Comparison of orthodontics-first and surgery-first approach in positional changes of the condyle after mandibular setback surgery using three-dimensional analysis

Publication date: Available online 26 July 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Tongyue Wang, Jeong Joon Han, Hee-Kyun Oh, Hong-Ju Park, Seunggon Jung, Min-Suk Kook
PurposeTo examine and compare the 3-dimensional postoperative changes of the condylar position after mandibular setback surgery using the orthodontics-first approach (OFA) and surgery-first approach (SFA).Materials and MethodsThis retrospective cohort study was conducted in patients who underwent bilateral sagittal split ramus osteotomy (BSSRO) for mandibular prognathism using OFA or SFA. Computed tomographic images were obtained and analyzed preoperatively (T0), postoperatively (T1), and at the 6-month follow-up (T2). Bodily shift of the condylar center and rotational movement of the condylar head were measured using the 3D coordinate system between each time points and compared between OFA and SFA group. Repeated-measures analysis of variance with a Bonferroni post hoc test was used to compare time-course changes of the condylar position for the two surgical-orthodontic approaches.Results55 patients (mean, 21.9 yr old; M:F, 31:24) were evaluated: 29 patients were treated by OFA and 26 patients were treated by SFA. In both groups, condyle showed perioperative lateral and inferior displacement with inward rotation, followed by the returning movement to its preoperative positions during 6 months after surgery. There was no significant difference between two groups in the time-course change of the condylar positionConclusionsRegardless of the timing of the operation (OFA vs. SFA), perioperative and postoperative changes of the condylar position after mandibular setback surgery are equivalent.



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