Comparison of postoperative condylar changes after unilateral sagittal split ramus osteotomy and bilateral sagittal split ramus osteotomy using 3-dimensional analysis

Abstract

This study aimed to evaluate postoperative changes in the condyle after unilateral sagittal split ramus osteotomy (USSRO) and to compare them with changes occurring after bilateral sagittal split ramus osteotomy (BSSRO). For 50 condyles from 25 patients, positional and volumetric changes of condyle were analyzed by using computed tomography images taken before, immediately after, and 6 months after surgery and compared between the USRRO and BSSRO groups. The condyle showed lateral and inferior displacement immediately after surgery and medial and superior movement at 6 months after surgery in the USSRO and BSSRO groups. No statistically significant difference was found between the 2 groups in the time-course positional change and rotation of the condyle. In the comparison of bodily shift and rotation between operated and nonoperated sides in USSRO group, there were no significant differences between the 2 sides, except for the perioperative rotation pattern on the coronal plane. At 6 months after surgery, the changed volume relative to preoperative condylar volume was only 5.2% in the USSRO group and 2.7% in the BSSRO group. The findings from this study suggest that USSRO can be used effectively in appropriately selected patients; however, temporomandibular joint (TMJ) problems may arise when condylar displacement is excessive enough to exceed physiologic tolerances.