Dreidimensionale Morphometrie des Kiefergelenks und der Mandibula in Relation zum Gesichtsschädelaufbau
Three-dimensional morphometry of the temporomandibular joint and mandible in relation to the skeletal pattern
von Carolin Alena Olbrisch
Datum der mündl. Prüfung:2022-11-08
Erschienen:2022-11-04
Betreuer:Prof. Dr. Philipp Franz Meyer-Marcotty
Gutachter:Prof. Dr. Philipp Franz Meyer-Marcotty
Gutachter:Prof. Dr. Nikolaus Gersdorff
Dateien
Name:eDiss_Olbrisch_Carolin.pdf
Size:2.69Mb
Format:PDF
Zusammenfassung
Englisch
Aim of the study: The aim of this study was to analyse the temporomandibular joint and mandibular morphology in relation to the skeletal pattern in an adult patient cohort three-dimensionally. Methods: The analysis was based on 3D models of the skull of 111 patients (49 female, 62 male; mean age 27 years ± 10.2 years) generated from CT/DVT data. Morphology of 1) the temporomandibular joint and 2) the mandible was assessed linear, angular, and volumetric. Skeletal pattern was classified a) in the transversal dimension into symmetrical, moderately asymmetrical and severely asymmetrical, b) in the sagittal dimension into class I, II and III and c) in the vertical dimension into hyperdivergent, hypodivergent and neutral. Results: 1a) Severely asymmetric patients showed a greater bilateral difference in condyle/mandible volume than symmetric and moderately asymmetric patients and condyle/mandible volume proved to be a suitable predictor of the degree of asymmetry. 1b) Class III patients showed thinner, higher, lower anterior-posterior and mesio-lateral inclination, more voluminous condyles, and reduced joint space than Class II patients and condyle depth, condyle inclination anterior-posterior and mesio-laterally, and condyle/mandible volume were found to be suitable predictors of sagittal skeletal pattern. 1c) Hypodivergent patients showed thicker, wider, more mesio-laterally inclined, more voluminous condyles, and increased joint space than hyperdivergent patients and condyle width and antero-posterior inclination were found to be suitable predictors of vertical skeletal pattern. 2a) There was no correlation between mandibular morphology and transversal skeletal pattern. 2b) Class III patients had narrower rami, longer corpora, smaller ramus and body angle, and larger mandibular angle than Class II patients and ramus and body angle were found to be suitable predictors of sagittal skeletal pattern. 2c) Hypodivergent patients had higher and wider rami, smaller gonial and body angle, larger ramus/mandibular volume, and smaller corpus/mandibular volume. Body angle, gonial angle, and corpus/mandibular volume were found to be suitable predictors of vertical skeletal pattern. Conclusion: Based on the present three-dimensional study, a comprehensive overview of the natural morphological variability of the temporomandibular joint and mandible in adults was provided and their correlation with the skeletal pattern in all three dimensions was demonstrated. The newly obtained information could improve treatment planning in patients with skeletal malocclusion and help identifying temporomandibular joint pathologies. In addition, this information provide an essential basis for further studies, for example, on the etiology of skeletal malocclusions.
Keywords: temporomandibular joint; mandible; skeletal pattern; 3D cephalometry; CBCT