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Three dimensional condylar positional and morphological changes following mandibular reconstruction based on CBCT

Saddam Noman Al-Wesabi1,2,3, Bassam Abotaleb4, Eissa Abdo Al-Shujaa5,4

  • 1Lanzhou University, Second Hospital, Oral and Maxillofacial Surgery Department, Lanzhou, Gansu Province, China. saddamalwesabi@gmail.com.

Head & Face Medicine
|February 7, 2023
PubMed
Summary

Mandibular reconstruction with condylar preservation causes immediate and permanent changes in condylar position and joint space. Patients adapt to these changes, showing no significant differences between operated and non-operated sides postoperatively.

Keywords:
Cone-beam computed tomography (CBCT)Free fibula flapMandibular reconstructionReconstruction with condylar preservationThree-dimensional analysis

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Reconstructive Surgery
  • Imaging Technology

Background:

  • Mandibular defects often require reconstruction, impacting temporomandibular joint (TMJ) function.
  • Preserving the condylar head during reconstruction is crucial for maintaining joint integrity.

Purpose of the Study:

  • To evaluate condylar positional changes after mandibular reconstruction with condylar head preservation.
  • To assess TMJ joint space and volumetric changes using Cone-Beam Computed Tomography (CBCT).

Main Methods:

  • Prospective study of 30 patients undergoing unilateral mandibular resection and reconstruction.
  • CBCT scans (preoperative, 2 weeks, and 6+ months postoperative) analyzed for condylar position and TMJ space.
  • Statistical analysis using t-tests and ANOVA.

Main Results:

  • Significant downward and mediolateral displacement of condyles on the tumor side post-reconstruction.
  • Increased TMJ joint spaces on the tumor side.
  • Relatively stable condylar positions and joint spaces on the non-tumor side.

Conclusions:

  • Mandibular reconstruction with condylar preservation leads to noticeable and lasting changes in condylar position and joint volume.
  • Patients adapt to postoperative changes, with no significant functional differences between sides based on the Helkimo index.