title: Condylar resorption after orthognathic surgery: A systematic review.
abstract: BACKGROUND
  Condylar resorption after orthognathic surgery (CROS) represents a progressive alteration of shape and volume of the mandibular condyle. It is a known factor of surgical relapse. The aim of this systematic review was to discuss the physiopathology, mechanisms, risk factors, diagnosis and treatment of this disease.
  
  
  METHODS
  A systematic review of the literature was performed on the Pubmed database from 1970 to 2014, using following terms: ("orthognathic surgery") AND ("condylar resorption" OR "progressive condylar resorption" OR "idiopathic condylar resorption" OR "condylar atrophy" OR "condylolysis"). Papers were included according inclusion and exclusion criterias.
  
  
  RESULTS
  The search leaded to 32 articles. Seventeen were included. CROS was a condylar remodeling secondary to an imbalance between mechanical stress applied to the temporomandibular joints (TMJ) and the host adaptive capacities. It mainly occurred in 14 to 50years old women with pre-existing TMJ dysfunction, estrogen deficiency, class II malocclusion with a high mandibular plane angle, a diminished posterior facial height and a posteriorly inclined condylar neck. Mandibular advancement superior to 10mm, counterclockwise rotation of the mandible and posteriorly condylar repositioning were associated with an increased risk of CROS.
  
  
  CONCLUSIONS
  Treatment consists in re-operation in case of degradation of the occlusal result after an inactivity period of at least 6 months. Condylectomy with allogenic or autologous reconstruction is an alternative. Prevention is crucial and requires at-risk patient information.
authors.affiliation: Service de chirurgie maxillofaciale et de chirurgie plastique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France. Electronic address: zcatherine01@gmail.com.
authors.forename: Z
authors.initials: Z
authors.lastname: Catherine
authors.affiliation: Service de chirurgie maxillofaciale et de chirurgie plastique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
authors.forename: P
authors.initials: P
authors.lastname: Breton
authors.affiliation: Service de chirurgie maxillofaciale et de chirurgie plastique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
authors.forename: P
authors.initials: P
authors.lastname: Bouletreau
mesh_terms: D000293:Adolescent; D000328:Adult; D001284:Atrophy; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000473:pathology*; D008875:Middle Aged; D057909:Orthognathic Surgery / Q000706:statistics & numerical data; D012086:Reoperation / Q000706:statistics & numerical data; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D055815:Young Adult
keywords: Bone resorption; Chirurgie orthognathique; Condyle mandibulaire; Mandibular condyle; Orthognathic surgery; Relapse; Récidive; Résorption osseuse