High oblique sagittal split osteotomy of the mandible: assessment of the positions of the mandibular condyles after orthognathic surgery based on cone-beam tomography

High oblique sagittal split osteotomy is an orthognathic technique to move the mandible. Our aim was to evaluate changes in the position of the condyle in the glenoid fossa and its angulation before and after high oblique sagittal split osteotomy (HSSO). Fifty patients (32 women and 18 men, mean age...

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Main Authors: Kühle, Reinald (Author) , Berger, Moritz (Author) , Saure, Daniel (Author) , Hoffmann, Jürgen (Author) , Seeberger, Robin (Author)
Format: Article (Journal)
Language:English
Published: 3 April 2016
In: The British journal of oral & maxillofacial surgery
Year: 2016, Volume: 54, Issue: 6, Pages: 638-642
ISSN:1532-1940
DOI:10.1016/j.bjoms.2016.03.017
Online Access:Verlag, Volltext: http://dx.doi.org/10.1016/j.bjoms.2016.03.017
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0266435616001339
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Author Notes:R. Kuehle, M. Berger, D. Saure, J. Hoffmann, R. Seeberger

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520 |a High oblique sagittal split osteotomy is an orthognathic technique to move the mandible. Our aim was to evaluate changes in the position of the condyle in the glenoid fossa and its angulation before and after high oblique sagittal split osteotomy (HSSO). Fifty patients (32 women and 18 men, mean age 26.3 (SD 7.4) years) had cone-beam computed tomographyic (CT) scans before operation, immediately postoperatively, and before removal of the osteosynthesis nine months postoperatively. The images were analysed to look for changes in the sagittal, coronal, and axial positions of the condyles. Twenty-four patients with class II malocclusion had a mean (SD) mandibular advancement of 6.51 (2.41) mm, and 26 patients with class III malocclusion had a mean (SD) mandibular setback of 4.16 (2.77) mm. The joint space increased significantly (p<0.05) relative to baseline immediately postoperatively, but there was no significant increase at the nine-month follow-up. The changes in position in the sagittal, coronal, and axial planes were comparable. Despite there being a short proximal joint-bearing segment, the results indicate that this technique allows free-hand condylar positioning into the fossa safely without any clinically relevant dislocations. 
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