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Early changes in condylar position after mandibular advancement: a three-dimensional analysis.
I Méndez-Manjón1, R Guijarro-Martínez1, A Valls-Ontañón1
1Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, S. Cugat del Vallés , Barcelona, Spain; Institute of Maxillofacial Surgery, Teknon Medical Centre, Barcelona, Spain.
International Journal of Oral and Maxillofacial Surgery
|February 4, 2016
Summary
Bilateral sagittal split osteotomy (BSSO) for mandibular advancement significantly alters condylar position. Further research is needed to understand temporomandibular joint adaptation to these changes.
Area of Science:
- Orthognathic Surgery
- Craniofacial Anatomy
- Temporomandibular Joint (TMJ) Biomechanics
Background:
- Skeletal class II malocclusion often requires surgical correction for mandibular advancement.
- Bilateral sagittal split osteotomy (BSSO) is a common surgical technique for mandibular advancement.
- Understanding condylar position changes post-BSSO is crucial for predicting TMJ outcomes.
Purpose of the Study:
- To quantitatively assess three-dimensional (3D) positional changes of the mandibular condyle after BSSO.
- To evaluate the statistical significance of condylar displacement following mandibular advancement surgery.
- To investigate the correlation between the extent of mandibular advancement and condylar displacement.
Main Methods:
- Prospective study of 22 skeletal class II patients undergoing BSSO.
- Pre- and postoperative cone beam computed tomography (CBCT) scans were acquired.
- Virtual superimposition of 3D skull models using the cranial base as a reference.
- 3D color mapping system (SimPlant O&O) for condylar position analysis.
- Brunner-Langer statistical test to assess significance (P<0.05).
Main Results:
- Mean mandibular advancement was 6.7±1.6mm.
- Statistically significant condylar positional changes were observed post-BSSO (P<0.05).
- A significant positive correlation existed between left condyle displacement and the amount of mandibular advancement (P<0.01).
Conclusions:
- Mandibular advancement via BSSO leads to statistically significant changes in condylar position.
- The degree of condylar displacement is related to the extent of mandibular advancement.
- Long-term studies are necessary to determine the temporomandibular joint's adaptive capacity to these post-surgical changes.
