Thekiya Altaf H, Mahmood Ayesha, Naqvi Zuber A, Zama Khan Danish Uz, Pharande Shilpa, Sharma Manish, Gupta Seema
Department of Orthodontics, Diamond Dental Care, Nanded, IND.
Department of Orthodontics, Sathya's Dental Zone, Hyderabad, IND.
Cureus. 2024 Dec 14;16(12):e75704. doi: 10.7759/cureus.75704. eCollection 2024 Dec.
Introduction The role of the condylar position in the correct functioning of the stomatognathic system has been the center of the study. Using cone-beam computed tomography (CBCT), this study looked at the three-dimensional (3D) position of the condylar bone in patients from Class I, Class II, Division 1, and Division 2. Materials and methods This cross-sectional, retrospective study was conducted using 102 CBCT records, with 34 records allocated to each category of malocclusion classification, such as dentoskeletal Class I, skeletal Class II, and dental Class II, Division 1 and 2. CBCT scans were conducted utilizing a Carestream New Generation CBCT apparatus (Carestream Dental, Atlanta, Georgia) in accordance with a standardized protocol (operating at a voltage of 120 kV, a current of 80 mA, a seven-second scan time, a field of view (FOV) measuring 10 x 10 cm, and a resolution of 0.2 voxels, and 1-mm slice thickness). The condylar position was assessed as the superior, inferior, and medial distance of the condyle from the glenoid fossa, along with the condylar angle. The distance from the most anterior point on the anterior surface of the condyle to the articular eminence was taken as anterior condylar distance; the distance of the superior surface of the condyle from the deepest point of the glenoid fossa was taken as superior condylar distance; the distance of the posterior surface of the condyle from the glenoid fossa was taken as posterior condylar distance; the condylar angle was measured as an angle between the XY line and the FH' line passing through X, where X is the center of the condyle; and the distance of the medial surface of the condyle from the glenoid fossa was taken as medial distance. The data were then subjected to statistical analyses. Results For anterior distance, the highest distance was noted in Class II Division 1 (3.32 ± 0.4 mm), and the lowest was seen in Class I (2.43 ± 0.26 mm). In the posterior distance, Class I exhibited the highest mean distance of 2.05 ± 0.14 mm, while Class II Division 1 showed the lowest distance of 1.83 ± 0.18 mm. For superior distance, the highest mean value was noticed in Class I patients at 2.92 ± 0.22 mm, and the lowest value was seen in Class II Division 1 at 2.61 ± 0.35 mm (p=0.001). For the condylar angle, the highest mean value was observed in Class I (30.96 ± 1.91) and the lowest in Class II Division 1 (26.71 ± 1.48), with p=0.001. Confirmatory factor analysis revealed that the most substantial loading was attributed to the condylar angle at -2.28, signifying its significant contribution to Fc1. Conclusion The condyle was placed anteriorly, superiorly, and medially in Class II Division 1 and posteriorly in Class II Division 2, compared to Class I patients.
引言 髁突位置在口颌系统正常功能中的作用一直是研究的核心。本研究使用锥形束计算机断层扫描（CBCT）观察了安氏Ⅰ类、安氏Ⅱ类1分类、安氏Ⅱ类2分类患者髁突骨的三维（3D）位置。
材料与方法 本横断面回顾性研究使用了102份CBCT记录，每种错牙合分类（如牙-骨型Ⅰ类、骨骼型Ⅱ类、牙型Ⅱ类1分类和2分类）各分配34份记录。使用Carestream新一代CBCT设备（Carestream Dental，佐治亚州亚特兰大）按照标准化方案进行CBCT扫描（操作电压为120 kV，电流为80 mA，扫描时间为7秒，视野（FOV）为10×10 cm，分辨率为0.2体素，层厚为1 mm）。评估髁突位置时，测量髁突相对于关节窝的上、下、内侧距离以及髁突角。髁突前表面最前点到关节结节的距离为髁突前距离；髁突上表面到关节窝最深点的距离为髁突上距离；髁突后表面到关节窝的距离为髁突后距离；髁突角测量为XY线与通过髁突中心X的FH'线之间的夹角；髁突内侧表面到关节窝的距离为内侧距离。然后对数据进行统计分析。
结果 对于前距离，安氏Ⅱ类1分类中距离最高（3.32±0.4 mm），安氏Ⅰ类中距离最低（2.43±0.26 mm）。在后距离方面，安氏Ⅰ类的平均距离最高，为2.05±0.14 mm，而安氏Ⅱ类1分类的距离最低，为1.83±0.18 mm。对于上距离，安氏Ⅰ类患者的平均值最高，为2.92±0.22 mm，安氏Ⅱ类1分类的最低值为2.61±0.35 mm（p = 0.001）。对于髁突角，安氏Ⅰ类的平均值最高（30.96±1.91），安氏Ⅱ类1分类的最低（26.71±1.48），p = 0.001。验证性因素分析显示，最大的负荷归因于髁突角，为-2.28，表明其对Fc1有显著贡献。
结论 与安氏Ⅰ类患者相比，安氏Ⅱ类1分类患者的髁突位于前方、上方和内侧，安氏Ⅱ类2分类患者的髁突位于后方。
