Rahbar Mehran, Sharifi Ali, Hayati Garjan Javad, Sheykhian Mojtaba
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
Maxillofac Plast Reconstr Surg. 2025 Jul 1;47(1):14. doi: 10.1186/s40902-025-00468-7.
The aim of the present study was to evaluate condylar volume and mandibular ramus in patients undergoing orthognathic surgery.
Relevant keywords were searched in the international databases Cochrane, Embase, and MEDLINE up to February 2025. Study selection criteria were based on the PICOS strategy; randomized clinical trial studies, cohort studies, cross-sectional studies, case-control studies (study (S)) that examined changes in condylar and ramus position (Outcome (O)) in orthognathic surgery as skeletal treatment (Intervention (I)) for Class III versus Class II (Comparison (C)) in patients who had undergone orthognathic surgery (Population (P)). Data were collected based on study findings from three-dimensional (3D) cephalometric/cone-beam computed tomographic (CBCT)analysis and measurements of condylar angle, volume, and position. The methodological index for non-randomized studies (MINORS) used to determine the quality of the studies. Mean differences were used as an effect size with fixed-effects model and inverse-variance methods of 95% confidence intervals (CI). Meta-analysis was performed using Stata (as of version 17).
The mean differences in condylar height between Class II and Class III were 2.19 mm (MD 2.19 mm 95% CI; 1.32 mm, 3.96 mm; p < 0.05). The mean differences in ramus angle between Class II and Class III were - 0.02° (MD - 0.02 95% CI - 0.06, 0.03; p > 0.05).
Based on the meta-analysis of the present study, orthognathic surgery did not significantly affect the microstructure of the mandibular ramus in the correction of class III malocclusions. In Class II, the condyle height was significantly reduced after orthognathic surgery, while the condyle width did not change.
PROSPERO CRD420251054773.
本研究旨在评估正颌手术患者的髁突体积和下颌升支。
截至2025年2月，在国际数据库Cochrane、Embase和MEDLINE中搜索相关关键词。研究选择标准基于PICOS策略；随机临床试验研究、队列研究、横断面研究、病例对照研究（研究（S）），这些研究考察了正颌手术中作为III类与II类骨骼治疗（干预（I））的髁突和升支位置变化（结果（O）），研究对象为接受正颌手术的患者（人群（P））。基于三维（3D）头影测量/锥形束计算机断层扫描（CBCT）分析的研究结果以及髁突角度、体积和位置的测量来收集数据。使用非随机研究的方法学指数（MINORS）来确定研究质量。采用固定效应模型和95%置信区间（CI）的逆方差方法，将平均差异用作效应量。使用Stata（截至版本17）进行荟萃分析。
II类和III类之间髁突高度的平均差异为2.19毫米（MD 2.19毫米，95% CI；1.32毫米，3.96毫米；p < 0.05）。II类和III类之间升支角度的平均差异为 -0.02°（MD -0.02，95% CI -0.06，0.03；p > 0.05）。
基于本研究的荟萃分析，正颌手术在矫正III类错牙合畸形时对下颌升支的微观结构没有显著影响。在II类中，正颌手术后髁突高度显著降低，而髁突宽度没有变化。
PROSPERO CRD420251054773。
