alexa Evaluation of Condylar and Ramal Asymmetry on Patients with Ectodermal Dysplasia | OMICS International
ISSN: 2161-1122
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Evaluation of Condylar and Ramal Asymmetry on Patients with Ectodermal Dysplasia

Tümen DS1, Callea M1, Yazgi AY1, Maglione M1, Yavuz I2*, Montanari M2, Tümen EC2, Currà MG3 and Uysal E3

1Department of Orthodontics, Dicle University, Turkey

2Department of Pediatric Dentistry, Dicle University, Turkey

3Department of Technique Programs, Vocational High School, Turkey

*Corresponding Author:
Izzet Yavuz
Department of Pediatric Dentistry
Dicle University, Turkey
Tel: +90 412 248 80
E-mail: [email protected]

Received date: January 29, 2014; Accepted date: July 18, 2014; Published date: July 20, 2014

Citation: Tümen DS, Callea M, Yazgi AY, Maglione M, Yavuz I, et al. (2014) Evaluation of Condylar and Ramal Asymmetry on Patients with Ectodermal Dysplasia. Dentistry 4:249. doi:10.4172/2161-1122.1000249

Copyright: © 2014 Tümen DS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

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Abstract

Objectives: To compare the condylar, ramal, condylar-plus-ramal mandibular asymmetry of patients with ectodermal dysplasia and healthy control subjects with using cone beam computerized tomography (CBCT).
Materials and methods: CBCT of 9 patients (4 girls, 5 boys) with ectodermal dysplasia and 10 healthy control subjects (5 girls and 5 boys) with normal occlusion were included to our study. Mandibular asymmetry index measurements (condylar, ramal, and condylar-plus-ramal) were made on the CBCT. The paired samples t-test was used to establish statistically significant differences between the sides for condylar, ramal and condylar-plus-ramal height measurements. Independent t test was used to determine possible statistically significant differences between the groups.
Results: There was no statistically significant difference between the right and left sides in condylar, ramal and condylar-plus-ramal height measurements of the patients with ectodermal dysplasia and normal occlusion sample. There was no statistically significant difference between the groups in asymmetry index measurements.
Conclusion: Patients with ectodermal dysplasia show similar condylar, ramal, condylar-plus-ramal measurements with healthy control subjects.

Keywords

Condylar and ramal asymmetry; Ectodermal dysplasia

Introduction

Ectodermal dysplasia (ED) is a large and complex group of disorders defined by the abnormal development of two or more structures derived from the ectodermal layer. As a result, HED patients mostly exhibit hypotrichosis, hypohidrosis, and cranial abnormalities. Patients often exhibit a smaller than normal face because of frontal bossing, and a depressed nasal bridge. Oral traits may express themselves as anodontia, hypodontia, and conical teeth. Anodontia also manifests itself by a lack of alveolar ridge development [1].

It has been proven that severe maxillary hypodontia in the permanent dentition, affects the cranial base and mandibular length in ED population [2]. In our study we decided to evaluate mandibular asymmetry due to hypodontia in ED patients (Figure 1).

dentistry-Maxillar-mandibular-hypodontia

Figure 1: Maxillar and mandibular hypodontia in the permanent dentition in ED patients

Aim

Therefore our aim was to compare the condylar, ramal, condylar-plus-ramal mandibular asymmetry of patients with ectodermal dysplasia and healthy control subjects with using cone beam computerized tomography(CBCT).

Material and Methods

CBCT of 9 patients (4 girls, 5 boys) with ectodermal dysplasia and 10 healthy control subjects (5 girls and 5 boys) with normal occlusion were included to our study (Figure 2).

dentistry-CBCT-patient-ectodermal-dysplasia

Figure 2: CBCT of a patient with ectodermal dysplasia

Reference lines were adjusted as following. Vertical line is passing from the most lateral points of condyle. Horizontal line is on the ramus tangent. Then, vertical distances of condyle and ramus were measured. According to Habets et al. [3], measurements were done and asymmetry index was calculated (Figure 3).

dentistry-Mandibular-asymmetry-index

Figure 3: Mandibular asymmetry index measurements (condylar, ramal, and condylar-plus-ramal) were made on the CBCT

The paired samples t-test was used to establish statistically significant differences between the sides for condylar, ramal and condylar-plus-ramal height measurements. Independent t test was used to determine possible statistically significant differences between the groups.

Results

There was no statistically significant difference between the right and left sides in condylar, ramal, and condylar-plus-ramal height measurements of the patients with ectodermal dysplasia and normal occlusion sample. There was no statistically significant difference between the groups in asymmetry index measurements (Table 1 and 2).

    E.D. Normal
Right Left   Right Left  
mean SD mean SD p mean SD mean SD p
Condylar 4,734 1,0915 5,152 1,3761 NS 5,180 0,8189 5,312 1,0097 NS
Ramal 39,832 5,2006 40,339 5,4876 NS 37,890 4,5079 38,363 3,7475 NS
Condylar + Ramal 44,567 6,1664 45,602 6,6987 NS 42,970 5,0735 43,675 4,1519 NS

Table 1: Statistically side comparisons of 2 groups

Asymmetry Index Group Mean SD p
CAI E.D. 6,909 6,1475 NS
NORMAL 3,874 3,6265
RAI E.D. 1,587 1,1416 NS
NORMAL 2,174 1,4654
CRAI E.D. 1,668 1,6199 NS
NORMAL 2,070 1,0870

Table 2: Descriptive statistics and comparisons of mandibular asymmetry index values of the 2 groups

Discussion

The first aim of this study was to compare the condy, ramal, condylar-plus-ramal mandibular asymmetry of patients with ectodermal dysplasia and sound patients.

Previous studies evaluated mandibular asymmetry in various malocclusion patterns [4-6].

These studies made their measurements on posteroanterior radiographies but they had some limitations of methodology and reliability [7].

Literature suggests that CBCT is more accurate in image description. In the present study CBCT was used in order to the reduce visualization techniques errors [8].

Several studies documented asymmetries in condylar position in the fossa in unilateral posterior crossbite children [9,10]. There was no significant difference between the sides in in our results. This contrasting result might be caused by sample selection. Most of our patients don’t have unilateral posterior crossbite.

Sezgin et al. [11] found that Class II/1 malocclusion has a significant effect on condylar asymmetry index when compared to Class II/2 and Class III malocclusion and normal occlusion types.

Our findings contradict with this study. In effect it is known that one of the main oral features of ED children is Class III malocclusion [1].

Conclusion

In effect it is known that one of the main oral features of ED children is Class III malocclusion but at the patients with ectodermal dysplasia show similar condylar, ramal, condylar-plus-ramal measurements with healthy control subjects.

This aspect has need to further studies for confirm results obtained in the present study.

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