The influence of the closing and opening muscle groups of jaw condyle biomechanics after mandible bilateral sagittal split ramus osteotomy

Qi, Xiaofeng; Limin, M.A.; Zhang, Shizhen

doi:10.1016/j.jcms.2011.07.024

Cited by 26 publications

(7 citation statements)

References 21 publications

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“…The decreases of the contact stress and minimum principal stress on the non-deviated side were also greater than those on the deviated side under the 2 occlusions. Both the simulated results and clinical cases suggested BSSRO could improve the asymmetric stress distributions, especially reducing the stresses at the non-deviated sides in accordance with the previous study by Qi et al [ 31 ] Thus, the patients with TMD but without serious maxillofacial deformity could recover by changing the biomechanical environment of TMJs.…”

Section: Discussionsupporting

confidence: 86%

“…In addition, the 3D finite element method was used to investigate the stress distribution of the closing and opening muscle groups of the jaw after BSSRO. [ 31 ] The results indicated that the significant differences of stress distributions between the patients with mandibular prognathism and healthy subjects had disappeared after BSSRO. However, these studies only considered the force or stress distributions of condyles.…”

Section: Discussionmentioning

confidence: 99%

“…The mandibles, maxillae, and discs were used to be considered as homogeneous materials, [ 25 , 31 ] which were inaccurate to simulate the inhomogeneous structures. In this study, the relevant empirical formulas (Equations (1)–(3)) based on Hounsfield units were chosen for the assignment of the Young's modulus values.…”

Section: Discussionmentioning

confidence: 99%

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The influence of bilateral sagittal split ramus osteotomy on the stress distributions in the temporomandibular joints of the patients with facial asymmetry under symmetric occlusions

et al. 2018

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The aim of this study is to compare the differences in the stress distributions in the temporomandibular joints (TMJs) of the patients with facial asymmetry before and after bilateral sagittal split ramus osteotomy (BSSRO) under the symmetric occlusions using the three-dimensional (3D) finite element method.Ten facial asymmetry patients (Preoperative group, age 24.6 ± 4.8 years) and 10 asymptomatic subjects (Control group, age 26.8 ± 4.9 years) were recruited. After the patients underwent BSSRO, they were further assigned as the Postoperative group. 3D geometries of the finite element models of the mandible, disc, maxilla, and teeth were reconstructed according to cone-beam computed tomography (CBCT) image data. Contact elements were used to simulate the interaction of the disc-condyle, disc-temporal bone, and upper-lower dentition. The muscle forces and boundary conditions corresponding to the central and anterior occlusions were applied on the models of the 3 groups. The finite element models were validated with experimental data showing the accuracy of the simulation results.The simulation predicted preoperative significant differences of stresses between non-deviated sides and deviated sides were disappeared after the surgery under the central and anterior occlusions (P < .05). Almost all stresses in the patient models had significantly decreased after BSSRO, leveling it to the stress values of the normal subjects. Moreover, the simulation results coincided with the clinical cases which showed that BSSRO had helped to release or remove the signs and symptoms of temporomandibular disorders (TMD).In conclusion, BSSRO could correct the asymmetric stress distributions of TMJs and decrease the magnitude of the stresses for the patients with facial asymmetry. Those decreases also associated with the recovery of TMD.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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The influence of bilateral sagittal split ramus osteotomy on the stress distributions in the temporomandibular joints of the patients with facial asymmetry under symmetric occlusions

et al. 2018

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“…However, achieving this level is dependent on defining such a standard first, and ideally using a validated performance assessment tool. Most reported instruments for condylar segment repositioning performance assessment, such as cephalometric analysis [ 31 ], CT [ 5 ], cone beam CT (CBCT) [ 32 , 33 ], and finite element analysis [ 34 ], can capture position aspects, but only in post-operative conditions. The CPS appears to be an efficient intra-operative learning tool that is completely safe.…”

Section: Discussionmentioning

confidence: 99%

“…We have emphasized in this study the importance of the condyle position during BSSO but we highlight the influence of the closing and opening muscle groups of the jaw on the stress distribution in the condyles with changing jaw position after BSSO with condylar resorption consequence [ 34 , 46 – 48 ].…”

Section: Discussionmentioning

confidence: 99%

Computer-assisted teaching of bilateral sagittal split osteotomy: Learning curve for condylar positioning

Savoldelli¹,

Chamorey

Bettega

2018

PLoS ONE

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Bilateral sagittal split osteotomy (BSSO) is a widely-performed procedure in orthognathic surgery for the correction of dentofacial deformity. Condylar positioning is a critical step during BSSO to maximize functional and morphological results. The unsuitable positioning of condyles represents one of the causative mechanisms that may induce temporomandibular joint noxious effects after BSSO. Repositioning devices can assist surgeons in maintaining the preoperative condylar position; however, empirical repositioning methods based on experience gained are still commonly used. Trainee learning curves are difficult to assess. The aim of this study was to evaluate the relevance of computer-assisted surgery in the acquisition of condylar positioning skills. Forty-eight patients underwent BSSO performed by six maxillofacial trainees (four junior residents and two senior experienced residents). A condyle positioning system (CPS) was used by a senior surgeon to record a condylar position score during the procedure. Firstly, scores were recorded when the trainee manually positioned the condyle without access to the CPS score (phase 1) and then when the trainee positioned the condyle and performed osteosynthesis with visual access to the CPS score (phase 2). Six parameters describing condylar three-dimensional motions were assessed: translational motion from top to bottom (TB), back to front (BF), and left to right (LR), axial rotation (AR), sagittal rotation (SR), frontal rotation (FR), and a total score (TS). There were no significant differences between junior and senior residents in condyle positioning without access to the CPS. Condyles were significantly better positioned during phase 2 with access to the CPS (p<0.001). Over time, use of the CPS (phase 2) produced significantly quicker improvements in scores (p = 0.042). For those teaching surgeries to trainees, computer-assisted devices can potentially result in more rapid learning curves than traditional “observations-imitation” models. Use of a CPS by trainees facilitated condylar repositioning that resulted in an accurate occlusal result and avoidance of adverse effects on the temporomandibular joint.

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Veränderungen der Dehnungsenergiedichte im Discus articularis des Temporomandibulargelenks nach sagittaler Ramus-Osteotomie anhand eines computertomographiebasierten Finite-Elemente-Modells

et al. 2023

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The influence of the closing and opening muscle groups of jaw condyle biomechanics after mandible bilateral sagittal split ramus osteotomy

Cited by 26 publications

References 21 publications

The influence of bilateral sagittal split ramus osteotomy on the stress distributions in the temporomandibular joints of the patients with facial asymmetry under symmetric occlusions

The influence of bilateral sagittal split ramus osteotomy on the stress distributions in the temporomandibular joints of the patients with facial asymmetry under symmetric occlusions

Computer-assisted teaching of bilateral sagittal split osteotomy: Learning curve for condylar positioning

Veränderungen der Dehnungsenergiedichte im Discus articularis des Temporomandibulargelenks nach sagittaler Ramus-Osteotomie anhand eines computertomographiebasierten Finite-Elemente-Modells

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