Condylar changes after orthognathic surgery for class III dentofacial deformity: a systematic review

Abstract

After orthognathic surgery for class II dentofacial deformity, remodelling of the mandibular condyle will take place. In a number of cases, this may evolve towards a phenomenon of condylar resorption. Yet, studies on the occurrence of this complication after the correction of a class III deformity are scarce. A systematic review of the literature was performed with the aim of identifying reports on condylar resorption or remodelling after orthognathic surgery for class III dentofacial deformity. A search of the international databases yielded 12 eligible studies. Eight studies reported some degree of postoperative condylar remodelling, while symptoms of condylar resorption were only described in a limited group of patients. Thus, the literature may show evidence of condylar remodelling after orthognathic treatment of class III patients, and anecdotal reports of condylar resorption exist. The small sample sizes, heterogeneity in methods and outcomes, and use of two-dimensional radiographs indicate the need for updated long-term research. In the future, the use of cone beam computed tomography data for volumetric and morphological condylar analysis in combination with three-dimensional cephalometry may provide the opportunity to further elucidate this phenomenon and better characterize its aetiology.

Assessment of the Thickness of the Roof of the Glenoid Fossa Using Cone Beam Computed Tomography in Orthognathic Surgery Patients: A Preliminary Study

“…However, Wolford et al [17] reported greater bone remodeling in two-versus one-jaw surgery. In one-jaw surgery, there is a difference in the position of the condyle, and the stress applied to the glenoid fossa, according to whether mandibular setback or advancement is performed [3,5,17].…”

“…Many studies have evaluated changes in condyle position and condyle shape after orthognathic surgery [3,[5][6][7]. Cevidanes et al [3] studied changes of the condyle of the TMJs after orthognathic surgery, and reported surgical displacement and adaptive responses relative to adjacent structures in the craniofacial complex [3].…”

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

“…[344][345][346] Condylar resorption, which mostly affects female patients, is a rare event and can be idiopathic or develop as a consequence of orthognathic surgery. 345,347,348 Condylar resorption may appear in up to 5% of the patients who underwent orthognathic surgery. 345,[347][348][349] Excessive load on the condyles and/or misguided condylar remodeling after orthognathic surgery have been discussed as etiologic factors.…”

“…345,347,348 Condylar resorption may appear in up to 5% of the patients who underwent orthognathic surgery. 345,[347][348][349] Excessive load on the condyles and/or misguided condylar remodeling after orthognathic surgery have been discussed as etiologic factors. 347,348 Most cases of condylar resorption occur as a sequel of the surgical correction of class II occlusion which involves counterclockwise mandibular rotation and anterior repositioning.…”

“…345,[347][348][349] Excessive load on the condyles and/or misguided condylar remodeling after orthognathic surgery have been discussed as etiologic factors. 347,348 Most cases of condylar resorption occur as a sequel of the surgical correction of class II occlusion which involves counterclockwise mandibular rotation and anterior repositioning. 347 These surgical jaw movements are known to cause increased muscular tension and changes in muscular activity.…”