Effect of bilateral sagittal split ramus osteotomy on temporomandibular joint symptom and condylar position in patients with skeletal class Ⅲ malocclusion by cone beam computed tomography

doi:10.7518/hxkq.2020.05.008

Abstract

Abstract:

Objective To investigate the effect of bilateral sagittal split ramus osteotomy (BSSRO) on temporomandibular joint (TMJ) symptom and condylar position in patients with skeletal class Ⅲ malocclusion treated with orthodontic-orthognathic surgical treatment. Methods Twenty-four patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgical treatment were included in the study. Their cone-beam computed tomography scans and TMJ symptom were evaluated, and their Helkimo index before BSSRO, 1 month after BSSRO, and 12 months after BSSRO was recorded. The maximum diameter of the horizontal and coronal sections, short axis diameters, neck width, height, joint space widths at different angles (45°, 90°, and 135°) of the condylar joint, bilateral condylar spacing, and different condylar angles (horizontal angle, vertical angle, and stress angle) in three dimensions were measured. Then, the changes in TMJ symptom and bone structure at different periods were analyzed. Results The Helkimo index was anamnestic (Ai) or dysfunctional (Di) levels 0 or 1 before and after BSSRO, and no difference in Helkimo index was observed. The horizontal angle and joint space widths at 45° and 90° increased whereas the joint space width at 135° decreased at 1 month after BSSRO compared with before BSSRO (P<0.05). Except for the increase in condylar horizontal angle (P<0.05), no significant difference in other measurement items was noted (P>0.05) 12 month after BSSRO. Conclusion BSSRO would not have a remarkable effect on the TMJ symptom and condylar position of patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgical treat?ment procedure and whose Helkimo index ranked Ai0, Ai1, Di0, and Di1.

Key words: bilateral sagittal split ramus osteotomy, skeletal class Ⅲ malocclusion, temporomandibular joint, condylar, cone beam computed tomography

CLC Number:

R783.5

Guo Meiling, Huang Zhen, Wang Chong, Wang Yujiang. Effect of bilateral sagittal split ramus osteotomy on temporomandibular joint symptom and condylar position in patients with skeletal class Ⅲ malocclusion by cone beam computed tomography[J]. West China Journal of Stomatology, 2020, 38(5): 519-524.

Figures/Tables 5

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References 17

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Helkimo指数		T0		T2
Helkimo指数		例数	比例/%	例数	比例/%
Ai	0级	17	70.8	17	70.8
	Ⅰ级	7	29.2	7	29.2
	Ⅱ级	0	0	0	0
Di	0级	17	70.8	17	70.8
	Ⅰ级	7	29.2	7	29.2
	Ⅱ级	0	0	0	0
	Ⅲ级	0	0	0	0

测量项目	T0组	T1组	T2组	P值
测量项目	T0组	T1组	T2组	T0-T1	T0-T2
d₁/mm	19.540±1.045	19.497±1.062	19.532±1.512	0.176	0.733
d₂/mm	8.191±0.377	8.192±0.917	8.193±0.374	0.553	0.628
D/mm	122.967±2.721	124.522±4.580	123.016±2.931	0.173	0.878
α角/°	14.831±2.809	20.836±2.435	17.657±2.774	0.001	0.044
L_1-45°/mm	1.815±0.346	2.266±0.534	1.833±0.290	0.006	0.603
L_1-90°/mm	1.702±0.150	2.255±0.767	1.726±0.167	0.011	0.755
L_1-135°/mm	2.487±0.206	2.158±0.315	2.398±0.258	0.038	0.693
h/mm	21.972±0.956	21.978±2.960	21.973±1.052	0.997	0.574
d₃/mm	8.013±0.532	8.012±0.927	8.008±0.583	0.985	0.905
L_2-45°/mm	1.970±0.260	2.952±0.481	2.012±0.314	0.000	0.651
L_2-90°/mm	2.064±0.211	2.643±0.635	2.108±0.231	0.001	0.736
L_2-135°/mm	2.017±0.206	1.682±0.372	1.995±0.333	0.007	0.536
d₄/mm	19.647±1.060	19.651±0.859	19.562±1.450	0.567	0.887
β角/°	9.961±2.576	9.125±5.446	10.216±2.040	0.113	0.609
γ角/°	65.906±4.880	64.856±5.082	63.261±5.136	0.656	0.838