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Condylar Changes in Patients after Orthodontic Treatment - A Retrospective Panoramic Study from Chennai, India

BACKGROUND Idiopathic condylar resorption (ICR) is a progressive, extensive loss of condylar resorption with or without temporomandibular joint (TMJ) symptoms. Orthodontic treatment causes abnormal joint loading, thus sustained physical stress to the articular surface of TMJ when exceeds adaptive capacity leads to dysfunctional remodelling of the mandible. Condylar changes were not assessed both during pre and post orthodontic treatment. The purpose of this study was to assess the condylar changes following orthodontic treatment using orthopantomogram (OPG). METHODS This retrospective study was conducted in a university dental hospital setting covering patients visiting for orthodontic treatment from October 2020 to February 2021. Analysis of pre-operative and post-operative OPG’s of patients who have undergone orthodontic treatment was done. Morphologic changes of condyle were recorded using idiopathic condylar resorption subgroups classification. The statistical software used for analysis was IBM Statistical Package for Social Sciences (SPSS 23) and a paired t test was used to assess the pre-operative and postoperative condylar changes. RESULTS 50 condyles of 25 patients (right and left side) ranging from 11 - 40 years of age were evaluated pre and post orthodontic treatment. Female predilection (60 %) with phenotype 1 (44 % - right; 44 % - left) being more common and left condyle most commonly affected. The mean and S.D. of the right side were - 680 and 0.748 respectively (P value 0.000) and left side values were - 800 and 1.118 respectively which was also statistically significant (P value 0.002). CONCLUSIONS ICR is the result of many predisposing and contributory factors and an accurate and timely diagnosis of this pathology is essential in dental practice. The available literature confirms the presence of condylar changes after orthodontic therapy, however more evidence-based high-quality clinical trials with detailed design and long-term follow-up periods need to be conducted yet in order to gain more insight and knowledge on the onset and progression of this pathology. KEY WORDS Idiopathic Condylar Resorption (ICR), Temporomandibular Joint (TMJ), Orthodontic Treatment