Assessment of Condylar Shape through Digital Panoramic Radiograph among Nepalese Population: A Proposal for Classification

Abstract

Background. Panoramic radiograph is the first and most commonly advised radiograph for screening of temporomandibular joints/condyles. Different shapes of the mandible have been discussed by various authors with no consensus for a definite classification for condyle shape. This study was conducted with the objective to observe various shapes of condyles, symmetry of bilateral condyles, and variations of condyle shapes among males and females. Materials and Methods. This cross-sectional study was conducted on digital panoramic radiographs available at a tertiary center of Lalitpur from 25.12.2020 to 20.06.2021 after ethical approval from the institutional review board (reference no. 077/078/27). Panoramic radiographs were selected on the basis of inclusion and exclusion criteria, and various shapes of condyles were noted on HP 15 inch flat LED monitor ( $1280\times 1024$ ). The collected data was analyzed using SPSS (chi-square test: a $p$ value of < 0.05 was considered significant). Intra- and interobserver agreement was observed for condylar shapes. Results. Among the selected 850 panoramic radiographs (1700 condyles), most of them, i.e., 1343 (79%), were round/oval, followed by flattened, i.e., 149 (8.76%), diamond/angled, i.e., 93 (5.47%), crooked finger shaped, i.e., 28 (1.6%), and mixed, i.e., 46 (2.7%), and the least common shape observed was bifid, i.e., 40 (2.3%) (18 (2.1%) left condyle and 22 (2.6%) right condyle). Conclusions. Six different types of condyle shapes were noted: type I, oval; type II, flat; type III, diamond; type IV, mixed; type V, bifid; and type VI, crooked finger among the study population of Lalitpur.