Analysis of Sagittal Position Changes of the Condyle After Mandibular Setback Surgery Across the Four Different Types of Plating Systems

Abstract

The authors analyzed the three-dimensional postoperative condylar position change across the plating systems. This retrospective study was conducted with the patients who underwent bilateral sagittal split ramus osteotomy with setback surgery. The condylar change was analyzed from preoperative cone-beam computed tomography to postoperative 1 month (T1) and postoperative 6 months (T2) using superimposition software, automatically merging based on the anterior cranial base. The condylar changes during T1 and T2 were analyzed across the four types of plates (4-hole sliding, heart-shaped, 3-hole sliding, and 4-hole conventional) Mean intraclass correlation coefficient values were consistently high for each measurement (>0.850). During T1, the conventional plate had a decreased condylar anterior distance when compared with the 3-hole sliding plate ( P = 0.032). During T2, the conventional plate had an increased condylar posterior distance when compared with the 3-hole sliding plate ( P = 0.031). S uperimposition software based on the anterior cranial base could be available for measurement of condylar position with highly reproducible results. After bilateral sagittal split ramus osteotomy, the 3-hole sliding plate could effectively compensate for the anterior displacement of the condyle compared to other plates.

Condylar Resorption After Orthognathic Surgery: A Review of Risk Factors With a Proposed Algorithm of Treatment

“…Ku et al, 2021 41 recently examined condylar position change after mandibular setback OS across 4 different plates and did not discuss CR or shape changes, instead focusing on condylar position changes that showed after 12 months and the current study agrees with the results of Ku and colleagues, as well as Park et al, 42 who affirmed that we still need more evidence on CR related with different plating systems using 3-dimensional analysis after different OS and DO devices. Furthermore, these findings were recently reaffirmed by Nayansi et al, 2023, 43 who examined distinct plating results at just setback OS in class III patients and, therefore, for CR outcomes in class II patients, particularly those who underwent BSSO with different fixation techniques, further evidence is still required.…”

Clinical Stability of Bespoke Snowman Plates for Fixation following Sagittal Split Ramus Osteotomy of the Mandible

“…However, SSRO, commonly used in the mandible, presents challenges for applying surgical guides compared to the maxilla, and the bone fracture pattern is more varied [ 21 , 34 , 35 ]. We conducted a clinical evaluation to assess the impact of a bespoke Snowman plate designed on the basis of sliding plate studies [ 22 , 23 , 24 , 25 , 26 , 27 ] on postoperative mandibular positioning. The study consisted of a control group using a bespoke four-hole plate and a study group using a bespoke Snowman plate with a sliding plate effect, with the aim of evaluating the stability of PSPs for up to 1 year after surgery.…”

“…Exclusion was necessary to compare groups with an equal number of screws. Snowman plates are customized; however, using three screws can result in an adjustable [ 68 ] or sliding plate effect [ 22 , 23 , 24 , 25 , 26 , 27 ] during surgery. The long-term success of orthognathic reconstructive surgery depends on the long-term stability of surgical correction [ 39 ].…”

“…Virtual surgical planning is used to prevent unwanted rotation of the proximal bone fragments. The Snowman plate can act as a conventional sliding plate when the screw is not placed in the anterior hole of a part fixed to the distal segment of the mandible [ 22 , 23 , 24 , 25 , 26 , 27 ]. Although sliding plates play a crucial role in stabilizing the condyle and allowing proper movement of the proximal segment, further research is warranted to understand the long-term clinical stability of patient-specific sliding plates, including the bespoke Snowman plate used in this study.…”

Accuracy of dental implant placement with computer-guided surgery: a retrospective cohort study

“…CBCT data were extracted as a file of Digital Imaging and Communications in Medicine (DICOM). A 3-dimentional analysis program (OnDemand 3D, Cybermed, Seoul, Korea) was used to compare the preoperative planned location of the implant with the postoperative implant position by the automated registration software [ 20 ]. The software was superimposed on the basis of voxels’ gray level within the anterior cranial bases of the two CBCT.…”