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Published on: January 28, 2020
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Condylar resorption after orthognathic surgery: A systematic review
Z Catherine1, P Breton1, P Bouletreau1
1Service de chirurgie maxillofaciale et de chirurgie plastique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
Summary
Condylar resorption after orthognathic surgery (CROS) is a condition causing mandibular changes and surgical relapse. Understanding its risk factors and prevention is key for successful outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- Temporomandibular Joint Disorders
Background:
- Condylar resorption after orthognathic surgery (CROS) involves progressive alteration of the mandibular condyle's shape and volume.
- CROS is a recognized factor contributing to surgical relapse following orthognathic procedures.
- This systematic review addresses the physiopathology, mechanisms, risk factors, diagnosis, and treatment of CROS.
Purpose of the Study:
- To systematically review and discuss the physiopathology, mechanisms, risk factors, diagnosis, and treatment of condylar resorption after orthognathic surgery (CROS).
Main Methods:
- A systematic literature review was conducted using the PubMed database from 1970 to 2014.
- Search terms included "orthognathic surgery" combined with various terms for condylar resorption.
- Inclusion and exclusion criteria were applied to select relevant studies.
Main Results:
- Seventeen articles were included from an initial search of 32.
- CROS is a condylar remodeling response to an imbalance between mechanical stress on the temporomandibular joints (TMJ) and host adaptive capacity.
- Risk factors include age (14-50 years), female sex, pre-existing TMJ dysfunction, estrogen deficiency, Class II malocclusion, high mandibular plane angle, diminished posterior facial height, and posteriorly inclined condylar neck.
- Mandibular advancements >10mm, counterclockwise mandibular rotation, and posterior condylar repositioning increase CROS risk.
Conclusions:
- Treatment may involve re-operation after a 6-month inactivity period if occlusal results degrade.
- Condylectomy with reconstruction (allogenic or autologous) is an alternative treatment option.
- Prevention is critical and necessitates informing at-risk patients.
Keywords:
Bone resorptionChirurgie orthognathiqueCondyle mandibulaireMandibular condyleOrthognathic surgeryRelapseRécidiveRésorption osseuse
