Bone Changes in the Condylar Process of the Mandible in Computed Tomography Images and Cephalogram in a Female Patient during a Growth Spurt Treated with a Removable Functional Appliance

Abstract

Introduction. Functional treatment is the type of treatment preferred in young patients with lateral bite because it leads to simultaneous improvement of occlusion and facial profile. Objective. The aim of this study is to assess bone changes within the condylar process of the mandible and to associate them with the changes observed in the analysis of lateral cephalograms and in the patient’s occlusion. Materials and Methods. Cone beam tomography of the temporomandibular joint, lateral radiogram of the skull, was performed at the beginning of treatment and after one year of therapy. Changes in cephalometric radiograms were evaluated by analyzing them and shown by making superimposition and staining layers. For the purpose of assessing bone changes within the condylar process, digital 3D solids of these processes were generated using data from computed tomography. Results. Correction towards Angle’s dental class I, overjet reduction from 8 mm to 3 mm, and improvement of the patient’s profile were obtained. A rotation of the occlusal plane and improvement in an ANB by 1° and in the WITS measurement by 2.7 mm were observed. A growth of the condylar processes “backwards” and “upwards” was also observed, as well as a change of their shape and volume. Conclusions. The obtained results suggest that the patient’s significant improvement in occlusal conditions is due to posterior growth stimulation of the condylar processes of the mandible. The results confirm the validity of using this treatment technique in the case of growing children with complete posterior occlusion.