{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T11:12:29Z","timestamp":1784805149407,"version":"3.55.0"},"reference-count":34,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This cross-sectional analytical study investigated the relationship between the craniofacial morphology, condylar displacement, and degenerative changes in the temporomandibular joints (TMJs) in adult patients with class II skeletal malocclusion. To compare cephalometric variables, joint space dimensions, and centric slide measurements between patients with and without CBCT-confirmed TMJ degenerative alterations. Methods: Sixty adults with class II malocclusion were divided into two equal groups (n = 30) based on the presence or absence of TMJ degenerative changes on CBCT. Joint spaces were measured, condylar displacement was evaluated using a condylar position indicator (CPI), and cephalometric analysis was performed in both maximal intercuspation and centric relation. Statistical comparisons were performed using t-tests, chi-squared tests, and Pearson\u2019s correlation analysis. Significance was set at p &lt; 0.05. Results: Patients with degenerative TMJ changes exhibited significantly greater overjet (p = 0.0001) and a trend toward increased ANB angles (p = 0.055). The superior joint space was reduced on the right side (p = 0.031). Condylar displacements \u2265 2 mm were more frequent in the affected group and correlated with sagittal cephalometric discrepancies (45% vs. 24% in controls). Conclusions: Aggravated skeletal class II malocclusion with increased overjet could be associated with TMJ degenerative changes. CR-based cephalometry and CBCT evaluation may aid in diagnostic assessment, but longitudinal studies are needed to confirm the clinical relevance.<\/jats:p>","DOI":"10.3390\/jcm14134499","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T05:53:13Z","timestamp":1750917193000},"page":"4499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Influence of Maxillofacial Morphology on Temporomandibular Joint Degenerative Alterations and Condyle Position Assessed by CBCT in Class II Malocclusion Adult Patients\u2014A Cross-Sectional Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Sebastian","family":"Dygas","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Medical University of Bialystok, 15-274 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izabela","family":"Szarmach","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Medical University of Bialystok, 15-274 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3453-2585","authenticated-orcid":false,"given":"Ilona","family":"Radej","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Medical University of Bialystok, 15-274 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Chaqu\u00e9s-Asensi","sequence":"additional","affiliation":[{"name":"Independent Researcher, 41009 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref_1","first-page":"211","article-title":"Reproducibility of the centric relation bite registration technique","volume":"64","author":"Wood","year":"1994","journal-title":"Angle Orthod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/S0889-5406(95)70146-X","article-title":"A three-dimensional comparison of condylar position changes between centric relation and centric occlusion using the mandibular position indicator","volume":"107","author":"Utt","year":"1995","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_3","first-page":"295","article-title":"The difference in condylar position between centric relation and centric occlusion in pretreatment Japanese orthodontic patients","volume":"72","author":"Hidaka","year":"2002","journal-title":"Angle Orthod."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1177\/154405910808700406","article-title":"Degenerative disorders of the temporomandibular joint: Etiology, diagnosis, and treatment","volume":"87","author":"Tanaka","year":"2008","journal-title":"J. Dent. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1439203","DOI":"10.1155\/2022\/1439203","article-title":"The Role of Maxillofacial Structure on Condylar Displacement in Maximum Intercuspation and Centric Relation","volume":"2022","author":"Radej","year":"2022","journal-title":"BioMed Res. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1179\/crn.2012.018","article-title":"The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms","volume":"30","author":"Ballesteros","year":"2012","journal-title":"Cranio"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1016\/j.ijom.2012.03.006","article-title":"The prevalence of TMJ osteoarthritis in asymptomatic patients with dentofacial deformities: A cone-beam CT study","volume":"41","author":"Krisjane","year":"2012","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1259\/dmfr\/17815139","article-title":"Evaluation of bone changes in the temporomandibular joint using cone beam CT","volume":"41","author":"Freire","year":"2012","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_9","first-page":"118","article-title":"Skeletal pattern in subjects with temporomandibular joint disorders","volume":"9","author":"Bran","year":"2013","journal-title":"Arch. Med. Sci."},{"key":"ref_10","unstructured":"Okeson, J. (2014). Management of Temporomandibular Disorder and Occlusion, Elsevier. [7th ed.]."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e0139743","DOI":"10.1371\/journal.pone.0139743","article-title":"Cephalometric Analysis of the Facial Skeletal Morphology of Female Patients Exhibiting Skeletal Class II Deformity with and without Temporomandibular Joint Osteoarthrosis","volume":"10","author":"Chen","year":"2015","journal-title":"PLoS ONE"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/s00056-016-0039-z","article-title":"Correlation between condylar position and different sagittal skeletal facial types","volume":"77","author":"Paknahad","year":"2016","journal-title":"J. Orofac. Orthop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/ocr.12454","article-title":"The relation of cephalometric features to internal derangements of the temporomandibular joint: A systematic review and meta-analysis of observational studies","volume":"24","author":"Shu","year":"2021","journal-title":"Orthod. Craniofac. Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pascu, L., Haiduc, R.-S., Alm\u0103\u0219an, O., and Leucu\u021ba, D.-C. (2025). Occlusion and Temporomandibular Disorders: A Scoping Review. Medicina, 61.","DOI":"10.3390\/medicina61050791"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1186\/s12903-023-03210-9","article-title":"Three-dimensional spatial analysis of the temporomandibular joint in adult patients with Class II division 2 malocclusion before and after orthodontic treatment: A retrospective study","volume":"23","author":"Zheng","year":"2023","journal-title":"BMC Oral Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12903-023-03728-y","article-title":"Three-dimensional evaluation of condylar morphology after orthodontic treatment in adult patients with Class II malocclusion by cone-beam computed tomography","volume":"24","author":"Shi","year":"2024","journal-title":"BMC Oral Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.ajodo.2003.08.029","article-title":"Cephalometric keys to internal derangement of temporomandibular joint in women with Class II malocclusions","volume":"126","author":"Ahn","year":"2004","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_18","first-page":"e1","article-title":"How a Discrepancy Between Centric Relation and Maximum Intercuspation Alters Cephalometric and Condylar Measurements","volume":"41","author":"Ferreira","year":"2020","journal-title":"Compend. Contin. Educ. Dent."},{"key":"ref_19","first-page":"e75597","article-title":"Volumetric Comparison of the Temporomandibular Joint Space in Skeletal Class I and II Patients Using Cone-Beam Computed Tomography: A Cross-Sectional Study","volume":"16","author":"Das","year":"2024","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1179\/crn.2005.036","article-title":"Craniofacial morphology and inclination of the posterior slope of the articular eminence in female patients with and without condylar bone change","volume":"23","author":"Estomaguio","year":"2005","journal-title":"Cranio"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1186\/s12903-022-02174-6","article-title":"Comprehensive three-dimensional positional and morphological assessment of the temporomandibular joint in different vertical skeletal patterns","volume":"22","author":"ALyafrusee","year":"2022","journal-title":"BMC Oral Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.tripleo.2009.02.023","article-title":"Research diagnostic criteria for temporomandibular disorders (RDC\/TMD): Development of image analysis criteria and examiner reliability for image analysis","volume":"107","author":"Ahmad","year":"2009","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.ajodo.2007.05.021","article-title":"Assessment of optimal condylar position with limited cone-beam computed tomography","volume":"135","author":"Ikeda","year":"2009","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.ijom.2005.04.003","article-title":"Dolphin Imaging Software: An analysis of the accuracy of cephalometric digitization and orthognathic prediction","volume":"34","author":"Power","year":"2005","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1053\/sodo.2003.34031","article-title":"Reproducibility of the roth power centric in determining centric relation","volume":"9","author":"Schmitt","year":"2003","journal-title":"Semin. Orthod."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6863014","DOI":"10.1155\/2022\/6863014","article-title":"Assessment of the Morphology and Degenerative Changes in the Temporomandibular Joint Using CBCT according to the Orthodontic Approach: A Scoping Review","volume":"2022","author":"Dygas","year":"2022","journal-title":"Biomed Res. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"24","DOI":"10.15644\/asc52\/1\/4","article-title":"Reproducibility of the Obtained Centric Relation Records in Patients with Disc Displacement with Reduction","volume":"52","author":"Tariba","year":"2018","journal-title":"Acta Stomatol. Croat."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e060","DOI":"10.1590\/1807-3107bor-2024.vol38.0060","article-title":"Prevalence of condylar morphological changes in individuals with class II malocclusion","volume":"38","author":"Oliveira","year":"2024","journal-title":"Braz. Oral Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1186\/s12903-025-05991-7","article-title":"Relationship between temporomandibular joint space and articular disc displacement","volume":"25","author":"Zhou","year":"2025","journal-title":"BMC Oral Health"},{"key":"ref_30","first-page":"643","article-title":"Dimensional and positional characteristics of the temporomandibular joint of skeletal Class II malocclusion with and without temporomandibular disorders","volume":"22","author":"Alhammadi","year":"2021","journal-title":"J. Contemp. Dent. Pr."},{"key":"ref_31","first-page":"ZE01","article-title":"Is Centric Relation and Centric Occlusion Discrepancy an Enigma? An Orthodontic Perspective","volume":"17","author":"Muthuraman","year":"2023","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"6","DOI":"10.4103\/0976-433X.116823","article-title":"Evaluation of correlation between cephalometric variables and internal derangement of temporomandibular joint in asymptomatic class II division I high angle patients using Helical computed tomography","volume":"4","author":"Kamatchi","year":"2013","journal-title":"SRM J. Res. Dent. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Choi, A., Park, J.H., Bay, C., and Chae, J.-M. (2025). Evaluation of Condyle\u2013Fossa Relationships in Adults with Various Skeletal Patterns Using Cone-Beam Computed Tomography. Appl. Sci., 15.","DOI":"10.3390\/app15020944"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"542","DOI":"10.2319\/0003-3219(2007)077[0542:TIRTMA]2.0.CO;2","article-title":"TMD in relation to malocclusion and orthodontic treatment","volume":"77","author":"Mohlin","year":"2007","journal-title":"Angle Orthod."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/13\/4499\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:58:30Z","timestamp":1760032710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/13\/4499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":34,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["jcm14134499"],"URL":"https:\/\/doi.org\/10.3390\/jcm14134499","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,25]]}}}