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Quantitative assessment of condyle positional changes before and after orthognathic surgery based on fused 3D images from cone beam computed tomography

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Abstract

Objectives

To establish one method that can be used to quantitatively evaluate the condyle positional changes with 3D images in postoperative mandibular prognathism patients.

Materials and methods

This is a retrospective observational study. Twenty-one patients who underwent bilateral sagittal split ramus osteotomy (BSSRO) were scanned with cone beam computed tomography (CBCT) for temporomandibular joints (TMJs) at 1 week preoperatively (T0), 1 to 2 weeks (T1), 3 months (T2), 6 months (T3), and 12 months (T4) postoperatively. The data were then grouped into T0T1, T1T2, T2T3, T3T4 and T0T1, T0T2, T0T3, and T0T4. Semi-automatic registration was conducted, and the condyle positional changes were measured in segmented 3D models. Inter- and intra-observer variability and the repeatability of registration were analyzed with paired t test; the repeated measurement analysis of variance was used for analyzing the repeatability of the marked points; the consistency of segmentation was analyzed with nonparametric test of multiple paired samples (Friedman test) and the independent-sample t test was applied to comparing changes between different periods of time. Differences were considered to be statistically significant when P < 0.05.

Results

In T0T1 and T1T2, the condylar position was changed greatly. In T2T3, the mean condylar translations were less than 0.2 mm in all directions, the mean rotational changes of condyle were less than 0.2 mm; in the period of T3T4, the mean condylar translations in all directions were less than 0.02 mm. For series 2, the condyle translational changes in axial, coronal, and sagittal views were within 0.10 mm, and the rotation direction of condyle in all three views was the same within 1 year after operation.

Conclusions

Fused three-dimensional images can be used to qualitatively and quantitatively evaluate condyle positional changes. The condylar position might be stable at 3 months postoperatively. The condyles of most of patients did not fully return to their preoperative position within 1 year after the operation.

Clinical relevance

One method for fusing images has been established to detect the condylar positional changes. This method may be applied to estimate the bony changes of condyle, even bony changes in other part of dentomaxillofacial region. Meanwhile, the data of condyle positional changes from asymptomatic patients after the surgery within 1 year can be used as a reference for further exploration of the relationship between orthognathic surgery and the occurrence of osteoarthritis postoperatively in the future.

Key Points

• By fused 3D images, the change of condylar position after bilateral sagittal split ramus osteotomy can be observed intuitively.

• For the patients with mandibular prognathism, the condylar position would be stable at 3 months postoperatively.

• The condyles of most mandibular prognathism patients did not fully return to their preoperative position within 1 year after operation.

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Abbreviations

CBCT:

cone beam computed tomography

BSSRO:

bilateral sagittal split ramus osteotomy

TMJ:

temporomandibular joint

3D:

three-dimensional

DICOM:

digital imaging and communications in medicine

FOV:

field of view

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Funding

This study has received funding by National Natural Science Foundation of China (No. 81671034).

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie, Haidian District, Beijing, 100081, China

    Ruo-han Ma, Gang Li & Xu-chen Ma

  2. Department of Stomatology, Peking University International Hospital, Beijing, China

    Shuang Yin

  3. Department of Imaging & Pathology, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium

    Yi Sun

  4. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China

    Zi-li Li

  5. Center for Temporomandibular Joint Disorders and Orofacial Pain and Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China

    Xu-chen Ma

Authors
  1. Ruo-han Ma
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Corresponding author

Correspondence to Gang Li.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of Institutional Review Board of Peking University School and Hospital of Stomatology (PKUSSIRB-201944056) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was not required for this study because all of the included patients in the present investigation were collected retrospectively. Exemption of informed consent will not affect the rights and health of included patients. The application for free informed consent has been approved by the Institutional Review Board.

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Ma, Rh., Li, G., Yin, S. et al. Quantitative assessment of condyle positional changes before and after orthognathic surgery based on fused 3D images from cone beam computed tomography. Clin Oral Invest 24, 2663–2672 (2020). https://doi.org/10.1007/s00784-019-03128-z

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  • DOI: https://doi.org/10.1007/s00784-019-03128-z

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