Exploring the effect of disc displacement on the risk and severity of condylar erosion in adult temporomandibular disorder patients: A CBCT and MRI study.

OBJECTIVE: The objective of the study was to investigate the relationship between types of disc displacement (DD) diagnosed by magnetic resonance imaging (MRI), and the risk (presence or absence) and severity of condylar erosion (CE) graded using cone-beam computed tomography (CBCT) in adult Temporomandibular disorders (TMD) patients. METHODS: A total of 353 TMD patients (283 females, 70 males) underwent MRI scans to categorise DD as normal (NA), anterior displacement with reduction (ADDR), or anterior displacement without reduction (ADDNR). CE severity was graded on a scale of 0-3 (absence, mild, moderate or severe) using CBCT. To establish the plausibility and cut-off points for CE diagnosis, the severity of CE was then further divided into three classifications: Grade 0 versus 1 + 2 + 3; Grades 0 + 1 versus 2 + 3; Grades 0 + 1 + 2 versus 3. Logistic regression analysis was performed, adjusting for age, gender and joint correlation. RESULTS: ADDNR significantly increased the risk of CE compared with NA (OR = 10.04, 95% CI: [6.41, 15.73]) and showed a significant increase in CE severity across all classifications (ORs = 10.04-18.95). The effects of ADDNR were significant in both genders (p < .001) and had a greater impact in females. ADDR was predominantly associated with mild CE. CONCLUSIONS: ADDNR significantly increased the risk and severity of CE independent of gender when compared to NA, whereas ADDR was mainly associated with mild CE. Slight cortical discontinuity may represent a subclinical diagnosis requiring further investigation.

Effect of orthodontic treatment with premolar extractions on occlusal planes: A retrospective study.

OBJECTIVE: To figure out whether premolar extractions treatment would influence the cant of the occlusal planes and thus affect dentoskeletal patterns in patients with different types of malocclusions. MATERIALS AND METHODS: A total of 140 post-orthodontic treatment subjects (96 females, 44 males) were included in this study, and their lateral cephalograms and demographic information were collected and analysed. The patients were divided into extraction and non-extraction groups. The ANB, SNA, SNB, Wits, Facial Height Index (FHI), SN-MP, SN-AOP, SN-POP and AOP-POP angle were measured on the cephalograms. Other possible confounding factors were recorded. Data were analysed by univariate analysis, stratified analysis, multivariate analysis, and coefficient analysis. RESULTS: After treatment, the changes in the AOP-SN, POP-SN and AOP-POP angle were statistically different between the extraction and non-extraction groups. The results were consistent in different skeletal malocclusions and extent of crowding according to stratified analysis. After adjusting all confounding factors, the cant of the posterior occlusal plane was flattened further by 2.14 degrees in the extraction group than the non-extraction group after orthodontic treatment, and the AOP-SN and AOP-POP angle would further increase by 1.72 and 3.81 degrees, respectively. Although no significant differences were found between the two groups, the SNA, ANB, and Wits in the extraction group decreased more with increased counterclockwise rotation of the mandible. CONCLUSION: Compared to the non-extraction group, there were more increases in the AOP-SN and AOP-POP angle and more posterior flattening in patients with four premolar extractions despite different types of dentoskeletal malocclusion, which were correlated to the change of variables in sagittal and vertical dimensions such as Wits and FHI.