Myrteza A, et al. Age and gender correlation of gonial angle, ramus height and bigonial width in dentate subjects in a dental school in Far North Queensland. J Clin Exp Dent. 2016; 8(1): e49–e54.
- Mattila M, Könönen M, Mattila K. Vertical asymmetry of the mandibular ramus and condylar heights measured with a new method from dental panoramic radiographs in patients with psoriatic arthritis. J Oral Rehabil. 1995; 22(10): 741–745.
- Miller VJ. The effect of age on condylar asymmetry in patients with craniomandibular disorders of arthrogenous origin. J Prosthet Dent. 1992; 67(6): 845–846.
- Miller VJ, Myers SL, Yoeli Z, et al. Condylar asymmetry and its relation to age in a group of patients with a craniomandibular disorder of myogenous origin. J Oral Rehabil. 1994; 21(6): 707–711.
- Miller VJ. Condylar asymmetry and handedness in patients with temporomandibular disorders. J Oral Rehabil. 1997; 24(7): 549–551.
- Mongini F, Preti G, Calderale PM, et al. Experimental strain analysis on the mandibular condyle under various conditions. Med Biol Eng Comput. 1981; 19(5): 521–523.
- Nebbe B, Major PW, Prasad NG, et al. TMJ internal derangement and adolescent craniofacial morphology: a pilot study. Angle Orthod. 1997; 67(6): 407–414.
- Nebbe B, Major PW, Prasad NG. Female adolescent facial pattern associated with TMJ disk displacement and reduction in disk length: part I. Am J Orthod Dentofacial Orthop. 1999; 116(2): 168–176.
- Peck S, Peck L, Kataja M. Skeletal asymmetry in esthetically pleasing faces. Angle Orthod. 1991; 61(1): 43–48.
- Pirttiniemi PM. Associations of mandibular and facial asymmetries--a review. Am J Orthod Dentofacial Orthop. 1994; 106(2): 191–200.
- Ramirez-Yañez GO, Stewart A, Franken E, et al. Prevalence of mandibular asymmetries in growing patients. Eur J Orthod. 2011; 33(3): 236–242.
- Raustia AM, Salonen MA. Gonial angles and condylar and ramus height of the mandible in complete denture wearers--a panoramic radiograph study. J Oral Rehabil. 1997; 24(7): 512–516.
- Saccucci M, D'Attilio M, Rodolfino D, et al. Condylar volume and condylar area in class I, class II and class III young adult subjects. Head Face Med. 2012; 8: 34.
- Sağlam AM. The condylar asymmetry measurements in different skeletal patterns. J Oral Rehabil. 2003; 30(7): 738–742.
- Saglam AA, Sanli G. Condylar asymmetry measurements in patients with temporomandibular disorders. J Contemp Dent Pract. 2004; 5(3): 59–65.
- Sop I, Mady Maricic B, Pavlic A, et al. Biological predictors of mandibular asymmetries in children with mixed dentition. Cranio. 2016; 34(5): 303–308.
- Staudt CB, Kiliaridis S. Association between mandibular asymmetry and occlusal asymmetry in young adult males with class III malocclusion. Acta Odontol Scand. 2010; 68(3): 131–140.
- Türp JC, Vach W, Harbich K, et al. Determining mandibular condyle and ramus height with the help of an orthopantomogram -- a valid method? J Oral Rehabil. 1996; 23(6): 395–400.
- Ueki K, Nakagawa K, Marukawa K, et al. The relationship between temporomandibular joint disc morphology and stress angulation in skeletal class III patients. Eur J Orthod. 2005; 27(5): 501–506.
- Uysal T, Sisman Y, Kurt G, et al. Condylar and ramal vertical asymmetry in unilateral and bilateral posterior crossbite patients and a normal occlusion sample. Am J Orthod Dentofacial Orthop. 2009; 136(1): 37–43.
- Van Elslande DC, Russett SJ, Major PW, et al. Mandibular asymmetry diagnosis with panoramic imaging. Am J Orthod Dentofacial Orthop. 2008; 134(2): 183–192.
- Yañez-Vico RM, Iglesias-Linares A, Torres-Lagares D, et al. Diagnostic of craniofacial asymmetry. Literature review. Med Oral Patol Oral Cir Bucal. 2010; 15(3): e494–e498.