Sophia Mousoulea1, Dimitrios Kloukos1,2, Dimitrios Sampaziotis1, Theodosia Vogiatzi3, Theodore Eliades4. 1. Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece. 2. Department of Orthodontics and Dentofacial Orthopedics, Faculty of Medicine, University of Bern, Switzerland. 3. Private practice, Athens, Greece. 4. Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland.
Abstract
Objective: To systematically search the literature and assess the available evidence regarding the incidence and quantification of condylar resorption following bilateral sagittal split osteotomy (BSSO) of the mandible in orthognathic patients. Search methods: Electronic database searches of published and unpublished literature were performed. The reference lists of eligible studies were hand searched for additional studies. Selection criteria: Randomized clinical trials (RCTs), prospective, and retrospective studies with patients of any age that underwent BSSO were included. Data collection and analysis: Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate. Results: One RCT, 3 prospective, and 10 retrospective studies were included in this review. The lack of standardized protocols and the high amount of heterogeneity precluded a valid interpretation of the actual results through pooled estimates. There was a substantial consistency among studies, however, that young, female patients with mandibular deficiency and high mandibular plane angle, submitted to surgical counterclockwise rotation of mandibular segments, were more prone to a higher risk for condylar resorption after BSSO. The level of evidence was found to be low given the high/serious risk of bias in all included studies. Conclusions: Condylar resorption should be taken into account as a potential postsurgical complication after BSSO. However, its incidence and quantification need precautious interpretation owing to the low level of evidence and the high heterogeneity of studies. Additional high-quality prospective research assisted by 3D imaging technology is needed to allow more definitive conclusions. Registration: Study not registered. Conflict of interest: None.
Objective: To systematically search the literature and assess the available evidence regarding the incidence and quantification of condylar resorption following bilateral sagittal split osteotomy (BSSO) of the mandible in orthognathic patients. Search methods: Electronic database searches of published and unpublished literature were performed. The reference lists of eligible studies were hand searched for additional studies. Selection criteria: Randomized clinical trials (RCTs), prospective, and retrospective studies with patients of any age that underwent BSSO were included. Data collection and analysis: Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate. Results: One RCT, 3 prospective, and 10 retrospective studies were included in this review. The lack of standardized protocols and the high amount of heterogeneity precluded a valid interpretation of the actual results through pooled estimates. There was a substantial consistency among studies, however, that young, female patients with mandibular deficiency and high mandibular plane angle, submitted to surgical counterclockwise rotation of mandibular segments, were more prone to a higher risk for condylar resorption after BSSO. The level of evidence was found to be low given the high/serious risk of bias in all included studies. Conclusions: Condylar resorption should be taken into account as a potential postsurgical complication after BSSO. However, its incidence and quantification need precautious interpretation owing to the low level of evidence and the high heterogeneity of studies. Additional high-quality prospective research assisted by 3D imaging technology is needed to allow more definitive conclusions. Registration: Study not registered. Conflict of interest: None.
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