Jaiswal M Shriya, Hwang Dae-Seok
Department of Oral and Maxillofacial Surgery, Dental and Life Science Institute, Dental School, Pusan National University.
Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea.
J Craniofac Surg. 2025;36(5):e575-e579. doi: 10.1097/SCS.0000000000011422. Epub 2025 May 5.
Temporal mandibular joint (TMJ) space volume is pivotal in upholding optimal joint function and occlusal stability. Mandibular setback surgery can impact TMJ space volume due to condylar positioning adjustments. This study aims to investigate the changes in TMJ space volume following mandibular setback surgery with intended manual condylar positioning.
This is a retrospective study of 20 patients of class III (skeletal), who underwent Le Fort I osteotomy and BSSO surgery at the OMFS Department of PNUDH between 2015 and 2022 by one surgeon. CBCT scans were obtained preoperatively (T0) and at specified postoperative time points (T1) and (T2). The groups were categorized into group A (Total space volume), group B (non-asymmetric), and group C (asymmetric). TMJ space volume measurements were taken using CBCT imaging software. Each slice of the TMJ space was drawn manually using specialized software. The measured areas in each slice were added to determine the TMJ volumes, and the statistical analysis was done.
Preliminary findings from this study indicate that there was a highly significant difference in TMJ space volume between group A, group B, and group C at T0, T1, and T2 following surgery. However, there were no significant differences within the groups, which means that the intended manual condylar positioning gives stability to the TMJ joint space.
This study suggests that mandibular setback surgery with intended manual condylar positioning can lead to transient changes in TMJ space volume, with subsequent recovery and adaptation.
颞下颌关节（TMJ）间隙容积对于维持最佳关节功能和咬合稳定性至关重要。下颌后缩手术由于髁突位置调整可能会影响TMJ间隙容积。本研究旨在调查在有意进行手动髁突定位的下颌后缩手术后TMJ间隙容积的变化。
这是一项对20例III类（骨骼型）患者的回顾性研究，这些患者于2015年至2022年期间在PNUDH的口腔颌面外科由一名外科医生进行了Le Fort I截骨术和双侧矢状劈开截骨术（BSSO）手术。在术前（T0）以及特定的术后时间点（T1）和（T2）获取锥形束计算机断层扫描（CBCT）。将这些组分为A组（总间隙容积）、B组（非不对称）和C组（不对称）。使用CBCT成像软件进行TMJ间隙容积测量。使用专门软件手动绘制TMJ间隙的每一层。将每一层测量的面积相加以确定TMJ容积，并进行统计分析。
本研究的初步结果表明，手术前后的T0、T1和T2时，A组、B组和C组之间的TMJ间隙容积存在高度显著差异。然而，组内没有显著差异，这意味着有意进行的手动髁突定位使TMJ关节间隙具有稳定性。
本研究表明，有意进行手动髁突定位的下颌后缩手术可导致TMJ间隙容积出现短暂变化，随后恢复并适应。
