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Is Condylar Displacement and Rotation in Maxillomandibular Advancement Surgery Associated With Long-Term Condylar

Trine Wulff Nielsen1, Michael Boelstoft Holte2, Gabriele Berg-Beckhoff3

  • 1PhD Fellow, Department of Oral and Maxillofacial Surgery, Department of Regional Health Research, Faculty of Health Sciences, University Hospital of Southern Denmark, 3D Lab Denmark & University of Southern Denmark, Esbjerg, Denmark.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|November 15, 2025
PubMed
Summary

Counterclockwise rotation of proximal segments in maxillomandibular advancement (MMA) surgery is linked to long-term skeletal relapse. Increased segment flaring is associated with condylar volume loss, though occlusion remains stable post-surgery.

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Area of Science:

  • Orthognathic surgery
  • Maxillofacial reconstruction
  • Skeletal stability

Background:

  • Long-term skeletal relapse after maxillomandibular advancement (MMA) surgery is poorly understood.
  • The role of perioperative condylar and proximal segment positioning in MMA outcomes requires further investigation.

Purpose of the Study:

  • To quantify mandibular condyle and proximal segment displacements following MMA.
  • To assess the association between these displacements and long-term condylar volume changes, skeletal relapse, and occlusal outcomes.

Main Methods:

  • Retrospective cohort study of 50 patients undergoing MMA.
  • Cone-beam computed tomography (CBCT) used for pre- and post-operative imaging.
  • Analysis of condylar and proximal segment positions, condylar volume changes, and skeletal relapse at the pogonion over 5 years.

Main Results:

  • Counterclockwise rotation of proximal segments significantly correlated with horizontal mandibular skeletal relapse.
  • Increased proximal segment flaring was associated with condylar volume loss.
  • A small percentage of patients (6%) developed minor anterior open bites, but occlusion remained stable overall.

Conclusions:

  • Perioperative proximal segment rotation is a significant predictor of long-term skeletal relapse after MMA.
  • Proximal segment flaring impacts condylar volume stability.
  • MMA demonstrates favorable long-term occlusal stability without the need for reoperation in most cases.