Three-dimensional evaluation of mandibular condyle changes following orthognathic surgery in Class III patients

To assess early temporomandibular joint (TMJ) adaptation by evaluating angular and volumetric changes of the mandibular condyle relative to the cranial base in skeletal Class III patients following orthognathic surgery using computed tomography (CT).

Forty-five skeletal Class III patients treated with bilateral sagittal split ramus osteotomy and Le Fort I osteotomy were retrospectively evaluated. Preoperative and postoperative CT scans were reconstructed into three-dimensional models and superimposed using stable cranial base references. Angular changes of the proximal segment in the sagittal, coronal, and axial planes, along with regional and total condylar volume changes, were analyzed.

A statistically significant but limited bilateral decrease in condylar volume was observed postoperatively (p < .05). Regional analysis demonstrated predominant resorption in the posterior and anterolateral regions and apposition in the anteromedial and anterior-central regions. Increased axial condyle - coronoid angles and decreased sagittal posterior condylar angles indicated medial and counterclockwise rotation of the proximal segment. No significant correlation was found between angular and volumetric changes.

Early TMJ adaptation after Class III orthognathic surgery appears predictable and remains within physiological limits, emphasizing the multifactorial nature of condylar remodeling.