title: Condylar resorption in orthognathic patients after mandibular bilateral sagittal split osteotomy: a systematic review.
abstract: To systematically search the literature and assess the available evidence regarding the incidence and quantification of condylar resorption following bilateral sagittal split osteotomy (BSSO) of the mandible in orthognathic patients.
  
  
  
  Electronic database searches of published and unpublished literature were performed. The reference lists of eligible studies were hand searched for additional studies.
  
  
  
  Randomized clinical trials (RCTs), prospective, and retrospective studies with patients of any age that underwent BSSO were included.
  
  
  
  Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate.
  
  
  
  One RCT, 3 prospective, and 10 retrospective studies were included in this review. The lack of standardized protocols and the high amount of heterogeneity precluded a valid interpretation of the actual results through pooled estimates. There was a substantial consistency among studies, however, that young, female patients with mandibular deficiency and high mandibular plane angle, submitted to surgical counterclockwise rotation of mandibular segments, were more prone to a higher risk for condylar resorption after BSSO. The level of evidence was found to be low given the high/serious risk of bias in all included studies.
  
  
  
  Condylar resorption should be taken into account as a potential postsurgical complication after BSSO. However, its incidence and quantification need precautious interpretation owing to the low level of evidence and the high heterogeneity of studies. Additional high-quality prospective research assisted by 3D imaging technology is needed to allow more definitive conclusions.
  
  
  
  Study not registered.
  
  
  
  None.
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece.
authors.forename: Sophia
authors.initials: S
authors.lastname: Mousoulea
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece.|Department of Orthodontics and Dentofacial Orthopedics, Faculty of Medicine, University of Bern, Switzerland.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kloukos
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Sampaziotis
authors.affiliation: Private practice, Athens, Greece.
authors.forename: Theodosia
authors.initials: T
authors.lastname: Vogiatzi
authors.affiliation: Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland.
authors.forename: Theodore
authors.initials: T
authors.lastname: Eliades
mesh_terms: D001862:Bone Resorption / Q000209:etiology*; D006801:Humans; D008310:Malocclusion / Q000601:surgery; D008334:Mandible / Q000601:surgery; D008335:Mandibular Condyle / Q000473:pathology*; D063168:Mandibular Osteotomy / Q000009:adverse effects* / Q000379:methods; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000009:adverse effects* / Q000379:methods; D012107:Research Design; D012399:Rotation