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http://dx.doi.org/10.4041/kjod.2013.43.2.74

Condylar repositioning using centric relation bite in bimaxillary surgery  

Lee, Chang-Youn (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University College of Medicine)
Jang, Chang-Su (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University College of Medicine)
Kim, Ju-Won (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University College of Medicine)
Kim, Jwa-Young (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University College of Medicine)
Yang, Byoung-Eun (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University College of Medicine)
Publication Information
The korean journal of orthodontics / v.43, no.2, 2013 , pp. 74-82 More about this Journal
Abstract
Objective: The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device. Methods: The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A sur vey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively. Results: No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05). Conclusions: Due to its simplicity, this method may be fea sible and useful for repositioning condyles.
Keywords
Centric relation; Temporomandibular joint; Orthognathic surgery;
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1 Epker BN, Wylie GA. Control of the condylarproximal mandibular segments after sagittal split osteotomies to advance the mandible. Oral Surg Oral Med Oral Pathol 1986;62:613-7.   DOI
2 Timmis DP, Aragon SB, Van Sickels JE. Masticatory dysfunction with rigid and nonrigid osteosynthesis of sagittal split osteotomies. Oral Surg Oral Med Oral Pathol 1986;62:119-23.   DOI
3 Leonard M. Preventing rotation of the proximal fragment in the sagittal ramus split operation. J Oral Surg 1976;34:942.
4 Bell WH, Proffit WR, White RP. Surgical correction of dentofacial deformities. Philadelphia: Saunders; 1980.
5 Luhr HG, Kubein-Meesenburg D. Rigid skeletal fixation in maxillary osteotomies. Intraoperative con trol of condylar position. Clin Plast Surg 1989; 16:157-63.
6 Luhr HG. The significance of condylar position using rigid fixation in orthognathic surgery. Clin Plast Surg 1989;16:147-56.
7 Hiatt WR, Schelkun PM, Moore DL. Condylar positioning in orthognathic surgery. J Oral Maxil lofac Surg 1988;46:1110-2.   DOI
8 Gateno J, Miloro M, Hendler BH, Horrow M. The use of ultrasound to determine the position of the mandibular condyle. J Oral Maxillofac Surg 1993; 51:1081-6.   DOI
9 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.
10 Bettega G, Dessenne V, Raphael B, Cinquin P. Computer- assisted mandibular condyle positioning in orthognathic surgery. J Oral Maxillofac Surg 1996; 54:553-8.   DOI
11 Luhr HG. Skelettverlagernde Operationen zur Harmo nisierung des Gesichtsprofiles. In: Pfeifer G, ed. Die Asthetik von Form und Funktion in der Plastischen und Wiederherstellungschirurgie. Stuttgart: Springer; 1985.
12 Helm G, Stepke MT. Maintenance of the pre operative condyle position in orthognathic surgery. J Craniomaxillofac Surg 1997;25:34-8.   DOI
13 Heffez L, Marsik J, Bressman J. A simple means of maintaining the condyle-fossa relationship. J Oral Maxillofac Surg 1987;45:288-90.   DOI
14 Raveh J, Vuillemin T, Ladrach K, Sutter F. New techniques for reproduction of the condyle relation and reduction of complications after sagittal ramus split osteotomy of the mandible. J Oral Maxillofac Surg 1988;46:751-7.   DOI
15 Fujimura N, Nagura H. New appliance for repositioning the proximal segment during rigid fixation of the sagittal split ramus osteotomy. J Oral Maxillofac Surg 1991;49:1026-7.   DOI
16 Harada K, Okada Y, Nagura H, Enomoto S. A new repositioning system for the proximal segment in sagittal split ramus osteotomy of the mandible. Int J Oral Maxillofac Surg 1994;23:71-3.   DOI
17 Landes CA. Proximal segment positioning in bilateral sagittal split osteotomy: intraoperative dynamic po si tioning and monitoring by sonography. J Oral Maxil lofac Surg 2004;62:22-8.
18 Will LA, Joondeph DR, Hohl TH, West RA. Condylar position following mandibular advancement: its rela tionship to relapse. J Oral Maxillofac Surg 1984; 42:578-88.   DOI
19 Jager A, Kubein-Meesenburg D, Luhr HG. Longitudinal study of combined orthodontic and surgical treatment of Class II malocclusion with deep overbite. Int J Adult Orthodon Orthognath Surg 1991; 6:29-38.
20 Bouletreau P, Bettega G, Breton P, Freidel M. Results of an evaluation of clinical practice in orthognathic surgery in France in 2002. Rev Stomatol Chir Maxillofac 2003;104:326-9.
21 Athanasiou AE, Mavreas D. Tomographic assessment of alterations of the temporomandibular joint after surgical correction of mandibular prognathism. Int J Adult Orthodon Orthognath Surg 1991;6:105-12.
22 Boucher L, Jacoby J. Posterior border movements of the human mandible. J Prosthet Dent 1961;11:836-41   DOI
23 Zak MJ, Dolan EA, Angelillo JC, McGraw TA. No effect of neuromuscular blockade on the temporomandibular joint position during general anesthesia. Anesth Prog 1992;39:212-4.
24 Helkimo M, Ingervall B, Carlsson GE. Variation of retruded and muscular position of mandible under different recording conditions. Acta Odontol Scand 1971;29:423-37.   DOI
25 Afzal A, Shameem A. Comparison of condylar positions in centric relation and centric occlusion in pre-treatment malocclusion cases. J Coll Physicians Surg Pak 2005;15:620-3.
26 McMillen LB. Border movements of the human mandible. J Prosthet Dent 1972;27:524-32.   DOI
27 Politi M, Toro C, Costa F, Polini F, Robiony M. Intra operative awakening of the patient during orthognathic surgery: a method to prevent the condylar sag. J Oral Maxillofac Surg 2007;65:109-14
28 Deng X, Wan Z, He SS, Wamalwa P, Chen S, Zhang ZY. The centric relation-maximum intercuspation discrepancy in adult angle's class II pretreatment patients. Hua Xi Kou Qiang Yi Xue Za Zhi 2011;29: 48-52.
29 Bamber MA, Abang Z, Ng WF, Harris M, Linney A. The effect of posture and anesthesia on the occlusal relationship in orthognathic surgery. J Oral Maxillofac Surg 1999;57:1164-72.   DOI
30 Dawson PE. Temporomandibular joint pain-dysfunc tion problems can be solved. J Prosthet Dent 1973;29:100-12.   DOI
31 Gilboe DB. Centric relation: functional anatomy. J Can Dent Assoc 1983;49:345-8.
32 Carlson CR, Okeson JP, Falace DA, Nitz AJ, Curran SL, Anderson D. Comparison of psychologic and phy siologic functioning between patients with masticatory muscle pain and matched controls. J Orofac Pain 1993;7:15-22.
33 McCollum BB. The mandibular hinge axis and a method of locating it. J Prosthet Dent 1960;10:428-33   DOI
34 Panula K, Somppi M, Finne K, Oikarinen K. Effects of orthognathic surgery on temporomandibular joint dysfunction. A controlled prospective 4-year followup study. Int J Oral Maxillofac Surg 2000;29:183-7.   DOI
35 Westermark A, Shayeghi F, Thor A. Temporo mandibular dysfunction in 1,516 patients before and after orthognathic surgery. Int J Adult Orthodon Orthognath Surg 2001;16:145-51.
36 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.   DOI
37 De Clercq CA, Neyt LF, Mommaerts MY, Abeloos JS. Orthognathic surgery: patients' subjective findings with focus on the temporomandibular joint. J Cranio maxillofac Surg 1998;26:29-34.   DOI
38 Wolford LM, Reiche-Fischel O, Mehra P. Changes in temporomandibular joint dysfunction after orthognathic surgery. J Oral Maxillofac Surg 2003;61:655-60   DOI
39 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   DOI
40 Béziat JL, Babic B, Ferreira S, Gleizal A. Justification for the mandibular-maxillary order in bimaxillary osteotomy. Rev Stomatol Chir Maxillofac 2009;110: 323-6.   DOI
41 Perez D, Ellis E 3rd. Sequencing bimaxillary surgery: mandible first. J Oral Maxillofac Surg 2011;69:2217-24   DOI