Tong Xi1, Martien de Koning2, Stefaan Bergé3, Theo Hoppenreijs4, Thomas Maal5. 1. Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Tong.Xi@radboudumc.nl. 2. Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Martien.deKoning@radboudumc.nl. 3. Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Stefaan.Berge@radboudumc.nl. 4. Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands. Electronic address: thoppenreijs@rijnstate.nl. 5. Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Thomas.Maal@radboudumc.nl.
Abstract
PURPOSE: To quantify the postoperative rotation of the proximal segments in 3D and to assess its role on skeletal relapse and condylar remodelling following BSSO advancement surgery. MATERIAL AND METHODS: 56 patients with mandibular hypoplasia who underwent BSSO advancement surgery were enrolled into the study. A CBCT scan was acquired preoperatively, at one week postoperatively and at one year postoperatively. After segmentation of the facial skeleton and condyles, 3D cephalometry and condylar volume analysis were performed. RESULTS: A mean mandibular advancement of 4.6 mm was found. 55% of the condyles decreased in volume postoperatively, with a mean reduction of 6.1 volume-percent. Among 11 patients who exhibited a clinically significant relapse of more than 2 mm, 10 patients exhibited a counterclockwise rotation of the proximal segments. The odds of skeletal relapse (>2 mm) was 4.8 times higher in patients whose proximal segments were rotated in a counterclockwise direction. Postoperative flaring (3.3 mm) and torque (0.3°) were, however, not associated with skeletal relapse or condylar remodelling. CONCLUSION: Gender, preoperative condylar volume, postoperative condylar remodelling, counterclockwise rotation of the proximal segment and the amount of surgical advancement were prognostic factors for skeletal relapse (r(2) = 0.83). The role of the mandibular plane angle in relapse is questionable.
PURPOSE: To quantify the postoperative rotation of the proximal segments in 3D and to assess its role on skeletal relapse and condylar remodelling following BSSO advancement surgery. MATERIAL AND METHODS: 56 patients with mandibular hypoplasia who underwent BSSO advancement surgery were enrolled into the study. A CBCT scan was acquired preoperatively, at one week postoperatively and at one year postoperatively. After segmentation of the facial skeleton and condyles, 3D cephalometry and condylar volume analysis were performed. RESULTS: A mean mandibular advancement of 4.6 mm was found. 55% of the condyles decreased in volume postoperatively, with a mean reduction of 6.1 volume-percent. Among 11 patients who exhibited a clinically significant relapse of more than 2 mm, 10 patients exhibited a counterclockwise rotation of the proximal segments. The odds of skeletal relapse (>2 mm) was 4.8 times higher in patients whose proximal segments were rotated in a counterclockwise direction. Postoperative flaring (3.3 mm) and torque (0.3°) were, however, not associated with skeletal relapse or condylar remodelling. CONCLUSION: Gender, preoperative condylar volume, postoperative condylar remodelling, counterclockwise rotation of the proximal segment and the amount of surgical advancement were prognostic factors for skeletal relapse (r(2) = 0.83). The role of the mandibular plane angle in relapse is questionable.
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