Correlation of Facial Form with Temporomandibular Joint-Space Dimensions: A CBCT-Based Cross-Sectional Study

Abstract

Introduction: The relationship between facial form and temporomandibular joint (TMJ) joint-space dimensions remains unclear, particularly regarding variation across different facial shapes. Cone-beam computed tomography (CBCT) provides accurate three-dimensional evaluation of TMJ structures and allows precise assessment of joint-space dimensions. This study aimed to evaluate the association between facial form and TMJ joint-space dimensions (anterior, superior, and posterior) using CBCT. Materials and Methods: This cross-sectional study included 69 adults aged 18–50 years with complete permanent dentition and no signs of temporomandibular disorders based on the Fonseca Index. Facial form was classified as round, oval, or square using standardized two-dimensional photography and an algorithm-based facial classification method (Fisherface-based analysis). CBCT images were obtained using a standardized TMJ protocol, and anterior, superior, and posterior joint spaces were measured bilaterally. Statistical comparisons were performed using ANOVA or Kruskal–Wallis tests (p < 0.05). Results: Most joint-space dimensions showed no significant differences among facial forms. A significant variation was observed only in the left posterior joint space (p = 0.002), where round-faced individuals exhibited the smallest mean value (2.39 ± 1.64 mm) compared with oval (3.77 ± 2.01 mm) and square (6.01 ± 3.12 mm) facial types. Conclusions: Facial form demonstrated minimal influence on temporomandibular joint joint-space dimensions, with differences observed only in the left posterior compartment. These findings suggest that facial-shape assessment may have limited but potentially complementary value in TMJ evaluation. However, the clinical implications should be interpreted cautiously given the predominantly non-significant findings.

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