Assessment of craniovertebromandibular symmetry using cone-beam computed tomography: validation of a patented three-dimensional diagnostic method

AIM. The aim of the study was to validate a patented three-dimensional method for assessing craniovertebromandibular symmetry using cone-beam computed tomography (CBCT) in patients with temporomandibular joint dysfunction (TMJD).

MATERIALS AND METHODS. Ninety patients (54 females and 36 males), aged 19–60 years, diagnosed with temporomandibular joint dysfunction (TMJD) and exhibiting extraocclusal disorders, were included in the study. A standardized CBCT protocol (FOV ≥ 13 × 15 cm) including the cranial base and cervical vertebrae C₀–C₂ was applied. Three-dimensional cephalometric analysis was performed in coronal, axial, and sagittal planes, measuring angular and linear parameters between cranial, mandibular, and cervical landmarks. Intra-class correlation coefficients (ICC) were calculated to determine reproducibility. Statistical analysis was conducted using paired t-tests, with significance set at p < 0.05.

RESULTS. Asymmetry was observed in 100% of subjects, regardless of clinically symmetrical occlusion. The largest deviations were found in the Zy–Go angular measurement, reflecting predominant cranial-mandibular imbalance. Significant right–left differences were recorded across all reference lines (Zy–Go, Po–U6, C₀–C₁, C₁–C₂) (p < 0.01–0.001). Mean ICC values exceeded 0.90, confirming high methodological reliability.

CONCLUSIONS. It was established that craniovertebromandibular asymmetry occurs in all patients with TMJD and identified extraocclusal disturbances. The developed CBCT-based protocol allows precise quantification of cranio-cervico-mandibular relationships, enhancing diagnostic accuracy and supporting individualized interdisciplinary management of occlusal and postural disturbances.

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