Three-Dimensional Quantitative Assessment of Condylar Displacement and Adaptive Remodeling in Asymmetrical Mandibular Prognathism Patients After Sagittal Split Ramus Osteotomy

Abstract

This study was performed to evaluate the condylar displacement and associated condylar remodeling in class III patients following mandibular setback surgery via sagittal split ramus osteotomy (SSRO). The sample comprised of 26 condyles of 13 subjects (mean age of 21.2±2.6 y). We evaluated patients with mandibular prognathism and facial asymmetry who had undergone SSRO for mandibular setback at Korea University Hospital between January 2016 and December 2018. Three-dimensional segmentation of the mandibular condyles was done using the initial cone-beam computed tomography scan and scan taken 12 months postoperatively or later. Quantitative assessments of the 3-dimensional condylar displacement from T0 to T1 and bony remodeling of 8 regions of the condylar head were performed. The correlation between the condylar displacement and condylar head remodeling on the deviated (D) and nondeviated (ND) sides was analyzed. Significant correlations between condylar displacement and surface remodeling were observed in both D and ND condyles. The anteroposterior condylar displacement was significantly different between the D and ND sides ( P =0.007). There was no significant difference in condylar remodeling between the 2 sides. Condylar displacement and adaptive remodeling after SSRO varied greatly among individuals. Compared with displacement in the ND condyle, displacement in the D condyle has a greater association with condylar remodeling in both D and ND condyles. There is no significant difference in condylar head remodeling between D and ND condyles.

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

“…Ku et al, 2021 41 recently examined condylar position change after mandibular setback OS across 4 different plates and did not discuss CR or shape changes, instead focusing on condylar position changes that showed after 12 months and the current study agrees with the results of Ku and colleagues, as well as Park et al, 42 who affirmed that we still need more evidence on CR related with different plating systems using 3-dimensional analysis after different OS and DO devices. Furthermore, these findings were recently reaffirmed by Nayansi et al, 2023, 43 who examined distinct plating results at just setback OS in class III patients and, therefore, for CR outcomes in class II patients, particularly those who underwent BSSO with different fixation techniques, further evidence is still required.…”

Treatment outcome and long-term stability of orthognathic surgery for facial asymmetry: A systematic review and meta-analysis

“…Integrating these datasets allows computer simulation surgery, which is reported to outperform traditional methods in enhancing facial midline symmetry. 17,54 Patients with facial asymmetry often show condylar deformation with degenerative changes, which can be accurately analyzed using CT. 65 Study groups using 2D and 3D imaging modalities for surgery and those who planned surgery with or without computer simulation all showed significant improvements in asymmetry. However, it was not possible to directly compare the outcome variables of the studies that used 2D and 3D imaging modalities due to the nature of the meta-analysis.…”