Condylar Reshape in Orthognathic Surgery: Morphovolumetric and Densitometric Analysis Based on 3D Imaging and Digital Workflow

J Maxillofac Oral Surg. 2022 Jun;21(2):501-509. doi: 10.1007/s12663-022-01689-3. Epub 2022 Feb 9.

Abstract

Background: Condylar remodelling (CR) is a complex of phenomena that generates in response of the temporo-mandibular joint to forces and stress to maintain a morphological, functional and occlusal homeostasis. The most worrying aspect of the condylar reshape is the condylar resorption which implies fast loss of vertical dimension (>6% of pre-surgical value), mandibular retraction and open bite with preserved articular function.

Materials and methods: Six parameters were analysed to study the condyles of twelve patients that underwent orthognathic surgery. The digital workflow was then described to make it reproducible enabling a more in-depth study of the reshaping processes that involving the condyle after a great stress like the surgery.

Results: The results of our study showed many statistically significant variations of the studied parameters. In all patients, it was noticed a decreased bone density (p = 0,002 per side).

Objectives: The aim of our study, with the aid of the contemporary 3D imaging and digital modelling and workflow technologies, is to investigate and analyse quantitatively and qualitatively the adaptative processes occurring in CR following bimaxillary repositioning. To the best of our knowledge, this is the only paper that investigates the CR considering six different variables at once.

Keywords: Bone density; Condylar reshape; Digital workflow; Morphovolumetric analysis; Orthognathic surgery.