Qualitative and quantitative assessment of condylar displacement after orthognathic surgery: A voxel-based three-dimensional analysis - 14/11/21

Doi : 10.1016/j.jormas.2021.11.003

Selene Barone ^a, Danila Muraca ^a, Fiorella Averta ^a, Federica Diodati ^a, Amerigo Giudice ^b,^⁎
^a School of Dentistry, Department of Health Sciences, Magna Graecia, University of Catanzaro, Viale Europa 88100 Catanzaro, Italy
^b Oral and Maxillofacial Surgeon, Professor, School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa 88100 Catanzaro, Italy

^⁎Corresponding author at: Magna Graecia University of Catanzaro, Viale Europa 88100 Catanzaro, Italy.Magna Graecia University of CatanzaroViale EuropaCatanzaro88100Italy

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Highlights

•	Voxel-based superimposition showed no significant condylar displacement in orthognathic surgery patients at 12 to 18 months of follow-up.
•	Anterior, lower, and medial displacement within 1 mm represented the most common post-operative condylar movement.
•	There was no correlation between the entity of condylar displacement and mandibular asymmetry.

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Abstract

Purpose

This study aimed to evaluate the morphometric changes in the position of the mandibular condyles before and after orthognathic surgery.

Methods

A retrospective single-center cohort study was conducted and included patients with a presurgical (T1) and postsurgical (T2) Cone Beam computed tomography (CBCT). The primary predictor variable was the orthognathic surgical treatment. Pre-operative and post-operative CBCT scans were superimposed using voxel-based registration. Semitransparent overlays of the models of condylar regions at T1 and T2 were created for the qualitative analysis. The primary outcome variable was the quantitative displacement of condyles (CoR; CoL) analyzed in X, Y, Z axis and the 3D distances. Descriptive and bivariate statistical analysis was performed, setting α=0.05.

Results

The study sample included 33 patients (mean age: 25.33±2.49 years) affected by skeletal class III malocclusion with or without skeletal asymmetry. The X-axis showed a mean movement of 0.25 ± 0.17 mm for CoR, and 0.52 ± 0.51 mm for CoL. The Y-axis showed a mean movement of 0.29 ± 0.2 mm for CoR, and 0.51 ± 0.8 mm for CoL. The Z-axis was 0.33 ± 0.2 mm for CoR, and 0.5 ± 0.49 mm for CoL. No statistically significant difference was calculated comparing the movement of condylar surface between asymmetric and not asymmetric patients (p = 0.26 for CoR; p = 0.13 for CoL). No statistically significant difference was found in intercondylar distance between T1 and T2 (p = 0.39).