Cone-beam computed tomography evaluation on the condylar displacement following sagittal split ramus osteotomy in asymmetric setback patients: Comparison between conventional approach and surgery-first approach

Oh, Myounghak; Hwang, Hyeon-Shik; Lee, Kyung-Min; Cho, Jin-Hyoung

doi:10.2319/122316-925.1

Cited by 10 publications

(9 citation statements)

References 32 publications

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“…No significant association was noted between asymmetrical set-back and condylar displacement. Wang et al 47 evaluated condylar displacement in class III patients after the SFA, and similar to Oh et al, 18 found no significant difference between the two surgical approaches; however, their patients did not have asymmetry. Oh et al 18 also emphasized that a CT scan taken in the upright position is more similar to the natural head position and is more suitable for the assessment of the position of the condyles.…”

Section: Changes In the Condylar Position After Surgerymentioning

confidence: 84%

Facial asymmetry correction: From conventional orthognathic treatment to surgery-first approach

Nik

Gholamrezaei

Keshvad

2019

J Dent Res Dent Clin Dent Prospects

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The surgery-first approach (SFA), which proceeds without presurgical orthodontic treatment, is assumed to shorten the treatment course because the direction of post-surgical orthodontic tooth movement conforms to the normal muscular forces. Moreover, the regional acceleratory phenomenon (RAP), evoked by surgery, helps in tooth alignment and compensation in a faster way. Although SFA has definite advantages, especially in class III individuals, there is a lack of data about its indications in patients with facial asymmetry. In this article, we reviewed recently published articles on the treatment of asymmetric patients using the SFA. Different aspects, including the three-dimensional assessment of stability in different planes, approaches for fabrication of a surgical splint, predictability of the results, skills needed for bimaxillary surgery, indications as the treatment of choice for condylar hyperplasia, and combination with distraction osteogenesis in candidates with severe asymmetries were found to be the main topics discussed for patients presenting with facial asymmetry

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Section: Changes In the Condylar Position After Surgerymentioning

confidence: 84%

Facial asymmetry correction: From conventional orthognathic treatment to surgery-first approach

Nik

Gholamrezaei

Keshvad

2019

J Dent Res Dent Clin Dent Prospects

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“…Because of this change in condylar head location, functional change, disorder of the temporomandibular joint, occlusion disorder, and relapse due to segmental movement can occur, and the condylar head must be located similar to the preoperative position to prevent side effects and relapse [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Positional change in mandibular condyle in facial asymmetric patients after orthognathic surgery: cone-beam computed tomography study

Choi

Kim

Lim

et al. 2018

Maxillofac Plast Reconstr Surg

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BackgroundWe evaluated change in the mandibular condyle after orthognathic surgery using cone-beam computed tomography (CBCT) in patients with facial asymmetry.MethodsThirty patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry were classified into two groups according to the amount of menton deviation (MD) from the facial midline on anteroposterior (AP) cephalogram: group A (asymmetry, MD ≥ 4 mm; n = 15) and group B (symmetry, MD < 4 mm; n = 15). Position and angle of condylar heads on the axial, sagittal, and coronal views were measured within 1 month preoperatively (T0) and postoperatively (T1) and 6 months (T2) postoperatively.ResultsOn axial view, both groups showed inward rotation of condylar heads at T1, but at T2, the change was gradually removed and the condylar head returned to its original position. At T1, both groups showed no AP condylar head changes on sagittal view, although downward movement of the condylar heads occurred. Then, at T2, the condylar heads tended to return to their original position. The change in distance between the two condylar heads showed that they had moved outward in both groups, causing an increase in the width between the two heads postoperatively. Analysis of all three-dimensional changes of the condylar head positions demonstrated statistically significant changes in the three different CBCT views in group B and no statistically significant changes in group A.ConclusionsThere was no significant difference between the two groups in condylar head position. Because sagittal split ramus osteotomy can be performed without significant change in symmetrical and asymmetrical cases, it can be regarded as an effective method to stabilize the condylar head position in patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry.

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“… 1 Recently, many studies have been conducted regarding postoperative condylar position using three-dimensional images. 2 3 4 5 6 7 8 9 10 11 12 13 14 Because of the nature of orthognathic surgery, dental parts such as the teeth and jaw are changed; the unchanged cranial base is commonly used as a baseline to superimposition. 15 16 As a result, images can be accurately superimposed, but the effects of orthognathic surgery on postoperative condylar position remain controversial due to the three-dimensional axis setting and remodeling of the temporomandibular joint complex.…”

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confidence: 99%

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

Choi

Lee

et al. 2021

Journal of Craniofacial Surgery

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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.

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Cone-beam computed tomography evaluation on the condylar displacement following sagittal split ramus osteotomy in asymmetric setback patients: Comparison between conventional approach and surgery-first approach

Abstract: The condylar displacement in three dimensions and the distance of condylar displacement in SSRO patients with facial asymmetry showed no significant difference between conventional and SF groups. Condylar displacement was not associated with asymmetric setback.

Cited by 10 publications

References 32 publications

Facial asymmetry correction: From conventional orthognathic treatment to surgery-first approach

Facial asymmetry correction: From conventional orthognathic treatment to surgery-first approach

Positional change in mandibular condyle in facial asymmetric patients after orthognathic surgery: cone-beam computed tomography study

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

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