Changes in condyle position after bilateral vertical ramus osteotomy with and without osteosynthesis

The purpose of the present study was to elucidate the importance of ramal osteosynthesis and evaluate postoperative condylar movements. The right temporomandibular joints of 53 patients with mandibular prognathism were examined by linear tomography the day before, 1 week after, and 1 year after surgery. During surgery the patients were randomly allocated to two groups: one with ( n = 26) and one without ( n = 27) osteosynthesis. It was found that osteosynthesis did not influence condyle position ( p > 0.3). The two groups were thereafter pooled. Radiographic measurements of the posterior and anterior interarticular space revealed that condyle position 1 week postoperatively was forward and downward in relation to the preoperative position (posterior fossa, p < 0.001; anterior fossa, p < 0.01). One year later the condyle position demonstrated a tendency to approximate the preoperative position, especially with respect to the posterior part, but there was still a significant ( p < 0.01) difference when related to the original position. In conclusion, osteosynthesis after ramus osteotomy seems to be of no importance when healing and postoperative condyle position are considered. Furthermore, 1 year after surgery the condyles were not reestablished in their preoperative positions.