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Association between condylar position changes and functional outcomes after condylar reconstruction by free fibular flap

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Abstract

Objectives

Stable and appropriate condyle positioning is necessary for maintaining temporomandibular joint function. It is unclear if this position remains stable in patients after free fibular flap (FFF) condylar reconstruction. We investigated whether condylar position deviated after reconstruction, and whether this affected functional recovery.

Materials and methods

We retrospectively reviewed 43 patients who underwent conventional FFF condylar reconstruction, and 5 patients who underwent reconstruction by computer-assisted three-dimensional (3D) printing methods. Three-dimensional models were built from cone-beam computed tomography images obtained immediately postoperatively and 1-year postoperatively. The glenoid fossa and fibular condyle centers were used to measure the fibular condyle position in the models. Clinical examination indices, including maximum mouth opening (MMO), pain during chewing/mouth opening, and patient satisfaction with mastication and 1-year outcomes were assessed.

Results

Fibular condyle position changed significantly over 1 year in both groups (P < 0.05). Clinical examination at 1 year after the surgery showed that in the conventional group, the MMO range was ≥ 35 mm in 76.7% of patients and < 35 mm in 23.3% of patients; 4.7% experienced pain during chewing/mouth opening, and 7% were dissatisfied with treatment outcomes. In the 3D printing group, all patients had an MMO range exceeding 35 mm, none had pain, and all were satisfied with functional outcomes.

Conclusions

The position of the fibular condyle deviates after reconstructive surgery, but it is unlikely to affect functional recovery.

Clinical relevance

These findings can form the basis for evaluation of functional outcomes of patients who have previously undergone condylar reconstruction by FFF.

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Funding

This work was supported by the National Natural Science Foundation of China (81360403), the Medical and Health Appropriate Technology Development and Promotion Project of Guangxi Province (S2018067), and Guangxi Nature Science Foundation (2019GXNSFAA185054).

Author information

Author notes

  1. Qinchao Tang and Yixing Li contributed equally to this work.

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, College of Stomatology, Guangxi Medical University, 10 Shuangyong Road, Nanning, 530021, Guangxi, China

    Qinchao Tang, Yixing Li, Tao Yu, Xueru Chen, Zhuoqian Zhou, Wanqian Huang & Feixin Liang

  2. Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Nanning, Guangxi, China

    Qinchao Tang, Tao Yu, Xueru Chen, Zhuoqian Zhou, Wanqian Huang & Feixin Liang

  3. Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning, Guangxi, China

    Qinchao Tang, Tao Yu, Xueru Chen, Zhuoqian Zhou, Wanqian Huang & Feixin Liang

  4. Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, Guangxi, China

    Qinchao Tang, Tao Yu, Xueru Chen, Zhuoqian Zhou, Wanqian Huang & Feixin Liang

  5. Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Guangxi Medical University, Nanning, Guangxi, China

    Yixing Li & Feixin Liang

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  1. Qinchao Tang
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Correspondence to Feixin Liang.

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The research was approved by the Ethics Committee of Guangxi Medical University (20130305-12). Informed consent was provided by all patients.

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Informed permission for publication was acquired from all patients.

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Tang, Q., Li, Y., Yu, T. et al. Association between condylar position changes and functional outcomes after condylar reconstruction by free fibular flap. Clin Oral Invest 25, 95–103 (2021). https://doi.org/10.1007/s00784-020-03338-w

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  • DOI: https://doi.org/10.1007/s00784-020-03338-w

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