DOI QR코드

DOI QR Code

Positional change in mandibular condyle in facial asymmetric patients after orthognathic surgery: cone-beam computed tomography study

  • Choi, Byung-Joon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Kim, Byung-Soo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Lim, Ji-Min (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Jung, Junho (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Lee, Jung-Woo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Ohe, Joo-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University)
  • 투고 : 2018.02.08
  • 심사 : 2018.04.26
  • 발행 : 2018.12.31

초록

Background: We evaluated change in the mandibular condyle after orthognathic surgery using cone-beam computed tomography (CBCT) in patients with facial asymmetry. Methods: Thirty 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. Results: On 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. Conclusions: There 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.

키워드

참고문헌

  1. Ellis E 3rd (2007) A method to passively align the sagittal ramus osteotomy segments. J Oral Maxillofac Surg 65:2125-2130 https://doi.org/10.1016/j.joms.2007.02.005
  2. Lee W, Park JU (2002) Three-dimensional evaluation of positional change of the condyle after mandibular setback by means of bilateral sagittal split ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:305-309 https://doi.org/10.1067/moe.2002.126452
  3. Hackney FL, Van Sickels JE, Nummikoski PV (1989) Condylar displacement and temporomandibular joint dysfunction following bilateral sagittal split osteotomy and rigid fixation. J Oral Maxillofac Surg 47:223-227 https://doi.org/10.1016/0278-2391(89)90221-8
  4. Baek SH, Kim TK, Kim MJ (2006) Is there any difference in the condylar position and angulation after asymmetric mandibular setback? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:155-163 https://doi.org/10.1016/j.tripleo.2005.04.007
  5. Tyndall DA, Renner JB, Phillips C et al (1992) Positional changes of the mandibular condyle assessed by three-dimensional computed tomography. J Oral Maxillofac Surg 50:1164-1172 https://doi.org/10.1016/0278-2391(92)90147-R
  6. Katsumata A, Fujishita M, Maeda M et al (2005) 3D-CT evaluation of facial asymmetry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 9:212-220 https://doi.org/10.1016/j.tripleo.2004.06.072
  7. Michiels G, Sather AH (1994) Determinants of facial attractiveness in a sample of white women. Int J Adult Orthodon Orthognath Surg 9:95-103
  8. Haraguchi S, Takada K, Yasuda Y (2002) Facial asymmetry in subjects with skeletal class III deformity. Angle Orthod 72:28-35
  9. Ueki K, Degerliyurt K, Hashiba Y et al (2008) Horizontal changes in the condylar head after sagittal split ramus osteotomy with bent plate fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:656-661 https://doi.org/10.1016/j.tripleo.2008.03.016
  10. Ueki K, Marukawa K, Nakagawa K et al (2002) Condylar and temporomandibular joint disc positions after mandibular osteotomy for prognathism. J Oral Maxillofac Surg 60:1424-1432 discussion 32-34 https://doi.org/10.1053/joms.2002.36098
  11. Ueki K, Marukawa K, Shimada M et al (2007) Condylar and disc positions after sagittal split ramus osteotomy with and without Le Fort I osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:342-348 https://doi.org/10.1016/j.tripleo.2006.05.024
  12. Sassouni V (1957) Position of the maxillary first permanent molar in the cephalofacial complex: a study in three dimensions. Am J Orthod 43:477-510 https://doi.org/10.1016/0002-9416(57)90175-6
  13. Ricketts RM (1976) Bioprogressive therapy as an answer to orthodontic needs. Part I. Am J Orthod 70:241-268 https://doi.org/10.1016/0002-9416(76)90332-8
  14. Nishimura A, Sakurada S, Iwase M et al (1997) Positional changes in the mandibular condyle and amount of mouth opening after sagittal split ramus osteotomy with rigid or nonrigid osteosynthesis. J Oral Maxillofac Surg 55:672-676 discussion 7-8 https://doi.org/10.1016/S0278-2391(97)90572-3
  15. Imamura R (2017) Assessment of the position and morphology of the condylar head of mandible after sagittal split ramus osteotomy: a postoperative comparative study from 1 to 6 months. Int J Oral-Med Sci 15:139-151 https://doi.org/10.5466/ijoms.15.139
  16. Hollender L, Ridell A (1974) Radiography of the temporomandibular joint after oblique sliding osteotomy of the mandibular rami. Scand J Dent Res 82:466-469
  17. Oh MH, Hwang HS, Lee KM et al (2017) Cone-beam computed tomography evaluation on the condylar displacement following sagittal split ramus osteotomy in asymmetric setback patients: comparison between conventional approach and surgery-first approach. Angle Orthod 87:733-738 https://doi.org/10.2319/122316-925.1
  18. Kim MI, Kim JH, Jung S et al (2015) Condylar positioning changes following unilateral sagittal split ramus osteotomy in patients with mandibular prognathism. Maxillofac Plast Reconstr Surg 37:36 https://doi.org/10.1186/s40902-015-0036-y
  19. Hu J, Wang D, Zou S (2000) Effects of mandibular setback on the temporomandibular joint: a comparison of oblique and sagittal split ramus osteotomy. J Oral Maxillofac Surg 58:375-380 discussion 80-81 https://doi.org/10.1016/S0278-2391(00)90915-7
  20. Kawamata A, Fujishita M, Nagahara K et al (1998) Three-dimensional computed tomography evaluation of postsurgical condylar displacement after mandibular osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:371-376 https://doi.org/10.1016/S1079-2104(98)90059-2
  21. Ueki K, Hashiba Y, Marukawa K et al (2008) Skeletal stability after mandibular setback surgery: bicortical fixation using a 2.0-mm locking plate system versus monocortical fixation using a nonlocking plate system. J Oral Maxillofac Surg 66:900-904 https://doi.org/10.1016/j.joms.2007.08.033
  22. Ueki K, Marukawa K, Shimada M et al (2005) Change in condylar long axis and skeletal stability following sagittal split ramus osteotomy and intraoral vertical ramus osteotomy for mandibular prognathia. J Oral Maxillofac Surg 63:1494-1499 https://doi.org/10.1016/j.joms.2005.06.013
  23. Kim JW, Kim DH, Lee SY et al (2009) 3-D CT evaluation of condyle head position, mandibular width, and mandibular angle after mandibular setback surgery. J Korean Assoc Oral Maxillofac Surg 35:229-239
  24. Choi KY, Lee SH (1996) Evaluation of condylar position using computed tomograph following bilateral sagittal split ramus osteotomy. Maxillofac Plast Reconstr Surg 18:570-593
  25. Lee SK, Kim KW, Kim CH (2004) Postoperative positional change of condyle after bilateral sagittal split ramus osteotomy associated with mandibular asymmetry. J Korean Assoc Oral Maxillofac Surg 30:359-367

피인용 문헌

  1. Evaluation of Condylar Positional, Structural, and Volumetric Status in Class III Orthognathic Surgery Patients vol.56, pp.12, 2018, https://doi.org/10.3390/medicina56120672
  2. Is distal segment ostectomy essential for stabilization of the condylar position in patients with facial asymmetry? vol.43, pp.1, 2021, https://doi.org/10.1186/s40902-021-00325-3