Department of Orthodontics, University Clinic of Dental Medicine, Faculty of Medicine, University of Geneva, Switzerland.
J Stomatol Oral Maxillofac Surg. 2022 Nov;123(6):e948-e955. doi: 10.1016/j.jormas.2022.03.008. Epub 2022 Mar 6.
Several systematic reviews have been published on the effects of mandibular surgery on condylar remodeling without reaching a consensus. The purpose of this systematic review of systematic reviews was to assess the impact of mandibular advancement or bimaxillary surgeries on condylar resorption. A literature search, using several electronic databases, was carried out by two reviewers independently. Article preselection was based on titles and abstracts, and final article selection based on full-text analysis of preselected studies. After final study selection, the quality of studies was assessed using the AMSTAR 2 tool. A decision algorithm was subsequently established to choose the best body of evidence. From an initial yield of 1'848 articles, 23 systematic reviews were identified for further analysis, with ten studies being included in the final selection. Despite the generally low quality of the reviews, certain associations could be made: young patients, female patients, and those with a high mandibular plane angle are more prone to condylar resorption following mandibular advancement osteotomies, especially if anterior rotation of the mandible is performed during surgery. Patients undergoing bimaxillary surgery also appear to have a higher risk of developing condylar resorption. In conclusion, these results confirm the multi-factorial nature of condylar resorption, stressing the need for well-controlled prospective studies with long-term follow-up to clearly identify potential risk factors associated with orthognathic surgery.
已经有几项关于下颌骨手术对髁突改建影响的系统评价发表，但尚未达成共识。本系统评价的目的是评估下颌前伸或双颌手术对髁突吸收的影响。两位评审员独立使用多个电子数据库进行文献检索。文章预选基于标题和摘要，最终预选研究的全文分析。最终研究选择后，使用 AMSTAR 2 工具评估研究质量。随后建立了决策算法来选择最佳证据体。从最初的 1848 篇文章中，确定了 23 篇系统评价进行进一步分析，其中有 10 项研究最终入选。尽管这些综述的质量普遍较低，但仍可以得出某些关联：年轻患者、女性患者和下颌平面角较高的患者在接受下颌骨前伸截骨术后更容易发生髁突吸收，尤其是在手术中进行下颌骨前旋时。接受双颌手术的患者似乎也有更高的发生髁突吸收的风险。总之，这些结果证实了髁突吸收的多因素性质，强调需要进行具有长期随访的良好对照前瞻性研究，以明确与正颌手术相关的潜在危险因素。
