Condylar position following mandibular advancement: Its relationship to relapse

Forty-one patients who elected to receive a bilateral sagittal osteotomy to advance the mandible were examined clinically and radiographically to assess condylar position preoperatively and at three specific times post-operatively. Parameters designed to measure changes in condylar and distal fragme...

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Veröffentlicht in:Journal of oral and maxillofacial surgery 1984-09, Vol.42 (9), p.578-588
Hauptverfasser: Will, Leslie A., Joondeph, Donarld R., Hohl, Thomas H., West, Roger A.
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container_end_page 588
container_issue 9
container_start_page 578
container_title Journal of oral and maxillofacial surgery
container_volume 42
creator Will, Leslie A.
Joondeph, Donarld R.
Hohl, Thomas H.
West, Roger A.
description Forty-one patients who elected to receive a bilateral sagittal osteotomy to advance the mandible were examined clinically and radiographically to assess condylar position preoperatively and at three specific times post-operatively. Parameters designed to measure changes in condylar and distal fragment position were located on tracings and digitized for statistical analysis. Changes in distal fragment position included advancement and clockwise rotation during the surgical interval and significant posterior relapse with continued clockwide rotation during the period of maxillomandibular fixation. A small amount of counterclockwise rotation associated with interocclusal splint removal was seen following fixation release. No significant condylar movement was seen during the surgical interval. During the period of maxillomandibular fixation, both condyles exhibited a significant superior movement, and the left condyle also moved posteriorly. No changes in condylar position were noted following release of fixation. The clinical significance of these condylar movements is not clear. Despite minimal changes, 18 patients, six of whom had had no preoperative symptoms and one of whom had exhibited reciprocal clicking, complained of temporomandibular joint pain or noise postoperatively. This suggests that maintenance of condylar position during surgery may not prevent temporomandibular joint dysfunction. In addition, the observed 37% relapse in surgical advancement in the absence of significant condylar distraction implies the interaction of other factors in the relapse process.
doi_str_mv 10.1016/0278-2391(84)90088-0
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Parameters designed to measure changes in condylar and distal fragment position were located on tracings and digitized for statistical analysis. Changes in distal fragment position included advancement and clockwise rotation during the surgical interval and significant posterior relapse with continued clockwide rotation during the period of maxillomandibular fixation. A small amount of counterclockwise rotation associated with interocclusal splint removal was seen following fixation release. No significant condylar movement was seen during the surgical interval. During the period of maxillomandibular fixation, both condyles exhibited a significant superior movement, and the left condyle also moved posteriorly. No changes in condylar position were noted following release of fixation. The clinical significance of these condylar movements is not clear. Despite minimal changes, 18 patients, six of whom had had no preoperative symptoms and one of whom had exhibited reciprocal clicking, complained of temporomandibular joint pain or noise postoperatively. This suggests that maintenance of condylar position during surgery may not prevent temporomandibular joint dysfunction. 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Parameters designed to measure changes in condylar and distal fragment position were located on tracings and digitized for statistical analysis. Changes in distal fragment position included advancement and clockwise rotation during the surgical interval and significant posterior relapse with continued clockwide rotation during the period of maxillomandibular fixation. A small amount of counterclockwise rotation associated with interocclusal splint removal was seen following fixation release. No significant condylar movement was seen during the surgical interval. During the period of maxillomandibular fixation, both condyles exhibited a significant superior movement, and the left condyle also moved posteriorly. No changes in condylar position were noted following release of fixation. The clinical significance of these condylar movements is not clear. Despite minimal changes, 18 patients, six of whom had had no preoperative symptoms and one of whom had exhibited reciprocal clicking, complained of temporomandibular joint pain or noise postoperatively. This suggests that maintenance of condylar position during surgery may not prevent temporomandibular joint dysfunction. In addition, the observed 37% relapse in surgical advancement in the absence of significant condylar distraction implies the interaction of other factors in the relapse process.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cephalometry - methods</subject><subject>Child</subject><subject>Dentistry</subject><subject>Facial bones, jaws, teeth, parodontium: diseases, semeiology</subject><subject>Humans</subject><subject>Immobilization</subject><subject>Malocclusion - surgery</subject><subject>Mandible - surgery</subject><subject>Mandibular Condyle - anatomy &amp; histology</subject><subject>Mandibular Condyle - diagnostic imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Osteotomy - methods</subject><subject>Otorhinolaryngology. 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Stomatology</topic><topic>Recurrence</topic><topic>Rotation</topic><topic>Temporomandibular Joint - physiology</topic><topic>Tomography, X-Ray - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Will, Leslie A.</creatorcontrib><creatorcontrib>Joondeph, Donarld R.</creatorcontrib><creatorcontrib>Hohl, Thomas H.</creatorcontrib><creatorcontrib>West, Roger A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>Journal of oral and maxillofacial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Will, Leslie A.</au><au>Joondeph, Donarld R.</au><au>Hohl, Thomas H.</au><au>West, Roger A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Condylar position following mandibular advancement: Its relationship to relapse</atitle><jtitle>Journal of oral and maxillofacial surgery</jtitle><addtitle>J Oral Maxillofac Surg</addtitle><date>1984-09</date><risdate>1984</risdate><volume>42</volume><issue>9</issue><spage>578</spage><epage>588</epage><pages>578-588</pages><issn>0278-2391</issn><eissn>1531-5053</eissn><coden>JOMSDA</coden><abstract>Forty-one patients who elected to receive a bilateral sagittal osteotomy to advance the mandible were examined clinically and radiographically to assess condylar position preoperatively and at three specific times post-operatively. 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source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Adolescent
Adult
Biological and medical sciences
Cephalometry - methods
Child
Dentistry
Facial bones, jaws, teeth, parodontium: diseases, semeiology
Humans
Immobilization
Malocclusion - surgery
Mandible - surgery
Mandibular Condyle - anatomy & histology
Mandibular Condyle - diagnostic imaging
Medical sciences
Middle Aged
Osteotomy - methods
Otorhinolaryngology. Stomatology
Recurrence
Rotation
Temporomandibular Joint - physiology
Tomography, X-Ray - methods
title Condylar position following mandibular advancement: Its relationship to relapse
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