Postoperative condylar position by sagittal split ramus osteotomy with and without bone graft

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Biomaterials in Surgery

Background:

• Sagittal split ramus osteotomy (SSRO) is a common procedure in orthognathic surgery.
• Maintaining condylar position post-osteotomy is crucial for functional and aesthetic outcomes.
• The role of bone grafting in the osteotomy gap requires further elucidation.

Purpose of the Study:

• To investigate the effect of bone grafting on condylar position following SSRO.
• To compare condylar displacement and rotation in grafted versus non-grafted osteotomy sites.

Main Methods:

• A comparative study involving 60 patients undergoing SSRO, divided into control (no graft) and study (bone graft) groups.
• Computed tomography (CT) with 2-mm slice thickness was used for imaging.
• 3D reconstruction and analysis quantified pre- and postoperative condylar displacement and rotation in axial and sagittal planes.

Main Results:

• No statistically significant differences in condylar position were observed between the grafted and non-grafted groups.
• Mediolateral condylar movement approached statistical significance (P = .051), suggesting a potential trend.
• Condylar displacement showed a significant relationship with mandibular setback, especially when exceeding 10 mm.

Conclusions:

• Bone grafting in the SSRO intersegmental gap is an effective method for maintaining space and desirable intersegmental position.
• Grafting appears to prevent excessive condylar displacement, particularly in cases requiring significant mandibular setback (>10 mm).