Long-term evaluation of condylar positional and volumetric parameters and skeletal stability in Class III bimaxillary orthognathic surgery patients

• Published in: International journal of oral and maxillofacial surgery 2024-08, Vol.53 (8), p.707-714
• Main Authors: Podcernina, J., Jakobsone, G., Urtane, I., Salms, G., Radzins, O.
• Format: Article
• Language: English
• Subjects: Angle Class III malocclusion; Bone remodeling; Cephalometry; Cone-beam computed tomography; Mandibular condyle; Orthognathic surgery; Sagittal split ramus osteotomy
• ISSN: 0901-5027; 1399-0020; 1399-0020
• DOI: 10.1016/j.ijom.2024.01.013

This retrospective study examined long-term (4–5 years) condylar positional and volumetric changes and skeletal stability after bimaxillary orthognathic surgery in skeletal Class III patients. Pre-surgical (T0: 0.9 ± 1.1 months) and post-surgical (T1: 0.6 ± 0.7 months; T2: 12.8 ± 3.1 months; T3: 56.5 ± 6.5 months) cone beam computed tomography (CBCT) images of 22 patients were obtained. CBCT multiplanar reformation (MPR) images were generated, and three-dimensional (3D) condylar models were constructed and superimposed to compare changes in condylar volume from pre- to postoperative. Condylar position in the sagittal and coronal planes altered immediately after surgery; however at long-term follow-up, the condyles had returned to their pre-surgical position. The condyles remained slightly inwardly rotated at short-term (−2.6°, 95% confidence interval −3.5° to −1.7°) and long-term (−1.9°, 95% confidence interval −2.8° to −1.0°) follow-up. Changes in condylar volume were insignificant after surgery. Condylar positional changes had no effect on skeletal stability. However, patients with an increased face height prior to surgery and more retrusive jaw position postoperatively were more prone to condylar resorption. Surgical changes remained stable 4–5 years after surgery. In conclusion, condylar position changed insignificantly following surgical correction in Class III patients provided that the correct surgical technique was employed.