Evaluation of mandibular condylar changes in patients following orthognathic surgery: A retrospective study

Abstract

Background:Condylar resorption as a cause of relapse after orthognathic surgery is well known. Several authors have presented evidence of the relation between orthognathic surgery and condylar remodeling and resorption. This study was done to appraise the condylar changes along with the form and function following orthognathic surgery, as well as to assess what factors may have contributed to the problems.Methodology:A diagnosis of progressive condylar resorption (PCR) was made by comparison of preoperative and postoperative radiographs (cephalometric radiograms), as well as clinical evaluations. The radiographs were taken for each patient preoperatively and postoperatively, which include immediately after osteotomy, at 6 months and 24 months. Additional radiographs were taken when required. Then, preoperative and postoperative tracings were compared at 24 months postoperatively.Results and Conclusion:It can be concluded from this study that females of relative low age (<18 years) appeared to be a high-risk factor for the occurrence of condylar alteration including PCR. A steep mandibular plane angle, the low facial height ratio (post/ant), and magnitude of surgery were also significantly related to the occurrence of condylar alteration, but the multivariance regression showed that these parameters had only limited value.

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

“…Regarding osteotomies associated with CR. Another interesting finding is that CR was found to be significantly higher postbimaxillary surgery (75.2%).and this was also reported by Hoppenreijs et al 14 and others 16,17,33 . The increased occurrence of CR after BSSO (15.3%) was emphasized by Jose Neto 26 and Jedrzejewski et al 27 where they reported maxilla-mandibular counter-clockwise rotation contributed to influencing TMJ position and health and that TMJ is more favorable to intraoral oblique ramus osteotomy with bimaxillary surgery compared with BSSO with rigid fixation.…”

“…Another interesting finding is that CR was found to be significantly higher postbimaxillary surgery (75.2%).and this was also reported by Hoppenreijs et al 14 and others. 16,17,33 The increased occurrence of CR after BSSO (15.3%) was emphasized by Jose Neto 26 and Jedrzejewski et al 27 where they reported maxilla-mandibular counter-clockwise rotation contributed to influencing TMJ position and health and that TMJ is more favorable to intraoral oblique ramus osteotomy with bimaxillary surgery compared with BSSO with rigid fixation. According to a survey conducted by de Santanaet al, 2012, 34 the most common OS performed by Oral and Maxillofacial Surgery is BSSO, and the current review revealed that it is the most commonly reported CR complication.…”

Does the Implementation of Virtual Planning has a Significant Impact on Reducing the Revision Rate in Orthognathic Surgery?

“…A mistake or overlooked detail during surgical planning, whether in the operating room (condyles) or in the postoperative period (relapse), may require additional surgery. 17,18 From the patients' perspective, the need for reoperation in the postoperative period is one of the most distressing complications. Therefore, meticulous preoperative planning, thorough surgical evaluation, and comprehensive postoperative monitoring are required.…”

“…Therefore, the surgeon should make thorough analysis and planning during the preoperative period. A mistake or overlooked detail during surgical planning, whether in the operating room (condyles) or in the postoperative period (relapse), may require additional surgery 17,18 . From the patients’ perspective, the need for reoperation in the postoperative period is one of the most distressing complications.…”