Long-term three-dimensional condylar remodeling during presurgical orthodontics and after orthognathic surgery of mandibular retrognathia with high mandibular plane angle,Clinical Oral Investigations

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Long-term three-dimensional condylar remodeling during presurgical orthodontics and after orthognathic surgery of mandibular retrognathia with high mandibular plane angle
Clinical Oral Investigations ( IF 3.1 ) Pub Date : 2022-08-17 , DOI: 10.1007/s00784-022-04686-5
Khadeegh F Al-Rezami _{1,

2} , Bassam M Abotaleb _{1,

3,

4} , Khaled Alkebsi _{1,

5} , Ruiyu Wang _{1,

5} , Akram Al-Nasri ₆ , Karim Sakran _{1,

5} , Mohammed Aladimi _{1,

5} , Pu Yang _{1,

2}

Affiliation

Objectives

Patients with high mandibular plane facial morphology are the most dominant facial type who experience TMJ abnormalities with resultant condylar resorption, affecting the orthodontic and orthognathic treatment outcomes. The study aimed to quantitatively assess the three-dimensional condylar remodeling during the presurgical orthodontics and after orthognathic surgery of the retrognathic mandible with a high mandibular plane angle. The study also investigated the correlation between the resultant remodeling based on the hypothesis that condylar resorption following orthognathic surgery is a part of a progressive presurgical resorption process.

Materials and methods

The study included adults with mandibular retrognathism and high mandibular plane angle who have computed tomography scans (CT) obtained before any treatment (T0), after completion of presurgical treatment before surgery (T1), and at long-term follow-up after surgery (T2). DICOM of CT scan was gathered and processed using ITK-SNAP and 3D Slicer software. The interval between T0 and T1 was represented as a presurgical phase, while between T1 and T2 was defined as a postsurgical phase (T1-T2).

Results

Twenty-five patients (50 condyles) were included with a mean age of 23 ± 3.2 years. The mean of the follow-up during the presurgical phase was 19.8 ± 7.1 months and 15.5 ± 5.5 months during the postsurgical phase. The condylar volume during the presurgical phase (T0-T1) was relatively stable (− 3.3 ± 37.2mm³). However, during the postsurgical phase (T1-T2), the volume was significantly reduced − 113.8 ± 98.3mm³ (P < 0.001). Localized condylar surface resorption during the postsurgical phase was significantly higher than during the presurgical phase (P < 0.05). No correlation was found between the localized condylar surface remodeling during the presurgical and postsurgical phases. However, a negative statistically significant correlation existed between the overall condylar volume changes during the presurgical and postsurgical phases (r = 0.502, P < 0.001).

Conclusion

Significant condylar resorption following orthognathic surgery of the retrognathic mandible with a high mandibular plane angle might occur regardless of the presurgical status of the condyle.

Clinical relevance

The study provided an evidence to be discussed with the patients and considered throughout the treatment of mandibular retrognathia with high mandibular plane angle.

中文翻译：

高下颌平面角下颌后缩术前正畸及正颌术后远期三维髁突重塑

目标

高下颌平面面部形态的患者是最主要的面部类型，他们会经历颞下颌关节异常并导致髁突吸收，影响正畸和正颌治疗结果。本研究旨在定量评估高下颌平面角下颌骨后颌骨术前正畸期间和正颌手术后的三维髁突重塑。该研究还基于以下假设调查了由此产生的重塑之间的相关性，即正颌手术后的髁突吸收是进行性术前吸收过程的一部分。

材料和方法

该研究包括在任何治疗前 (T0)、完成术前术前治疗后 (T1) 以及术后长期随访的下颌骨后移和高下颌平面角度的成人进行计算机断层扫描 (CT)。 T2). 使用 ITK-SNAP 和 3D Slicer 软件收集和处理 CT 扫描的 DICOM。T0 和 T1 之间的间隔表示为术前阶段，而 T1 和 T2 之间的间隔定义为术后阶段 (T1-T2)。

结果

包括 25 名患者（50 个骨节），平均年龄为 23 ± 3.2 岁。术前阶段的平均随访时间为 19.8 ± 7.1 个月，术后阶段为 15.5 ± 5.5 个月。术前阶段 (T0-T1) 的髁突体积相对稳定 (− 3.3 ± 37.2mm ³ )。然而，在术后阶段 (T1-T2)，体积显着减少 − 113.8 ± 98.3mm ³ ( P < 0.001)。术后阶段的局部髁突表面吸收明显高于术前阶段（P < 0.05)。在术前和术后阶段，局部髁突表面重塑之间没有相关性。然而，在术前和术后阶段，总体髁突体积变化之间存在显着的负相关性（r = 0.502，P < 0.001）。