Three-dimensional quantitative assessment of surgical stability and condylar displacement changes after counterclockwise maxillomandibular advancement surgery: Effect of simultaneous articular disc repositioning

Autor(es)

Gomes, Liliane Rosas ^[1] ; Soares Cevidanes, Lucia Helena ^[2] ; Gomes, Marcelo Regis ; de Oliveira Ruellas, Antonio Carlos ^[3] ; Obelenis Ryan, Daniel Patrick ^[4] ; Paniagua, Beatriz ^[5] ; Wolford, Larry Miller ^[6] ; Goncalves, Joao Roberto ^[1]

Afiliação do(s) autor(es)

^[1] Sao Paulo State Univ, Araraquara Sch Dent, Dept Orthodont & Pediat Dent, Araraquara, SP - Brazil

^[2] Univ Michigan, Sch Dent, Dept Orthodont & Pediat Dent, Ann Arbor, MI 48109 - USA

^[3] Univ Fed Rio de Janeiro, Sch Dent, Dept Orthodont, Rio De Janeiro - Brazil

^[4] Univ Texas Hlth Sci Ctr San Antonio, Sch Dent, San Antonio, TX 78229 - USA

^[5] Univ N Carolina, Sch Med, Dept Psychiat, Chapel Hill, NC 27515 - USA

^[6] Baylor Univ, Med Ctr, Texas A&M Univ, Dept Oral & Maxillofacial Surg, Coll Dent, Dallas, TX - USA

• Tipo de documento: Artigo Científico
• Fonte: AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS; v. 154, n. 2, p. 221-233, AUG 2018.
• Citações Web of Science: 1

Resumo

Introduction: In this study, we quantitatively assessed 3-dimensional condylar displacement during counterclockwise maxillomandibular advancement surgery (CMMA) with or without articular disc repositioning, focusing on surgical stability in the follow-up period. Methods: The 79 patients treated with CMMA had cone-beam computed tomography scans taken before surgery, immediately after surgery, and, on average, 15 months postsurgery. We divided the 142 condyles into 3 groups: group 1 (n = 105), condyles of patients diagnosed with symptomatic presurgical temporomandibular joint articular disc displacement who had articular disc repositioning concomitantly with CMMA; group 2 (n = 23), condyles of patients with clinical verification of presurgical articular disc displacement who had only CMMA; and group 3 (n = 14), condyles of patients with healthy temporomandibular joints who had CMMA. Presurgical and postsurgical 3-dimensional models were superimposed using voxel-based registration on the cranial base. Three-dimensional cephalometrics and shape correspondence were applied to assess surgical and postsurgical displacement changes. Results: Immediately after surgery, the condyles moved mostly backward and medially and experienced lateral yaw, medial roll, and upward pitch in the 3 groups. Condyles in group 1 showed downward displacement, whereas the condyles moved upward in groups 2 and 3 (P 0.001). Although condylar displacement changes occurred in the 3 groups, the overall surgical procedure appeared to be fairly stable, particularly for groups 1 and 3. Group 2 had the greatest amount of relapse (P 0.05). Conclusions: CMMA has been shown to be a stable procedure for patients with healthy temporomandibular joints and for those who had simultaneous articular disc repositioning surgery. (AU)

• Processo FAPESP: 13/22417-0 - Osteoartrite da articulação têmporo-mandibular: avaliação tridimensional quantitativa do padrão de remodelação condilar decorrente da cirurgia ortognática de avanço mandibular e rotação anti-horária do complexo maxilo-mandibular
• Beneficiário: Liliane de Carvalho Rosas Gomes
• Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado