대한치과교정학회지 (The korean journal of orthodontics)

  • 제54권4호
  • /
  • Pages.247-256
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  • 2024
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  • 2234-7518(pISSN)
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  • 2005-372X(eISSN)
대한치과교정학회 (The Korean Association Of Orthodontists)
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Evaluation of mandibular condyle position in Class III patients after bimaxillary orthognathic surgery: A cone-beam computed tomography study

  • Osman Kucukcakir (Department of Oral and Maxillofacial Surgery, Istanbul University) ;
  • Nilufer Ersan (Department of Dentomaxillofacial Radiology, Yeditepe University) ;
  • Yunus Ziya Arslan (Department of Robots and Smart Systems, Institute of Science, Turkish-German University) ;
  • Erol Cansiz (Department of Oral and Maxillofacial Surgery, Istanbul University)
  • 투고 : 2023.10.05
  • 심사 : 2024.05.19
  • 발행 : 2024.07.25
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초록

Objective: This retrospective study evaluated the mandibular condyle position before and after bimaxillary orthognathic surgery performed with the mandibular condyle positioned manually in patients with mandibular prognathism using cone-beam computed tomography. Methods: Overall, 88 mandibular condyles from 44 adult patients (20 female and 24 male) diagnosed with mandibular prognathism due to skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I performed using the manual condyle positioning method were included. Cone-beam computed tomography images obtained 1-2 weeks before (T0) and approximately 6 months after (T1) surgery were analyzed in three planes using 3D Slicer software. Statistical significance was set at P < 0.05 level. Results: Significant inward rotation of the left mandibular condyle and significant outward rotation of the right mandibular condyle were observed in the axial and coronal planes (P < 0.05). The positions of the right and left condyles in the sagittal plane and the distance between the most medial points of the condyles in the coronal plane did not differ significantly (P > 0.05). Conclusions: While the change in the sagittal plane can be maintained as before surgery with manual positioning during the BSSRO procedure, significant inward and outward rotation was observed in the axial and coronal planes, respectively, even in the absence of concomitant temporomandibular joint disorder before or after the operation. Further long-term studies are needed to correlate these findings with possible clinical consequences.

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참고문헌

  1. Kim YI, Cho BH, Jung YH, Son WS, Park SB. Cone-beam computerized tomography evaluation of condylar changes and stability following two-jaw surgery: le fort I osteotomy and mandibular setback surgery with rigid fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:681-7. http://doi.org/10.1016/j.tripleo.2010.08.001
  2. Hong M, Kim MJ, Shin HJ, Cho HJ, Baek SH. Three-dimensional surgical accuracy between virtually planned and actual surgical movements of the maxilla in two-jaw orthognathic surgery. Korean J Orthod 2020;50:293-303. https://doi.org/10.4041/kjod.2020.50.5.293
  3. Mda B, F ME, McZ D. Methods of mandibular condyle position and rotation center used for orthognathic surgery planning: a systematic review. J Stomatol Oral Maxillofac Surg 2022;123:345-52. https://doi.org/10.1016/j.jormas.2021.06.004
  4. Meric G. A literature review of the sentric relation and registration methods up to date. J Dent Fac Ataturk Uni 2010;2010:54-9. https://dergipark.org.tr/en/pub/ataunidfd/issue/2481/31754
  5. Bettega G, Cinquin P, Lebeau J, Raphael B. Computer-assisted orthognathic surgery: clinical evaluation of a mandibular condyle repositioning system. J Oral Maxillofac Surg 2002;60:27-34; discussion 34-5. https://doi.org/10.1053/joms.2002.29069
  6. Ueki K, Moroi A, Sotobori M, Ishihara Y, Marukawa K, Takatsuka S, et al. A hypothesis on the desired postoperative position of the condyle in orthognathic surgery: a review. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:567-76. https://doi.org/10.1016/j.oooo.2011.12.026
  7. Savoldelli C, Chamorey E, Bettega G. Computer-assisted teaching of bilateral sagittal split osteotomy: learning curve for condylar positioning. PLoS One 2018;13:e0196136. https://doi.org/10.1371/journal.pone.0196136
  8. Podcernina J, Urtane I, Pirttiniemi P, Salms Ģ, Radzins O, Aleksejuniene J. Evaluation of condylar positional, structural, and volumetric status in class III orthognathic surgery patients. Medicina (Kaunas) 2020;56:672. https://doi.org/10.3390/medicina56120672
  9. Costa F, Robiony M, Toro C, Sembronio S, Polini F, Politi M. Condylar positioning devices for orthognathic surgery: a literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:179-90. https://doi.org/10.1016/j.tripleo.2007.11.027
  10. Choi BJ, Kim BS, Lim JM, Jung J, Lee JW, Ohe JY. Positional change in mandibular condyle in facial asymmetric patients after orthognathic surgery: cone-beam computed tomography study. Maxillofac Plast Reconstr Surg 2018;40:13. https://doi.org/10.1186/s40902-018-0152-6
  11. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016;15:155-63. https://doi.org/10.1016/j.jcm.2016.02.012
  12. Bethge LS, Ballon A, Mack M, Landes C. Intraoperative condyle positioning by sonographic monitoring in orthognathic surgery verified by MRI. J Craniomaxillofac Surg 2015;43:71-80. https://doi.org/10.1016/j.jcms.2014.10.012
  13. Gerressen M, Stockbrink G, Smeets R, Riediger D, Ghassemi A. Skeletal stability following bilateral sagittal split osteotomy (BSSO) with and without condylar positioning device. J Oral Maxillofac Surg 2007;65:1297-302. https://doi.org/10.1016/j.joms.2006.10.026
  14. Sander AK, Martini M, Konermann AC, Meyer U, Wenghoefer M. Freehand condyle-positioning during orthognathic surgery: postoperative cone-beam computed tomography shows only minor morphometric alterations of the temporomandibular joint position. J Craniofac Surg 2015;26:1471-6. https://doi.org/10.1097/SCS.0000000000001781
  15. Hollender L, Ridell A. Radiography of the temporomandibular joint after oblique sliding osteotomy of the mandibular rami. Scand J Dent Res 1974;82:466-9. https://doi.org/10.1111/j.1600-0722.1974.tb00403.x
  16. Hu J, Wang D, Zou S. Effects of mandibular setback on the temporomandibular joint: a comparison of oblique and sagittal split ramus osteotomy. J Oral Maxillofac Surg 2000;58:375-80; discussion 380-1. https://doi.org/10.1016/s0278-2391(00)90915-7
  17. Kawamata A, Fujishita M, Nagahara K, Kanematu N, Niwa K, Langlais RP. Three-dimensional computed tomography evaluation of postsurgical condylar displacement after mandibular osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:371-6. https://doi.org/10.1016/s1079-2104(98)90059-2
  18. Kim MI, Kim JH, Jung S, Park HJ, Oh HK, Ryu SY, et al. Condylar positioning changes following unilateral sagittal split ramus osteotomy in patients with mandibular prognathism. Maxillofac Plast Reconstr Surg 2015;37:36. https://doi.org/10.1186/s40902-015-0036-y
  19. Lee JS, Xi T, Kwon TG. Three-dimensional analysis of mandibular condyle position in patients with deviated mandibular prognathism. Int J Oral Maxillofac Surg 2017;46:1052-8. https://doi.org/10.1016/j.ijom.2017.02.1272
  20. Lee W, Park JU. 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 2002;94:305-9. https://doi.org/10.1067/moe.2002.126452
  21. Ma RH, Li G, Yin S, Sun Y, Li ZL, Ma XC. Quantitative assessment of condyle positional changes before and after orthognathic surgery based on fused 3D images from cone beam computed tomography. Clin Oral Investig 2020;24:2663-72. https://doi.org/10.1007/s00784-019-03128-z
  22. Sobouti F, Hadian H, Pakravan AH, Rahimi Z, Rakhshan V, Dadgar S. Short-term and long-term alterations of condylar position after bilateral sagittal split ramus osteotomy for mandibular setback: a preliminary before-after clinical trial. Dent Res J (Isfahan) 2022;19:19. https://doi.org/10.4103/1735-3327.338782
  23. Ueki K, Nakagawa K, Takatsuka S, Shimada M, Marukawa K, Takazakura D, et al. Temporomandibular joint morphology and disc position in skeletal class III patients. J Craniomaxillofac Surg 2000;28:362-8. https://doi.org/10.1054/jcms.2000.0181
  24. Kim YI, Jung YH, Cho BH, Kim JR, Kim SS, Son WS, et al. The assessment of the short- and long-term changes in the condylar position following sagittal split ramus osteotomy (SSRO) with rigid fixation. J Oral Rehabil 2010;37:262-70. https://doi.org/10.1111/j.1365-2842.2009.02056.x
  25. Nishimura A, Sakurada S, Iwase M, Nagumo M. 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 1997;55:672-6; discussion 677-8. https://doi.org/10.1016/s0278-2391(97)90572-3
  26. Kim JW, Lee DH, Lee SY, Kim JH, Lee SH. 3-D CT evaluation of condyle head position, mandibular width, and mandibular angle after mandibular setback surgery. J Korean Assoc Oral Maxillofac Surg 2009;35:229-39. https://www.jkaoms.org/journal/view.html?uid=374&vmd=Full
  27. Jung GS, Kim TK, Lee JW, Yang JD, Chung HY, Cho BC, et al. The effect of a condylar repositioning plate on condylar position and relapse in two-jaw surgery. Arch Plast Surg 2017;44:19-25. https://doi.org/10.5999/aps.2017.44.1.19
  28. Omar EAZ, Bamber MA. Orthognathic model surgery by using of a passive robot arm. Saudi Dent J 2010;22:47-55. https://doi.org/10.1016/j.sdentj.2010.02.006
  29. Ueki K, Hashiba Y, Marukawa K, Alam S, Nakagawa K, Yamamoto E. 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 2008;66:900-4. https://doi.org/10.1016/j.joms.2007.08.033
  30. Choi KY, Lee SH. Evaluation of condylar position using computed tomograph following bilateral sagittal split ramus osteotomy. Maxillofac Plast Reconstr Surg 1996;18:570-93. https://kiss.kstudy.com/Detail/Ar?key=1956811