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Mandibular setback by bilateral sagittal split osteotomy: a two-year three-dimensional study of condylar positional
Rana A A M Al-Mohana1, Huang Jianping2, Maged S Alhammadi3
1Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen.
Mandibular setback surgery using bilateral sagittal split osteotomy (BSSO) does not cause long-term changes in temporomandibular joint (TMJ) condyle morphology. This study found no significant alterations in condylar position, dimensions, or joint spaces after BSSO.
Area of Science:
- Orthognathic surgery
- Temporomandibular joint (TMJ) research
- Craniofacial adaptation
Background:
- Mandibular prognathism correction often involves bilateral sagittal split osteotomy (BSSO).
- Understanding long-term temporomandibular joint (TMJ) adaptation post-BSSO is crucial for patient outcomes.
- Previous studies have not fully elucidated subtle 3D changes in condylar morphology over time.
Purpose of the Study:
- To investigate the long-term three-dimensional (3D) adaptation of the temporomandibular joint (TMJ) condyle after mandibular setback surgery.
- To assess changes in condylar position, inclination, dimensions, and joint spaces following bilateral sagittal split osteotomy (BSSO).
Main Methods:
- Computed tomography (CT) scans of 46 TMJs from 23 patients were analyzed.
- Scans were taken preoperatively (T0), within 1 week postoperatively (T1), and at a 2-year follow-up (T2).
- Quantitative 3D measurements of condylar parameters and joint spaces were statistically compared across time points.
Main Results:
- A significant increase in the anterior joint space was noted between T0 and T1.
- No statistically significant changes were observed in posterior, superior, or medial joint spaces.
- Condylar inclination, position, linear dimensions, and volumetric joint space remained stable across all time points.
Conclusions:
- Mandibular setback via BSSO does not lead to significant short- or long-term condylar morphological alterations.
- The temporomandibular joint (TMJ) appears to adapt without significant changes in condylar structure after this surgical procedure.
- This study provides comprehensive 3D evidence supporting the stability of condylar morphology post-BSSO.
