How to Optimally Position a Condylar Segment in Orthognathic Surgery?

Byoung Eun Yang PhD, Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
Seung Min Oh DDS, Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
Kang Nam Park DDS, Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
Jwa Young Kim , Oral and Maxillofacial Surgery, Hallym University College of Medicine Sacred Heart Hospital, Anyang, South Korea
Purpose: Changes in the condylar position after orthognathic surgery can cause many complications. This study was to evaluate the displacement evaluated a simple approach for condylar repositioning in orthognathic surgery as a method to rapidly obtain the patient’s centric relation (CR) bite position without pre-fabricated equipment.

Materials and Methods: The study subjects included 29 patients who underwent orthognathic surgery in Dept. of Oral and Maxillofacial Surgery in Hallym University hospital between August 2008 and March 2012. We performed Bilateral sagittal split ramus osteotomy(BSSO) in 9 patients  who was evaluated by cephalography with the condylar repositioning method according to the patient’s CR bite and conducted bimaxillary surgery with conventional Le-Fort I osteotomy and BSSO in 20 patients who was measured condylar displacement by tomography analysis. A survey for TMJ(temporomandibular Joint) sound, pain and locking was performed. We used Wilcoxon signed rank tests and McNemer test for analysis.

Results: In BSSO, measurements of changes in the condylar position via radiographic images did not indicate significant differences after surgery (P>0.05). In surveys of TMJ symptoms, the scores for categories (sound, pain, mouth opening limitation) also did not show any increases after surgery.  And there were no significant changes in the anterior, superior and posterior joint space of the TMJ (p>0.05) and no significant changes in TMJ sound (p>0.05) in bimaxillary surgery.

Conclusion: Because of its conveniences, it will be helpful to inexperienced surgeons in condylar posiition control.

References:

Helm G, Stepke MT. Maintenance of the preoperative condyle position in orthognathic surgery. J Craniomaxillofac Surg 1997;25:34-38

Gerressen M, Stocbrink G, Riediger D, Ghassemi A. Skeletal stability following bilateral sagittal splint osteotomy(BSSRO) with and without condylar positioning device. J Oral Maxillofac Surg 2007;65:1297-302

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