An evaluation of condylar and ramal vertical asymmetry in adolescents with unilateral and bilateral posterior crossbite using cone beam computed tomography (CBCT)

The primary purpose was to evaluate condylar and ramal vertical asymmetry in adolescent patients displaying unilateral posterior (UCB) and bilateral posterior crossbite (BCB) malocclusions. A secondary aim was to compare the findings with a matched control group exhibiting normal occlusion (CG) using cone beam computed tomography (CBCT).The study groups consisted of (1) 30 patients (Mean age: 14.49 +/- 1.91 years) with a UCB, (2) 29 patients (Mean age: 14.57 +/- 1.84 years) with a BCB, and (3) 36 patients (Mean age: 14.24 +/- 2.42 years) as a matched control group (CG). Condylar, ramal, condylar-plus-ramal height and index measurements were performed using CBCT images following the method of Habets et al. A paired t-test was performed for side comparison in each group. Oneway ANOVA (Analysis of Variance) was used to determine statistically-significant differences between the groups for asymmetry index measurements and Tukey's HSD test was employed for individual group differences.There was no statistically significant difference in condylar height (CH), ramal height (RH), and condylar plus ramal height (CH + RH) measurements between the right and left sides of the UCB group and CG, except for the RH in the BCB group (p = 0.045). Tukey's HSD test showed that the ramal asymmetry index (RAI) and the condylar plus the ramal asymmetry index (CRAI) were statistically significantly different between the UCB and BCB groups (p = 0.035 and p = 0.015, respectively).Although the condylar asymmetry index (CAI) values were found to be high in the groups of UCB (13.84 +/- 11.33), BCB (9.38 +/- 8.56), and CG (10.58 +/- 9.48), the comparisons amongst the groups were not statistically significant. The asymmetry between the UCB and BCB groups was observed for RAI and CRAI values, rather than CAI values.