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CBCT and Cephalometric Analysis of the TMJ Complex After Treatment Using a MARA Appliance Melissa Danette Shotell

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CBCT and Cephalometric Analysis of the TMJ Complex After Treatment Using a MARA Appliance Melissa Danette Shotell Loma Linda University TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works Loma Linda University Electronic Theses, Dissertations & Projects 9-2014 CBCT and Cephalometric Analysis of the TMJ Complex after Treatment Using a MARA Appliance Melissa Danette Shotell Follow this and additional works at: http://scholarsrepository.llu.edu/etd Part of the Orthodontics and Orthodontology Commons Recommended Citation Shotell, Melissa Danette, "CBCT and Cephalometric Analysis of the TMJ Complex after Treatment Using a MARA Appliance" (2014). Loma Linda University Electronic Theses, Dissertations & Projects. 220. http://scholarsrepository.llu.edu/etd/220 This Thesis is brought to you for free and open access by TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works. It has been accepted for inclusion in Loma Linda University Electronic Theses, Dissertations & Projects by an authorized administrator of TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works. For more information, please contact [email protected]. LOMA LINDA UNIVERSITY School of Dentistry in conjunction with the Faculty of Graduate Studies _________________________ CBCT and Cephalometric Analysis of the TMJ Complex after Treatment Using a MARA Appliance by Melissa Danette Shotell _________________________ A thesis submitted in partial satisfaction of the requirements for the degree of Master of Science in Orthodontics and Dentofacial Orthopedics _________________________ September 2014 © 2014 Melissa Danette Shotell All Rights Reserved Each person whose signature appears below certifies that this thesis in his opinion is adequate, in scope and quality, as a thesis for the degree Master of Science in Orthodontics and Dentofacial Orthopedics. , Chairperson Joseph Caruso, Professor of Orthodontics Kitichai Rungcharassaeng, Professor of Orthodontics R. David Rynearson, Associate Professor of Orthodontics iii ACKNOWLEDGEMENTS I would like to express my deepest gratitude to my committee members for their guidance and support throughout this study. Dr. Caruso, Dr. Rungcharassaeng, and Dr. Rynearson, thank you for lending your time and expertise to this project, and for encouraging me throughout the process. I would like to thank Dr. William Johnston and Dr. Khaled Bahjri for their work on the statistical analysis of this study. Thank you to Chris Kabot and IBUR Biosystems for their help with the image analysis. iv DEDICATION I dedicate this thesis to my husband Michael Scherer for his support in everything I do. v CONTENTS Approval Page .................................................................................................................... iii Acknowledgements ............................................................................................................ iv Dedication ............................................................................................................................v Table of Contents ............................................................................................................... vi List of Tables ................................................................................................................... vii List of Figures .................................................................................................................. viii List of Abbreviations.......................................................................................................... ix Abstract ............................................................................................................................. xii Chapter 1. Review of literature..................................................................................................1 2. CBCT and cephalometric analysis of the TMJ complex after treatment using a MARA appliance .....................................................................................................7 Abstract ..............................................................................................................7 Introduction ......................................................................................................10 Hypothesis........................................................................................................10 Materials and Methods .................................................................................... 11 Data Collection .......................................................................................... 11 Lateral Cephalometric Images ...................................................................12 3D CBCT Images .......................................................................................15 Metric Analysis of Images ...................................................................16 Mandibular Length ..............................................................................17 Mandibular Condyle Volume ...............................................................17 Sample Size ................................................................................................19 Experimental Control .................................................................................19 Statistical Analysis ....................................................................................19 Results ..............................................................................................................20 Lateral Cephalometric Images ...................................................................21 vi 3D CBCT Images .......................................................................................25 Metric Analysis of Images ...................................................................25 Mandibular Length ..............................................................................27 Mandibular Condyle Volume ...............................................................28 Discussion ........................................................................................................28 Lateral Cephalometric Images ...................................................................29 3D CBCT Images .......................................................................................30 Metric Analysis of Images ...................................................................31 Mandibular Length ..............................................................................32 Mandibular Condyle Volume ...............................................................33 Conclusion .......................................................................................................34 3. Extended Discussion ..............................................................................................36 Study Improvements and Future Directions ....................................................36 References ..........................................................................................................................38 vii TABLES Tables Page 1. Summary of cephalometric measurements ............................................................23 2. Summary of cephalometric statistics .....................................................................24 3. Analysis of the treatment and time effects on MCW in axial plane using Two-way ANOVA .................................................................................................25 4. Analysis of the treatment and time effects on MCW in frontal plane using Two-way ANOVA ................................................................................................25 5. Analysis of the treatment and time effects on MCD in axial plane using Two-way ANOVA ................................................................................................26 6. Analysis of the treatment and time effects on MCD in sagittal plane using Two-way ANOVA ................................................................................................26 7. Analysis of the treatment and time effects on MCH in frontal plane using Two-way ANOVA ................................................................................................27 8. Analysis of the treatment and time effects on MCH in sagittal plane using Two-way ANOVA ................................................................................................27 9. Analysis of the treatment and time effects on Mandibular Length (mm) using Two-way ANOVA ......................................................................................27 10. Analysis of the treatment and time effects on Mandibular Condylar Volume measured in surface area triangles using Two-way ANOVA ..................28 viii FIGURES Figures Page 1. MARA appliance illustration ..................................................................................3 2. MARA appliance illustration ..................................................................................3 3. Measurements on the lateral cephalogram. ............................................................14 4. Detailed measurements of the TMJ complex. ........................................................15 5. Condylar measurements in the axial, frontal and sagittal views. ...........................16 6. Mandibular Length measurement .........................................................................17 7. Mandibular Condyle Volume measurement ...........................................................18 ix ABBREVIATIONS Ba Basion
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