Occlusal adjustment after local resection of type 1 condylar osteochondroma

Abstract

To evaluate the feasibility of the orthodontic traction after local resection of the condylar osteochondroma (OC).From November 2011 to September 2016, consecutive patients with condylar OC who underwent orthodontic extraction after local resection of the mass were reviewed. Clinical data and cone-beam computed tomography (CT) were obtained before treatment (T0), 1 week after surgery (T1), and at least 6-month follow-up after OC resection (T2). Repeated-measures analysis of variance with Bonferroni multiple-comparison test was used to compare the 3-dimensional cephalometric variables at different time points and the paired t test was used to compare changes of temporomandibular joint (TMJ) space between the 2 sides at T1 and T2.The sample consisted of 23 patients (16 females and 7 males). The mean postoperative follow-up interval was 10.9 months. No recurrence was observed during the postoperative follow-up period. Facial symmetry and occlusion were greatly improved. B deviation and the distance of gonion on the OC-affected side to the Frankfort horizontal (FH) were significantly improved from T0 to T1 and T2 (P < .01). The anterior space (AS) and superior space (SS) of the OC-affected side were significantly larger than that of the contralateral side at T1 in parasagittal CT views (P < .05), while no difference was found between the two sides at T2.Local resection is an effective technique with less damage to the condyle. The application of postoperative directional traction could guide the condyle into the fossa, achieve normal TMJ space and stable occlusion, and eventually provide functional and esthetic outcomes.

Clinical Application of Individualized 3D-Printed Templates in the Treatment of Condylar Osteochondroma

“…The measurements were changed from T1 to T2, showing the adaptive reconstruction process of the neo condyle. In the two sides, the AJS, SJS, PJS, and MJS vectors were increased in our study; however, these results were the opposite of those obtained in the study of Zhigui Ma, which showed decreases in AS and SS in OC-affected and unaffected sides [ 20 ]. This may be due to the different postoperative orthodontic methods used.…”

“…The maxillary and mandibular composite models were matched using bone tissue and 3D scanned tooth models, aligned into a common coordinate system, and then the facial soft-tissue model was also imported into ProPlan CMF 3.0 software (Materialise, Belgium). The measurements presented in our study were similar to those obtained using the method described by Ma, Zhigui [ 20 ]. The measurement system was described as follows: (1) The Frankfort horizontal (FH) plane was defined through the right and left orbitale (Or) and the midpoint of the bilateral porion (Po); (2) The midsagittal reference plane was defined as the plane perpendicular to the horizontal plane passing through the nasion and sella, and then adjusted through the mirror function; (3) The B, Go, Po, Pog, and Pog* points were marked on each side ( Figure 2 ).…”

“…To evaluate the change of condylar position in different periods (T0p, T1, T2), the linear measurements of the OC joint space in the actual postoperative and virtual planned models were assessed and compared with each other. All linear vectors were defined from the most prominent condylar points (anterior, superior, posterior, medial, lateral) to the glenoid fossa, in accordance with a previous study [ 20 , 21 ]. The anterior joint space (AJS), superior joint space (SJS), and posterior joint space (PJS) were measured in the sagittal image, and the medial joint space (MJS) and lateral joint space (LJS) were measured in the coronal image.…”