Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Internal Medicine Neurology Oncology Pediatrics Respiratory Medicine Surgery
Congress Coverage
2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting

Keynote Webinar | Spotlight on Diet and Diabetes

Watch on-demand

An expert-led symposium exploring the prevention and management of type 2 diabetes through dietary interventions. 
ADVANCED SEARCH
Log in
Top
Journal of Maxillofacial and Oral Surgery

19-11-2023 | REVIEW PAPER

Direction and Range of Condylar Positional Changes in the First-Year Post-surgical Orthodontics Interventions in Adult Patients with Skeletal Class III Deformity: A Systematic Review and Meta-analysis

Authors: Amine Fattal, Vaibhav Gandhi, Rafael Denadai, Essam Osman, Eric Jein-Wein Liou

Published in: Journal of Maxillofacial and Oral Surgery

Login to get access

Abstract

Objectives

Assess the available scientific literature regarding the direction and extent of condylar positional changes during the first year of post-surgical orthodontics interventions in class III patients.

Materials and Methods

PubMed, Cochrane Library, Embase, and Google Scholar databases were searched up to March 2022 for studies involving the measurement of condylar positional changes after surgical treatment of Class III dentofacial deformity in adults with BSSO without or without Le Fort I osteotomies. The methodological index for non-randomized studies (MINORS) was utilized to assess the risk of bias and quality of non-randomized studies. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcome was condyle positional changes between the following time points: T0: before treatment, T1: immediately post treatment, T2: 4, 6, or 9 months post treatment, T3: one year post treatment.

Results

Nineteen studies were included in the systematic review. Eleven studies were deemed low quality, and the rest were of medium quality. The meta-analysis included 12 studies and showed statistically significant downward, outward positional changes at T1(Immediately after surgery). Inward Yaw rotation was significant at T1(1–4 month post-surgery) and T2(4–9 months post-surgery).

Conclusion

Surgically induced condylar changes tend to go back to normal within the first year after surgery, except for condylar yaw rotations.
Literature
1.
Pullinger AG, Solberg WK, Hollender L, Petersson A (1987) Relationship of mandibular condylar position to dental occlusion factors in an asymptomatic population. Am J Orthod Dentofac Orthop 91(3):200–206 CrossRef
2.
da Silva RJ, Valadares Souza CV, Souza GA, Ambrosano GMB, Freitas DQ, Sant’Ana E et al (2018) Changes in condylar volume and joint spaces after orthognathic surgery. Int J Oral Maxillofac Surg 47(4):511–517 CrossRefPubMed
3.
Alhammadi MS, Fayed MS, Labib A (2017) Three-dimensional assessment of condylar position and joint spaces after maxillary first premolar extraction in skeletal Class II malocclusion. Orthod Craniofac Res 20(2):71–78 CrossRefPubMed
4.
Han YS, Jung YE, Song IS, Lee SJ, Seo BM (2016) Three-dimensional computed tomographic assessment of temporomandibular joint stability after orthognathic surgery. J Oral Maxillofac Surg 74(7):1454–1462 CrossRefPubMed
5.
Sonego CL, Bobrowski AN, Chagas OL Jr, Torriani MA (2014) Aesthetic and functional implications following rotation of the maxillomandibular complex in orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg 43(1):40–45 CrossRefPubMed
6.
Mendez-Manjon I, Guijarro-Martinez R, Valls-Ontanon A, Hernandez-Alfaro F (2016) Early changes in condylar position after mandibular advancement: a three-dimensional analysis. Int J Oral Maxillofac Surg 45(6):787–792 CrossRefPubMed
7.
Kuehle R, Berger M, Saure D, Hoffmann J, Seeberger R (2016) High oblique sagittal split osteotomy of the mandible: assessment of the positions of the mandibular condyles after orthognathic surgery based on cone-beam tomography. Br J Oral Maxillofac Surg 54(6):638–642 CrossRefPubMed
8.
Wessberg GA, Washburn MC, LaBanc JP, Epker BN (1982) Autorotation of the mandible: effect of surgical superior repositioning of the maxilla on mandibular resting posture. Am J Orthod 81(6):465–472 CrossRefPubMed
9.
Farronato G, Giannini L, Galbiati G, Maspero C (2011) Sagittal and vertical effects of rapid maxillary expansion in Class I, II, and III occlusions. Angle Orthod 81(2):298–303 CrossRefPubMedPubMedCentral
10.
De Paula L, Ruellas A, Paniagua B, Styner M, Turvey T, Zhu H et al (2013) One-year assessment of surgical outcomes in Class III patients using cone beam computed tomography. Int J Oral Maxillofac Surg 42(6):780–789 CrossRefPubMedPubMedCentral
11.
Melgaco CA, ColumbanoNeto J, Jurach EM, NojimaMda C, Nojima LI (2014) Immediate changes in condylar position after rapid maxillary expansion. Am J Orthod Dentofac Orthop 145(6):771–779 CrossRef
12.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analy ses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ (Clin Res ed) 339:b2700 CrossRef
13.
Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 73(9):712–716 CrossRefPubMed
14.
Wang LC, Lee YH, Tsai CY, Wu TJ, Teng YY, Lai JP et al (2021) Postsurgical stability of temporomandibular joint of skeletal class III patients treated with 2-Jaw orthognathic surgery via computer-aided three-dimensional simulation and navigation in orthognathic surgery (CASNOS). Biomed Res Int 2021:1563551 PubMedPubMedCentral
15.
Shrestha A, Song SH, Aung HN, Sangwatanakul J, Zhou N (2021) Three-dimensional cephalometric analysis: the changes in condylar position pre- and post-orthognathic surgery with skeletal class III malocclusion. J Craniofac Surg 32(2):546–551 CrossRefPubMed
16.
Lee CH, Cho SW, Kim JW, Ahn HJ, Kim YH, Yang BE (2019) Three-dimensional assessment of condylar position following orthognathic surgery using the centric relation bite and the ramal reference line: a retrospective clinical study. Medicine 98(12):e14931 CrossRefPubMedPubMedCentral
17.
Zupnik JT, Ioshida M, Yatabe M, Ruellas ACO, Gomes LR, Aronovich S et al (2019) Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions. Int J Oral Maxillofac Surg 48(6):739–745 CrossRefPubMedPubMedCentral
18.
Ma HD, Shu JH, Deng XZ, Liu Z (2019) Effect of sagittal split ramus osteotomy on morphologic parameters of temporomandibular joint in patients with mandibular prognathism. Medicine (Baltimore) 98(22):e15830 CrossRefPubMed
19.
Hwang HS, Jiang T, Sun L, Lee KM, Oh MH, Biao Y et al (2019) Condylar head remodeling compensating for condylar head displacement by orthognathic surgery. J Craniomaxillofac Surg 47(3):406–413 CrossRefPubMed
20.
Xue C, Tian Y, Wang L, Yang X, Luo E, Bai D (2018) Surgical guide and CAD/CAM prebent titanium plate for sagittal split ramus osteotomy in the correction of mandibular prognathism. Br J Oral Maxillofac Surg 56(7):586–593 CrossRefPubMed
21.
Park JC, Kim UK, Hwang DS (2018) Three-dimensional analysis of perioperative condylar displacement after mandibular setback surgery with intended manual condylar positioning. J Craniofac Surg 29(8):e767–e773 CrossRefPubMed
22.
Choi BJ, Lee BS, Kwon YD, Lee JW, Yun SU, Ryu KS et al (2018) Correlation between intraoperative proximal segment rotation and post-sagittal split ramus osteotomy relapse: a three-dimensional cone beam computed tomography study. Int J Oral Maxillofac Surg 47(5):613–621 CrossRefPubMed
23.
Wang T, Han JJ, Oh HK, Park HJ, Jung S, Kook MS (2016) Comparison of orthodontics-first and surgery-first approach in positional changes of the condyle after mandibular setback surgery using three-dimensional analysis. J Oral Maxillofac Surg 74(12):2487–2496 CrossRefPubMed
24.
Choi BJ, Choi YH, Lee BS, Kwon YD, Choo YJ, Ohe JY (2014) A CBCT study on positional change in mandibular condyle according to metallic anchorage methods in skeletal class III patients after orthognatic surgery. J Cranio-Maxillofac Surg 42(8):1617–1622 CrossRef
25.
Kim HM, Baek SH, Kim TY, Choi JY (2014) Evaluation of three-dimensional position change of the condylar head after orthognathic surgery using computer-aided design/computer-aided manufacturing-made condyle positioning jig. J Craniofac Surg 25(6):2002–2007 CrossRefPubMed
26.
Hwang DS, Kim YI, Lee KM (2014) Effect of intended manual condylar positioning on skeletal and dental changes in Skeletal Class III deformities: CBCT-generated Half-Cephalograms. J Cranio-Maxillofac Surg 42(1):7–12 CrossRef
27.
Kim YJ, Oh KM, Hong JS, Lee JH, Kim HM, Reyes M et al (2012) Do patients treated with bimaxillary surgery have more stable condylar positions than those who have undergone single-jaw surgery? J Oral Maxillofac Surg 70(9):2143–2152 CrossRefPubMed
28.
Kim YI, Cho BH, Jung YH, Son WS, Park SB (2011) Cone-beam computerized tomography evaluation of condylar changes and stability following two-jaw surgery: Le Fort I osteotomy and mandibular setback surgery with rigid fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 111(6):681–687 CrossRef
29.
Kim YI, Jung YH, Cho BH, Kim JR, Kim SS, Son WS et al (2010) The assessment of the short- and long-term changes in the condylar position following sagittal split ramus osteotomy (SSRO) with rigid fixation. J Oral Rehabil 37(4):262–270 CrossRefPubMed
30.
Vandeput AS, Verhelst PJ, Jacobs R, Shaheen E, Swennen G, Politis C (2019) Condylar changes after orthognathic surgery for class III dentofacial deformity: a systematic review. Int J Oral Maxillofac Surg 48(2):193–202 CrossRefPubMed
31.
An SB, Park SB, Kim YI, Son WS (2014) Effect of post-orthognathic surgery condylar axis changes on condylar morphology as determined by 3-dimensional surface reconstruction. Angle Orthod 84(2):316–321 CrossRefPubMed
32.
Ngan P, Moon W (2015) Evolution of class III treatment in orthodontics. Am J Orthod Dentofacial Orthop 148(1):22–36 CrossRefPubMed
33.
Zamboni R, de Moura FRR, Brew MC, Rivaldo EG, Braz MA, Grossmann E et al (2019) Impacts of orthognathic surgery on patient satisfaction, overall quality of life, and oral health-related quality of life: a systematic literature review. Int J Dent 2019:2864216 CrossRefPubMedPubMedCentral
34.
Li J, Ryu SY, Park HJ, Kook MS, Jung S, Han JJ et al (2017) Changes in condylar position after BSSRO with and without Le Fort I osteotomy via surgery-first approach in mandibular prognathism with facial asymmetry. Oral Surg Oral Med Oral Pathol Oral Radiol 123(6):661–669 CrossRefPubMed
35.
Lim SY, Jiang T, Oh MH, Kook MS, Cho JH, Hwang HS (2017) Cone-beam computed tomography evaluation on the changes in condylar long axis according to asymmetric setback in sagittal split ramus osteotomy patients. Angle Orthod 87(2):254–259 CrossRefPubMed
36.
Hwang DS, Kim YI, Lee KM (2014) Effect of intended manual condylar positioning on skeletal and dental changes in Skeletal Class III deformities: CBCT-generated half-cephalograms. J Craniomaxillofac Surg 42(1):7–12 CrossRefPubMed
37.
van der Vlis M, Dentino KM, Vervloet B, Padwa BL (2014) Postoperative swelling after orthognathic surgery: a prospective volumetric analysis. J Oral Maxillofac Surg 72(11):2241–2247 CrossRefPubMed
38.
Ohba S, Ozaki H, Miura KI, Koga T, Kawasaki T, Yoshida N et al (2018) Physiological positioning strategy alters condylar position after mandibular ramus sagittal split osteotomies for mandibular prognathism. Cranio 36(3):181–188 CrossRefPubMed
Metadata
Title
Direction and Range of Condylar Positional Changes in the First-Year Post-surgical Orthodontics Interventions in Adult Patients with Skeletal Class III Deformity: A Systematic Review and Meta-analysis
Authors
Amine Fattal
Vaibhav Gandhi
Rafael Denadai
Essam Osman
Eric Jein-Wein Liou
Publication date
19-11-2023
Publisher
Springer India
Published in
Journal of Maxillofacial and Oral Surgery
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-023-02042-y