Department of Orthodontics (Head: Prof. Dr. Jin-Hyoung Cho), School of Dentistry, Chonnam National University, Gwangju, South Korea; Department of Orthodontics (Head: Prof. Dr. Robert Boyd), Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA.
Department of Orthodontics (Head: Prof. Dr. Jin-Hyoung Cho), School of Dentistry, Chonnam National University, Gwangju, South Korea.
J Craniomaxillofac Surg. 2019 Mar;47(3):406-413. doi: 10.1016/j.jcms.2018.11.029. Epub 2018 Dec 5.
The purpose of this study was to evaluate the association between kind of condylar displacement due to orthognathic surgery and the subsequent adaptive condylar head remodeling. The sample in this retrospective cohort study consisted of 30 patients (12 female and 18 male; mean age 22.7 y) with skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (SSRO). Three-dimensional superimpositions of cone-beam computed tomography (CBCT) scan derived images from immediately after and 6 months after surgery were to reveal the type of remodeling, while images from before and immediately after surgery were to identify the type of condylar displacement. Laterally displaced condyles showed bone resorption on the lateral surfaces and deposition on the medial surfaces, whereas the contrary was found in medially displaced condyles. Anteriorly displaced condyles showed resorption on the anterior surfaces and deposition on the posterior surfaces, whereas the contrary was found in posteriorly displaced condyles. Superior surfaces of the condyles showed bone resorption regardless of displacement direction. The results indicate that condylar remodeling patterns (resorption/deposition) are determined by the direction of condylar displacement during surgery. However, condylar displacement by surgery is not completely compensated by condylar head remodeling, especially in case of downward displacement.
本研究旨在评估因正颌手术导致的髁突移位类型与随后的适应性髁突头重塑之间的关系。本回顾性队列研究的样本包括 30 名（12 名女性和 18 名男性；平均年龄 22.7 岁）骨骼 III 类错畸形患者，他们接受了双侧矢状劈开下颌升支截骨术（SSRO）。通过对术后即刻和术后 6 个月的锥形束 CT（CBCT）扫描衍生图像进行三维叠加，以揭示重塑类型，而术前和术后即刻的图像则用于确定髁突移位的类型。侧向移位的髁突在外侧表面出现骨吸收，而在内侧表面出现骨沉积，而在向内侧移位的髁突中则相反。向前移位的髁突在前表面出现骨吸收，而在后表面出现骨沉积，而向后移位的髁突则相反。髁突的上表面无论移位方向如何，均出现骨吸收。结果表明，髁突重塑模式（吸收/沉积）由手术过程中髁突移位的方向决定。然而，手术引起的髁突位移不能完全通过髁突头重塑来补偿，尤其是在髁突向下位移的情况下。
