3D comparative evaluation of condylar morphology between chronic area nut chewers and non-chewers- a study protocol (Preprint)

BACKGROUND Areca nut (AN) is a commonly consumed psychoactive substance, especially in South and Southeast Asia. Chronic chewing of AN has been linked to multiple health problems including temporomandibular joint disorders (TMD). Excessive strain on temporomandibular joint during chronic AN chewing can lead to repetitive injury, resulting in micro and macro trauma to both TMJ and surrounding masticatory structures. Accordingly previous studies reported regarding its long-term impact on TMJ using conventional two-dimensional (2D) imaging. However, the present study aims to perform comparative evaluation of condylar morphology between chronic AN chewers and non-chewers using 3 dimensional imaging OBJECTIVE To evaluate condylar morphology in chronic AN chewers and non-chewers using 3D imaging and then to compare condylar morphology between chronic AN chewers and non-chewers using 3D imaging METHODS This study will include 90 patients which will be divided as Chronic AN chewer-45 and non- chewer 45. Study will be undertaken after obtaining Institutional Ethics committee approval and informed written consent from each patient. Detailed habit history of all the habitual will be recorded. Every patient will be assessed for clinical examination and the radiographic evaluation for condylar morphology. Condylar morphology will be evaluated using CBCT scans in both sagittal and coronal planes. All the findings will be recorded and then analysed for statistical significance. RESULTS It is expected that chronic AN chewer will demonstrate significant condylar morphological alterations compared to non-chewer, as visualized on CBCT. These changes are expected to include structural variations and pathological alterations such as osteophytes, surface flattening, and erosions CONCLUSIONS The study aims to overcome the limitations of conventional 2D radiography and provide a more accurate assessment of condylar morphology. The findings are expected to bridge an existing gap in the literature, offering valuable insights on the effects of chronic AN chewing on condylar structure using 3D imaging, and may contribute to improved diagnostic, preventive, and management strategies for TMD. CLINICALTRIAL Trial registration number is CTRI/2025/06/088238. Registry name is Clinical Trials Registry - India (CTRI) and date of registration is 4/6/2025