Evaluation of mandibular symmetry and morphology in adult patients with unilateral posterior crossbite: a CBCT study using a surface-to-surface matching technique

Abstract

Objectives: To investigate mandibular morphology in adults affected by posterior unilateral crossbite (PUXB) and to evaluate the hemi mandibular volumes from the crossbite (CB) and non-CB sides of the same patients.

Methods: Thirty-eight cone beam computed tomography (CBCT) images were consecutively recruited and the Digital Imaging and Communications in Medicine (DICOM)-formatted scans were volume rendered into a surface three-dimensional (3D) mesh model and volumes to obtain the 3D model of the mandibular bone. To achieve the surface point-to-point analysis of the mandibular models, a reverse engineering software was used. The same procedure was performed for an age-matched control group (19 CBCT images).

Results: Total mandibular volume showed a difference of 2.46 cm3 between patients and controls, which was not statistically significant. A mean difference of 1.53 cm3 was found comparing the hemi mandibular volumes from the CB and non-CB sides of PUXB patients, this difference was statistically significant (P ≤ 0.01). Findings for the surface-to-surface deviation analysis, demonstrated a higher percentage of mismatch in patients PUXB, over 10% at 0.5 mm tolerance level.

Limitations: Limitations are related to the intrinsic surfaces matching methodology, that make difficult to evaluate discrepancies among different mandibular anatomical units.

Conclusion: Adult patients affected by PUXB show a greater mandibular structural asymmetry compared to controls because of a lower matching percentage obtained from the surface-to-surface matching technique.

Implications: Treatment of adult patients affected by PUXB should take into consideration the possibility of a mild mandibular asymmetry mainly localized at the condyle and gonial angle levels.