Evaluation of the trabecular structure of the mandibular condyles by fractal analysis in patients with different dentofacial skeletal patterns

Objective: An orthodontic malocclusion may affect the temporomandibular joint structures in susceptible individuals. This study aims to investigate the bone density of the mandibular condyles in patients presenting with different dentofacial skeletal patterns.

Methods: Panoramic radiographs of 200 randomly selected patients with a skeletal and dental Class I, Class II division 1, Class II division 2 and Class III malocclusion were evaluated. Bone density of the right and left mandibular condyles was measured using fractal analysis.

Results: No significant difference was detected between the right and left condyles in the various malocclusion groups. However, post-hoc tests showed that Class I patients had significantly higher FD values than Class III and Class II division 1 patients in both right and left condyles following intergroup comparisons. The only significant difference between the genders was detected in the left condyle of Class II division 1 patients, as male patients were found to have significantly higher FD values than females.

Conclusions: The results of the present study showed that Class II division 1 and Class III patients displayed significantly lower fractal dimension (FD) values in their mandibular condyles when compared to Class I patients. This might be associated with the possible presence of a temporomandibular disorder in Class II division I patients which resulted in changes to condylar structure, and with less bone complexity in the temporomandibular joint of older Class III patients likely due to continued condylar growth.