Computer-assisted surgical planning and simulation for unilateral condylar benign lesions causing facial asymmetry.
OBJECTIVE
The purpose of this study was to investigate the best surgical sequence for the treatment of unilateral condylar benign lesions causing facial asymmetry by applying computer-assisted surgical planning and simulation.


METHODS
Computed tomography (CT) data from 12 patients whose maxillary cant was corrected by maintaining the vertical position of the central incisors and equally intruding the long side of the maxilla and extruding the short side were analyzed by ProPlan CMF 1.4 software (Materialise Medical, Leuven, Belgium). Condylectomy and double jaw orthognathic surgery with 2 different surgical sequences were simulated: 1) maxillary LeFort I osteotomy first (MaxF), then condylectomy, followed by bilateral sagittal split ramus osteotomy (BSSO); and 2) mandible first (ManF), beginning with condylectomy, then BSSO, and lastly LeFort I osteotomy. The greatest space between the maxillary and mandibular first molar in the interim positions was measured virtually to compare the 2 surgical sequences.


RESULTS
The vertical distance between the upper and lower teeth of ManF patients was significantly smaller than that of MaxF patients (mean 2.99 mm, P < .001).


CONCLUSIONS
When occlusal cants are corrected by equally intruding one side and extruding the other side of the maxillary dentition, the interim position is more conducive to sequencing corrective surgery by performing condylectomy, then BSSO, followed by Le Fort I osteotomy.
Department of Oral Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Chuan
C
Lu
Department of Oral Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: Lucyhe119@163.com.
Dongmei
D
He
Department of Oral Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Chi
C
Yang
Department of Oral Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Dong
D
Huang
Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, TX, USA.
Edward
E
Ellis
D000328:Adult; D003198:Computer Simulation; D005146:Facial Asymmetry / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures; D019340:Osteotomy, Le Fort; D059229:Osteotomy, Sagittal Split Ramus; D012189:Retrospective Studies; D012984:Software; D025321:Surgery, Computer-Assisted; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome