Positional changes of the mandibular condyle in unilateral sagittal split ramus osteotomy combined with intraoral vertical ramus osteotomy for asymmetric class III malocclusion
박준, 홍기은, 윤지언, 신은섭, 김철훈, 김복주, 김정한,
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박준 ( Park Jun ) - Dong-A University College of Medicine Department of Oral and Maxillofacial Surgery
홍기은 ( Hong Ki-Eun ) - Dong-A University College of Medicine Department of Oral and Maxillofacial Surgery
윤지언 ( Yun Ji-Eon ) - Dong-A University College of Medicine Department of Oral and Maxillofacial Surgery
신은섭 ( Shin Eun-Sup ) - Dong-A University College of Medicine Department of Oral and Maxillofacial Surgery
김철훈 ( Kim Chul-Hoon ) - Dong-A University College of Medicine Department of Oral and Maxillofacial Surgery
김복주 ( Kim Bok-Joo ) - Dong-A University College of Medicine Department of Oral and Maxillofacial Surgery
김정한 ( Kim Jung-Han ) - Dong-A University College of Medicine Department of Oral and Maxillofacial Surgery
Abstract
Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class Ⅲ malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated.
Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed.
Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement.
Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.
키워드
Orthognathic surgery; Facial asymmetry; Sagittal split ramus osteotomy; Intraoral vertical ramus osteotomy; Temporomandibular joint disorder
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