INTRODUCTIONThe most important and unique joint of the body is temperomandibular joint. Human mandibular condyles may be categorized into five basic types: flattened, convex, angled, rounded and concave. Morphologic changes of condyle occur due to developmental variations, remodeling, various diseases, trauma, endocrine disturbances and radiation therapy. changes in shapes and sizes of condyle also plays an important role in genetic, acquired, functional factors, age groups.
. The appearance of the mandibular condyle varies greatly among different age groups and individuals. Morphologic changes may occur on the basis of simple developmental variability as well as remodeling of condyle to accommodate developmental variations, malocclusion, trauma and other development abnormalities and diseases . A complete understanding of the anatomy and morphology of the TMJ is essential to differentiate between the normal and the abnormal morphology of the condyle. There are studies focusing on various shapes and sizes of mandibular condyle in health and diseases. The ABO blood group antigens also appear to have been important throughout the evolution because the frequencies of occurance of different ABO blood types vary among different populations. Inspite of their clinical importance, their physiological functions of the ABO blood group antigens remains mystery. People with the common blood type O express neither the A nor B antigen, and they are perfectly healthy.
Various studies has been conducted that have been made between particular ABO phenotypes and an increased susceptibility to various disease. For example, there is association between ABO phenotype and stomach ulcers (more common in group O individuals) and gastric cancer (more common in group A individuals). Another study showed, that the individuals with blood type O tend to have lower levels of the von Willebrand Factor (vWF), the important protein involved in blood clotting. The aim of the study is to correlate the morphology of the condyle and ABO blood group. This can be useful in identification purposes of the victim.MATERIALA AND METHOD20 randomly selected patients were selected. The mandibular condyles of the selected patients were subjected for the analysis of the morphology of the condyle. The morphology of the condyles are analysed in opg.
Followed by examination of the blood group. The materials required for the blood grouping are antisera for A, B and D. the morphology of the condyle is analysed by digital opg. The statistical analysis was done.RESULTSThe results obtained was, there is no correlation between the blood grouping and the morphology of the condyle.
FIG 1. Sex distribution in abo blood group and condyle morphology.Graph 2. Distribution of types of condyleGraph 3: Age distribution DISCUSSIONThe study was conduced to assess if there is any correlation between thr morhology of the condyle and the ABO blood grouping. This can be useful for identification of th victim in forensic medicine. The morphology of the condyle is unique. It is different for different person and I is different in same individual.
The shape of the condye also depends on the age, sex, occlusion , genetic, external factor and functional factor. In our study, the morphology of the condyle is classified into four types. Type A was flattened, type B is convex, type C is angled, and type D is rounded. The basic blood group is A+, B+, AB+,0+,A-, B- AB- and O-. the sampes from age 17 years to 60 years were selcete. The important selection criteria was, both the condyle of the patient shoud fall in one single type. On evaluation, out of 20 patients 11 patient fell the the type D, and 4 patients under the type C , 2 patient under B and 3 patients under A. the maximum sample denoted the type D that is, the fell under the type round.
There was no correlation between the morphology of the condyle and the type of the blood group. The morphology of the mandibular condyle varies in both shape and size. The outlin of the condyle appears ovoid from superior. It is 15 to 20 mm in latero medial and 8 to 10 mm antero medially. There are many studies conducted to asses the variation in the mandibular condyle.
The normal variaion can be different in different indiiduals and differ on both right and left side. The mandibular condyle aries in different cobditions. Condylar hyperplasia, condylar hypoplasia, agenesis, bifid condyle, syndermes includind hemifacial microsomia, trecher colin syndrome, hallermann-steff syndrome, pierre robin syndrome, oculo mandibulo dyscephaly, progeria, degenerative joint diseaes and inflammatory diseases such as, rgematoid arthiritis, psoriatic arthiritis, septic arthiritis, cyst of tempromandibular joints such as aneurysmal bone cyst, simple bone cyst, ganglion cyst and synovial cyst.
Tumors of temperomandibular joint osteoma, oseochondroma, chonroblastoma,. Meabolic diseases such as, gout. Endocrine diseases including, hypothyroidism and hypopituitiarism. Trauma and radiation were also included.In 1960s and 1970s studies were conucted mainly on dry skulls and autopsy material.
The studies used macroscopic observations, radiological cephalometry and tomography. In 1961, was the first one to report about the different shapes of mandibular condyle . Initially Yale classified condylar head based on superior view into three categories namely concave, convex and flat, however later on the simplified it into four categories namely convex, flattened, angled and rounded. Further more certain studies a study was conducted to correlate the relationship between malocclusion and the morphology of the condyles in childres. The result revealed that the size of the condyle in male is greater than the size of the female. And the alteraration and the discrepancy in the midline increase the growth of the condyle. At the beginning of the 20th century an Austrian scientist, Karl Landsteiner, noted that the RBCs of some individuals were agglutinated by the serum from other individuals. He made a note of the patterns of agglutination and showed that blood could be divided into group.
Landsteiner, stuied that theantibodies in the serum is responsible for the reactions between the RBCs and serum were related to the presence of markers (antigens) on the RBCs. Agglutination occurred when the RBC antigens were bound by the antibodies in the serum. He further named the antigen as A and B thus to which the anti body is absent. The four basic ABO phenotypes are O, A, B, and AB. The immune system forms antibodies against whichever ABO blood group antigens are not found on the individual’s RBCs.
Thus, a group A individual will have anti-B antibodies and a group B individual will have anti-A antibodies. Blood group O is common, and individuals with this blood type will have both anti-A and anti-B in their serum. Blood group AB is the least common, and these individuals will have neither anti-A nor anti-B in their serum.
ABO antibodies in the serum are formed naturally. Their production is stimulated when the immune system encounters the “missing” ABO blood group antigens in foods or in micro-organisms. This happens at an early age because sugars that are identical to, or very similar to, the ABO blood group antigens are found throughout nature.The ABO locus has three main alleleic forms: A, B, and O. ABO antibodies in the serum are formed naturally.
The of the production antibody is stimulated when the immune system start to search for the “missing” ABO blood group antigens in foods or in micro-organisms. This happens at an early age because sugars that are identical to, or very similar to, the ABO blood group antigens are found throughout nature. The functions of the ABO blood group antigens are not known. Individuals who lack the A and B antigens are healthy, suggesting that any function the antigens have is not important, at least not in modern times.
No diseases are known to result from the lack of expression of ABO blood group antigens, but the susceptibility to a number of diseases has been linked with a person’s ABO phenotype. Such correlations remain controversial and include the observation that gastric cancer appears to be more common in group A individuals , whereas gastric and duodenal ulcers occur more often in group O individuals .Few studies conduted shows that there is clear correlation between the ABO phenotype and the level of two proteins involved in blood clotting; factor VII (FVIII) and von Willebrand factor (vWF) . Blood group O individuals have about 25% less FVIII and vWF in their plasma. It is well established that low levels of FVIII and vWF are a cause of excess bleeding, and therefore it may also be the case that increased levels make clotting more likely, increasing the risk of both arterial (ischemic heart disease) and venous (thromboembolic disease) problems. Indeed, non-group O individuals have been shown to be at an increased risk of both arterial and venous disease .ABO antibodies are of major clinical significance for two reasons: they are naturally occurring and are found universally, and, they are highly reactive. The proper protocol for the routine practice of identifying the blood type and cross matching blood products will prevent adverse transfusion reactions caused by ABO antibodies.
However, clerical error can result in “the wrong blood” being transfused into a patient, an error which can result in the death of the patient .If a recipient who has blood group O is transfused with non-group O RBCs, the naturally occurring anti-A and anti-B in the recipient’s serum binds to their corresponding antigens on the transfused RBCs. These antibodies fix complement and cause rapid intravascular hemolysis, triggering an acute hemolytic transfusion reaction that can cause disseminated intravascular coagulation, shock, acute renal failure, and death.