Anatomical and Clinical Implications in Neocondyle Stability After a Condylectomy

J Craniofac Surg. 2020 Jan/Feb;31(1):241-250. doi: 10.1097/SCS.0000000000006045.

Abstract

: A condylectomy of the mandibular condyle is considered to be the treatment of choice in most cases of condylar head hyperactivity. The aim of the procedure is to remove the growth center of the mandible which is responsible for the mandibular enlargement and asymmetry. This surgical procedure has an impact on the condyle shape and position, but the restoration of mandibular movement and a stable joint position (namely, the proper alignment of the newly shaped condylar head within the condyle fossa) should also be considered important surgical outcomes. In this article, the authors present their own experience in performing condylectomies with an arthroplasty procedure and a special forced suturing technique (FST) in terms of achieving early, accurate mandibular movement and maintaining a stable condyle position in early and late outcomes.

Materials and methods: A modified high condylectomy with arthroplasty and FST results had been studied in anatomical, radiological, and clinical model.

Results: Early findings after FST are promising. A slight improvement in lateral jaw movement was noted after condylectomy with arthroplasty (P < 0.05) both in early and late follow-up. Incisal opening, mandibular protrusion, and lateral movement were sustained. A stable condyle position within the fossa was achieved in each case of condylectomy with arthroplasty (P < 0.05).

Conclusions: The FST condylectomy and reattachment of the lateral pterygoid muscle in a new, wider position provided an improvement in lateral jaw movement as well as in incisal opening and mandibular protrusion in early follow-up examination compared to the presurgical values. It seems that the FST enabled a better new condylar head position in the glenoid fossa and improved early functional mandibular movement.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Mandibular Condyle / surgery*
  • Osteotomy*
  • Pterygoid Muscles / surgery
  • Young Adult