title: Short- and long-term changes of condylar position after bilateral sagittal split ramus osteotomy for mandibular advancement in combination with Le Fort I osteotomy evaluated by cone-beam computed tomography.
abstract: OBJECTIVE
  Bilateral sagittal split ramus osteotomy (BSSO) may change condylar position, which can be one of the factors contributing to skeletal relapse. This study evaluated short- and long-term changes in condylar position using cone-beam computed tomography (CBCT) and investigated changes in temporomandibular joint (TMJ) signs after BSSO for mandibular advancement in combination with Le Fort I osteotomy.
  
  
  METHODS
  Thirty-one patients were included, and CBCT data of 62 TMJs were collected before surgery (T0), immediately after surgery (T1), 3 months after surgery (T2), and at the last follow-up at 12.1 ± 3.0 months after surgery (T3). The relation of the condyle to the fossa was evaluated by the method of Pullinger and Hollender (Oral Surg Oral Med Oral Pathol 62:719, 1986). Clinical examination, with a special focus on signs of temporomandibular disorder (TMD), was documented at T0, T2, and T3. Repeated-measures analysis of variance (P = .05) and χ2 test (P = .05) were performed.
  
  
  RESULTS
  Data of 27 patients were used for statistical analysis. Values from the formula of Pullinger and Hollender changed significantly with time, but there was no significant difference between the right and left condyles. Condyles moved inferoposteriorly immediately after surgery (T0 to T1) followed by anterosuperior movement 3 months after surgery (T1 to T2). The superimposed effect showed posterosuperior movement compared with the initial position before surgery (T0 to T2) and this position remained stable at 1-year follow-up (T2 to T3). A decrease of TMD signs over time, from 22.6% (T0) to 12.9% (T2) and 9.7% (T3), was observed, which showed no statistical significance.
  
  
  CONCLUSIONS
  There were obvious changes in condylar position after BSSO in combination with Le Fort I osteotomy. Condyles tended to be located in a concentric position in relation to the glenoid fossa 3 months after surgery and remained stable during the 1-year follow-up. These changes did not cause an increase of TMD signs.
authors: Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
authors: Shuo
authors: S
authors: Chen
authors: Jie
authors: J
authors: Lei
authors: Xing
authors: X
authors: Wang
authors: Kai-Yuan
authors: KY
authors: Fu
authors: Payam
authors: P
authors: Farzad
authors: Biao
authors: B
authors: Yi
mesh_terms: D000328:Adult; D002508:Cephalometry / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D004424:Ear Canal / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D063172:Genioplasty / Q000379:methods; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging; D019248:Jaw Fixation Techniques / Q000295:instrumentation; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008334:Mandible / Q000000981:diagnostic imaging; D019186:Mandibular Advancement / Q000379:methods*; D008335:Mandibular Condyle / Q000000981:diagnostic imaging*; D008437:Maxilla / Q000601:surgery; D017090:Occlusal Splints; D024343:Open Bite / Q000601:surgery; D009915:Orbit / Q000000981:diagnostic imaging; D009971:Orthodontics, Corrective / Q000379:methods; D056948:Orthognathic Surgical Procedures / Q000379:methods; D019340:Osteotomy, Le Fort / Q000379:methods*; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods*; D011446:Prospective Studies; D013701:Temporal Bone / Q000000981:diagnostic imaging; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis; D055815:Young Adult