Condylar change after upward and forward rotation of the maxillomandibular complex

Cottrell, David A.; Suguimoto, Roberto Macoto; Wolford, Larry M.; Sachdeva, Rohit; Guo, Ingrid Y.

doi:10.1016/s0889-5406(97)70211-7

Cited by 20 publications

(9 citation statements)

References 20 publications

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“…Ellis and Hinton 45 (1991) have shown remodeling changes occurring in the TMJ of the adult Macaca mulatta monkey. In human tomographic radiographs, superficial change with no major clinical relevance has been detected in the contour of healthy TMJ after surgery 28 . Changes in joint loading, muscle activity and the new condylar position may contribute to this adaptive occurrence 28 , 46 .…”

Section: Resultsmentioning

confidence: 99%

“…The adverse effects of mandibular advancement surgery on the TMJs form a pertinent theme well explored in the literature 5 , 7 , 20 , 29 , 56 , 65 , 81 , 99 , 104 , 105 , 134 , 138 , 139 , 142 . The TMJ response ranged from adaptive, which included physiological bone remodeling 28 , 34 , 45 , to irreversible complications 9 , 10 , 55 . Undesired TMJ responses to treatments in both short and long-term follow-up periods, such as condyle torque 14 , 138 , joint sounds (clicking, popping, crepitus) 53 , deteriorated discomfort and pain 107 , 141 , deviated or limited mouth opening 55 , 96 , 138 , and condylar resorption (CR) 29 , 81 , 96 have all been reported.…”

Section: Introductionmentioning

confidence: 99%

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TMJ response to mandibular advancement surgery: an overview of risk factors

Valladares‐Neto

Cevidanes

Rocha³

et al. 2014

J. Appl. Oral Sci.

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ObjectiveIn order to understand the conflicting information on temporomandibular joint (TMJ) pathophysiologic responses after mandibular advancement surgery, an overview of the literature was proposed with a focus on certain risk factors. MethodsA literature search was carried out in the Cochrane, PubMed, Scopus and Web of Science databases in the period from January 1980 through March 2013. Various combinations of keywords related to TMJ changes [disc displacement, arthralgia, condylar resorption (CR)] and aspects of surgical intervention (fixation technique, amount of advancement) were used. A hand search of these papers was also carried out to identify additional articles. ResultsA total of 148 articles were considered for this overview and, although methodological troubles were common, this review identified relevant findings which the practitioner can take into consideration during treatment planning: 1- Surgery was unable to influence TMJ with preexisting displaced disc and crepitus; 2- Clicking and arthralgia were not predictable after surgery, although there was greater likelihood of improvement rather than deterioration; 3- The amount of mandibular advancement and counterclockwise rotation, and the rigidity of the fixation technique seemed to influence TMJ position and health; 4- The risk of CR increased, especially in identified high-risk cases. ConclusionsYoung adult females with mandibular retrognathism and increased mandibular plane angle are susceptible to painful TMJ, and are subject to less improvement after surgery and prone to CR. Furthermore, thorough evidenced-based studies are required to understand the response of the TMJ after mandibular advancement surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

TMJ response to mandibular advancement surgery: an overview of risk factors

Valladares‐Neto

Cevidanes

Rocha³

et al. 2014

J. Appl. Oral Sci.

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“…The average thickness of the RGF increased from 0.83±0.44 mm to 0.86±0.46 mm (Table 3). There have been many studies of changes in the condyle and glenoid fossa of TMJs after orthognathic surgery [11][12][13][14][15]. Cottrell et al [11] reported minimal long-term changes in healthy patients after orthognathic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…There have been many studies of changes in the condyle and glenoid fossa of TMJs after orthognathic surgery [11][12][13][14][15]. Cottrell et al [11] reported minimal long-term changes in healthy patients after orthognathic surgery. An et al [12] noted that surgical correction of skeletal deformities requires a soft-tissue response and condylar remodeling, to adapt to the new environment.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Thickness of the Roof of the Glenoid Fossa Using Cone Beam Computed Tomography in Orthognathic Surgery Patients: A Preliminary Study

Park

Seo

Lim

et al. 2019

JOMP

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Purpose:The aim of this study was to assess the change in thickness of the roof of the glenoid fossa (RGF) in patients undergoing orthognathic surgery using cone-beam computed tomography (CBCT) images. Methods:This retrospective study measured the thickness of the RGF in 19 patients (10 males, 9 females) who underwent orthognathic surgery at Chosun University Dental Hospital. The thickness of the RGF was measured perpendicularly between the 'glenoid fossa line' and 'middle cranial fossa line' on parasagittal and paracoronal reconstructions.Results: The mean RGF thickness increased from 0.83±0.44 mm to 0.86±0.46 mm after surgery. The average change in thickness of the RGF was 0.17±0.18 mm. The thickness of the RGF in the temporomandibular joint (TMJ) showed no significant difference by sex, and the change in thickness of the TMJ did not vary by surgical method. Conclusions:We found that the thickness of the RGF increased after orthognathic surgery, as revealed by CBCT. Further studies including larger numbers of subjects and long-term follow-up are needed to confirm the results of this study.

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“…Both the amount of mandibular advancement and the degree of maxillary and mandibular rotation, associated with the rigidity of the internal fixation technique, increases the load on the temporomandibular joint (TMJ), influencing its final position and integrity [ 1 ]. The adaptive responses to this overload that remodel the condyle and the temporal fossa may be associated with transient arthralgia and functional limitations [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Temporomandibular joint regeneration: proposal of a novel treatment for condylar resorption after orthognathic surgery using transplantation of autologous nasal septum chondrocytes, and the first human case report

et al. 2018

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BackgroundUpon orthognathic mandibular advancement surgery the adjacent soft tissues can displace the distal bone segment and increase the load on the temporomandibular joint causing loss of its integrity. Remodeling of the condyle and temporal fossa with destruction of condylar cartilage and subchondral bone leads to postsurgical condylar resorption, with arthralgia and functional limitations. Patients with severe lesions are refractory to conservative treatments, leading to more invasive therapies that range from simple arthrocentesis to open surgery and prosthesis. Although aggressive and with a high risk for the patient, surgical invasive treatments are not always efficient in managing the degenerative lesions.MethodsWe propose a regenerative medicine approach using in-vitro expanded autologous cells from nasal septum applied to the first proof-of-concept patient. After the required quality controls, the cells were injected into each joint by arthrocentesis. Results were monitored by functional assays and image analysis using computed tomography.ResultsThe cell injection fully reverted the condylar resorption, leading to functional and structural regeneration after 6 months. Computed tomography images showed new cortical bone formation filling the former cavity space, and a partial recovery of condylar and temporal bones. The superposition of the condyle models showed the regeneration of the bone defect, reconstructing the condyle original form.ConclusionsWe propose a new treatment of condylar resorption subsequent to orthognathic surgery, presently treated only by alloplastic total joint replacement. We propose an intra-articular injection of autologous in-vitro expanded cells from the nasal septum. The proof-of-concept treatment of a selected patient that had no alternative therapeutic proposal has given promising results, reaching full regeneration of both the condylar cartilage and bone at 6 months after the therapy, which was fully maintained after 1 year. This first case is being followed by inclusion of new patients with a similar pathological profile to complete an ongoing stage I/II study.Trial registrationThis clinical trial is approved by the National Commission of Ethics in Medical Research (CONEP), Brazil, CAAE 12484813.0.0000.5245, and retrospectively registered in the Brazilian National Clinical Trials Registry and in the USA Clinical Trials Registry under the Universal Trial Number (UTN) U1111–1194-6997.Electronic supplementary materialThe online version of this article (10.1186/s13287-018-0806-4) contains supplementary material, which is available to authorized users.

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Condylar change after upward and forward rotation of the maxillomandibular complex

Cited by 20 publications

References 20 publications

TMJ response to mandibular advancement surgery: an overview of risk factors

TMJ response to mandibular advancement surgery: an overview of risk factors

Assessment of the Thickness of the Roof of the Glenoid Fossa Using Cone Beam Computed Tomography in Orthognathic Surgery Patients: A Preliminary Study

Temporomandibular joint regeneration: proposal of a novel treatment for condylar resorption after orthognathic surgery using transplantation of autologous nasal septum chondrocytes, and the first human case report

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