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Three-dimensional quantitative changes of condyle in patients with skeletal class III malocclusion after bimaxillary orthognathic surgery with 5-year follow-up

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Abstract

Objective

The present study aimed to characterize three-dimensional (3D) long-term quantitative condyle change including positional, surface, and volumetric alterations in patients with skeletal class III malocclusion treated with bimaxillary orthognathic surgery.

Material and methods

Twenty-three eligible patients (9 males, 14 females, mean age: 28.28 years old) treated from Jan. 2013 to Dec. 2016 with postoperative follow-up over 5 years were retrospectively enrolled. Cone-beam computed tomography scan for each patient was conducted at 4 stages: 1 week preoperatively (T0), immediately after surgery (T1), 12 months postoperatively (T2), and 5-year postoperatively (T3). Positional changes, surface, and volumetric remodeling of condyle were measured in segmented visual 3D models and statistically compared between stages.

Results

Our 3D quantitative calibrations revealed that the condylar center shifted in anterior (0.23 ± 1.50 mm), medial (0.34 ± 0.99), and superior (1.11 ± 1.10 mm) directions and rotated outward (1.58 ± 3.11°), superior (1.83 ± 5.08°), and backward (4.79 ± 13.75°) from T1 to T3. With regard to condylar surface remodeling, bone formation was frequently observed in the anteromedial areas, while bone resorption was commonly detected in the anterolateral area. Moreover, condylar volume remained largely stable with a minimal reduction during the follow-up.

Conclusion

Collectively, although condyle undergoes positional changes and bone remodeling after bimaxillary surgery in patients with mandibular prognathism, these changes largely fall in the range of physical adaptations in the long run.

Clinical relevance

These findings advance the current understanding of long-term condylar remodeling after bimaxillary orthognathic surgery in skeletal class III patients.

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Acknowledgements

We would like to thank all members of the Departments of Oral and Maxillofacial Surgery, Oral Orthodontics, and Oral Radiography, Nanjing Medical University, for their work in data collection and valuable discussion.

Funding

This work is financially supported, in whole or in part, by Key Research Program in Jiangsu Province-Social Developmental Project (BE2020706), a project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions (2018–87).

Author information

Author notes

  1. Ziyu Wang, Yijin Shi, and Yi Wang contributed equally to this study.

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China

    Ziyu Wang, Yijin Shi, Hongbing Jiang & Jie Cheng

  2. Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, 210029, People’s Republic of China

    Yijin Shi, Wenjing Chen, Hongbing Jiang & Jie Cheng

  3. Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Jiangsu, 210029, People’s Republic of China

    Ziyu Wang, Wenjing Chen & Jie Cheng

  4. Department of Oral and Maxillofacial Surgery, Anhui Provincial Hospital/The Affiliated Hospital of University of Science and Technology of China, He Fei, 230031, People’s Republic of China

    Yi Wang

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Contributions

Drs. Ziyu Wang and Yijin Shi performed the radiographic analyses, data collection, and statistical analyses. Dr. Yi Wang and Prof. Wenjing Chen participated in the study design, data collection, and analyses. Prof. Hongbing Jiang and Jie Cheng conceived and supervised the whole project and drafted the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jie Cheng.

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Ethical approval

This present study was reviewed and approved by the institutional ethic committee of Nanjing Medical University and performed in accordance with institutional guidelines.

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Written informed consent was obtained from all patients involved.

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The authors declare no competing interests.

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Wang, Z., Shi, Y., Wang, Y. et al. Three-dimensional quantitative changes of condyle in patients with skeletal class III malocclusion after bimaxillary orthognathic surgery with 5-year follow-up. Clin Oral Invest 27, 4061–4071 (2023). https://doi.org/10.1007/s00784-023-05032-z

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