Improvement of a condylar positioning system for the mandibular ramus sagittal split osteotomy

Indications to the use of condylar repositioning devices in the surgical treatment of dental-skeletal class III

“…Because of the surgical and biomechanical problems mentioned and according to our experience and to what the existing literature has advocated, the use of CPDs for the surgical treatment of dental-skeletal III Class patients must be limited and is indicated only in the presence of TMJ dysfunction in the presurgical period 5,8,21 or in case of insufficient experience of the operator. 2,5 CPD maintains condylar position stability in all 3 planes of space during surgery, whereas manual reposition permits small changes, as our analysis revealed. Such changes, although modest, are not acceptable in patients with presurgical TMJ dysfunction, requiring the exact replication of the asymptomatic condylar position.…”

“…Therefore, replicating the presurgical condyle position in the surgery is considered by many to be an important factor in achieving valid and lasting functional results. 1,2,6,[12][13][14][15][16][17] The use of CPDs requires stable intermaxillary fixation during their application and poses some difficulties such as an increase in operative times 8 and the risk of partial bone disruption at maxilla during their application. It also poses biomechanical problems requiring the utmost precision during the construction of the splint or of the temporary intraoperative wax bite 5,8-10 and when used in cases requiring mandibular autorotation.…”

“…In cases of mandibular and maxillary repositioning without presurgical TMJ dysfunctions, the CPD may not be used, depending on the operator's experience, 2,5 and the mandibular ramus may be repositioned manually, as suggested by Tuinzing 28 and Mori et al 2 In the 15 patients who underwent surgical treatment without the use of condylar repositioning plates, 2 points of mandibular reference were marked through 2 brief transverse furrows: one along the sagittal osteotomy line and the second along the vestibular osteotomy line (Fig 3). The 2 reference points allow 3-dimensional measurements, by means of a caliper, the correct symmetry of the mandibular displacements and the precise correspondence with the movements made in the maxilla.…”

“…For patients with dental-skeletal Class III and with normal presurgical joint function, the use of CPDs is unnecessary but the experience of the operator remains a factor of paramount importance in the maintenance of the condyle position. [2][3][4][5] The manual positioning of the mandibular condyle reduces operative times and avoids biomechanical and surgical problems related to the use of CPDs, but it requires the utmost competence and experience of the operators.…”

Indications to the use of condylar repositioning devices in the surgical treatment of dental-skeletal class III

“…Because of the surgical and biomechanical problems mentioned and according to our experience and to what the existing literature has advocated, the use of CPDs for the surgical treatment of dental-skeletal III Class patients must be limited and is indicated only in the presence of TMJ dysfunction in the presurgical period 5,8,21 or in case of insufficient experience of the operator. 2,5 CPD maintains condylar position stability in all 3 planes of space during surgery, whereas manual reposition permits small changes, as our analysis revealed. Such changes, although modest, are not acceptable in patients with presurgical TMJ dysfunction, requiring the exact replication of the asymptomatic condylar position.…”

“…Therefore, replicating the presurgical condyle position in the surgery is considered by many to be an important factor in achieving valid and lasting functional results. 1,2,6,[12][13][14][15][16][17] The use of CPDs requires stable intermaxillary fixation during their application and poses some difficulties such as an increase in operative times 8 and the risk of partial bone disruption at maxilla during their application. It also poses biomechanical problems requiring the utmost precision during the construction of the splint or of the temporary intraoperative wax bite 5,8-10 and when used in cases requiring mandibular autorotation.…”

“…In cases of mandibular and maxillary repositioning without presurgical TMJ dysfunctions, the CPD may not be used, depending on the operator's experience, 2,5 and the mandibular ramus may be repositioned manually, as suggested by Tuinzing 28 and Mori et al 2 In the 15 patients who underwent surgical treatment without the use of condylar repositioning plates, 2 points of mandibular reference were marked through 2 brief transverse furrows: one along the sagittal osteotomy line and the second along the vestibular osteotomy line (Fig 3). The 2 reference points allow 3-dimensional measurements, by means of a caliper, the correct symmetry of the mandibular displacements and the precise correspondence with the movements made in the maxilla.…”

“…For patients with dental-skeletal Class III and with normal presurgical joint function, the use of CPDs is unnecessary but the experience of the operator remains a factor of paramount importance in the maintenance of the condyle position. [2][3][4][5] The manual positioning of the mandibular condyle reduces operative times and avoids biomechanical and surgical problems related to the use of CPDs, but it requires the utmost competence and experience of the operators.…”

Development of a simulation system in mandibular orthognathic surgery based on integrated three-dimensional data

“…Three sets of data—CT, 3D cephalogram, and dental casts—were taken before and 6 months after the operation for all patients. Even though the positions of the mandibular proximal segments were secured with a mandibular repositioning system [20], this cannot ensure complete rigidity mediolaterally. For this reason, it is difficult to detect the exact site and degree of bony interference in the operation field with only the naked eye.…”

Indications to the use of condylar repositioning devices in the surgical treatment of dental-skeletal class III

“…Because of the surgical and biomechanical problems mentioned and according to our experience and to what the existing literature has advocated, the use of CPDs for the surgical treatment of dental-skeletal III Class patients must be limited and is indicated only in the presence of TMJ dysfunction in the presurgical period 5,8,21 or in case of insufficient experience of the operator. 2,5 CPD maintains condylar position stability in all 3 planes of space during surgery, whereas manual reposition permits small changes, as our analysis revealed. Such changes, although modest, are not acceptable in patients with presurgical TMJ dysfunction, requiring the exact replication of the asymptomatic condylar position.…”

“…Therefore, replicating the presurgical condyle position in the surgery is considered by many to be an important factor in achieving valid and lasting functional results. 1,2,6,[12][13][14][15][16][17] The use of CPDs requires stable intermaxillary fixation during their application and poses some difficulties such as an increase in operative times 8 and the risk of partial bone disruption at maxilla during their application. It also poses biomechanical problems requiring the utmost precision during the construction of the splint or of the temporary intraoperative wax bite 5,8-10 and when used in cases requiring mandibular autorotation.…”

“…In cases of mandibular and maxillary repositioning without presurgical TMJ dysfunctions, the CPD may not be used, depending on the operator's experience, 2,5 and the mandibular ramus may be repositioned manually, as suggested by Tuinzing 28 and Mori et al 2 In the 15 patients who underwent surgical treatment without the use of condylar repositioning plates, 2 points of mandibular reference were marked through 2 brief transverse furrows: one along the sagittal osteotomy line and the second along the vestibular osteotomy line (Fig 3). The 2 reference points allow 3-dimensional measurements, by means of a caliper, the correct symmetry of the mandibular displacements and the precise correspondence with the movements made in the maxilla.…”

“…For patients with dental-skeletal Class III and with normal presurgical joint function, the use of CPDs is unnecessary but the experience of the operator remains a factor of paramount importance in the maintenance of the condyle position. [2][3][4][5] The manual positioning of the mandibular condyle reduces operative times and avoids biomechanical and surgical problems related to the use of CPDs, but it requires the utmost competence and experience of the operators.…”

Development of a simulation system in mandibular orthognathic surgery based on integrated three-dimensional data

“…Three sets of data—CT, 3D cephalogram, and dental casts—were taken before and 6 months after the operation for all patients. Even though the positions of the mandibular proximal segments were secured with a mandibular repositioning system [20], this cannot ensure complete rigidity mediolaterally. For this reason, it is difficult to detect the exact site and degree of bony interference in the operation field with only the naked eye.…”

Indications to the use of condylar repositioning devices in the surgical treatment of dental-skeletal class III

“…Because of the surgical and biomechanical problems mentioned and according to our experience and to what the existing literature has advocated, the use of CPDs for the surgical treatment of dental-skeletal III Class patients must be limited and is indicated only in the presence of TMJ dysfunction in the presurgical period 5,8,21 or in case of insufficient experience of the operator. 2,5 CPD maintains condylar position stability in all 3 planes of space during surgery, whereas manual reposition permits small changes, as our analysis revealed. Such changes, although modest, are not acceptable in patients with presurgical TMJ dysfunction, requiring the exact replication of the asymptomatic condylar position.…”

“…Therefore, replicating the presurgical condyle position in the surgery is considered by many to be an important factor in achieving valid and lasting functional results. 1,2,6,[12][13][14][15][16][17] The use of CPDs requires stable intermaxillary fixation during their application and poses some difficulties such as an increase in operative times 8 and the risk of partial bone disruption at maxilla during their application. It also poses biomechanical problems requiring the utmost precision during the construction of the splint or of the temporary intraoperative wax bite 5,8-10 and when used in cases requiring mandibular autorotation.…”

“…In cases of mandibular and maxillary repositioning without presurgical TMJ dysfunctions, the CPD may not be used, depending on the operator's experience, 2,5 and the mandibular ramus may be repositioned manually, as suggested by Tuinzing 28 and Mori et al 2 In the 15 patients who underwent surgical treatment without the use of condylar repositioning plates, 2 points of mandibular reference were marked through 2 brief transverse furrows: one along the sagittal osteotomy line and the second along the vestibular osteotomy line (Fig 3). The 2 reference points allow 3-dimensional measurements, by means of a caliper, the correct symmetry of the mandibular displacements and the precise correspondence with the movements made in the maxilla.…”

“…For patients with dental-skeletal Class III and with normal presurgical joint function, the use of CPDs is unnecessary but the experience of the operator remains a factor of paramount importance in the maintenance of the condyle position. [2][3][4][5] The manual positioning of the mandibular condyle reduces operative times and avoids biomechanical and surgical problems related to the use of CPDs, but it requires the utmost competence and experience of the operators.…”

Development of a simulation system in mandibular orthognathic surgery based on integrated three-dimensional data

“…Three sets of data—CT, 3D cephalogram, and dental casts—were taken before and 6 months after the operation for all patients. Even though the positions of the mandibular proximal segments were secured with a mandibular repositioning system [20], this cannot ensure complete rigidity mediolaterally. For this reason, it is difficult to detect the exact site and degree of bony interference in the operation field with only the naked eye.…”