Abstract
BackgroundCondylar remodelling (CR) is a complex of phenomena that generates in response of the temporo-mandibular joint to forces and stress to maintain a morphological, functional and occlusal homeostasis. The most worrying aspect of the condylar reshape is the condylar resorption which implies fast loss of vertical dimension (>6% of pre-surgical value), mandibular retraction and open bite with preserved articular function.Materials and MethodsSix parameters were analysed to study the condyles of twelve patients that underwent orthognathic surgery. The digital workflow was then described to make it reproducible enabling a more in-depth study of the reshaping processes that involving the condyle after a great stress like the surgery.ResultsThe results of our study showed many statistically significant variations of the studied parameters. In all patients, it was noticed a decreased bone density (p = 0,002 per side).ObjectivesThe aim of our study, with the aid of the contemporary 3D imaging and digital modelling and workflow technologies, is to investigate and analyse quantitatively and qualitatively the adaptative processes occurring in CR following bimaxillary repositioning. To the best of our knowledge, this is the only paper that investigates the CR considering six different variables at once.
Highlights
Condylar remodelling (CR) is a group of phenomena that generates in response to forces and stress acting on the temporo-mandibular joint in order to maintain a morphological, functional and occlusal homeostasis
Background Condylar remodelling (CR) is a complex of phenomena that generates in response of the temporomandibular joint to forces and stress to maintain a morphological, functional and occlusal homeostasis
Incidence of TMJ disorders following orthognathic surgery between 6.7% and 25%. [6,7,8] Condylar resorption incidence rate varies between 1 and 31%. [9,10,11] Behind this resorption much have been written, it has been hypothesised that this may be due to the activity of periostine, cytokines, oxygen free radicals and osteoclasts secondary to increased biomechanical stress. [12, 13] Jung et al, Arnett et al, and Mercurio et al hypothesised that CR following orthognathic surgery may be caused by temporary devascularisation and denervation due to a wide periosteal elevation. [4, 14, 15] the prolonged use of elastic orthodontic forces, as well as muscular tension originated from the pterygoid-masseter sling reposition, may influences the joint stress
Summary
Condylar remodelling (CR) is a group of phenomena that generates in response to forces and stress acting on the temporo-mandibular joint in order to maintain a morphological, functional and occlusal homeostasis. The main promoting factor is joint compression This condition may follow orthognathic surgery, orthodontic treatment, bruxism and clenching, occlusal tilt and mandibular trauma. [4, 5] While joint degeneration results in pain, limited mouth opening and joint noise; condylar resorption implies fast loss of vertical dimension (greater than 6% of pre-surgical value), mandibular retraction and open bite with preserved articular function. Condylar remodelling (CR) is a complex of phenomena that generates in response of the temporomandibular joint to forces and stress to maintain a morphological, functional and occlusal homeostasis. The digital workflow was described to make it reproducible enabling a more in-depth study of the reshaping processes that involving the condyle after a great stress like the surgery
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