Gulcek Betul Nazli, Ozbilen Elvan Onem, Biren Sibel
Angle Orthod. 2023 Mar 1;93(2):168-175. doi: 10.2319/052922-394.1.
To evaluate the axial and dimensional changes of the condylar head after orthognathic surgery, including Le Fort I and bilateral sagittal split ramus osteotomies, and to assess condylar remodeling through three-dimensional (3D) surface superimposition.
Twenty-four patients (15 females, 9 males; mean age: 32.22 ± 6.92 years) with skeletal Class III deformity were included in the study. Cone-beam computed tomography data obtained in the preoperative (T0) and postoperative (T1) periods were examined using Mimics and 3-Matic software. The height, depth, and width of the condylar head and its angular changes were measured. The volumes of the 3D reconstructed models were calculated, and remodeling amounts were evaluated through regional surface superimposition. Statistical significance was set at P < .05.
Following the surgery, there was a significant decrease in the size of condyles (P < .05). An inward rotation of the condyles was found in the axial plane (T0: 79.60 ± 6.01°, T1: 76.6 ± 6.48°, P < .05). The maximum resorption, maximum apposition, mean remodeling, and mean absolute remodeling were -2.63 ± 1.23 mm, 1.15 ± 0.4 mm, -0.30 ± 0.34 mm, and 0.73 ± 0.43 mm, respectively. No correlation was found between the angular changes and remodeling parameters or linear and volumetric changes of the condylar head (P > .05).
Condyles undergo a remodeling process with a resorptive character following orthognathic surgery, without clinically significant effects in the present study.
评估正颌外科手术后髁突头部的轴向和尺寸变化，包括Le Fort I型截骨术和双侧矢状劈开下颌支截骨术，并通过三维（3D）表面叠加评估髁突重塑情况。
本研究纳入了24例骨骼III类畸形患者（15例女性，9例男性；平均年龄：32.22±6.92岁）。使用Mimics和3-Matic软件检查术前（T0）和术后（T1）获得的锥形束计算机断层扫描数据。测量髁突头部的高度、深度和宽度及其角度变化。计算3D重建模型的体积，并通过区域表面叠加评估重塑量。设定统计学显著性为P < 0.05。
手术后，髁突大小显著减小（P < 0.05）。在轴向平面发现髁突向内旋转（T0：79.60±6.01°，T1：76.6±6.48°，P < 0.05）。最大吸收、最大增生、平均重塑和平均绝对重塑分别为-2.63±1.23 mm、1.15±0.4 mm、-0.30±0.34 mm和0.73±0.43 mm。未发现角度变化与髁突头部的重塑参数或线性和体积变化之间存在相关性（P > 0.05）。
正颌外科手术后髁突经历了具有吸收特征的重塑过程，在本研究中未产生临床显著影响。
