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This retrospective study aimed to evaluate the difference in the temporomandibular joint (TMJ) space volume between the deviated (Dev) and non-deviated (NDev) side following transoral vertical ramus osteotomy (TOVRO) in patients with mandibular prognathism combined with asymmetry using reconstructed 3-dimensional images. Sixty joints from 30 patients who underwent TOVRO between January 2018 and December 2021 were included. Computed tomography (CT) or cone-beam CT was performed before surgery (T0), and 6 (T1) and 12 months postoperatively (T2). The volume of the overall joint space (Vjs) and its compartments (i.e., the anterior, posterior, medial, and lateral joint spaces) were calculated at each time point. A linear mixed model and repeated-measures covariance pattern with unstructured covariance were used. Vjs increased at T1 compared to T0 and decreased at T2 compared to T1 (p < 0.0001). Furthermore, the volume changes over time were statistically significant in all compartments (p < 0.05); however, there was no significant difference in the Vjs and its compartments between the Dev and NDev side over time (p > 0.05). Adjustments for sex and mandibular movements did not affect the results. This study can provide the basis in TMJ spatial change and predicting the prognosis after TOVRO in facial asymmetry. [ABSTRACT FROM AUTHOR]

Introduction: Facial asymmetry can be attributed to a multitude of underlying causes. Multiple reference points can be utilized for guidance in surgery planning. The scope of mandibular overgrowth and asymmetry should always be measured on CBCT radiographs (cone-beam computed tomography). The assessment of the mental foramen, and the supra and infraorbital foramina is crucial in surgical procedures. Their potential as reference points for predicting specific conditions has never been studied before. The authors explored if the mentioned foramina can be used for diagnostic purposes to distinguish the type of asymmetry or perhaps could improve any surgery planning in those skeletal asymmetry cases. Material and methods: Evaluation of 30 CBCT radiographs in the present preliminary study based on three study groups consisting of patients with normal skeletal features without any skeletal malocclusion (n = 10), and those compared with hemimandibular elongation (HE = 10) and hyperplasia (CH/HH = 10). For the evaluation of asymmetry, fluctuating asymmetry indices were calculated. Results: The fluctuating asymmetry indices did not differ between both sexes; however, they were remarkably higher in the CH groups than in HE or control. Some of the indices showing the highest differences show some potential as promising predictors for early detection of CH. Conclusions: The condylar hyperplasia shows the highest facial asymmetry among study groups and metric traits. The supraorbital-mental foramina measurement may be used for initial screening for the occurrence of condylar hyperplasia Additional measurements could increase the predictive value of this indicator. Further study on improved samples could confirm the hypothesis of facial foramina displacement influence on jaw osteotomy planning. [ABSTRACT FROM AUTHOR]

Skeletal variations and dental profiles are closely related to skeletal class III malocclusion, with maxillary hypoplasia and mandibular hyperplasia, or a combination of both. Many factors affect facial asymmetry including condylar hyperplasia, condylar fracture, condylar resorption, internal bleeding of the temporomandibular joint (TMJ), and a history of one-sided chewing. The standard approach for class III treatment is a combination of pre-surgical and post-surgical orthodontic treatment, accompanied by orthognathic surgery. The article presents of 31 years old male with class III malocclussion and asymmetric mandible who underwent combined treatment of orthodontic and orthognatic surgery to solve his malocclusion and improved aesthetics and functional occlusion. Decompensation orthodontic phase involved in preadjusted edgewise orthodontic, with MBT prescription. The patient underwent orthognatic surgery to correct maxilla, mandible prognatism, and menton deviation. Post surgical with orthodontic treatment was accomplished for finishing stage. The patient's aesthetics and functional occlusion were improved. Performing treatment in three phases achieve better occlusion stability after surgery, appropriate dental compensation, jaw coordination, and obtain more predictable results before orthognathic surgery. [ABSTRACT FROM AUTHOR]

Craniofacial microsomia (CFM), also known as the oculo‐auriculo‐vertebral spectrum, is a congenital disorder characterized by hypoplasia of the mandible and external ear due to tissue malformations originating from the first and second branchial arches. However, distinguishing it from other syndromes of branchial arch abnormalities is difficult, and causal variants remain unidentified in many cases. In this report, we performed an exome sequencing analysis of a Brazilian family with CFM. The proband was a 12‐month‐old boy with clinical findings consistent with the diagnostic criteria for CFM, including unilateral mandibular hypoplasia, microtia, and external auditory canal abnormalities. A heterozygous de novo nonsense variant (c.713C>G, p.S238*) in PUF60 was identified, which was predicted to be pathogenic in silico. PUF60 has been reported as a causal gene in Verheij syndrome, but not in CFM. Although the boy showed craniofacial abnormalities and developmental delay that overlapped with Verheij syndrome, the facial asymmetry with unilateral hypoplasia of the mandible observed in this case did not match the previously reported phenotypes of PUF60 variants. Our findings expand the phenotypic range of PUF60 variants that cover CFM and Verheij syndrome. [ABSTRACT FROM AUTHOR]

Background: The current high standards in orthognathic surgery demand surgical solutions that are both ⁠ functionally ⁠ effective and aesthetically pleasing. Our approach offers one for enhanced stability, attractiveness, and nerve protection ⁠ with improved accessibility ⁠ in the majority of orthognathic scenarios ⁠ compared to an inverted L osteotomy. Methods: A case series is presented to illustrate the application and outcomes of HSSO, an optimised approach that combines the advantages of a transoral inverted L osteotomy with specific enhancements and increased versatility, ⁠ with accessibility and exposure similar to a BSSO. Results: HSSO as a completely transoral technique, demonstrate the ability to perform significant counterclockwise rotations of the mandible, eliminating the need for trocars or skin incisions. We experinced high postoperative stability when HSSO was performed in conjunction with a three-piece LeFort 1 osteotomy on a dynamic opposing arch. In comparison to an inverted L approach, we postulated that HSSO offers advantages in stability, due to the increased segmental overlap of the proximal and distal segments of the mandible. This approach is designed to enhance the safety of the inferior alveolar nerve compared to traditional sagittal split methods. Furthermore, HSSO represents an alternative to total joint replacement in select cases of idiopathic condylar resorption and is effective for correcting mandibular asymmetries while maintaining jawline aesthetics. This is achieved through the manipulation of the mandibular angle, ramus height, and inferior border without creating a step deformity in the soft tissue. Conclusions: The outcomes of HSSO highlight its capacity to deliver predictable, functional, and aesthetically pleasing results, offering a viable alternative to more traditional orthognathic techniques. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to determine the relation)ship between the vertical mandibular ramus asymmetry and the hand measurements asymmetry in growing patients. Material and Methods. Panoramic radiographs and comparative radiographs of the right and left hands of 40 patients (14 males and 26 females) between 6 and 16 years old (mean age of 11.35±1.99 years) were evaluated. The total height of the mandibular ramus was measured, and the asymmetry index was calculated. The lengths of the proximal, middle and distal phalanges and the metacarpals of the five digits of both hands were measured and the absolute differences R-L were calculated for each one. Results. A statistically significant association between the presence of vertical mandibular ramus asymmetry and the presence of phalanges asymmetry FPII (p=0.016), FPIII (p=0.016), FPIV (p=0.033), FMIII (p=0.031) and FMIV (p=0.016) was observed. Conclusions. Mandibular asymmetry appears not to be isolated but also present in other body districts such as the phalanx bones. The total vertical asymmetry of the mandibular ramus showed an association with the asymmetry of the lengths of the FPIII, FMIII, FPIV, FMIV and FPII in growing individuals, with association between the side of mandibular asymmetry and the side of the phalanx’s asymmetry. The asymmetry of this phalanges increases with increasing index of vertical mandibular ramus asymmetry. [ABSTRACT FROM AUTHOR]

This study compares condylar volumetric asymmetry and facial asymmetry in patients with cleft lip and/or palate (CLP) and controls. The mandibular condyle is important to facial growth, but its role in facial asymmetry for those with CLP has not been described. Condylar volumes and mandibular asymmetry were retrospectively calculated using Mimics Version 23.0 (Materialise, Leuven, Belgium) from patients with CLP undergoing computed tomography (CT) imaging and a cohort of controls. A total of 101 participants, 60 with CLP and 41 controls, had mean condylar volumetric asymmetry of 16.4 ± 17.4 % (CLP) and 6.0 ± 4.0 % (controls) (p = 0.0002). Patients with CLP who had clinically significant chin deviation (>4 mm) had more asymmetric condyles than those without significant chin deviation (p = 0.003). The chin deviated toward the smaller condyle in patients with facial asymmetry more often than in patients without facial asymmetry (81 % vs. 62 %, p = 0.033). While controls had some degree of condylar asymmetry, it tended to be milder and not associated with facial asymmetry. There is a greater degree of condylar volumetric asymmetry in patients with CLP compared to individuals in the general population. Clinically significant facial asymmetry in CLP is associated with a higher degree of condylar asymmetry, with the facial midline deviating toward the smaller condyle. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular joint (TMJ) ankylosis frequently results in mandibular asymmetry, which impairs an affected person’s ability to function and look good. Because of the intricacy of TMJ ankylosis and the variety of surgical procedures available, correcting mandibular asymmetry surgically can be difficult. Methods: Patients with mandibular asymmetry and TMJ ankylosis who had surgery at a tertiary care facility between certain periods were the subject of a retrospective investigation. Medical records were used to gather information on patient demographics, pre-operative imaging, surgical methods, and post-operative results. Surgical methods included condylectomy with or without reconstruction, joint reconstruction with or without orthognathic surgery, and unilateral or bilateral mandibular distraction osteogenesis (MDO). Occlusion, patient-reported results, and facial symmetry made up the evaluation criteria. Findings: The study had a total of 50 patients, with different surgical method distributions. Comparing unilateral and bilateral MDO to condylectomy and joint reconstruction, notable gains in face symmetry and occlusion were seen. The largest complication rate was seen with condylectomy, mostly from recurrence and device-related issues, albeit the rates of other procedures varied as well. Conclusion: In conclusion, customized treatment planning is necessary for the correction of mandibular asymmetry in individuals with TMJ ankylosis. Although mandibular distraction osteogenesis produces better results for occlusion and facial symmetry, it is crucial to carefully weigh the risks involved. While still feasible treatments, condylectomy and joint reconstruction require strict monitoring for any consequences. In order to enhance patient care in this difficult patient group, future research should concentrate on improving treatment procedures and long-term results.

Summary: This study evaluated the stability of bilateral sagittal split ramus osteotomy (BSSRO) associated with positional plagiocephaly and temporal and masseter muscles using posteroanterior cephalogram analysis and three-dimensional computed tomography (3D-CT). This retrospective cohort study included 31 patients who underwent BSSRO for mandibular asymmetry. The cranial vault asymmetry index (CVAI) and the cephalic index were used as indicators of positional plagiocephaly. The distance from the vertical reference line to the menton (Me) was measured on posteroanterior cephalograms immediately and 1 year after surgery, and postoperative stability was assessed. Temporal and masseter muscles were constructed from 3D-CT data and their volumes were measured. Simple regression analysis showed a significant correlation between postoperative changes in the vertical reference line to the Me and the CVAI (R = 0.56, p = 0.001), the amount of surgical movement in the vertical reference line to the Me (R = 0.41, p = 0.023), and the variable temporal muscle volume (R = 0.27, p = 0.028). There was no significant correlation between postoperative changes in the vertical reference line to the Me and the cephalic index (R = 0.093, p = 0.62) and variable masseter muscle volume (R = 0.16, p = 0.38). According to multivariate analysis, CVAI (p = 0.003) and amount of surgical movement in the vertical reference line to the Me (p = 0.014) were significant predictors of postoperative change in the vertical reference line to the Me. Positional plagiocephaly and amount of surgical movement influence lateral skeletal stability following BSSRO for mandibular asymmetry.

Abstract Introduction An accurate identification of mandibular asymmetries is required by modern orthodontics and orthognathic surgery to improve diagnosis and treatment planning of such deformities. Although craniofacial deformities are very frequent pathologies, some types of asymmetries can be very difficult to assess without the proper diagnostic tools. The purpose of this study was to implement the usage of three-dimensional (3D) segmentation procedures to identify asymmetries at the mandibular level in adult patients with different vertical and sagittal patterns where the asymmetries could go unnoticed at the observational level. Methods The study sample comprised 60 adult patients (33 women and 27 men, aged between 18 and 60 years). Subjects were divided into 3 sagittal and vertical skeletal groups. CBCT images were segmented, mirrored and voxel-based registered with reference landmarks using ITK-SNAP® and 3DSlicer® software’s. 3D surface models were constructed to evaluate the degree of asymmetry at different anatomical levels. Results There was a degree of asymmetry, with the left hemimandible tending to contain the right one (0.123 ± 0.270 mm (CI95% 0.036–0.222; p

In this study, the prevalence of mandibular midline deviation in different types of malocclusions were evaluated taking into account sexual dimorphism in patients with mixed and permanent dentition. With the aforementioned aim, a cross-sectional study was carried out on a total of 214 patients (134 females and 80 males) aged between 7-15 years (with a mean age of 9.5 ± 2 years). On the study casts of each subject participating in the study, the displacement of the lower dental midline compared to the upper one was measured in different classes of malocclusion, taking into account sexual dimorphism. Three study groups were formed: first with mandibular midline deviation with values less than 2 mm, second with deviation between 2-4 mm and third with deviation more than 4 mm. Subsequently, the prevalence of the displacement of the lower dental midline was assessed taking into account the sexual dimorphism and the Angle classes malocclusions analyzed (Angle Class I, II/1, II/2, III) and UPC (unilateral posterior crossbite). Mandibular midline deviation greater than 2 mm was observed in more than three quarters (75.7%) of the patients in the studied group. In the five classes of malocclusion, a higher frequency of displacement of the lower dental midline was appreciated in the range of 2-4 mm of 59.8%. In this interval, the highest percentage of displacement was observed in Angle Class II/1 (18.2%), followed by unilateral posterior crossbite UPC (15%) and Angle Class II/2 (13.1%). Most large displacement of the lower dental midline (with a value more 4 mm) was recorded in unilateral posterior crossbite UPC (5.6%). Although the displacement of the mandibular midline was recorded in a slightly increased percentage in males (61.25%) compared to the group of females (58.95%), from a statistical point of view, no notable differences were reported between the two genders. Dental midline deviation changes should be noted and analyzed from the beginning of orthodontic treatment in order not to cause later functional or aesthetic disorder.

Hemifacial hyperplasia (HFH) is a rare congenital disorder characterized by marked unilateral overgrowth of the facial tissues. A subtype of HFH is congenital infiltrating lipomatosis of the face (CIL-F). This disease is characterized by unilateral diffuse infiltration of mature adipose cells in the facial soft tissue and is associated with skeletal hypertrophy. This work aims to report a case of a CIL-F patient with right facial asymmetry and progressive growth at adolescent age, causing mandibular asymmetry due to signs of concomitant unilateral condylar hyperplasia. At the age of seventeen, a condylectomy was performed to stop the progression of asymmetric mandibular growth. Five years later, the patient developed CIL-F-associated temporomandibular joint ankylosis, manifesting as progressive restricted mouth opening along with temporal facial pain. In this CIL-F patient, a TMJ reconstruction with an alloplastic total joint prosthesis was successfully performed with optimal maximal mouth opening, complete alleviation of temporal facial pain, and stable dental occlusion one year postoperatively. A TMJ reconstruction with a complete alloplastic total joint prosthesis proved to be a predictable, stable, and safe treatment option in a patient with CIL-F-associated TMJ ankylosis who was previously treated with condylectomy due to progressive mandibular asymmetry. [ABSTRACT FROM AUTHOR]

Introduction: An accurate identification of mandibular asymmetries is required by modern orthodontics and orthognathic surgery to improve diagnosis and treatment planning of such deformities. Although craniofacial deformities are very frequent pathologies, some types of asymmetries can be very difficult to assess without the proper diagnostic tools. The purpose of this study was to implement the usage of three-dimensional (3D) segmentation procedures to identify asymmetries at the mandibular level in adult patients with different vertical and sagittal patterns where the asymmetries could go unnoticed at the observational level. Methods: The study sample comprised 60 adult patients (33 women and 27 men, aged between 18 and 60 years). Subjects were divided into 3 sagittal and vertical skeletal groups. CBCT images were segmented, mirrored and voxel-based registered with reference landmarks using ITK-SNAP® and 3DSlicer® software's. 3D surface models were constructed to evaluate the degree of asymmetry at different anatomical levels. Results: There was a degree of asymmetry, with the left hemimandible tending to contain the right one (0.123 ± 0.270 mm (CI95% 0.036–0.222; p < 0.001). Although the subjects under study did not present significant differences between mandibular asymmetries and their sagittal or vertical skeletal pattern (p = 0.809 and p = 0.453, respectively), a statistically significant difference has been found depending on the anatomical region (p < 0.001; CI95%=1.020–1.021), being higher in the condyle, followed by the ramus and the corpus. Conclusions: Although mandibular asymmetries cannot be correlated with vertical and sagittal skeletal patterns in symmetric patients, knowledge about 3D segmentation procedures and color maps can provide valuable information to identify mandibular asymmetries. [ABSTRACT FROM AUTHOR]

Introduction: Mandibular osteotomies in facial asymmetry are complicated by the abnormal position and course of inferior alveolar nerve. This manuscript aims to evaluate the possible variations in the preoperative positions of mandibular canal and mandibular foramen in patients with mandibular asymmetry due to condylar hyperplasia or condylar hypoplasia. Materials & Methods: This study included 15 patients with mandibular asymmetry due to condylar hyperplasia or condylar hypoplasia for which bilateral sagittal split osteotomy (BSSO) was performed as a corrective procedure. The presence/absence and extent of postoperative neurosensory deficiency was recorded subjectively and objectively. The measurements were done using multiplanar reconstruction (MPR) of three-dimensional radiographic imaging and were compared to normal subjects. Discussion: The results revealed that the mandibular canal was closer to the buccal cortex on the affected side and the inferior border on both sides in the region of second molar in condylar hyperplasia. In condylar hypoplasia, the canal was nearer to the inferior border and the alveolar crest in relation to second and third molars respectively on the affected and contralateral sides.The mandibular foramen was also more superior to the occlusal plane on both sides in both condylar hyperplasia and hypoplasia. Conclusion: Based on the study outcomes, the authors propose that assessment of the positions of mandibular canal and mandibular foramen is crucial to avoid postoperative neurosensory deficiencies. [ABSTRACT FROM AUTHOR]

The article discusses mandibular alveolar bone thickness in untreated Class I subjects with different vertical skeletal patterns, emphasizing the importance of limiting buccal-lingual movement, especially in high-angle patients, to avoid periodontal complications. Topics include 3D imaging analysis, correlations between sella-nasion–mandibular plane angle and alveolar thickness, and implications for orthodontic treatment planning.

Objective: The purpose of this study was to analyze three-dimensional dental compensation in patients with different types of skeletal Class III malocclusion with mandibular asymmetry, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction measurement technology, thereby providing clinical guidance and reference for combined orthodontic and orthognathic treatment. Methods: 81 patients with skeletal Class III malocclusion with mandibular asymmetry were selected in accordance with the inclusion criteria. According to a new classification method based on the direction and amount of menton deviation relative to ramus deviation, patients were divided into three groups called Type 1, Type 2, and Type 3. In Type 1, the direction of menton deviation was consistent with that of ramus deviation and the amount of menton deviation was greater than that of ramus deviation. In Type 2, the direction of menton deviation was consistent with that of ramus deviation and the amount of menton deviation was smaller than that of ramus deviation. In Type 3, the direction of menton deviation was inconsistent with that of ramus deviation. The maxillary occlusal plane (OP), anterior occlusal plane (AOP), and posterior occlusal plane (POP) were measured on reconstructed CBCT images. The vertical, transverse, and anteroposterior distances from maxillary teeth to reference planes and the 3D angles between the long axis of these teeth and reference planes were measured. These dental variables measured from the deviated and non-deviated sides were compared within each group, as well as among each other. Results: Of the 81 patients with asymmetrical Class III malocclusion, 52 patients were categorized in Type 1, 12 patients in Type 2, and 17 patients in Type 3. There were significant differences between deviated and non-deviated sides in Type 1 and Type 3 (p < 0.05). In Type 1, the vertical distances of maxillary teeth on the deviated side were lower than those on the non-deviated side, and AOP, OP, and POP on the deviated side were larger than those on the non-deviated side (p < 0.05). In Type 3, the vertical distances of the maxillary teeth on the deviated side were lower (p < 0.05), and the AOP and OP on the deviated side were larger than those on the non-deviated side. In all three groups, the transverse distances of the maxillary teeth from the mid-sagittal plane on the deviated side were larger than those on the non-deviated side (p < 0.05), and the angles between the long axis of maxillary teeth and the mid-sagittal plane on the deviated side were larger, respectively (p < 0.05). Conclusions: The maxillary teeth on the deviated side were observed to have smaller eruption heights in Type 1 and Type 3. In Type 1, AOP, POP, and OP were greater on the deviated side, while in Type 3, only AOP and OP were greater on the deviated side. The maxillary teeth of patients in all three groups on the deviated side were buccal and buccally inclined. Larger sample observations are still needed to further verify these findings. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to compare changes in the stability of the pharyngeal airway space (PAS) and the hyoid bone position between patients with and without mandibular asymmetry. We included 104 patients who underwent sagittal split ramus osteotomy. Patients whose menton was deviated by ≥ 4 mm from the facial median line were categorized as the asymmetry group. The patients were divided into the symmetry group (72 patients) and the asymmetry group (32 patients). The patients treated were evaluated using lateral cephalometric radiography 1 and 6 months postoperatively. Following orthognathic surgery, the airway space in the oropharynx and the hypopharynx significantly decreased in both the both groups (p < 0.05). The diameters of the oropharynx and hypopharynx in the asymmetry group gradually decreased after sagittal split ramus osteotomy compared with those in the symmetry group (p < 0.05). The hyoid bone was moved in an inferoposterior direction postoperatively in both groups. In the symmetry group, the hyoid bone that was moved inferiorly tended to move back toward the original position over a period of 6 months postoperatively(p < 0.05). In the asymmetry group, the hyoid bone that was moved inferiorly remained in the same position 6 months postoperatively. These results showed that the time required before pharyngeal airway morphology and the hyoid bone were stabilized was relatively longer in the asymmetry group. [ABSTRACT FROM AUTHOR]

Abstract Background Investigating the morphological and functional effects on mandibular asymmetry (MA) is important not only to understand the developmental process of masticatory dysfunction, but also to provide suggestions for evidence-based occlusal treatment. Aim To evaluate three-dimensional temporomandibular joint (TMJ) morphology and its relationship to asymmetrical condylar movement in MA patients. Materials and methods Fifty subjects were divided into MA and control groups (n = 25 each) according to a menton deviation of 4 mm from the mid-sagittal plane. TMJ morphology (condyle, glenoid fossa and TMJ spaces) were evaluated using a three-dimensional analysis programme. Three-dimensional condylar movements (from the sagittal and horizontal planes) were recorded and measured by computerized axiography on protrusion. Side-to-side asymmetry was measured for each parameter. The asymmetry index value was calculated to assess the correlation between TMJ morphology and condylar movement. For the statistical analysis, Wilcoxon’s signed-ranked test, the Mann–Whitney U test, and Spearman’s rank correlation were used. Results Glenoid fossa volume, surface area, anteroposterior length, and condylar volume were significantly smaller, and articular eminence angle, glenoid fossa, and condylar axial angle were significantly larger, on the shifted side of the MA group when compared with those on the non-shifted side and the mean values of the control group (P

The aim of this study was to assess the diagnostic accuracy of single photon emission tomography (SPECT) in unilateral condylar hyperplasia (UCH). To this end, 3D morphometric changes of the mandibles in one year were assessed (T0 vs. T1) and compared over SPECT results in T1, in a sample of 40 patients. A contingency table was constructed based on these results for SPECT diagnostic accuracy evaluation, classifying patients as SPECT true-positive, true-negatives, false positives and false-negatives. Additionally, the morphometric analysis was used to describe the presentation of mandibular changes using principal component analysis (PCA) and non-parametric statistics. We obtained diagnostic accuracy results of sensitivity 81%, specificity 63%, positive predictor value (PPV) 59%, negative predictor value (NPV) 83% and accuracy 70%, showing that SPECT yields poor results regarding accuracy diagnostic performance. The morphometric analysis showed that individuals without progress of asymmetry and those with more progress differ particularly in a group of landmarks representing the mental region and the right mandibular body. Based on these landmarks, difference among the four SPECT-accuracy groups was statistically significant (p < 0.001), where the landmark showing the largest change within a year had a mean increase of 1.13 + 0.66 mm. Within the limitations of the study, it seems that SPECT alone is not suitable for making surgical decisions regarding condylectomy in active UCH. Follow up with morphological assessment methods are recommended for confirming an active UCH in combination with SPECT. [ABSTRACT FROM AUTHOR]

This study is intended to focus on the evaluation of posterior vertical mandibular asymmetry by calculating the mandibular asymmetry index on the panoramic radiography in different types of malocclusions, considering the sexual dimorphism in children and adolescent patients and performing a comparative analysis between these groups. In this context, a cross-sectional study was conducted for a group of 214 patients (134 females and 80 males with a mean age of 9.5 ± 2 years). The asymmetry index was calculated for each patient according to the Habets method. The results were analyzed by using the independent Student t-test, ANOVA and Mann–Whitney U-test at the 95% confidence level (p < 0.05). The results of the analyses showed a statistically significant difference between males and females at the level of the condylar index (p = 0.023) and a significant difference in the unilateral posterior crossbite in the Mann–Whitney U test (p = 0.01). No statistically significant differences were found between males and females in the index of the mandibular ramus and condyle-plus-ramus. The highest value of the asymmetry index was recorded at the level of the condyle. We found higher values of asymmetry in Angle Class I malocclusions in all groups and in Class II/1 in the group of females. [ABSTRACT FROM AUTHOR]

Background: Although jaw asymmetry is commonly seen in skeletal Class III patients, its correlation with occlusal function and masticatory muscle activity has not been fully elucidated. Objectives: The purpose of this study was to investigate the occlusal function and masticatory muscle activity in skeletal Class III patients with various patterns of mandibular asymmetry. Methods: Forty‐two patients and 10 normal participants were examined. The patients were categorised into three groups. Groups 1 and 2 exhibited menton and ramus deviation to the same side. Menton deviation was larger than ramus deviation in Group 1, whereas Group 2 showed the inverse relation. Group 3 patients showed menton and ramus deviation in opposite directions. Occlusal contact area (OCA), relative bite force (RBF), and temporalis anterior (TA) and masseter muscle (MM) activity at maximum clenching were measured using T‐Scan Novus system and Bio‐EMG‐III. Statistical analysis was performed using the t‐test, one‐way analysis of variance with Bonferroni correction and Spearman correlation (α =.05). Results: Compared with normal participants, the patients had smaller OCA and greater asymmetry in the distribution of masticatory muscle activity. Greater ramus deviation was associated with smaller OCA in Group 1 but with larger OCA in Group 3. In Group 1, greater menton deviation was related to stronger TA activity on the non‐deviation side. In Group 2, greater ramus deviation was related to stronger MM activity on the deviation side. Conclusion: Deviation of the menton and ramus was individually related to OCA and masticatory muscle activity, and this relationship varied according to the pattern of mandibular asymmetry. [ABSTRACT FROM AUTHOR]

Craniofacial symmetry is an important factor in creating a harmonious facial appearance. Genetic and external factors may cause the formation of mandibular asymmetry. The aim of this study was to evaluate vertical mandibular asymmetries in adolescents who had unilateral mandibular first permanent molar (FPM) teeth extracted at an early age. The study group consisted of 60 subjects (30 females, 30 males with a mean age of 16.18±1.04 years) who had their mandibular permanent first molar tooth extracted before the age of 12, and the control group consisted of 60 healthy subjects (30 females, 30 males with a mean age of 16.23±0.92 years). Condylar asymmetry index (CAI), ramal asymmetry index (RAI), and condylar-ramal asymmetry index (CRAI) were calculated using panoramic radiographs of the subjects. Independent samples t-test was used to evaluate the differences between groups. CAI, RAI, and CRAI values were similar between male and female subjects in both control and study groups, and no statistically significant difference was found (p>0.05). No statistically significant difference was observed between the group who had their mandibular first permanent molar teeth extracted at an early age and the control group (p>0.05). CAI values were relatively higher in both groups, but there was no significant difference between the CAI, RAI, and CRAI values between the groups. [ABSTRACT FROM AUTHOR]

In patients with mandibular asymmetry, the volume of the mandible divided by the mandibular median plane is significantly larger on the non-deviated (N-Dev) side than on the deviated (Dev) side. However, it has been reported that there is no significant difference between the volumes of the N-Dev and Dev sides when the mandibular ramus and body are divided. The purpose of this study was to investigate which region is responsible for the volume difference between the N-Dev and Dev sides. Cone Beam Computed Tomography (CBCT) images of patients with mandibular asymmetry were analyzed by measuring the volume, and linear analysis of the mandibular body, ramus, and condyle on the N-Dev and Dev side was performed. In this study, CBCT images of 37 patients (8 Japanese, 16 Korean, and 13 Egyptian) aged ≥ 18 years with mandibular asymmetry (men: 20, women: 17) were used to evaluate mandibular asymmetry. In patients with mandibular asymmetry, the N-Dev side showed significantly larger values than the Dev side for both volume and linear condyle, ramus, and mandibular body measurements. These results do not differ according to sex or ethnicity. Therefore, it is suggested that the N-Dev side of mandibular asymmetry is large without any regional specificity in pathophysiology. [ABSTRACT FROM AUTHOR]

IntroductionThis study aims to quantitively analyze mandibular ramus and body deformities, assessing the asymmetry and progression in different components.MethodsThis is a retrospective study on hemifacial microsomia children. They were divided into mild/severe groups by Pruzansky-Kaban classification and into three age groups (

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Background: Investigating the morphological and functional effects on mandibular asymmetry (MA) is important not only to understand the developmental process of masticatory dysfunction, but also to provide suggestions for evidence-based occlusal treatment. Aim: To evaluate three-dimensional temporomandibular joint (TMJ) morphology and its relationship to asymmetrical condylar movement in MA patients. Materials and methods: Fifty subjects were divided into MA and control groups (n = 25 each) according to a menton deviation of 4 mm from the mid-sagittal plane. TMJ morphology (condyle, glenoid fossa and TMJ spaces) were evaluated using a three-dimensional analysis programme. Three-dimensional condylar movements (from the sagittal and horizontal planes) were recorded and measured by computerized axiography on protrusion. Side-to-side asymmetry was measured for each parameter. The asymmetry index value was calculated to assess the correlation between TMJ morphology and condylar movement. For the statistical analysis, Wilcoxon's signed-ranked test, the Mann–Whitney U test, and Spearman's rank correlation were used. Results: Glenoid fossa volume, surface area, anteroposterior length, and condylar volume were significantly smaller, and articular eminence angle, glenoid fossa, and condylar axial angle were significantly larger, on the shifted side of the MA group when compared with those on the non-shifted side and the mean values of the control group (P < 0.05). The TMJ spaces of the MA group showed no bilateral difference but were significantly narrower in the medial, superior, and anterior joint spaces when compared with the control group (P < 0.05). Condylar path length and sagittal condylar inclination were significantly asymmetrical. The asymmetry index of the condyle volume was significantly correlated with that of the condylar path length (P = 0.005). The asymmetry index of the glenoid fossa volume and the articular eminence angle were significantly correlated with that of the sagittal condylar inclination (P = 0.009 and P = 0.002, respectively), and the asymmetry index of glenoid fossa volume was significantly correlated with the bilateral transverse condylar inclination (P = 0.006 and P = 0.016, respectively). Conclusions: Morphological asymmetry of the TMJ is significantly different between the shifted and non-shifted sides and is closely related to functional asymmetry of condylar movement in MA patients. (350/350). [ABSTRACT FROM AUTHOR]

Background: Mandibular asymmetries are commonly seen as asymmetric traits among orthodontic and orthognathic patients which require bilateral mandibular assessment for diagnosis and treatment. An orthopantomogram can be used to measure and compare right and left sides of mandible. The objective of this study was to investigate the reliability of left and right sides of orthopantomogram for determining the linear mandibular measurements and to check whether these values are identical with the values of linear mandibular measurements determined from lateral cephalogram. Methods: Orthopantomogram and lateral cephalogram were taken from 118 patients of age group 12-35 years from Orthodontic department, Liaquat College of Medicine & Dentistry and Darul Sehat Hospital, Karachi, Pakistan. Linear mandibular measurements were detected and compared between orthopantomograms and lateral cephalograms. Right and the left sides of orthopantomograms were compared for all of the linear mandibular parameters by using paired t-test. Independent sample t-test was performed for the comparison between orthopantomogram and lateral cephalogram using SPSS version 26.0. Results: Statistically significant differences were observed when orthopantomograms were compared with lateral cephalograms for mandibular body length (p=0.000) and total mandibular length (p=0.000). No statistically significant difference was found between orthopantomograms and lateral cephalograms for ramus height (p=0.226, p=0.177). Neither any significant difference was observed between right and left sides of an orthopantomogram. Conclusion: An orthopantomogram can be used to evaluate vertical mandibular measurements as reliably as a lateral cephalogram. However, it is required for clinicians to be vigilant when determining horizontal mandibular measurements from orthopantomograms as they are unpredictable. [ABSTRACT FROM AUTHOR]

Introduction Unilateral cleft lip and palate (UCLP) often leads to maxillary hypoplasia and skeletal Class III malocclusion, with conflicting evidence on mandibular asymmetry. This study evaluated vertical mandibular asymmetry in UCLP patients, comparing them with non-cleft individuals having skeletal Class III and Class I malocclusions. Methods Mandibular asymmetry was evaluated using orthopantomograms (OPGs) from 90 subjects divided into three groups of 30 each: UCLP group, non-cleft skeletal Class III, and non-cleft skeletal Class I. Measurements included condylar height, ramal height, condylar + ramal height, gonial angle, antigonial notch depth, mandibular body length, and total mandibular length. These parameters were analyzed to assess vertical mandibular asymmetry. Asymmetry indices were calculated for condylar, ramal, and combined condylar and ramal heights to compare mandibular symmetry across the groups. Results The UCLP group showed significant vertical asymmetry, with reduced condylar (-1.267 mm), ramal (-1.700 mm), and combined heights (-2.967 mm) on the cleft side, along with shorter mandibular body (-3.633 mm) and total lengths (-4.067 mm). Asymmetry indices in UCLP were comparable to non-cleft skeletal Class III but significantly differed from non-cleft skeletal Class I for condylar asymmetry (p = 0.042). No significant differences were found between non-cleft skeletal Class III and skeletal Class I groups. Conclusion This study revealed significant vertical mandibular asymmetry in UCLP patients, with reduced condylar and ramal heights on the cleft side. UCLP patients exhibited greater condylar asymmetry compared to skeletal Class I individuals, but no significant differences were found with non-cleft skeletal Class III patients. Early intervention is crucial to address these growth disturbances and improve patient outcomes., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, Government Dental College, Thiruvananthapuram issued approval DCT/IEC/SS/24/11 dated 10/01/2024. Institutional Ethics Committee approval was obtained for this retrospective study from the Institutional Ethics Committee, Government Dental College, Thiruvananthapuram, as per approval number DCT/IEC/SS/24/11 dated 10/01/2024. Data were collected retrospectively from patient records in the Department of Orthodontics. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mohan et al.)

Osteochondroma (OC) is a common bone tumour that rarely affects the mandibular condylar process. This pathology can show typical clinical features, such as facial asymmetry, deviation of the chin and dental inferior midline, changes in condylar morphology and malocclusion with an increased posterior mandibular vertical height. The management of condylar OC is a debated topic among surgeons. Most of them combine systematically condylectomy with orthognathic surgery while only few others perform in the first instance only condylectomy followed by functional therapy. A case of a 32-year-old female diagnosed with a mandibular condylar OC successfully treated with condylectomy alone is presented. A literature review is carried out focusing on surgical management, clinical and imaging features, highlighting the differences between OC and other condylar growing lesions., When maxillary alterations are not present or are mild as in the presented patient, the low condylectomy alone, followed by elastic functional therapy, can correct both the aesthetic and the occlusal disorders resulting from condylar OC removal. In case of severe dentoalveolar maxillary compensation, orthognatic surgery must be performed with the low condylectomy to quickly correct facial symmetry and occlusion., (Copyright © 2024 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)

Nowadays, maxillo-facial surgery procedures are greatly dependent on good general anesthesia and adequate maintenance care of the airways. Nasotracheal intubation (NTI) is one of the most common ones, especially in orthognathic surgery, temporomandibular joint-related surgeries, or others. Nasotracheal intubation itself is not a problem; however, maintaining its stable and safe position, regardless of the excess of surgical maneuvers in the facial skeleton, is important. There are a lot of techniques, personal modifications, and materials used to support tube placement. It is quite common that either plaster or a bandage roll can be useful with a combination of various forms of sponges or wipes in different shapes, sizes, and elasticity to support the tube's adequate position, especially when maintaining a good shape and position of the nose and symmetry line and avoiding unnecessary tube flexion. In the following paper, one of the tube support alternatives with an anti-bedsore heel disc will be presented. [ABSTRACT FROM AUTHOR]

This study is intended to focus on the evaluation of posterior vertical mandibular asymmetry by calculating the mandibular asymmetry index on the panoramic radiography in different types of malocclusions, considering the sexual dimorphism in children and adolescent patients and performing a comparative analysis between these groups. In this context, a cross-sectional study was conducted for a group of 214 patients (134 females and 80 males with a mean age of 9.5 ± 2 years). The asymmetry index was calculated for each patient according to the Habets method. The results were analyzed by using the independent Student t-test, ANOVA and Mann–Whitney U-test at the 95% confidence level (p < 0.05). The results of the analyses showed a statistically significant difference between males and females at the level of the condylar index (p = 0.023) and a significant difference in the unilateral posterior crossbite in the Mann–Whitney U test (p = 0.01). No statistically significant differences were found between males and females in the index of the mandibular ramus and condyle-plus-ramus. The highest value of the asymmetry index was recorded at the level of the condyle. We found higher values of asymmetry in Angle Class I malocclusions in all groups and in Class II/1 in the group of females.

Hemimandibular hyperplasia (HH) and elongation (HE) are the most common pathologies present in the mandible. Presented condylar hyperplasias have their own radiological and clinical features. In most cases, patients suffer from various forms of malocclusion. From a total of 150 asymmetrical jaw radiographs evaluated, 46 were evaluated and included in this study. A retrospective study on the data of 46 selected patients treated, diagnosed, and consulted from various forms of mandibular and skeletal asymmetry based on routine diagnostic panoramic radiographs evaluated typical and atypical radiological and anatomical symptoms of condylar hyperplasia. The presented evaluation focused on mandibular, maxillary, and other bones, in order to distinguish condylar hyperplasia from other forms of mandibular asymmetry. The degree of maxillary downward growth followed by the occurrence of an open bite on the affected side estimate the degree/presence or cessation of growth in the affected condyle. Mandibular asymmetry with incisor teeth inclination remains the most typical characteristic of condylar hyperplasia. Increased height of mandibular ramus differentiates between condylar hyperplasia and elongation, which also influences the position of the inferior alveolar nerve. Mentioned symptoms, described as the acronym "Go Moira!", are useful in a quick and simple "glimpse of an eye" differential diagnostic approach. It is possible to quickly and accurately establish the first diagnosis simply by a careful evaluation of patients' panoramic radiographs. [ABSTRACT FROM AUTHOR]

Objectives: To compare the characteristics of mandibular asymmetry in patients with unilateral craniofacial microsomia (CFM) and class II asymmetry. Materials and methods: Pretreatment cone-beam computed tomography of consecutive adults with Pruzansky-Kaban type I and IIA CFM (CFM group) was analyzed by 3D cephalometry. Fourteen mandibular landmarks and two dental landmarks were identified. The mandibular size and positional asymmetry were calculated by using landmark-based linear and volumetric measurements, in terms of asymmetry ratios (affected/non-affected side) and absolute differences (affected − non-affected side). Results were compared with non-syndromic class II with matched severity of chin deviation (Class II group). Statistical analyses included independent t test, paired t test, chi-square test, and ANOVA. Results: CFM group (n, 21; mean age, 20.4 ± 2.5 years) showed significantly larger size asymmetry in regions of mandibular body, ramus, and condyle compared to Class II group (n, 21; mean age, 27.8 ± 5.9 years) (p < 0.05). The curvature of mandibular body was asymmetric in CFM. Regarding the positional asymmetry of mandibular body, while a comparable transverse shift and a negligible yaw rotation were found among the two groups, the roll rotation in CFM was significantly greater as well as the occlusal (6.06° vs. 4.17°) and mandibular (7.84° vs. 2.80°) plane cants (p < 0.05). Conclusions: Mild CFM showed significantly more severe size asymmetry and roll rotation in mandible than non-CFM class II asymmetry. Clinical relevance: To improve the mandibular size and positional asymmetry in CFM, adjunct hard tissue augmentation or reduction in addition to OGS orthodontics with a meticulous roll and yaw planning is compulsory, which is expected to be distinct from treating non-CFM class II asymmetry. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to compare the condylar size of the deviated and non-deviated sides in patients with mandibular asymmetry. The relationship of the condylar size difference between the deviated and non-deviated sides and the involvement of the anteroposterior or vertical skeletal patterns were subsequently examined. Materials and methods: Cone-beam computed tomography (CBCT) was performed in 47 Japanese, Korean, and Egyptian people over the age of 18 for orthodontic diagnosis. The amount of deviation of Menton (Me) from the reference plane in the middle of the face was targeted at 4 mm or more. The side where Me exists was defined as the deviated side, and the opposite side was defined as the non-deviated side. The measurement items were condylar length, condylar width, and condylar height. The deviated and non-deviated sides were compared. Results: Statistically significant differences were found in the condylar length and condylar height (p < 0.05, p < 0.000, respectively). The factors involved in this significant difference were also examined. Condylar length was defined as the anteroposterior skeletal pattern between Class III and Class II. Conclusion: Patients with mandibular asymmetry have a condylar size difference between the deviated and nondeviated sides. This right – left difference was suggested to be related to the anteroposterior skeletal pattern. [ABSTRACT FROM AUTHOR]

Objectives: Investigate the activity of rhythmic masseter muscles activity (RMMA) during sleep in patients with dentofacial deformities. Materials and methods: Fifty patients with dentofacial deformities (16 male, 34 female) who required orthognathic surgery. An electrode was attached to the masseter muscle bilaterally, and preoperative polysomnography was performed. The frequency of RMMA onset per hour was measured on the left and the right sides. Values were classified as phasic (grinding: P-RMMA) and tonic (clenching: T-RMMA) to examine the onset of RMMA. Correlation between the RMMA index and various morphological and physical factors were determined including sleep or awake, rapid eye movement (REM), non-rapid eye movement (NREM) phases (NR1-NR4) in the sleep stage, phasic and tonic, gender, and mandibular asymmetry. Results: The RMMA index values at the time of sleep were significantly small than during awake. The values were significantly higher during the NREM sleep than during the REM sleep and were the highest in the NR1 phase. P-RMMA index was significantly higher than the T-RMMA index. The P-RMMA index was also significantly higher than the T-RMMA index for men. In patients with greater asymmetry in the RMMA index values between the left and the right side (more than 30% difference), deviation between the midpoint of the maxillary and the mandibular incisal edges (U1-L1 deviation) was significantly higher. Conclusion: RMMA in patients with dentofacial deformity was statistically higher in awake than sleep, higher in NREM sleep than REM sleep, higher in male than female on grinding, and higher in upper and lower incisor high deviation. [ABSTRACT FROM AUTHOR]

Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The aim of our cross-sectional study is to determine whether there is a link between sex, skeletal class and mandibular asymmetry in orthodontic patients, with tooth length and asymmetry in tooth length on contralateral sides of the mandible. Methods: As the source for relevant data to answer this question, 3D cone-beam tomography (CBCT) images of a total of 95 future orthodontic patients were retrospectively selected from private practice records and were analyzed. The CBCT images were part of routine orthodontic diagnosis. Patients were divided into three groups (Class I, Class III with asymmetry and Class III without asymmetry) based on skeletal variables assessed on orthodontic cephalometric images and frontal photos of the face. Three null hypotheses were developed, and a series of statistical tests was performed in order to support or reject them. Results: We have established that there exists a sexual dimorphism in some of the teeth's lengths in our sample. Furthermore, we failed to find a link between mandibular asymmetry and asymmetry in tooth length. We have also found a link between skeletal class and tooth length differences in some of the analyzed measurements. Conclusions: Computational models used to design orthodontic appliances and to plan orthodontic treatment should be more individualized to consider a patient's sex and skeletal class. [ABSTRACT FROM AUTHOR]

Objectives: To determine normal mandibular linear values in three vertical groups, to compare right and left side to highlight a prevalent pattern towards mandibular asymettry. Methods: This is a descriptive cross sectional study in which pre-orthodontic treatment panoramic radiographs and lateral cephalograms of 224 patients (between 18 to 34 years) undergoing treatment in Orthodontic Department of Bahria University Medical and Dental College were used and traced on an acetate sheet. There were 74 patients in high angle, 76 and 78 in low angle and normal angle group respectively based on their vertical growth pattern using SNMP angle. Condylar height (CH) and Ramal height (RH), and condylar plus ramal height (CH+RH) measurements were done as previously described by Habets. Results: There was no statistically significant difference between the three groups as determined by one way ANOVA. Condylar height and Gonial angle showed statistically significant difference when right and left side was compared, with increased values on the right side. Conclusion: There was no statistically significant difference in condylar, ramal, and total asymmetry index between different vertical groups. Between the right and left sides, condylar height and gonial angles were significantly increased on the right side. However, Ramal height showed no significant difference. Ramal index has a strong linear correlation with total asymmetry index. [ABSTRACT FROM AUTHOR]

Facial asymmetry is a feature that occurs to a greater or lesser extent in the general population. As its severity is usually slight, facial asymmetry may not be noticeable to the patient. However, there are cases when severe facial asymmetry not only affects the facial aesthetics by distorting facial proportions, but also contributes to problems related to the function of the stomatognathic system. The nodal signalling pathway appears to be of particular importance in the process of mandibular asymmetry, as it affects not only structures formed from the first pharyngeal arch, but also other organs, such as the heart and lungs. Following the evaluation of the available literature, the inheritance of mandibular asymmetry is a very complex and multifactorial process, and the genes whose altered expression appears to be a more important potential aetiological factor for asymmetry include PITX2, ACTN3, ENPP1 and ESR1. This systematic review attempts to systematise the available literature concerning the impact of signalling pathway disruption, including the disruption of the nodal signalling pathway, on the development of mandibular asymmetry. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the difference in prevalence of temporomandibular disorder (TMD) before and after orthognathic surgery (OGS), particularly in patients with mandibular asymmetry. A prospective cohort study of patients undergoing corrective orthognathic surgery was conducted. Pre-operative and post-operative (3 months, 6 months and 1 year) TMD assessment were performed according to the Diagnostic Criteria for TMD (DC/TMD) protocol. 64 patients were included in the study. Overall, there was a significant reduction of 26.5% in TMD prevalence from 60.9% pre-operatively to 34.4% 1-year post-operatively (p = 0.003). In all, 37.5% of patients had their TMD condition treated, 50% had no change in their symptoms while 12.5% experienced a worsening of their symptoms. No significant difference in terms of change in TMJ status was observed among the different ramus procedures, the type and magnitude of mandibular movement, skeletal class, and presence of mandibular asymmetry. In conclusion, it appears that corrective orthognathic surgery for dentofacial deformities might provide a secondary benefit of treating TMD. However, surgeons have to be aware that a small percentage of patients might experience a deterioration of their TMD condition, and that those who were previously asymptomatic may develop TMD symptoms after surgery. [ABSTRACT FROM AUTHOR]

Objectives: Various methods have been used to classify class III asymmetry. There is little information on the use of an asymmetry index to examine soft tissue changes and outcomes for patients with class III asymmetry. This study aimed to (1) evaluate soft tissue changes and outcomes for three types of mandibular asymmetry and (2) determine if measures are associated with type of asymmetry. Materials and methods: Adults who consecutively underwent bimaxillary surgery using surgery-first approach for correction of class III asymmetry were divided into three groups based on type of mandibular asymmetry. This previously reported classification system is simple and mutually independent, categorizing mandibular asymmetry according to the amount and direction of ramus asymmetry relative to menton deviation: patients with a larger transverse ramus distance on the menton deviation side were divided into group 1 and group 2; group 1 (n = 45) exhibited a menton deviation larger than ramus discrepancy; group 2 (n = 11) exhibited a menton deviation less than ramus discrepancy; group 3 (n = 22) had larger transverse ramus distance contralateral to the side of the menton deviation. Soft tissue facial asymmetry indices, calculated from cone beam computed tomography images, assessed midline and contour asymmetry presurgery, changes postsurgery, and outcomes. Results: Compared with groups 1 and 2, the presurgery index for contour and midline asymmetry was smallest for group 3. All the three groups had significant improvement in midline asymmetry postsurgery, and outcome measures were good; there were no differences between groups. However, contour asymmetry only improved significantly for groups 1 and 2. The outcome for contour asymmetry was fair for groups 1 and 3 and poor for group 2. Conclusions: Bimaxillary surgery significantly improved facial midline asymmetry. The type of mandibular asymmetry was associated with postsurgical changes and outcomes for contour asymmetry. Clinical relevance: Understanding the types of mandibular asymmetry could help clinicians to develop treatment plans and predict treatment changes and outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Clinical Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This systematic review aimed to investigate the correlation between mandibular asymmetry and temporomandibular disorders (TMDs). Materials and Methods: A systematic search of the published literature was performed in electronic databases such as PubMed (MEDLINE), Scopus, Web of Science, Cochrane, Google Scholar, Clinicaltrials.gov, and Saudi Digital Library. Gray literature was searched through System for Information on Grey Literature through OpenGrey. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed in the investigation. The focussed question according to PICO format was: "does the mandibular asymmetry contribute to temporomandibular disorders"? Eligibility criteria included clinical trials (CTs), observation studies, cross-sectional and cohort studies in English that investigated mandibular asymmetries and TMD among patients. Blind and duplicate study selection, data extraction, and risk of bias assessment were carried out. Results: The initial search resulted in 1906 articles, of which 11 (8 CTs, 1 cross-sectional, 1 retrospective, and 1 observational) studies were selected for qualitative synthesis after fulfilling the eligibility criteria. Conclusion: Most of the studies included in this review showed either very high risk or high risk of bias. Despite the low certainty of evidence, the current study indicated a likely relationship between mandibular asymmetries and TMDs. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to investigate mandibular asymmetry as a possible etiopathologic factor in temporomandibular disorder (TMD). Materials and methods: A prospective cross-sectional study of patients with dentofacial deformities seeking corrective orthognathic surgery was conducted. The pre-operative prevalence of TMD in patients with mandibular asymmetry and other dentofacial deformities was assessed using the Diagnostic Criteria for TMD (DC/TMD) Axis I protocol. Results: A total of 134 patients were recruited – 82 with mandibular asymmetry and 52 without. There was a significantly higher prevalence of TMD in those with mandibular asymmetry (67.1%; 95% CI 59 to 75%) compared to those without (40.4%; 95% CI 32 to 49%, p = 0.002). The overall pre-operative prevalence of TMD in this population of patients was 56.7% (95% CI 48 to 65%). Pain disorder only was present in 9.7%, TMJ disorder only in 29.9%, and both pain and TMJ disorders in 17.2%. The most prevalent type of TMD is disc displacement with reduction (77.6%), followed by myalgia (35.5%) and arthralgia (21.1%). Conclusion: The prevalence of TMD in those with mandibular asymmetry was significantly higher than those without, suggesting that mandibular asymmetry could be a possible etiopathologic factor in TMD. Clinical relevance: The significantly higher prevalence of temporomandibular disorder in those with mandibular asymmetry suggests that we need to be especially cognizant of this condition in our pre-operative, surgical, and post-operative management of this group of orthognathic patients. [ABSTRACT FROM AUTHOR]

The aimed of study to analysis the IGF-1 rs5742632 Single-nucleotide polymorphisms (SNPs) based on the severity of mandibular asymmetry. This is a cross-sectional study of genotypefenotype study of IGF-1 rs5742632 SNPs and mandibular asymmetry. There were 60 pretreatment adult orthodontic medical record that was included in this study. The mandibular asymmetry was measured in panoramic radiographs with Lemos method. The SNPs of IGF-1 rs5742632 analysis was performed based on polymerase chain reaction – restriction fragment polymorphisms (PCR-RFLP). The test of genotype distribution and allele frequency for significance by using the Chi square- test followed by Hardy-Weinberg Equilibrium calculation. There were twenty subjects (33.3%) of TT, eleven subjects (18.33%) of CC, and twenty nine subjects (48.33%) of TC with the meant age of 21.71 ± 2.31 year old. There was a significant difference (p<0.05) IGF-1 rs5742632 polymorphism among light, moderate, and severe mandibular asymmetry. The analysis framework of modeling mandibular asymmetry severity from DNA polymorphism can contribute the assessment of feasibility and psychological acceptability the genetic screening to change clinician’s management mindset in the orthodontics primary care setting. [ABSTRACT FROM AUTHOR]

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)