Evaluation of condylar morphology following orthognathic surgery on digital panoramic radiographs. Could methodology influence the range of “normality” in condylar changes?

Abstract

Objectives: To evaluate the morphological condylar changes following orthognathic surgery by using a rapid and reliable computational method on panoramic radiographs. Methods: Digital panoramic radiographs of 45 patients who underwent bilateral sagittal split osteotomy (alone or associated with a Le Fort I osteotomy) between 2007 and 2010 were analysed. Calculation of the area, perimeter and height of 90 condyles was performed by using a specific computational method. Measurements were taken before surgery (m 1 ), 1 day after surgery (m 2 ) and 1 year after surgery (m 3 ). The evolution of each index was analysed using paired t-tests between measures before and 1 day after surgery (m 1 2 m 2 ) and measures before and 1 year after surgery (m 1 2 m 3 ). The changes in the condylar area, perimeter and height were examined using the Bland and Altman plotting method. Results: There were no statistically significant changes in the mean condylar area, perimeter or height between m 1 and m 2 or between m 1 and m 3 . The Bland and Altman plots for each index showed that a very limited number of condyles increased or decreased in area, perimeter and/or height outside the boundaries of the measurement error. Given the impossibility for a condyle to increase in size, these results are considered to represent the limits of the computational method used. Conclusions: This study demonstrated that there were no significant morphological condylar changes at the 1-year follow-up following surgery and that the range of normality in condylar changes could be influenced by the methodology used. Dentomaxillofacial Radiology (2013Radiology ( ) 42, 20120463. doi: 10.1259 Cite this article as: Scolozzi P, Momjian A, Courvoisier D S, Kiliaridis S. Evaluation of condylar morphology following orthognathic surgery on digital panoramic radiographs. Could methodology influence the range of "normality" in condylar changes? Dentomaxillofac Radiol 2013; 42: 20120463.

Evaluation of condylar resorption rates after orthognathic surgery in class II and III dentofacial deformities: A systematic review

“…Of these 56 articles, 50 were excluded because they did not describe the condylar resorption rate, the method of analysis used, or the validation of a new technique for 3D analysis. Thus, six articles (Kobayashi et al, 2012;Park et al, 2012;Scolozzi et al, 2013;An et al, 2014;Ueki et al, 2015;Xi et al, 2015) were selected for the qualitative analysis, and none presented sufficient data for a quantitative analysis (Fig. 1).…”

“…Rates of condylar resorption ranged from 0.0% to 4.2% (Tables 4 and 5). Only three studies presented condylar resorption data (Park et al, 2012;An et al, 2014;Xi et al, 2015), while studies involving similar patients did not indicate the rate of condylar resorption (Scolozzi et al, 2013;Ueki et al, 2015) (Fig. 2).…”

“…Of the six studies selected, three were prospective (Kobayashi et al, 2012;Scolozzi et al, 2013;Xi et al, 2015), and three were retrospective (Park et al, 2012;An et al, 2014;Ueki et al, 2015). They were published between 2012 and 2015, and the number of patients in each study ranged from 6 to 76.…”

“…They were published between 2012 and 2015, and the number of patients in each study ranged from 6 to 76. They included patients with class III skeletal patterns (Park et al, 2012;An et al, 2014;Ueki et al, 2015), class II patterns 15, (Scolozzi et al, 2013;Xi et al, 2015) (Table 1).…”

“…For analysis of the condylar resorption rate, five studies (Kobayashi et al, 2012;Park et al, 2012;An et al, 2014;Ueki et al, 2015;Xi et al, 2015) used computed tomography, and one (Scolozzi et al, 2013) used panoramic radiography. The analyses were performed with different software; however three studies used measurements (Park et al, 2012;Scolozzi et al, 2013;Ueki et al, 2015), and three used overlays (Kobayashi et al, 2012;An et al, 2014;Xi et al, 2015) of the images. Rates of condylar resorption ranged from 0.0% to 4.2% (Tables 4 and 5).…”