Dataset Information

A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma.

ABSTRACT:

Background

Mandibular condylar osteochondroma (OC) could lead to facial morphologic and functional disturbances, such as facial asymmetry, malocclusion, and temporomandibular joint dysfunction. However, after condylar OC resection, the inaccurate reposition of the neocondyle still needs to be solved. The purpose of this study was to explore the feasibility of the condylar osteotomy and repositioning guide to reposition the neocondyle in the treatment of patients with severe deformity secondary to condylar OC.

Results

Three patients with severe deformity secondary to OC of the mandibular condyle were enrolled in this study. With the aid of condylar osteotomy and repositioning guide, condylar OC resection and repositioning were carried out, and the accuracy and stability of these guides were evaluated. All patients healed uneventfully, and no facial nerve injury and condylar ankylosis occurred. Compared with the computerized tomography scans in centric relation before surgery and 3 days after surgery, the results showed that the facial symmetry was greatly improved in all the patients. Also, after the superimposition of the condylar segments before surgery and 3 days after surgery, the postoperative reconstructed condyles had a high degree of similarity to the reconstruction of the virtual surgical planning. Observed from the sagittal and coronal directions, the measurements of condylar positions were very close to those of virtual surgical planning. Moreover, it also showed stable results after a 1-year follow-up.

Conclusions

For patients with severe deformity secondary to condylar OC, condylar osteotomy, and repositioning guide was expected to provide a new option for the improvement of facial symmetry and occlusal relationship.

SUBMITTER: Qi L

PROVIDER: S-EPMC7847561 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma.

Qi Lei L Cao Ningning N Ge Weiwen W Jiang Tengfei T Fan Linfeng L Zhang Lei L

Orphanet journal of rare diseases 20210130 1

<h4>Background</h4>Mandibular condylar osteochondroma (OC) could lead to facial morphologic and functional disturbances, such as facial asymmetry, malocclusion, and temporomandibular joint dysfunction. However, after condylar OC resection, the inaccurate reposition of the neocondyle still needs to be solved. The purpose of this study was to explore the feasibility of the condylar osteotomy and repositioning guide to reposition the neocondyle in the treatment of patients with severe deformity sec ...[more]

PMID: 33516245

Similar Datasets

Project description: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.

Project description:Background Preoperative deformity and hinge position are associated with the magnitude of the gap opening during corrective osteotomy. A larger opening gap angle is associated with a higher risk of complications. This cross-sectional study sought to identify a suitable hinge position that results in the smallest opening angle during tibial condylar valgus osteotomy (TCVO). Methods The data of 66 arthritic knees treated by TCVO were included, comprising 16 knees with the hinge points selected medial to the center (group M), 21 knees with the hinge points selected at the center (group C), and 29 knees with the hinge points selected lateral to the center of the intercondylar eminence (group L). The opening gap angles and the correction amounts of the medial proximal tibial angle (ΔMPTA) were compared among the 3 groups to identify the preliminary relationship between the hinge positions and the opening gap angle. A simplified geometric model with the hinge positions selected at the medial beak, the center, and the lateral beak of the intercondylar eminence was constructed to simulate the realignment process. Several anatomical points were allocated as Cartesian coordinates. The opening gap angle with different hinge positions was mathematically formulated with MATLAB (MathWorks, Natick, MA, USA). Results The average ΔMPTAs were 9.4±2.9°, 9.4±3.5°, and 9.3±3.0° in groups L, C, and M, respectively. The opening angle of the osteotomy gap was the largest in group M and the smallest in group L (29.7±11.1° and 16.9±5.3°; P<0.01). The comparison of the opening angle per the ΔMPTA revealed a similar pattern. The simulated realignment process indicated that the hinge point at the lateral beak of the intercondylar eminence led to the smallest opening angle. The opening angle during TCVO was mathematically derived in terms of the ΔMPTA, the position of the intersection of the pre- and postoperative joint lines, and the position of the hinge point. Conclusions The hinge point at the lateral beak of the intercondylar eminence results in the smallest opening angle and may be suitable for TCVO.

Dataset Information

A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma.

Background

Results

Conclusions

Publications

A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma.

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