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Fernandes ABN, Vilela LT, Chagas TF, Ruellas ACDO, Mattos CT, Souza MMGD. Does mandibular advancement ortho-surgical procedure cause condyle changes? A case-series analysis. Dental Press J Orthod 2024; 29:e2423261. [PMID: 38985076 PMCID: PMC11235570 DOI: 10.1590/2177-6709.29.3.e2423261.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/23/2024] [Indexed: 07/11/2024] Open
Abstract
INTRODUCTION Mandibular advancement surgery corrects bone bases while establishing patients' functional and aesthetic rehabilitation. However, little is known about the results of this procedure in the structures that make up the stomatognathic system, as the condyles. OBJECTIVE This study aimed to evaluate the structural and positional changes of mandibular condyles in ortho-surgical patients who underwent mandibular advancement surgery. MATERIAL AND METHODS A prospective investigation was conducted with cone-beam computed tomography images. Using Dolphin Imaging® software, seven ortho-surgical patients with Angle Class II malocclusion and mandibular deficiency were evaluated. The images assessed were obtained at pre-surgical phase and after, at least, 1 year of the procedure. To study the structural and positional changes of condyles, linear and angular measurements were obtained, and the right and left sides of patients were compared. Descriptive statistical analysis was performed and, in order to verify possible significant differences, normality tests (Kolmogorov-Smirnov) were applied, followed by a paired t-test to define significance. RESULTS For all measures evaluated in this study, no statistically significant differences were found. CONCLUSION The ortho-surgical procedure performed did not change the structure and position of the condyles of patients who underwent surgical mandibular advancement. Right and left mandibular condyles behaved similarly, suggesting stability and condylar adaptation after surgery.
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Affiliation(s)
| | - Luíza Trindade Vilela
- Federal University of Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro, Brazil)
| | - Taísa Figueiredo Chagas
- Federal University of Rio de Janeiro, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro, Brazil)
| | | | - Cláudia Trindade Mattos
- Federal Fluminense University, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro, Brazil)
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Dadgar S, Sobouti F, Hadian H, Pakravan A, Rahimi Z, Rakhshan V. 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. [PMID: 35308442 PMCID: PMC8927962 DOI: 10.4103/1735-3327.338782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/02/2021] [Accepted: 09/20/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Materials and Methods: Results: Conclusion:
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Quantitative assessment of condyle positional changes before and after orthognathic surgery based on fused 3D images from cone beam computed tomography. Clin Oral Investig 2019; 24:2663-2672. [DOI: 10.1007/s00784-019-03128-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/16/2019] [Indexed: 11/26/2022]
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Domínguez Camacho A, Velásquez Cujar SA. The use of four different lasers in a “surgery first” case, for orthodontic movement acceleration, paresthesia, aphthous ulcer, edema, and pain control. LASERS IN DENTAL SCIENCE 2019; 3:61-70. [DOI: 10.1007/s41547-018-0048-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/01/2018] [Indexed: 12/11/2023]
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Holzinger D, Willinger K, Millesi G, Schicho K, Breuss E, Wagner F, Seemann R. Changes of temporomandibular joint position after surgery first orthognathic treatment concept. Sci Rep 2019; 9:2206. [PMID: 30778128 PMCID: PMC6379562 DOI: 10.1038/s41598-019-38786-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/28/2018] [Indexed: 11/19/2022] Open
Abstract
Orthognathic surgery treatment (OGS) after orthodontic treatment of dentofacial deformities is a widely performed procedure, often accompanied by a bilateral sagittal split osteotomy (BSSO). Positioning of the condyle during this procedure is a crucial step for achieving optimal functional and anatomical results. Intraoperatively poorly positioned condyles can have a negative effect on the postoperative result and the patient’s well-being. Changes of the condylar position during OGS Procedures and its effects on the temporomandibular joint in orthognathic surgical interventions (OGS) are subject of scientific discussions. However, up to date, no study has investigated the role of condyle position in the surgery first treatment concept. The aim of this study was to investigate the influence of OGS on the three-dimensional position of the condyle in the joint in a surgery first treatment concept without positioning device and to record the change in position quantitatively and qualitatively. Analysis of our data indicated that OGS in surgery first treatment concept has no significant effect on the position of the condyle and the anatomy of the temporomandibular joint.
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Affiliation(s)
- Daniel Holzinger
- Department of Oral and Maxillofacial surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Katrin Willinger
- Department of Oral and Maxillofacial surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Gabriele Millesi
- Department of Oral and Maxillofacial surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Kurt Schicho
- Department of Oral and Maxillofacial surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Elisabeth Breuss
- University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Florian Wagner
- Department of Oral and Maxillofacial surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Rudolf Seemann
- Department of Oral and Maxillofacial surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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Zupnik JT, Ioshida M, Yatabe M, Ruellas ACO, Gomes LR, Aronovich S, Benavides E, Edwards SP, Paniagua B, Cevidanes LHS. Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions. Int J Oral Maxillofac Surg 2019; 48:739-745. [PMID: 30712988 DOI: 10.1016/j.ijom.2019.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/20/2018] [Accepted: 01/08/2019] [Indexed: 11/17/2022]
Abstract
The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3±9.47years) and 14 patients with skeletal class III (mean age 25.6±6.27years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks. The directions and amounts of condylar displacement were assessed by intra- and inter-class Mann-Whitney U-test or t-test. Class II patients presented significantly greater amounts of lateral (P=0.002) and inferior (P=0.038) translation than class III patients. The magnitudes of condylar translational displacements were small for both groups. Skeletal class III patients had predominantly medial (P=0.024) and superior (P=0.047) condylar translation. Skeletal class II patients presented greater condylar counterclockwise pitch (P=0.007) than class III patients. Two-jaw surgery for the correction of open bite led to different directions and amounts of condylar rotational displacement in patients with skeletal class II compared to class III malocclusion, with greater rotational than translational displacements.
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Affiliation(s)
- J T Zupnik
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M Ioshida
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M Yatabe
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA.
| | - A C O Ruellas
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - L R Gomes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - S Aronovich
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
| | - E Benavides
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI, USA
| | - S P Edwards
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
| | | | - L H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
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Berger M, Nova I, Kallus S, Ristow O, Eisenmann U, Dickhaus H, Engel M, Freudlsperger C, Hoffmann J, Seeberger R. Electromagnetic navigated condylar positioning after high oblique sagittal split osteotomy of the mandible: a guided method to attain pristine temporomandibular joint conditions. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:407-414.e1. [PMID: 29402731 DOI: 10.1016/j.oooo.2017.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/03/2017] [Accepted: 12/13/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Reproduction of the exact preoperative proximal-mandible position after osteotomy in orthognathic surgery is difficult to achieve. This clinical pilot study evaluated an electromagnetic (EM) navigation system for condylar positioning after high-oblique sagittal split osteotomy (HSSO). STUDY DESIGN After HSSO as part of 2-jaw surgery, the position of 10 condyles was intraoperatively guided by an EM navigation system. As controls, 10 proximal segments were positioned by standard manual replacement. Accuracy was measured by pre- and postoperative cone beam computed tomography imaging. RESULTS Overall, EM condyle repositioning was equally accurate compared with manual repositioning (P > .05). Subdivided into 3 axes, significant differences could be identified (P < .05). Nevertheless, no significantly and clinically relevant dislocations of the proximal segment of either the EM or the manual repositioning method could be shown (P > .05). CONCLUSIONS This pilot study introduces a guided method for proximal segment positioning after HSSO by applying the intraoperative EM system. The data demonstrate the high accuracy of EM navigation, although manual replacement of the condyles could not be surpassed. However, EM navigation can avoid clinically hidden, severe malpositioning of the condyles.
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Affiliation(s)
- Moritz Berger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany.
| | - Igor Nova
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Germany
| | - Sebastian Kallus
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Germany
| | - Oliver Ristow
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Urs Eisenmann
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Germany
| | - Hartmut Dickhaus
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Germany
| | - Michael Engel
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | | | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
| | - Robin Seeberger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Germany
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Méndez-Manjón I, Guijarro-Martínez R, Valls-Ontañón A, Hernández-Alfaro F. Early changes in condylar position after mandibular advancement: a three-dimensional analysis. Int J Oral Maxillofac Surg 2016; 45:787-92. [DOI: 10.1016/j.ijom.2016.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 10/10/2015] [Accepted: 01/06/2016] [Indexed: 11/30/2022]
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Are Hyoid Bone and Tongue the Risk Factors Contributing to Postoperative Relapse for Mandibular Prognathism? BIOMED RESEARCH INTERNATIONAL 2016; 2016:5284248. [PMID: 27042664 PMCID: PMC4793095 DOI: 10.1155/2016/5284248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/20/2016] [Accepted: 01/24/2016] [Indexed: 12/01/2022]
Abstract
Objective. The purpose of this study was to investigate postoperative stability and the correlation between hyoid, tongue, and mandible position following surgery for mandibular prognathism. Materials and Methods. Thirty-seven patients, treated for mandibular prognathism using intraoral vertical ramus osteotomy (IVRO), were evaluated cephalometrically. A set of four standardized lateral cephalograms were obtained from each subject preoperatively (T1), immediately postoperatively (T2), six weeks to three months postoperatively (T3), and more than one year postoperatively (T4). The Student t-tests, the Pearson correlation coefficient, and the multiple linear regression were used for statistical analysis. Results. Immediately after surgery, menton (Me) setback was 12.8 mm, hyoid (H) setback was 4.9 mm, and vallecula epiglottica (V) setback was 5.8 mm. The postoperative stability significantly correlated (r = −0.512, p < 0.01) with the amount of setback. The hyoid bone and tongue did not have significant effects on postoperative stability. Multiple linear regression model (R2 = 0.2658, p < 0.05) showed predictability: Horizontal Relapse Me (T4-T2) = −6.406 − 0.488Me (T2-T1) + 0.069H (T2-T1) − 0.0619V (T2-T1). Conclusion. Mandibular setback surgery may push the hyoid and tongue significantly backward, but this did not correlate with mandibular relapse. Postoperative stability significantly correlated with the amount of mandibular setback.
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