Politis Constantinus, Van De Vyvere Gaétan, Agbaje Jimoh Olubanwo
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Katholieke Universiteit Leuven.
Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven.
J Craniofac Surg. 2019 Jan;30(1):169-174. doi: 10.1097/SCS.0000000000004837.
The aim was to postoperatively evaluate a conservative treatment approach to bilateral condylar resorption after orthognathic surgery. A retrospective study was carried out on 730 consecutive patients undergoing sagittal split osteotomy, 2013 to 2016. The mean follow-up period was 2.29 years. Clinical and radiographic findings of patients with postoperative bilateral condylar resorption were searched. Syndromic patients and patients with juvenile rheumatoid arthritis were excluded from this study. Of the 730 patients, 6 (0.82%) required treatments because of bilateral postoperative condylar resorption but had no surgery at the temporomandibular joint (TMJ). Five patients with TMJ symptoms because of postoperative condylar resorption were managed with conservative treatment. About 2 of the 6 patients were successfully retreated with orthognathic surgery in the upper jaw to close the open bite. The TMJ symptoms can successfully be managed with conservative therapy, whereas skeletal relapse can be retreated with orthognathic surgery in the upper jaw, depending on the amount of overjet. Patient undergoing orthognathic surgery may develop bilateral condylar resorption though the frequency is <1%, most of these patients can be managed conservatively.
本研究旨在对正颌外科手术后双侧髁突吸收的保守治疗方法进行术后评估。对2013年至2016年连续接受矢状劈开截骨术的730例患者进行了回顾性研究。平均随访期为2.29年。对术后双侧髁突吸收患者的临床和影像学检查结果进行了检索。本研究排除了综合征患者和青少年类风湿性关节炎患者。在730例患者中，6例（0.82%）因术后双侧髁突吸收需要治疗，但未在颞下颌关节（TMJ）进行手术。5例因术后髁突吸收出现TMJ症状的患者接受了保守治疗。6例患者中有2例通过上颌正颌手术成功进行了再次治疗，以关闭开牙合。TMJ症状可以通过保守治疗成功控制，而骨骼复发可以根据覆盖量通过上颌正颌手术进行再次治疗。接受正颌手术的患者可能会出现双侧髁突吸收，尽管发生率<1%，但大多数患者可以通过保守治疗。
