Condylar position following mandibular advancement: its relationship to relapse

Area of Science:

• Orthognathic Surgery
• Temporomandibular Joint (TMJ) Disorders
• Craniofacial Reconstruction

Background:

• Bilateral sagittal osteotomy is a common procedure for mandibular advancement.
• Understanding condylar position changes and their impact on TMJ is crucial for surgical outcomes.

Purpose of the Study:

• To assess condylar position changes after bilateral sagittal osteotomy for mandibular advancement.
• To correlate condylar position with postoperative temporomandibular joint symptoms and surgical relapse.

Main Methods:

• Clinical and radiographic examination of 41 patients.
• Analysis of condylar and distal fragment position using digitized tracings.
• Statistical analysis of positional changes at multiple postoperative intervals.

Main Results:

• Distal fragment advanced and rotated clockwise during surgery, with significant posterior relapse during maxillomandibular fixation.
• Condyles showed superior and posterior movement during fixation, with no changes post-fixation release.
• 18 patients reported TMJ pain or noise postoperatively, irrespective of initial symptoms.

Conclusions:

• Mandibular advancement via bilateral sagittal osteotomy can lead to significant relapse and temporomandibular joint dysfunction.
• Condylar position changes during maxillomandibular fixation may not prevent postoperative TMJ issues.
• Relapse appears multifactorial, not solely dependent on condylar distraction.