Browse > Article
http://dx.doi.org/10.1186/s40902-015-0036-y

Condylar positioning changes following unilateral sagittal split ramus osteotomy in patients with mandibular prognathism  

Kim, Myung-In (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
Kim, Jun-Hwa (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
Jung, Seunggon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
Park, Hong-Ju (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
Oh, Hee-Kyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
Kook, Min-Suk (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
Publication Information
Maxillofacial Plastic and Reconstructive Surgery / v.37, no., 2015 , pp. 36.1-36.7 More about this Journal
Abstract
Background: This study was performed to evaluate three-dimensional positional change of the condyle using three-dimensional computed tomography (3D-CT) following unilateral sagittal split ramus osteotomy (USSRO) in patients with mandibular prognathism. Methods: This study examined two patients exhibiting skeletal class III malocclusion with facial asymmetry who underwent USSRO for a mandibular setback. 3D-CT was performed before surgery, immediately after surgery, and 6 months postoperatively. After creating 3D-CT images by using the In-vivo $5^{TM}$ program, the axial plane, coronal plane, and sagittal plane were configured. Three-dimensional positional changes from each plane to the condyle, axial condylar head axis angle (AHA), axial condylar head position (AHP), frontal condylar head axis angle (FHA), frontal condylar head position (FHP), sagittal condylar head axis angle (SHA), and sagittal condylar head position (SHP) of the two patients were measured before surgery, immediately after surgery, and 6 months postoperatively. Results: In the first patient, medial rotation of the operated condyle in AHA and anterior rotation in SHA were observed. There were no significant changes after surgery in AHP, FHP, and SHP after surgery. In the second patient, medial rotation of the operated condyle in AHA and lateral rotation of the operated condyle in FHA were observed. There were no significant changes in AHP, FHP, and SHP postoperatively. This indicates that in USSRO, postoperative movement of the condylar head is insignificant; however, medial rotation of the condylar head is possible. Although three-dimensional changes were observed, these were not clinically significant. Conclusions: The results of this study suggest that although three-dimensional changes in condylar head position are observed in patients post SSRO, there are no significant changes that would clinically affect the patient.
Keywords
Citations & Related Records
연도 인용수 순위
  • Reference
1 Magalhaes AE, Stella JP, Tahasuri TH (1995) Change in condylar position following bilateral sagittal split osteotomy with setback. Int J Adult Orthodon Orthognath Surg 10:137-145
2 Hullihen SP (1849) Case of elongation of the underjaw and distortion of the face and neck, caused by a burn, successfully treated. Am J Dent Sci 9:157-168
3 Blair VP (1907) Operations on jaw bones and face, study of etiology and pathological osteotomy of developmental malrelationships of maxilla and mandible to each other and to facial outline and of operative treatment when beyond the scope of the orthodontist. Gynecol Obstet 4:67-78
4 Limberg AA (1950) New method of surgical treatment of ankylosis of the mandible, especially in recidivation and in gross facial asymmetry. Khirurgiia (Mosk) 10:27-32
5 Obwegeser H, Trauner R (1955) Zuroperationstechnikbei der progenie und anderenunterkieferanomalien.DtschZahnMundKieferheikd 23:1-26.
6 Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42-47
7 Hunsuck EE (1968) A modified intraoral sagittal splitting technic for correction of mandibular prognathism. J Oral Maxillofac Surg 26:250-254
8 Bell WH, Profit WR, White RP (1980) Surgical correction of dentofacial deformities, Vol 1. W.B.SaundersCo, Philadelphia
9 Epker BN (1977) Modifications in the sagittal osteotomy of the mandible. J Oral Surg 35:157-159
10 Harris MD, Van Sickels JE, Alder M (1999) Factors influencing condylar position after the bilateral sagittal split osteotomy fixed with bicortical screws. J Oral Maxillofac Surg 57:654-655   DOI
11 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   DOI
12 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   DOI
13 Will LA, Joondeph DR, Hohl TH, West RA (1984) Condylar position following mandibular advancement: its relationship to relapse. J Oral Maxillofac Surg 42:578-588   DOI
14 Freihofer HP, Petresevic D (1975) Late results after advancing the mandible by sagittal splitting of the rami. J Maxillofac Surg 3:250-257   DOI
15 Hu J, Wang D, Wou 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   DOI
16 Kundert M, Hadjianghelou O (1980) Condylar displacement after sagittal splitting of the mandibular rami. A short-term radiographic study. J Maxillofac Surg 8:278-287   DOI
17 Nickerson JW Jr (1983) Stabilization of the proximal segment in sagittal split osteotomy: a new technique. J Oral Maxillofac Surg 41:683-685   DOI
18 Kawamata A, Fujishita M, Nagahara K, Kanematu N, Niwa K, Langlais RP (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   DOI
19 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   DOI
20 Leonard M (1976) Preventing rotation of the proximal fragment in the sagittal ramus split operation. J Oral Surg 34:942-948
21 Epker BN, Wylie GA (1986) Control of the condylar-proximal mandibular segments after sagittal split osteotomies to advance the mandible. Oral Surg Oral Med Oral Pathol 62:613-617   DOI
22 Jaager A, Kubein-Meesenburg D, Luhr HG (1991) Longitudinal study of combined orthodontic and surgical treatment of class II malocclusion with deep overbite. Int J Adult Orthodon Orthognath Surg 6:29-38