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Published in: Maxillofacial Plastic and Reconstructive Surgery 1/2023

Open Access 01-12-2023 | Research

Condylar volume and positional changes following a bilateral sagittal split ramus osteotomy in skeletal class II and III malocclusions

Authors: Chulyoung Park, Hyejin Kim, Jaeyoung Ryu, Seunggon Jung, Hong-Ju Park, Hee-Kyun Oh, Min-Suk Kook

Published in: Maxillofacial Plastic and Reconstructive Surgery | Issue 1/2023

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Abstract

Background

Mandibular condyle remodeling and displacement are post-orthognathic surgery concerns that can potentially lead to occlusal issues after bilateral sagittal split ramus osteotomy. This retrospective study examined the relationship between condylar volume changes and position alterations after surgery in patients with skeletal class II and III malocclusions using cone-beam CT.

Methods

The study included 16 patients (6 with Class II malocclusion, 10 with Class III malocclusion) who underwent bilateral sagittal split ramus osteotomy at Chonnam National University Hospital. Cone-beam CT data were collected at three specific time points: before surgery, immediately after surgery, and approximately 6 months post-surgery. Mandibular movement was measured using InVivoDental 5.4.6. ITK-SNAP 3.8.0 was used to assessed condylar volume changes post-surgery. Condyle positions were evaluated in four parts with RadiAnt DICOM Viewer 4.6.9. Statistical analyses were performed using the SPSS version 23.

Results

Considering both Class II and III malocclusion, a 2.91% volume reduction was noted immediately and at 6 months after surgery. Both Class II and III cases demonstrated a decrease in superior joint space by -0.59 mm and medial joint space by -1.09 mm. No significant correlation was found between this process and condylar volume change.

Conclusions

The mandibular condyle volume decreased, and superior-medial movement of the condyle was detected in patients with Class II and III malocclusion immediately and at 6 months after surgery with no volume-position correlation.
Literature
1.
go back to reference Obwegeser H, Trauner R (1955) Zur Operationstechnik bei der Progenie und anderen Unterkieferanomalien. Dtsch Zahn MundKieferheilkd 23:1–10 Obwegeser H, Trauner R (1955) Zur Operationstechnik bei der Progenie und anderen Unterkieferanomalien. Dtsch Zahn MundKieferheilkd 23:1–10
2.
go back to reference Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42–47 Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42–47
3.
go back to reference Epker BN (1977) Modifications in the sagittal osteotomy of the mandible. J Oral Surg 35:157–159PubMed Epker BN (1977) Modifications in the sagittal osteotomy of the mandible. J Oral Surg 35:157–159PubMed
4.
go back to reference Kerstens HC, Tuinzing DB, Golding RP, vander Kwast WA, (1990) Condylar atrophy and osteoarthrosis after bimaxillary surgery. Oral Surg Oral Med Oral Pathol 69:274–80CrossRefPubMed Kerstens HC, Tuinzing DB, Golding RP, vander Kwast WA, (1990) Condylar atrophy and osteoarthrosis after bimaxillary surgery. Oral Surg Oral Med Oral Pathol 69:274–80CrossRefPubMed
5.
go back to reference Joss CU, Vassalli IM (2009) Stability after bilateral sagittal split osteotomy advancement surgery with rigidinternal fixation: A systematic review. J Oral Maxillofac Surg 67:301–13 ([CrossRef] [PubMed])CrossRefPubMed Joss CU, Vassalli IM (2009) Stability after bilateral sagittal split osteotomy advancement surgery with rigidinternal fixation: A systematic review. J Oral Maxillofac Surg 67:301–13 ([CrossRef] [PubMed])CrossRefPubMed
6.
go back to reference Kobayashi T, Izumi N, Kojima T, Sakagami N, Saito I, Saito C (2012) Progressive condylar resorption after mandibular advancement. Br J OralMaxillofac Surg 50:176–180CrossRef Kobayashi T, Izumi N, Kojima T, Sakagami N, Saito I, Saito C (2012) Progressive condylar resorption after mandibular advancement. Br J OralMaxillofac Surg 50:176–180CrossRef
7.
go back to reference de Moraes PH, Rizzati-Barbosa CM, Olate S, Moreira RW, de Moraes M (2012) Condylar resorption after orthognathic surgery: a systematic review. Int J Morphol 30:1023–1028CrossRefPubMed de Moraes PH, Rizzati-Barbosa CM, Olate S, Moreira RW, de Moraes M (2012) Condylar resorption after orthognathic surgery: a systematic review. Int J Morphol 30:1023–1028CrossRefPubMed
8.
go back to reference Hackney FL, Van Sickels JE, Nummikoski PV (1989) Condylar displacement and temporomandibular joint dysfunction following bilateral sagittal split osteotomy and rigid fixation. J Oral Maxillofac Surg 47:223–227CrossRefPubMed Hackney FL, Van Sickels JE, Nummikoski PV (1989) Condylar displacement and temporomandibular joint dysfunction following bilateral sagittal split osteotomy and rigid fixation. J Oral Maxillofac Surg 47:223–227CrossRefPubMed
9.
go back to reference Rebellato J, Lindauer SJ, Sheats RD, Isaacson RJ (1999) Condylar positional changes after mandibular advancement surgery with rigid internal fixation. Am J Orthod Dentofacial Orthop 116:93–100CrossRefPubMed Rebellato J, Lindauer SJ, Sheats RD, Isaacson RJ (1999) Condylar positional changes after mandibular advancement surgery with rigid internal fixation. Am J Orthod Dentofacial Orthop 116:93–100CrossRefPubMed
10.
go back to reference Harris MD, Van Sickels JE, Alder M (1999) Factors influencing condylar position after the bilateral sagittal split osteotomy fixed withbicortical screws. J Oral Maxillofac Surg 57:650–654CrossRefPubMed Harris MD, Van Sickels JE, Alder M (1999) Factors influencing condylar position after the bilateral sagittal split osteotomy fixed withbicortical screws. J Oral Maxillofac Surg 57:650–654CrossRefPubMed
11.
go back to reference Alder ME, Deahl ST, Matteson SR, Van Sickels JE, Tiner GD, Rugh JD (1999) Short-term changes of condylar position after sagittal split osteotomy for mandibular advancement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87:159–165CrossRefPubMed Alder ME, Deahl ST, Matteson SR, Van Sickels JE, Tiner GD, Rugh JD (1999) Short-term changes of condylar position after sagittal split osteotomy for mandibular advancement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87:159–165CrossRefPubMed
12.
go back to reference Kadesjö N, Benchimol D, Falahat B, Näsström K, Shi X-Q (2015) Evaluation of the effective dose of cone beam CT and multislice CT for temporomandibular joint examinations at optimized exposure levels. Dentomaxillofac Radiol 44:20150041CrossRefPubMedCentralPubMed Kadesjö N, Benchimol D, Falahat B, Näsström K, Shi X-Q (2015) Evaluation of the effective dose of cone beam CT and multislice CT for temporomandibular joint examinations at optimized exposure levels. Dentomaxillofac Radiol 44:20150041CrossRefPubMedCentralPubMed
13.
go back to reference Park SB, Yang YM, Kim YI, Cho BH, Jung YH, Hwang DS (2012) Effect of bimaxillary surgery on adaptive condylar head remodeling: metric analysis and image interpretation using cone-beam computed tomography volume superimposition. J Oral Maxillofac Surg 70:1951–1959CrossRefPubMed Park SB, Yang YM, Kim YI, Cho BH, Jung YH, Hwang DS (2012) Effect of bimaxillary surgery on adaptive condylar head remodeling: metric analysis and image interpretation using cone-beam computed tomography volume superimposition. J Oral Maxillofac Surg 70:1951–1959CrossRefPubMed
14.
go back to reference Ha MH, Kim YI, Park SB, Kim SS, Son WS (2013) Cone-beam computed tomographic evaluation of the condylar remodeling occurring after mandibular set-back by bilateral sagittal split ramus osteotomy and rigid fixation. Korean J Orthod 43:263–270CrossRefPubMedCentralPubMed Ha MH, Kim YI, Park SB, Kim SS, Son WS (2013) Cone-beam computed tomographic evaluation of the condylar remodeling occurring after mandibular set-back by bilateral sagittal split ramus osteotomy and rigid fixation. Korean J Orthod 43:263–270CrossRefPubMedCentralPubMed
15.
go back to reference Mendez-Manjon I, Guijarro-Martınez 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 45:787–792CrossRefPubMed Mendez-Manjon I, Guijarro-Martınez 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 45:787–792CrossRefPubMed
16.
go back to reference Ramesh B, Joseph VS, Donald F (2006) Condylar resroption following temporomandibular joint arthroscopy in a patient with essential thrombocythemia. Oral Surg Oral Med Oral Pathol Oral Radilo Endod 101:581–587CrossRef Ramesh B, Joseph VS, Donald F (2006) Condylar resroption following temporomandibular joint arthroscopy in a patient with essential thrombocythemia. Oral Surg Oral Med Oral Pathol Oral Radilo Endod 101:581–587CrossRef
17.
go back to reference Ferri J, Nicot R, Maes JM, Raoul G, Lauwers L (2016) Condylar resorptions and orthodontic-surgical treatment: State of the art. Int Orthod 14:503–527PubMed Ferri J, Nicot R, Maes JM, Raoul G, Lauwers L (2016) Condylar resorptions and orthodontic-surgical treatment: State of the art. Int Orthod 14:503–527PubMed
18.
19.
go back to reference Park SY, Choi YK, Lee SH, Kang HJ, Kim SS, Kim SH, Kim YI (2022) Long-term condylar remodelling after bimaxillary orthognathic surgery in skeletal Class III patients. Brit J Oral Maxillofac Surg 60:1056–1061CrossRef Park SY, Choi YK, Lee SH, Kang HJ, Kim SS, Kim SH, Kim YI (2022) Long-term condylar remodelling after bimaxillary orthognathic surgery in skeletal Class III patients. Brit J Oral Maxillofac Surg 60:1056–1061CrossRef
21.
go back to reference Hwang SJ, Haers PE, Seifert B, Sailer HF (2004) Non-surgical risk factors for condylar resorption after orthognathic surgery. J Craniomaxillofac Surg 32:103–111CrossRefPubMed Hwang SJ, Haers PE, Seifert B, Sailer HF (2004) Non-surgical risk factors for condylar resorption after orthognathic surgery. J Craniomaxillofac Surg 32:103–111CrossRefPubMed
22.
go back to reference Hwang SJ, Haers PE, Zimmermann A, Oechslin C, Seifert B, Sailer HF (2000) Surgical risk factors for condylar resorption after orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:542–552CrossRefPubMed Hwang SJ, Haers PE, Zimmermann A, Oechslin C, Seifert B, Sailer HF (2000) Surgical risk factors for condylar resorption after orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89:542–552CrossRefPubMed
23.
go back to reference Kato Y, Hiyama S, Kuroda T, Fujisaki T (1999) Condylar resorption 2 years following active orthodontic treatment: a case report. Int J Adult Orthodon Orthognath Surg 14:243–250PubMed Kato Y, Hiyama S, Kuroda T, Fujisaki T (1999) Condylar resorption 2 years following active orthodontic treatment: a case report. Int J Adult Orthodon Orthognath Surg 14:243–250PubMed
24.
go back to reference Hoppenreijs TJ, Stoelinga PJ, Grace KL, Robben CM (1999) Long-term evaluation of patients with progressive condylar resorption following orthognathic surgery. Int J Oral Maxillofac Surg 28:411–418CrossRefPubMed Hoppenreijs TJ, Stoelinga PJ, Grace KL, Robben CM (1999) Long-term evaluation of patients with progressive condylar resorption following orthognathic surgery. Int J Oral Maxillofac Surg 28:411–418CrossRefPubMed
25.
go back to reference Cutbirth M, Van Sickels JE, Thrash WJ (1998) Condylar resorption after bicortical screw fixation of mandibular advancement. J Oral Maxillofac Surg 56:178–183CrossRefPubMed Cutbirth M, Van Sickels JE, Thrash WJ (1998) Condylar resorption after bicortical screw fixation of mandibular advancement. J Oral Maxillofac Surg 56:178–183CrossRefPubMed
26.
27.
go back to reference Mitsimponas K, Mehmet S, Kennedy R, Shakib K (2018) Idiopathic condylar resorption. Br J Oral Maxillofac Surg 56:249–255CrossRefPubMed Mitsimponas K, Mehmet S, Kennedy R, Shakib K (2018) Idiopathic condylar resorption. Br J Oral Maxillofac Surg 56:249–255CrossRefPubMed
28.
go back to reference Jagger RG, Absi EG, Jeremiah HG, Sugar AW (2006) Bilateral mandibular condylysis in a patient with systemic sclerosis. Dentomaxillofac Radiol 35:461–463CrossRefPubMed Jagger RG, Absi EG, Jeremiah HG, Sugar AW (2006) Bilateral mandibular condylysis in a patient with systemic sclerosis. Dentomaxillofac Radiol 35:461–463CrossRefPubMed
29.
go back to reference da Silva RJ, Valadares Souza CV, Souza GA, Ambrosano GMB, Freitas DQ, E Sant’Ana, de Oliveira-Santos C, (2018) Changes in condylar volume and joint spaces after orthognathic surgery. Int J Oral Maxillofac Surg 47:511–7CrossRefPubMed da Silva RJ, Valadares Souza CV, Souza GA, Ambrosano GMB, Freitas DQ, E Sant’Ana, de Oliveira-Santos C, (2018) Changes in condylar volume and joint spaces after orthognathic surgery. Int J Oral Maxillofac Surg 47:511–7CrossRefPubMed
30.
go back to reference Lim YN, Park IY, Kim JC, Byun SH, Yang BE (2020) Comparison of Changes in the Condylar Volume and Morphology in Skeletal Class III Deformities Undergoing Orthognathic Surgery Using a Customized versus Conventional Miniplate: A Retrospective Analysis. J Clin Med 9:2794CrossRefPubMedCentralPubMed Lim YN, Park IY, Kim JC, Byun SH, Yang BE (2020) Comparison of Changes in the Condylar Volume and Morphology in Skeletal Class III Deformities Undergoing Orthognathic Surgery Using a Customized versus Conventional Miniplate: A Retrospective Analysis. J Clin Med 9:2794CrossRefPubMedCentralPubMed
31.
go back to reference Chen S, Lei J, Wang X, Fu K-Y, Farzad P, Yi B (2013) Short- and Long-Term Changes of Condylar Position After Bilateral Sagittal Split Ramus Osteotomy for Mandibular Advancement in Combination With Le Fort I Osteotomy Evaluated by Cone-Beam Computed Tomography. J Oral Maxillofac Surgy 71:1956–1966CrossRef Chen S, Lei J, Wang X, Fu K-Y, Farzad P, Yi B (2013) Short- and Long-Term Changes of Condylar Position After Bilateral Sagittal Split Ramus Osteotomy for Mandibular Advancement in Combination With Le Fort I Osteotomy Evaluated by Cone-Beam Computed Tomography. J Oral Maxillofac Surgy 71:1956–1966CrossRef
32.
go back to reference Kawamata A, Fujishita M, Nagahara K, Kanematu N, Niwa K, Langlais RP (1998) Three dimensional computed tomography evaluation of postsurgical condylar displacement after mandibular osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:371–376CrossRefPubMed Kawamata A, Fujishita M, Nagahara K, Kanematu N, Niwa K, Langlais RP (1998) Three dimensional computed tomography evaluation of postsurgical condylar displacement after mandibular osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:371–376CrossRefPubMed
33.
go back to reference Shaoo NK, Agarwal SS, Datana S, Bhandari SK (2022) Long-Term Study of Relapse After Mandibular Orthognathic Surgery: Advancement Versus Setback. J Maxillofac Oral Surg 21:469–480CrossRef Shaoo NK, Agarwal SS, Datana S, Bhandari SK (2022) Long-Term Study of Relapse After Mandibular Orthognathic Surgery: Advancement Versus Setback. J Maxillofac Oral Surg 21:469–480CrossRef
34.
go back to reference Vinay Darshan S, Ronad YA, Kishore MSV, Sadashiva Shetty K, Rajesh M, Suman SD (2014) Long Term Stability and Relapse Following Mandibular Advancement and Mandibular Setback Surgeries: A Cephalometric Study. J Intern Oral Health 6:42–46 Vinay Darshan S, Ronad YA, Kishore MSV, Sadashiva Shetty K, Rajesh M, Suman SD (2014) Long Term Stability and Relapse Following Mandibular Advancement and Mandibular Setback Surgeries: A Cephalometric Study. J Intern Oral Health 6:42–46
Metadata
Title
Condylar volume and positional changes following a bilateral sagittal split ramus osteotomy in skeletal class II and III malocclusions
Authors
Chulyoung Park
Hyejin Kim
Jaeyoung Ryu
Seunggon Jung
Hong-Ju Park
Hee-Kyun Oh
Min-Suk Kook
Publication date
01-12-2023
Publisher
Springer Nature Singapore
Published in
Maxillofacial Plastic and Reconstructive Surgery / Issue 1/2023
Electronic ISSN: 2288-8586
DOI
https://doi.org/10.1186/s40902-023-00408-3

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