A Study on the Size of TMD Patient's Condyle Head

OBJECTIVE: In many TMD cases, deformed and reduced condyle heads were frequently observed. This study was prepared to compare the dimensions between normal and symptomatic condyles, using MR images. MATERIALS: One hundred and twenty one patients with clinical signs and MRI-confirmed diagnosis of disc displacement were selected for this study. Thirty eight TMJs from nineteen asymptomatic volunteers who had no clinical symptoms and no disc displacement on sagittal and coronal view of MRI, were served as normal. METHODS: Symptomatic condyles were classified according to the severity of the anterior disc displacement. The amount of anterior disc displacement was evaluated at sagittal section, and they were classified into 4 groups as normal(N), little(G0), mild(G1), moderate(G2) and severe displacement(G3). The dimentions of condyle were measured at the 200% magnified view, by digitizing program. All dimensions were compared among each groups on the central section of sagittal and coronal views, and the statistical analysis was performed. RESULTS: The mean value of anteroposterior length of normal condyle was 0.79+/-0.13cm at sagittal section and mediolateral length was 2.12+/-0.22cm on coronal section. The mean value of anteroposterior length of symptomatic condyle was 0.67+/-0.16cm at sagittal section and mediolateral length was 1.97+/-0.28cm on coronal section. CONCLUSIONS: The size of symptomatic condyle was smaller than normal TMJ. The size of condyle was decreased as the amount of the disc displacement was increased. The dimensional change was found on the anterior articular surface of condyle at the mild or moderate disc displacement. And at the case of severe disc displacement, dimensional change was found on the superior articular surface.

THE THREE DIMENSIONAL STRESS ANALYSIS ON VARIOUS DIRECTIONS OF THE MANDIBULAR CONDYLE MOVEMENT BY USING FINITE ELEMENT METHOD

The condyle head of mandible was usually influenced by the stressful forces generated from a voluntary movement of bone fragment after the sagittal ramus osteotomy which would be mainly performed for the mandibular deformity patient. In this study we measured the stress values exerted on condyle and evaluated which area of condyle had a more stress concentration while condyle head moved in X, Y and Z axis by using a 3 dimensional finite element model. The result were as follows: 1. On bodily movement, the value of maximum force was 40.98Kg/cm2 at the (-X) direction and the stress area was the center of superiposterior nonaticular area of the condyle. 2. On ratational movement, the value of maximum force was 173.1Kg/cm2 at the (+Y) direction and the stress area was the anterior area of condyle neck. 3. From the general point of view there were more stress on rotational movement than on bodily movement. 4. The stress concentration area was the condyle head on bodily movement and the condyle neck on ratational movement. 5. From the result of this study. We found out that this results were a correspondence with clinical predictions in which a condyle head got the most stress concentration only when a condyle head in the posterior rotational position during orthognathic surgery. 6. The results of this study show that we should consider not to place the condyle head in the posterior position and posterior rotational position during orthognathic surgery.