A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma

Abstract

Background Mandibular condylar osteochondroma (OC) could lead to facial morphologic and functional disturbances, such as facial asymmetry, malocclusion, and temporomandibular joint dysfunction. However, after condylar OC resection, the inaccurate reposition of the neocondyle still needs to be solved. The purpose of this study was to explore the feasibility of the condylar osteotomy and repositioning guide to reposition the neocondyle in the treatment of patients with severe deformity secondary to condylar OC. Results Three patients with severe deformity secondary to OC of the mandibular condyle were enrolled in this study. With the aid of condylar osteotomy and repositioning guide, condylar OC resection and repositioning were carried out, and the accuracy and stability of these guides were evaluated. All patients healed uneventfully, and no facial nerve injury and condylar ankylosis occurred. Compared with the computerized tomography scans in centric relation before surgery and 3 days after surgery, the results showed that the facial symmetry was greatly improved in all the patients. Also, after the superimposition of the condylar segments before surgery and 3 days after surgery, the postoperative reconstructed condyles had a high degree of similarity to the reconstruction of the virtual surgical planning. Observed from the sagittal and coronal directions, the measurements of condylar positions were very close to those of virtual surgical planning. Moreover, it also showed stable results after a 1-year follow-up. Conclusions For patients with severe deformity secondary to condylar OC, condylar osteotomy, and repositioning guide was expected to provide a new option for the improvement of facial symmetry and occlusal relationship.

Clinical Application of Individualized 3D-Printed Templates in the Treatment of Condylar Osteochondroma

“…In the present study, the superimposition of the planned models and postoperative condyle segment showed that the mean 3D deviation of the condylar osteotomy guide between T0p and T1 was 0.5794 mm, which was similar to that in Lei Qi’s study [ 21 ]. The maximum deviation was 1.34 mm, with average in lingual sides owing to the need to grind the surface of the neo condyle smooth when the osteotomy performed.…”

“…During the treatment, there are three major possible complications, including facial paralysis, massive bleeding during operation, and cranial base injury [ 21 , 25 ]. However, the virtual plan and 3D-printed templates can decrease the occurrence of such complications [ 21 ].…”

“…To evaluate the change of condylar position in different periods (T0p, T1, T2), the linear measurements of the OC joint space in the actual postoperative and virtual planned models were assessed and compared with each other. All linear vectors were defined from the most prominent condylar points (anterior, superior, posterior, medial, lateral) to the glenoid fossa, in accordance with a previous study [ 20 , 21 ]. The anterior joint space (AJS), superior joint space (SJS), and posterior joint space (PJS) were measured in the sagittal image, and the medial joint space (MJS) and lateral joint space (LJS) were measured in the coronal image.…”

Surgical Guides and Prebent Titanium Improve the Planning for the Treatment of Dentofacial Deformities Secondary to Condylar Osteochondroma

“…More new and innovative technologies have been used on dentofacial deformities to improve surgical accuracy, simplify surgical procedures, shorten the operative time, and reduce complications. 14-16,18-23,26…”

“…More new and innovative technologies have been used on dentofacial deformities to improve surgical accuracy, simplify surgical procedures, shorten the operative time, and reduce complications. [14][15][16][18][19][20][21][22][23]26 Clinical Report There were 8 adults were successfully treated by the combined utilization of computer-aided design and manufacturing surgical cutting and drilling guides with pre-bent titanium miniplates. Their diagnosis based on computed tomographic (CT) examination was condylar osteochondroma and was confirmed postoperatively in pathology.…”