Condylar position following ramus osteotomy and functional osteosynthesis. A clinical function-analytic and computer tomographic study.

Opponents of the application of a stable fixation of the fragments with compression screws in osteotomies of the mandibular ramus quite often claim that there is the possibility of a postoperative dislocation of the proximal fragment with consequent functional disturbances of the temporo-mandibular joint. For determination of the frequency and the extent of such possible displacements of the condyle, a total of 174 patients, in whom ramus osteotomies were performed, were clinically examined. In 9 of them, a functional analysis and in 10 other patients, a CT scan investigation of the position of the TM joint, was carried out. Only in 1 case could a considerable dislocation of the proximal fragment be observed, which was due to a strong unilateral deviation of the ascending ramus. For correction of the functional disturbance the bone screws had to be removed in this particular case. In those cases where a functional analysis and CT study were undertaken, only slight changes of the pre- and post-operative position of the condyles were observed: it did not lead to clinical disturbances and complaints.