Evaluation of condylar positioning in bimaxillary orthognathic surgery using intraoperative cone-beam computed tomography

Contreras, Albert Malet; Altschiller, J.; Gantz, Alfredo; Barrera, A.; Yanine, Nicolás; Cosmelli, R.; Gaete, C.; Cifuentes, J.

doi:10.1016/j.ijom.2017.02.1087

Cited by 1 publication

(7 citation statements)

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“…Imaging positioning systems were non-invasive and contributed to real-time monitoring, including sonographic 18 and mobile CBCT. 17,19 There was no significant change in other distances of the condyle in a fossa in the sonographic positioning, except the anterior distance increased in Class III patients. 18 Due to the limited spatial resolution, it is difficult for surgeons to identify the condyles on sonographic views lengthening the surgical duration.…”

Section: Imaging Positioning Systemsmentioning

confidence: 79%

“…Imaging positioning systems were non‐invasive and contributed to real‐time monitoring, including sonographic 18 and mobile CBCT 17,19 . There was no significant change in other distances of the condyle in a fossa in the sonographic positioning, except the anterior distance increased in Class III patients 18 .…”

Section: Resultsmentioning

confidence: 99%

“…Benefiting from short pre‐operative preparation duration, short surgical duration and low prices, the non‐computer‐assisted positioning techniques are still widely adopted in clinical practice. However, a few patients had unsatisfied positioning outcomes after surgery because of high technical requirements for surgeons 9,17,19 . Therefore, these techniques are more suitable in regular and slight asymmetry cases for skilled surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…The non-computer-assisted methods were classified into manual positioning, [8][9][10] CPDs, [11][12][13] titanium plate positioning [14][15][16] and imaging positioning systems. [17][18][19] The computer-assisted ones were classified into CAD/CAM CPDs, [20][21][22][23][24] CAD/CAM titanium plate positioning [25][26][27] and computer-assisted navigation systems. [28][29][30]…”

Section: Re Sultsmentioning

confidence: 99%

“…However, a few patients had unsatisfied positioning outcomes after surgery because of high technical requirements for surgeons. 9,17,19 Therefore, these techniques are more suitable in regular and slight asymmetry cases for skilled surgeons.…”

Section: Computer-assisted Navigation Systemmentioning

confidence: 99%

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Intraoperative condylar positioning techniques on mandible in orthognathic surgery

Chow

Liu

et al. 2022

Orthod Craniofacial Res

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Purpose The surgical condylar displacement often resulted in relapse and serious symptoms of temporomandibular joint disorders (TMD) after orthognathic surgery. To minimize the displacement, numerous techniques have been proposed. To verify their accuracy in positioning and effectiveness in preventing post‐operative TMD and relapse, we reviewed the literature related to intraoperative condylar positioning techniques on the mandible in this study. Methods The literature on condylar positioning techniques was reviewed with two charts, including the non‐computer‐assisted and the computer‐assisted positioning methods. The pre‐ and post‐operative alterations of condyles, the post‐operative temporomandibular joint (TMJ) function and surgical relapse were analysed regarding the techniques. The clinical usage and characteristics were reviewed as well. Results A total of 22 articles, including 907 patients, have been reported since 2001. Nearly all methods reach a considerable positioning accuracy within the range of 1‐2 mm and 1‐2° from the pre‐operative position. We ranked the accuracy of the methods from high to low: CAD/CAM CPDs > CAD/CAM titanium plate positioning > manual positioning > computer‐assisted navigation systems > imaging positioning systems. Most skeletal class II and class III patients achieved great occlusion and had no TMJ dysfunction or relapse after condylar positioning. Conclusions Both the non‐computer‐assisted and computer‐assisted condylar positioning techniques reach considerable accuracy in locating the pre‐operative condyle position and preventing TMJ dysfunction and surgical relapse. Different levels of surgeons and cases can benefit from multiple suggested positioning methods. Further research with large samples and long‐term follow‐up is worth looking forward to upgrading the current methods, improving the clinical utility and developing new positioning techniques.

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Section: Imaging Positioning Systemsmentioning

confidence: 79%