Abstract
BackgroundWe evaluated change in the mandibular condyle after orthognathic surgery using cone-beam computed tomography (CBCT) in patients with facial asymmetry.MethodsThirty patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry were classified into two groups according to the amount of menton deviation (MD) from the facial midline on anteroposterior (AP) cephalogram: group A (asymmetry, MD ≥ 4 mm; n = 15) and group B (symmetry, MD < 4 mm; n = 15). Position and angle of condylar heads on the axial, sagittal, and coronal views were measured within 1 month preoperatively (T0) and postoperatively (T1) and 6 months (T2) postoperatively.ResultsOn axial view, both groups showed inward rotation of condylar heads at T1, but at T2, the change was gradually removed and the condylar head returned to its original position. At T1, both groups showed no AP condylar head changes on sagittal view, although downward movement of the condylar heads occurred. Then, at T2, the condylar heads tended to return to their original position. The change in distance between the two condylar heads showed that they had moved outward in both groups, causing an increase in the width between the two heads postoperatively. Analysis of all three-dimensional changes of the condylar head positions demonstrated statistically significant changes in the three different CBCT views in group B and no statistically significant changes in group A.ConclusionsThere was no significant difference between the two groups in condylar head position. Because sagittal split ramus osteotomy can be performed without significant change in symmetrical and asymmetrical cases, it can be regarded as an effective method to stabilize the condylar head position in patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry.
Highlights
We evaluated change in the mandibular condyle after orthognathic surgery using cone-beam computed tomography (CBCT) in patients with facial asymmetry
Subjects We studied 30 patients (19 males, 11 females; age range, 18–25 years; average age, 22 years) who underwent orthognathic surgery at the Oromaxillofacial Surgery Department of Kyung Hee University Dental Hospital between 2010 and 2012 because of prognathism or facial asymmetry
Change in condylar head location in the axial plane axial condylar head angle (A-angle) increased from 20.63° ± 5.98° and 18.13° ± 8.09° at T0 in groups A and B, respectively, to 22.93° ± 7.16° and 20.33° ± 7.87°, respectively, at T1
Summary
We evaluated change in the mandibular condyle after orthognathic surgery using cone-beam computed tomography (CBCT) in patients with facial asymmetry. Orthognathic surgery is a commonly conducted surgical procedure to improve nonesthetic facial appearance and accomplish more stable and functional balance on the masticatory system with optimal occlusion. Good occlusal relation and clinically normal locations of condylar heads are significant factors to prevent relapse after BSSRO. Choi et al Maxillofacial Plastic and Reconstructive Surgery (2018) 40:13 abnormal occlusion can be corrected postoperatively by correctional treatments, including postoperative orthodontic measures when normal condyle head location is assured. Postoperative condyle head location can vary depending on various factors, such as skill level of the surgeon, amount and direction of displacement of the distal from the proximal segments on the surgical plan, anatomic shape of the proximal segment, and fixation method [2, 3]. Asymmetric movement of the distal segment occurs in patients with facial asymmetry, and outward displacement of the condylar head can occur. The condylar head on the larger setback side was more posteriorly positioned than that on the lesser setback side
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