title: Effect of bimaxillary surgery on adaptive condylar head remodeling: metric analysis and image interpretation using cone-beam computed tomography volume superimposition.
abstract: OBJECTIVE
  The aim of the present study was to use cone-beam computed tomography volume superimposition to investigate the effect of bimaxillary orthognathic surgery on condylar head remodeling.
  
  
  METHODS
  Using a retrospective study design, 2 investigators evaluated the cone-beam computed tomography data of subjects who had undergone Le Fort I osteotomy and mandibular setback surgery. The predictor variable was time, grouped as preoperative versus postoperative. The outcome variables were the measurement changes of the condylar heads and the distribution of the condylar head remodeling signs. Paired t and χ(2) tests were performed for the purposes of the 2-dimensional metric analysis and the condylar head remodeling distribution. P < .05 was considered significant.
  
  
  RESULTS
  The sample was composed of 22 adults (11 men and 11 women, age 20.3 ± 3.2 years) diagnosed with skeletal Class III malocclusion. The intra- and interoperator reliabilities of the image interpretation showed substantial agreement, according to Cohen's kappa index. The condylar heights on the sagittal and coronal planes decreased after surgery. Bone resorption occurred predominantly in the anterior and superior areas on the sagittal plane, the superior and lateral areas on the coronal plane, and the anterolateral and posterolateral areas on the axial plane (P < .05). Bone formation was apparent only in the anteromedial area on the axial plane (P < .05).
  
  
  CONCLUSIONS
  Bimaxillary orthognathic surgery caused a decrease in the condylar heights and condylar head remodeling. The cone-beam computed tomography volume superimposition method showed that the condylar head had undergone remodeling after bimaxillary surgery.
authors: Department of Orthodontics, Pusan National University College of Dentistry, Busan, South Korea.
authors: Soo-Byung
authors: SB
authors: Park
authors: Yu-Mi
authors: YM
authors: Yang
authors: Yong-Il
authors: YI
authors: Kim
authors: Bong-Hae
authors: BH
authors: Cho
authors: Yun-Hoa
authors: YH
authors: Jung
authors: Dae-Seok
authors: DS
authors: Hwang
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D016723:Bone Remodeling / Q000502:physiology*; D001862:Bone Resorption / Q000000981:diagnostic imaging; D002508:Cephalometry / Q000379:methods; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008335:Mandibular Condyle / Q000000981:diagnostic imaging* / Q000473:pathology; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010012:Osteogenesis / Q000502:physiology; D019340:Osteotomy, Le Fort / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D012189:Retrospective Studies; D055815:Young Adult