Background and aims: To asses, by using the Cone Beam CT (CBCT) reformatted images, the presence of anatomical variants of the sinonasal cavities and to determine the correlation of these variations with the onset of maxillary sinus inflammations.Method: The study is a retrospective one and consists of the investigation of 130 patients with CBCT imaging, patients that were referred to the Maxillo-Facial Clinic, Radiology Department of the Iuliu Hatieganu University of Medicine and Pharmacy in Cluj-Napoca, for clinical symptoms of sinusitis within a period of 24 months. The images were analyzed for the presence of different anatomical variations and sinus inflammation. The CBCT images were obtained using a NewTom 3G scanner and the data acquired were statistically analyzed using Chi-square test, Odds ratio data and confidence intervals, with a determined p<0.05 considered to be statistically significant.Results: The anatomical variants were detected both in the inflammation and control group. From the spectrum of variations concha bullosa, deviation of uncinate process and asymmetrical ethmoid roof presented significant association with sinusitis. The deviated position of the uncinate process appeared in more than 50% of patients in the positive group [OR=2.55] compared with a third of the control group. Concha bullosa was observed in 31% cases, 23% in the control group and 34% in the positive group [OR=1.73]. Haller cells showed a small difference between groups [OR=1.14] whereas the ethmoid roof asymmetry was evidently more prevalent in the inflammation group.Conclusion: The anatomical variants of the paranasal sinuses are not incidental, being found in a large number of patients and may be a predisposing factor in the onset and recurrence of sinuses inflammation. The CBCT technique, due to the finest multiplanar reconstruction, permits a very good pre-therapeutic assessment of these predisposing conditions.

This study aimed at evaluating the mandibular condyle position changes before and after bimaxillary orthognathic surgery in class II and III malocclusion patients. CBCT scans from patients who underwent bimaxillary orthognathic surgery were analyzed: Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). Both condyles were independently assessed for their largest anterior and posterior joint spaces, smallest medial joint spaces, and condyle angles concerning the transverse line. In the sagittal plane, the minimum size of the anterior and posterior joint spaces was measured. In the coronal plane, the smallest medial joint space was measured. The position of the condyle within the glenoid fossa was determined before and after surgery. A total of 56 TMJs from 28 patients were studied. Following orthognathic surgery, the anterior and posterior space in class II increased. Postoperatively, the anterior joint space in class III decreased. In 42.85% of malocclusion class II patients and 57.14% of malocclusion class III patients, the pre-and post-surgical position of the condyle changed, the condyle was anteriorly positioned (42.85%) in class II patients and centrically positioned (71.4%) in class III patients. Significant changes in the joint space, condylar position, and condyle angle were found in the class II and class III subjects.

Occlusal splints are used as a non-invasive treatment for patients diagnosed with temporomandibular disorders (TMD). Another non-invasive treatment option for TMD patients is kinesiotherapy, which may be used alone or in conjunction with occlusal splint therapy. The aim of this study was to evaluate the changes in the intra-articular spaces of the temporomandibular joint (TMJ) after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients. Twenty-four patients (N = 24) diagnosed with TMD according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were included. Cone beam computed tomography (CBCT) images were taken before and after treatment. The anterior, superior, posterior, and medial joint spaces were measured on the CBCT images, and the condylar ratio was calculated using Pullinger and Hollender’s formula. Additionally, the thickness of the glenoid fossa (GFT), condylar medio-lateral widths (MLW), and condylar height (HCo) were measured. The condylar ratio was significantly higher after treatment (p = 0.049). The changes in dimensions of the anterior, superior, posterior and medial joint spaces were not statistically significant after treatment. No statistically significant differences were found in the dimensions of the GFT, MLW, and HCo post treatment. The condylar position did not shift anteriorly in a statistically significant way after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients.