Bae Jung-Hwan, Hwang Ji-Young, Lee Jae-Yeol, Hwang Dae-Seok
Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University Yangsan, Republic of Korea.
J Craniofac Surg. 2025 Jun 1;36(4):e446-e449. doi: 10.1097/SCS.0000000000011026. Epub 2024 Dec 24.
This study aimed to quantitatively analyze temporomandibular joint (TMJ) space volume changes before and after bilateral sagittal split ramus osteotomy (BSSRO) with intended manual condyle positioning in patients with severe facial asymmetry.
A retrospective study was conducted, including 20 patients with facial asymmetry (menton deviation >8 mm) who underwent BSSRO with intended manual condyle positioning at a single institution. Cone beam computed tomography (CBCT) images were obtained preoperatively (T0), 2 days postoperatively (T1), and 6 months postoperatively (T2). TMJ space volumes on the deviation side (DS) and non deviation side (NDS) were measured at each time point. Changes in TMJ space volume were analyzed over time and compared between the DS and NDS using appropriate statistical methods.
Both the DS and NDS exhibited an increasing trend in TMJ space volume from T0 to T1, followed by a reduction at T2, approaching levels similar to T0. The change in volume from T0 to T1 was more pronounced on the DS compared with the NDS.
In patients with severe facial asymmetry undergoing BSSRO, there is a tendency for the TMJ space to increase initially. However, incorporating manual condylar positioning to achieve a stable condyle position results in the TMJ space returning to pre-surgery levels by 6 months postoperatively. These findings suggest that intended manual condyle positioning may help maintain proper TMJ function following BSSRO in patients with severe facial asymmetry.
本研究旨在定量分析重度面部不对称患者在进行双侧矢状劈开下颌支截骨术（BSSRO）并有意进行髁突手动定位前后颞下颌关节（TMJ）间隙体积的变化。
进行一项回顾性研究，纳入20例面部不对称（颏点偏斜>8 mm）且在单一机构接受BSSRO并有意进行髁突手动定位的患者。在术前（T0）、术后2天（T1）和术后6个月（T2）获取锥形束计算机断层扫描（CBCT）图像。在每个时间点测量偏斜侧（DS）和非偏斜侧（NDS）的TMJ间隙体积。使用适当的统计方法分析TMJ间隙体积随时间的变化，并在DS和NDS之间进行比较。
从T0到T1，DS和NDS的TMJ间隙体积均呈增加趋势，随后在T2时减小，接近T0时的水平。与NDS相比，DS从T0到T1的体积变化更明显。
在接受BSSRO的重度面部不对称患者中，TMJ间隙最初有增大的趋势。然而，通过手动髁突定位实现稳定的髁突位置，可使TMJ间隙在术后6个月恢复到手术前水平。这些发现表明，有意进行髁突手动定位可能有助于在重度面部不对称患者接受BSSRO后维持TMJ的正常功能。
