Evaluation of bone contact area and intercondylar distance changes in orthognathic surgery - a comparison between BSSO and HSSO technique depending on mandibular displacement extent,Clinical Oral Investigations

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Evaluation of bone contact area and intercondylar distance changes in orthognathic surgery - a comparison between BSSO and HSSO technique depending on mandibular displacement extent
Clinical Oral Investigations ( IF 3.1 ) Pub Date : 2024-03-01 , DOI: 10.1007/s00784-024-05584-8
Stephan Christian Möhlhenrich _{1,

2} , Kristian Kniha ₂ , Florian Peters ₂ , Marius Heitzer ₂ , Josef Szalma ₃ , Andreas Prescher ₄ , Gholamreza Danesh ₁ , Frank Hölzle ₂ , Ali Modabber ₂

Affiliation

Objectives

The present study aims to assess the impact of bilateral and high oblique sagittal split osteotomy (BSSO/HSSO), as well as displacement distances and directions on the expected and achievable bone contact area (BCA) and changes in the intercondylar distance (ICD). The primary question addressed is whether mandibular splitting through BSSO results in a greater BCA and/or ICD when compared to splitting through HSSO.

Materials and methods

Totally 80 mandibular displacements were performed on 20 fresh cadavers, for each subject, four splints were produces to facilitate mandibular advancement as well as setbacks of 4 and 8 mm. Pre- and postoperative CBCT scans were performed to plan the surgical procedures and to analyze the expected and achieved BCA and ICD.

Results

Regarding the maximum mandibular displacement, the expected BCA for HSSO/BSSO were 352.58 ± 96.55mm² and 1164.00 ± 295.50mm², respectively, after advancement and 349.11 ± 98.42mm² and 1344.70 ± 287.23mm², respectively, after setback. The achieved BCA for HSSO/BSSO were 229.37 ± 75.90mm² and 391.38 ± 189.01mm², respectively, after advancement and 278.03 ± 97.65mm² and 413.52 ± 169.52 mm², respectively after setback. The expected ICD for HSSO/BSSO were 4.51 ± 0.73 mm and 3.25 ± 1.17 mm after advancement and − 5.76 ± 1.07 mm and − 4.28 ± 1.58 mm after setback. The achieved ICD for HSSO/BSSO were 2.07 ± 2.9 mm and 1.7 ± 0.60 mm after advancement and − 2.57 ± 2.78 mm and − 1.28 ± 0.84 mm after setback. Significant differences between the BCA after HSSO and BSSO were at each displacement (p < 0.001), except for the achieved BCA after 8-mm setback and advancement (p ≥ 0.266). No significant differences were observed regarding ICD, except for the expected ICD after 8-mm setback and advancement (p ≤ 0.037).

Conclusions

Compared to the virtual planning, the predictability regarding BCA and ICD was limited. ICD showed smaller clinical changes, BCA decreased significantly in the BSSO group.

Clinical relevance

BCA and ICD might have been less important in choosing the suitable split technique. in orthognathic surgery.

中文翻译：

正颌手术中骨接触面积和髁间距离变化的评估——根据下颌移位程度比较 BSSO 和 HSSO 技术

目标

本研究旨在评估双侧高斜矢状劈开截骨术 (BSSO/HSSO) 以及位移距离和方向对预期和可实现的骨接触面积 (BCA) 以及髁间距离 (ICD) 变化的影响。解决的主要问题是，与通过 HSSO 分裂相比，通过 BSSO 分裂下颌是否会导致更大的 BCA 和/或 ICD。

材料和方法

对 20 具新鲜尸体进行了总共 80 次下颌移位，为每个受试者制作了 4 个夹板以促进下颌前移以及 4 毫米和 8 毫米的后退。进行术前和术后 CBCT 扫描以计划手术程序并分析预期和实现的 BCA 和 ICD。

结果

关于最大下颌位移，HSSO/BSSO的预期BCA在前进后分别为352.58±96.55mm ²和1164.00±295.50mm ² ，在后退后分别为349.11±98.42mm ²和1344.70±287.23mm ² 。 HSSO/BSSO 前进后达到的 BCA 分别为 229.37 ± 75.90mm ²和 391.38 ± 189.01mm ² ，挫折后分别为 278.03 ± 97.65mm ²和 413.52 ± 169.52 mm ² 。 HSSO/BSSO 的预期 ICD 前进后为 4.51 ± 0.73 mm 和 3.25 ± 1.17 mm，后退后为 − 5.76 ± 1.07 mm 和 − 4.28 ± 1.58 mm。 HSSO/BSSO 的 ICD 前进后为 2.07 ± 2.9 mm 和 1.7 ± 0.60 mm，后退后为 − 2.57 ± 2.78 mm 和 − 1.28 ± 0.84 mm。 HSSO 和 BSSO 后的 BCA 之间在每个位移处均存在显着差异 ( p < 0.001)，但在 8 毫米后退和前进后实现的 BCA 除外 ( p ≥ 0.266)。除了 8 毫米后退和前进后预期的 ICD 之外，没有观察到 ICD 方面的显着差异 ( p ≤ 0.037)。