Literature DB >> 23973047

Short- and long-term changes of condylar position after bilateral sagittal split ramus osteotomy for mandibular advancement in combination with Le Fort I osteotomy evaluated by cone-beam computed tomography.

Shuo Chen1, Jie Lei, Xing Wang, Kai-Yuan Fu, Payam Farzad, Biao Yi.   

Abstract

PURPOSE: Bilateral sagittal split ramus osteotomy (BSSO) may change condylar position, which can be one of the factors contributing to skeletal relapse. This study evaluated short- and long-term changes in condylar position using cone-beam computed tomography (CBCT) and investigated changes in temporomandibular joint (TMJ) signs after BSSO for mandibular advancement in combination with Le Fort I osteotomy.
MATERIALS AND METHODS: Thirty-one patients were included, and CBCT data of 62 TMJs were collected before surgery (T0), immediately after surgery (T1), 3 months after surgery (T2), and at the last follow-up at 12.1 ± 3.0 months after surgery (T3). The relation of the condyle to the fossa was evaluated by the method of Pullinger and Hollender (Oral Surg Oral Med Oral Pathol 62:719, 1986). Clinical examination, with a special focus on signs of temporomandibular disorder (TMD), was documented at T0, T2, and T3. Repeated-measures analysis of variance (P = .05) and χ2 test (P = .05) were performed.
RESULTS: Data of 27 patients were used for statistical analysis. Values from the formula of Pullinger and Hollender changed significantly with time, but there was no significant difference between the right and left condyles. Condyles moved inferoposteriorly immediately after surgery (T0 to T1) followed by anterosuperior movement 3 months after surgery (T1 to T2). The superimposed effect showed posterosuperior movement compared with the initial position before surgery (T0 to T2) and this position remained stable at 1-year follow-up (T2 to T3). A decrease of TMD signs over time, from 22.6% (T0) to 12.9% (T2) and 9.7% (T3), was observed, which showed no statistical significance.
CONCLUSIONS: There were obvious changes in condylar position after BSSO in combination with Le Fort I osteotomy. Condyles tended to be located in a concentric position in relation to the glenoid fossa 3 months after surgery and remained stable during the 1-year follow-up. These changes did not cause an increase of TMD signs.
Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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Year:  2013        PMID: 23973047     DOI: 10.1016/j.joms.2013.06.213

Source DB:  PubMed          Journal:  J Oral Maxillofac Surg        ISSN: 0278-2391            Impact factor:   1.895


  15 in total

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8.  Evaluation of Condylar Position after Orthognathic Surgery for Treatment of Class II Vertical Maxillary Excess and Mandibular Deficiency by Using Cone-Beam Computed Tomography.

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9.  Condylar response to large mandibular advancement combined with maxillary impaction and counterclockwise rotation: A computed tomographic study.

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10.  Fixation Methods for Mandibular Advancement and Their Effects on Temporomandibular Joint: A Finite Element Analysis Study.

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