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3D analysis of condylar and mandibular remodeling one year after intra-oral ramus vertical lengthening osteotomy

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Abstract

Objectives

Among the existing techniques for the correction of mandibular posterior vertical insufficiency (PVI), the intra-oral ramus vertical lengthening osteotomy (IORVLO) can be proposed as it allows simultaneous correction of mandibular height and retrusion. This study assessed the 3D morpho-anatomical changes of the ramus-condyle unit and occlusal stability after IORVLO.

Materials and methods

This retrospective analysis compared immediate and 1-year post-operative 3D CBCT reconstructions. The analysis focused on the condylar height (primary endpoint) and on the changes in condylar (condylar diameter, condylar axis angle) and mandibular (ramus height, Frankfort-mandibular plane angle, gonion position, intergonial distance, angular remodeling) parameters. Additionally, this analysis investigated the maxillary markers and occlusal stability.

Results

On the 38 condyles studied in 21 included patients (mean age 23.7 ± 3.9 years), a condylar height (CH) loss of 0.66 mm (p < 0,03) was observed, with no correlation with the degree of ramus lengthening (mean 13.3 ± 0.76 mm). Only one patient presented an occlusal relapse of Class II, but a 3.4 mm (28%) condylar diameter loss and a 33% condylar volume reduction with loss of 1 mm and 3.4 mm in CH and condyle diameter, respectively. A mean 3.56 mm (p < 0.001) decrease in ramus height was noted, mainly due to bone resorption in the mandibular angles.

Conclusion

This study confirms the overall stability obtained with IORVLO for the correction of PVI.

Clinical relevance

This study aims to precise indication of IORVLO, and to validate the clinical and anatomical stability of results.

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Acknowledgements

We would like to thank Pr Sang-Hwy Lee for his help and advice on this work.

Author information

Authors and Affiliations

  1. Nantes Université, CHU Nantes, Service de Chirurgie Maxillo-Faciale Et Stomatologie, 44000, Nantes, France

    Samy Bencherqui, Jean-Philippe Perrin, Pierre Corre & Hélios Bertin

  2. School of Dentistry, Department of Health Sciences, Magna, Graecia University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy

    Selene Barone

  3. Department of Orthodontics & Ped Dentistry, University of Michigan, Ann Arbor, MI, USA

    Lucia Cevidanes

  4. Nantes Université, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, 44000, Nantes, France

    Pierre Corre & Hélios Bertin

  5. Nantes Université, Univ Angers, CHU Nantes, INSERM, CNRS, CRCI2NA, 44000, Nantes, France

    Hélios Bertin

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  1. Samy Bencherqui
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Contributions

Conceptualization: Samy Bencherqui, Helios Bertin, Pierre Corre, Selene Barone; Data curation: Samy Bencherqui, Jean-Philippe Perrin, Pierre Corre; Formal Analysis: Samy Bencherqui, Selene Barone; Funding acquisition: Not Applicable; Investigation: Samy Bencherqui, Selene Barone; Methodology: Pierre Corre, Lucia Cevidanes, Helios Bertin; Project administration: Helios Bertin, Pierre Corre; Resources: Helios Bertin, Pierre Corre, Selene Barone, Lucia Cevidanes; Supervision: Helios Bertin, Pierre Corre, Lucia Cevidanes; Validation: Helios Bertin, Lucia Cevidanes, Pierre Corre; Visualization: Samy Bencherqui, Selene Barone; Writing – original draft: Samy Bencherqui; Writing – review & editing: Samy Bencherqui, Selene Barone, Pierre Corre, Helios Bertin, Lucia Cevidanes.

Corresponding author

Correspondence to Samy Bencherqui.

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Ethics approval

Due to the retrospective nature of the study, it was formally granted exemption from approval by the ethics committee of the Nantes University Hospital in accordance with French legislation article L. 1121–1 paragraph 1 and R1121-2 of the Public Health Code.

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The authors declare no competing interests.

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Bencherqui, S., Barone, S., Cevidanes, L. et al. 3D analysis of condylar and mandibular remodeling one year after intra-oral ramus vertical lengthening osteotomy. Clin Oral Invest 28, 114 (2024). https://doi.org/10.1007/s00784-024-05504-w

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