3D Analysis of Condylar Position After Sagittal Split Osteotomy of the Mandible in Mono- and Bimaxillary Orthognathic Surgery - a Methodology Study in 18 Patients

Overview

Journal J Orofac Orthop

Specialty Dentistry

Date 2010 Nov 18

PMID 21082305

Citations 9

Authors

Florian Guy Draenert

Christina Erbe

Viola Zenglein

Peer W Kammerer

Susanne Wriedt

Bilal Al Nawas

Affiliations

Soon will be listed here.

Abstract

Objectives: This study analyzes the condylar position with intercondylar distance and angle after sagittal split osteotomy in mono- and bimaxillary orthognathic surgery applying cone-beam computed tomography (CBCT) images before and after surgery.

Materials And Methods: Data of 18 patients, ten males (mean age 28 years) and eight females (mean age 26 years) undergoing the described surgery between 2008 and 2009 were analyzed. CBCT scans were performed with the KaVo 3DeXam (KaVo, Biberach/ Riß, Germany) (identical with the iCAT scan device) before and after surgery. The exported DICOM data were analyzed with ImageJ morphometry software. Patients were also asked about TMJ problems. The two-tailed t test was used and significance was set at a p value less than p = 0.05.

Results: There was no significant difference between the pre- and postoperative distances between condylar centers (mean difference: 1 mm) (p = 0.69) and intercondylar angle (mean difference: 6.6°) (p = 0.27).

Conclusions: CBCT is a novel imaging technique appropriate for detailed and three-dimensional analysis of the condylar position in orthognathic surgery. Available freeware analysis software can be applied for metrical measurements. Our cases showed no significant changes of condylar position immediately after surgery without intraoperative condylar fixation.

Citing Articles

Pre- and Post-Operative Cone Beam Computed Tomography Assessment of the Temporomandibular Joint in Patients with Orthognathic Surgery.

Vogl T, Zyada W, Helal R, Naguib N, Lingwal N, Nour-Eldin N Diagnostics (Basel). 2024; 14(13).

PMID: 39001279 PMC: 11241033. DOI: 10.3390/diagnostics14131389.

Does mandibular advancement ortho-surgical procedure cause condyle changes? A case-series analysis.

Fernandes A, Vilela L, Chagas T, Carlos de Oliveira Ruellas A, Mattos C, de Souza M Dental Press J Orthod. 2024; 29(3):e2423261.

PMID: 38985076 PMC: 11235570. DOI: 10.1590/2177-6709.29.3.e2423261.oar.

A three-dimensional method to calculate mechanical advantage in mandibular function : Intra- and interexaminer reliability study.

Sanchez-Ayala A, Sanchez-Ayala A, Kolodzejezyk R, Urban V, Lagravere M, Campanha N J Orofac Orthop. 2022; 84(5):321-339.

PMID: 35254453 DOI: 10.1007/s00056-022-00378-7.

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

Vale F, Francisco I, Scherzberg J, Guimaraes A, Caramelo F, Malo L J Clin Exp Dent. 2018; 10(9):e891-e901.

PMID: 30386522 PMC: 6203919. DOI: 10.4317/jced.54933.

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

Tabrizi R, Shahidi S, Bahramnejad E, Arabion H J Dent (Shiraz). 2016; 17(4):318-325.

PMID: 27942547 PMC: 5136410.

References

Coppenrath E, Draenert F, Lechel U, Veit R, Meindl T, Reiser M . [Cross-sectional imaging in dentomaxillofacial diagnostics: dose comparison of dental MSCT and NewTom 9000 DVT]. Rofo. 2008; 180(5):396-401. DOI: 10.1055/s-2008-1027142. View

Jalbert F, Paoli J . [Osirix: free and open-source software for medical imagery]. Rev Stomatol Chir Maxillofac. 2007; 109(1):53-5. DOI: 10.1016/j.stomax.2007.07.007. View

Lee J, Yun K, Kim C, Park J . Articular disc position in association with mandibular setback surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 105(1):e19-21. DOI: 10.1016/j.tripleo.2007.07.038. View

Ellis 3rd E . Condylar positioning devices for orthognathic surgery: are they necessary?. J Oral Maxillofac Surg. 1994; 52(6):536-52; discussion 552-4. DOI: 10.1016/0278-2391(94)90085-x. View

WARE W, Taylor R . Condylar repositioning following osteotomies for correction of mandibular prognathism. Am J Orthod. 1968; 54(1):50-9. DOI: 10.1016/0002-9416(68)90145-0. View

Sforza C, Ugolini A, Rocchetta D, Galante D, Mapelli A, Gianni A . Mandibular kinematics after orthognathic surgical treatment a pilot study. Br J Oral Maxillofac Surg. 2008; 48(2):110-4. DOI: 10.1016/j.bjoms.2008.09.002. View

Fernandez Sanroman J, Gomez Gonzalez J, Alonso Del Hoyo J, Gil F . Morphometric and morphological changes in the temporomandibular joint after orthognathic surgery: a magnetic resonance imaging and computed tomography prospective study. J Craniomaxillofac Surg. 1997; 25(3):139-48. DOI: 10.1016/s1010-5182(97)80005-4. View

LUHR H, Schauer W, Jager A, Kubein-Meesenburg D . [Changes in the shape of the mandible by orthodontic surgical technics with stable fixation of the segments]. Fortschr Kieferorthop. 1986; 47(1):39-47. DOI: 10.1007/BF02167595. View

Freihofer Jr H . [Model test on the change of position of the mandibular condyle after sagittal splitting of the mandible]. SSO Schweiz Monatsschr Zahnheilkd. 1977; 87(1):12-22. View

10.

Iida S, Reuther T, Aikawa T, Sakai T, Okura M . A new attachment for proximal segment positioning for bimaxillary dysgnathic surgery--technical note. J Craniomaxillofac Surg. 2006; 34(4):217-9. DOI: 10.1016/j.jcms.2006.01.002. View

11.

Saka B, Petsch I, Hingst V, Hartel J . The influence of pre- and intraoperative positioning of the condyle in the centre of the articular fossa on the position of the disc in orthognathic surgery. A magnetic resonance study. Br J Oral Maxillofac Surg. 2004; 42(2):120-6. DOI: 10.1016/S0266-4356(03)00236-5. View

12.

Bell 3rd F, Small E . Inexpensive osteotomes for orthognathic surgery. J Oral Surg. 1975; 33(7):545. View

13.

Chidiac J, Shofer F, LASTER L, Ghafari J . Comparison of CT scanograms and cephalometric radiographs in craniofacial imaging. Orthod Craniofac Res. 2002; 5(2):104-13. DOI: 10.1034/j.1600-0544.2002.01170.x. View

14.

LUHR H, Kubein-Meesenburg D, Schwestka-Polly R . [The importance and technic of temporomandibular joint positioning in the sagittal splitting of the mandible]. Fortschr Kieferorthop. 1991; 52(2):66-72. DOI: 10.1007/BF02164708. View

15.

Steinhauser E . Bone screws and plates in orthognathic surgery. Int J Oral Surg. 1982; 11(4):209-16. DOI: 10.1016/s0300-9785(82)80069-0. View

16.

Swennen G, Mommaerts M, Abeloos J, De Clercq C, Lamoral P, Neyt N . A cone-beam CT based technique to augment the 3D virtual skull model with a detailed dental surface. Int J Oral Maxillofac Surg. 2009; 38(1):48-57. DOI: 10.1016/j.ijom.2008.11.006. View

17.

Wangerin K . [One-stage procedure for bimaxillary correction of extremely severe malocclusions. Pretreatment, planning and operation methods with functionally stable fixation of upper and lower jaws]. Dtsch Z Mund Kiefer Gesichtschir. 1990; 14(6):424-31. View

18.

Sund G, Eckerdal O, Astrand P . Changes in the temporomandibular joint after oblique sliding osteotomy of the mandibular rami. A longitudinal radiological study. J Maxillofac Surg. 1983; 11(2):87-91. DOI: 10.1016/s0301-0503(83)80021-6. View

19.

Ueki K, Marukawa K, Hashiba Y, Nakagawa K, Degerliyurt K, Yamamoto E . Changes in the duration of the chewing cycle in patients with skeletal class III with and without asymmetry before and after orthognathic surgery. J Oral Maxillofac Surg. 2008; 67(1):67-72. DOI: 10.1016/j.joms.2008.06.018. View

20.

MOFFETT Jr B, Johnson L, McCabe J, ASKEW H . ARTICULAR REMODELING IN THE ADULT HUMAN TEMPOROMANDIBULAR JOINT. Am J Anat. 1964; 115:119-41. DOI: 10.1002/aja.1001150108. View