Is there a difference between the thicknesses of the rami in mandibular asymmetry?

The purpose of this retrospective study was to investigate whether the thicknesses of the two rami differ in patients with mandibular asymmetry. Preoperative cone beam computed tomography scans of 78 patients with mandibular asymmetry were assessed for ramus thickness, mandibular length, and mandibular shift. The results showed that the ramus was thinner on the longer side than on the shorter side in 85.9% of the patients. On average, the longer side of the mandible was 2.74mm longer (range 0.07-9.90mm, standard deviation 1.92mm) and 0.55mm thinner (range -0.61 to 2.02mm, standard deviation 0.59mm) than the shorter side (both P<0.001). This study indicates a trend in the discrepancy in ramus thickness between the longer and shorter side of about 8% of the mean thickness of the ramus. Regression analysis showed that for every 1-mm increase in the length of the mandible, the thickness of the superior aspect of the ramus was reduced by 0.041 mm (P=0.009) and the anterior aspect by 0.125 mm (P=0.001). Age and sex did not have a significant influence on the thickness of the mandible. It is concluded that the longer side of the mandible tends to be thinner at the ramus than the shorter side in patients with mandibular asymmetry. The implication of this finding could be important in relation to the sagittal split ramus osteotomy.