Maksillomandibuler Asimetri Hastalarında Ortognatik Cerrahi Sonrası Kondil Morfolojisi Değişikliklerinin Üç Boyutlu Değerlendirilmesi

Abstract

The aim of the study is to evaluate the morphological changes in mandibular condyles after orthognathic surgery and compare the effect of orthognathic surgery on surface changes in the condyle in asymmetric and non-asymmetrical patients using 3D measurement. A retrospective study was designed using CBCT data of 42 patients (21 female and 21 male), all of whom were operated at Hacettepe University Oral & Maxillofacial Surgery Department, Ankara, Turkey. Measurements were performed on pre-operative and post-operative CBCT records of 28 patients with asymmetry and 14 patients without asymmetry. Two independent study groups were formed as condyles, deviation side and contralateral side of asymmetry patients. A control group was formed for the patients without asymmetry and comparisons were made with the study group. The micro CT analysis program “CTAn Software” (ver. 1.20.3.0, Bruker, Skyscan, Aartselaar, Belgium) was used for measurements and analyses. “CTVol Software” (ver. 2.3.2.0, Bruker, Kontich, Belgium) was used for 3D modeling and surface registration processes. Microstructural analyzes were used to provide information about trabecular bone remodeling and resorption. Condyle surface and structure changes occurred in all groups. Significant bone volume reduction occurred at the deviation side condyle of the study group. The results of the bone microstructural analysis on the deviation side were also consistent with the resorption pattern. Although bone surface and bone structure alterations were observed in all our patients which is a part of remodeling process; significantly higher bone resorption was observed at the deviation side condyle.

Keywords: Ortognathic Surgery, Facial Asymmetry, Mandible Condyle, Cone Beam Computed Tomography, Three-Dimensional Modeling, Bone Microstructural Analysis, Bone Remodelling