Korean J Orthod.  2013 Dec;43(6):263-270. 10.4041/kjod.2013.43.6.263.

Cone-beam computed tomographic evaluation of the condylar remodeling occurring after mandibular set-back by bilateral sagittal split ramus osteotomy and rigid fixation

• Ha MH
• Kim YI
• Park SB
• Kim SS
• Son WS

• KMID: 2273419
• DOI: http://doi.org/10.4041/kjod.2013.43.6.263

Abstract

OBJECTIVE
To evaluate condylar head remodeling after mandibular set-back sagittal split ramus osteotomy (SSRO) with rigid fixation in skeletal class III deformities. The correlation between condylar head remodeling and condylar axis changes was determined using cone-beam computed tomography (CBCT) superimposition.
METHODS
The CBCT data of 22 subjects (9 men and 13 women) who had undergone mandibular set-back SSRO with rigid fixation were analyzed. Changes in the condylar head measurements and the distribution of the signs of condylar head remodeling were evaluated by CBCT superimposition.
RESULTS
The subjects showed inward rotation of the axial condylar angle; reduced condylar heights on the sagittal and coronal planes; and resorptive remodeling in the anterior and superior areas on the sagittal plane, superior and lateral areas on the coronal plane, and anterior-middle and anterior-lateral areas on the axial plane (p < 0.05).
CONCLUSIONS
The CBCT superimposition method showed condylar head remodeling after mandibular set-back SSRO with rigid fixation. In skeletal class III patients, SSRO with rigid fixation resulted in rotation, diminution, and remodeling of the condylar head. However, these changes did not produce clinical signs or symptoms of temporomandibular disorders.

Keyword

Cone-beam computed tomography; Class III orthognathic surgery; Surgery

MeSH Terms

Axis, Cervical Vertebra
Cone-Beam Computed Tomography
Congenital Abnormalities
Head
Humans
Male
Methods
Osteotomy, Sagittal Split Ramus*
Temporomandibular Joint Disorders

Figure

• 

  Figure 1 Two-dimensional metric analysis of the condylar head before and after surgery: condylar width and depth on the axial plane (A), condylar width and height on the coronal plane (B), and condylar depth and height on the sagittal plane (C).

• 

  Figure 2 Image interpretation for the assessment of remodeling signs: the areas for the classification of the remodeling signs. A, Anterior-medial (AA), anterior-middle (AB), anterior-lateral (AC), posterior-medial (PA), posterior-middle (PB), and posterior-lateral (PC) in the axial plane. B, Medial (A), superior (B), and lateral (C) in the coronal plane. C, Anterior (A), superior (B), and posterior (C) in the sagittal plane.

• 

  Figure 3 Superimposition for condylar head remodeling: axial (A), sagittal (B), and coronal (C) in preoperative images; axial (D), sagittal (E), and coronal (F) in postoperative images; and axial (G), sagittal (H), and coronal (I) in superimposed images.

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